Lorie Brown’s life has taken the well-known aphorism, “Once a nurse, always a nurse!” and supercharged it by adding; “Even if the nurse becomes an attorney!”. And while it might be challenging to wrap one’s mind around the combination of a nurse (characterized by kindness and caring) with the stereotyped lawyer (insensate and adversarial); Lorie Brown has, in fact, successfully combined the two careers into a powerful and influential profession.
Awards & Achievements
Medical Legal Analyst
Staff Attorney for the Indiana Department of Insurance
Attorney/Partner/Director at a law firm specializing in Medical Malpractice and Health law
Adjunct Assistant Professor at the Indiana University School Nursing
Board Member of the Indiana State Nurses Association
Presently: President Brown Law Office, PC (17 years & 5 months)
Presently: Legal Nurse Consultant Mentor, LNC Mentor (15 years & 5 months)
Presently: The Nurse Protection Association
Presently: Founder of EmpoweredNurses.org
Interview - Question & Answer
Lorie, it is obvious from both your websites; Brown Law Office, P.C. and Empowered Nurses that you have the refreshing passion of someone on a mission. Would you elaborate on that?
First of all, thank you! Well, right now, nurses “come with the room”—like dietary and housekeeping. So when you come with the room like that, you have very little power. We are 80% of the hospital workforce and have zero percent of the power. In order for nurses to get their power back, we are going to have to do something radical. I’m not sure what that is, but I know if we stick together, we’ll be able to affect the change. I know right now patient care has been affected because of it; and I know nurses are not taking care of themselves because of it. So it’s a huge problem. But I know that by coming together and figuring out solutions collectively then we can affect healthcare and improve our professions and speak our minds.
Lorie, how do you so successfully combine your kind nursing heart with the legal system which so often appears not to have one? The two professions appear to be so remotely removed from one another.
When you are with a patient, they don’t have a sign over their head telling you what their nursing or medical diagnosis is. You have to assess, plan, intervene and evaluate. The same is true for law. When you have a client that comes to the office, they don’t have a sign over their head and you have to assess, plan, intervene and evaluate. So really, it’s the very same process. I practice law just like nursing. I believe I put the care back in the law. I treat my clients, like I’m finding out the good, the bad and the ugly about their case and then I find the best strategy to help them. I really, truly care about them. I think that’s what sets me apart. I think both in nursing and in law, we tend to get this thick skin; like we shouldn’t show emotion because how can we then deal with this horrible stuff that happens in front of us?
How do you balance those conflicting feelings?
In order to be effective, you can’t have that thick skin. For me, I’ve found that to be authentic, have integrity and develop a relationship allows me to figure out what evidence the client has which I can present in a light most favorable to them.
What types of cases do nurses bring to you?
Every nurse that I have ever represented; and I have represented over 400, never thought they’d get called before the board. They are good nurses. They never thought they’d be in front of the board. But then something happens, and then they are.
How do you help them?
I have a system that I use-“G.I.F.T.S.”; it’s an acronym. The letter G is for “Giving.” Nurses are giving to their patients of course, but they’re not always giving to themselves. So the G is for giving to themselves and their co-workers and to administration. Hopefully the giving part is going to help prevent some of the lateral violence that goes on in nursing; as well as bring nurses together in the profession. Where nurses get in trouble is; we’re supposed to be a team and help out all the patients on the floor, not just our own patients. So people get in trouble get in trouble when they don’t help out other patients; even though it is not their patient and even though the other nurse says they will take care of it.
The “I” is for the word “Integrity.” Integrity is being honest in your documentation, and thorough. A lot of time we can be so busy that we forget to write something down, or forget to document that we gave someone meds, things like that. All of that can get you in trouble. Integrity is also about being honest in the documentation you take before the board. In my state, it is a disclosure state, so if you’ve been terminated or disciplined as a healthcare provider; you have got to let the board know that. They even consider attendance. That means if you’ve ever been disciplined for attendance, they want to know.
