October 6, 2015


The blossoming profession of legal nurse consulting is experiencing the pains associated with any new career being carved. These medical-legal professionals consist of experienced registered nurses who use their expertise while assisting legal teams decipher medical records and orders. These nurses may testify on stand or analyze medical cases while working with adjudication in medical malpractice, tort, worker’s compensation or even compliance cases. Because legal nurses may have some office duties, they can be mistaken for legal assistants or paralegals – although this is not the case. Practicing legal nurses, whether they carry the certification of LNCC or CNLC, are experienced registered nurses who are trained as experts in both medical and legal matters.

Certification Processes

There are two types of certification awards for legal nurses including the LNCC, or Legal Nurse Consultant Certified, and the CLNC, or the Certified Legal Nurse Consultant. Although the paths to both certifications require legal nurse experience and education, the practice and education requirements