“F” is for “Focus and Follow-Through.” Focus and follow-through are probably the number one area that nurses get in trouble because we are so busy. We are thinking about what is next or what happened; we’re not right there in the present moment. The biggest problems occur when you are not thinking about what you’re doing in that moment. For example, I had a situation where a nurse was giving a feeding a bolus and was called to an emergency and she just left the patient with the feeding going. She took care of the other patient and forgot about it. The patient got too much feeding, her abdomen swelled and she had to go to the hospital. The nurse didn’t mean to by any means.
The “T” is for “Trusting Your Gut.” As nurses, we know there’s a problem in our gut, but we don’t always act on it because we’re afraid. We’re afraid to call the doctor because the doctor might yell at us. Our mind talks us out of taking the action we need to take.
The “S” stands for “Source.” Source means that we are responsible for everything that happens in our practice. Being the source means you don’t blame the administration for not having enough staff; you don’t blame the charge nurse for giving you a bad assignment. If you do that, you’ll never have your power.You have to be the source of your practice.
Lorie, after you had your nursing degree you returned to school for a Master's Degree in Nursing. What prompted you to do that?
I was frustrated being a staff nurse. I didn’t feel as if I was valued or listened to. I felt that if I had my own staff I could do things my way; and my way was much more participative and much more team oriented. So I did it; I went into administration for 4 years before I went to law school. I loved it; I had an amazing staff and did things very differently. But I also found out that if you don’t conform to administration, then you have to leave. I was doing fine and had a great staff; but it was like a mid-career crisis. If you think you can go into middle management and think you can make a difference; you can make a difference for your floor itself and your patients, but you can’t make a bigger difference for the hospital as a whole.
Is that what prompted you to go to law school and make a bigger difference?
No, I had never planned on it. But I got divorced and had a good divorce attorney who said I could do this. And I’m grateful!
I understand you also consult on plaintiff's cases now in medical malpractice? Can you tell us what that is like?
Yes, I do. Sometimes I hate doing what I have to do, but when you smell something that isn’t quite right you have to say something about it. One nurse said she had been terminated from a couple of jobs. She had been through 3 or 4 jobs and so I said to her, “If I were to look into your employment file, what would I see? What’s the discipline?” She said there had been no discipline. So I asked her if she had left voluntarily, and when she said no I asked her why she had to leave. She said, “Positive drug screen.” So had I not had the experience of representing nurses, I would never have known to ask.
What was it like to work medical malpractice cases?
When you do med mal cases, it’s usually not the nurses that are involved. It’s usually an issue with the hospital or physician. But I would see so many nurses get reported before the board; and again, they never thought they would get reported.
Is that why you began representing nurses and helping them to feel empowered?
Yes; I just wanted to get back to my roots. I wanted to help nurses directly.
You shared earlier that as a practicing RN you were afraid to do and say certain things which could ultimately improve patient care. Where did the fear come from?
I was new and I was green, and I had a very scary experience. I was working on a med surge floor and a patient coded. One nurse came out of the code room and asked me to get some items from central supply. I agreed, and immediately went to the phone to call someone from central supply. I asked them to deliver the necessary equipment. The voice at the other end of the phone said, “We don’t deliver.” I was shocked! I couldn’t believe this patient’s life was at stake and necessary equipment could not be brought to the floor to help this patient. Evidently, I was not so diplomatic in the exchange. The next day I found myself in the head nurse’s office. She asked me about my attitude and my manner during the phone conversation with central supply. Then she wrote me up! I couldn’t believe I got in trouble for that! Why in the world would central supply not deliver life-saving equipment, when no one else was available? And why would nursing put up with this arrangement? This is just one example when I realized that things just weren’t quite right in nursing. After this incident, I learned really quickly to keep my mouth shut and not make waves. I think a lot of nurses feel that way.
And that incident ultimately led to EmpoweredNurses.org?
There are nurses who are kind, caring, compassionate nurses who put their patients first. I knew they had great solutions to improve patient care; and that’s where Empowered Nurses cames in. Empowered Nurses is an organization designed to empower nurses so that they can speak their minds; stand in their power and be change agents to improve patient care.
What would you say to nurses in general about the profession?
Nurses need to come together. They need to focus on what they want to achieve and to focus on solutions instead of problems.
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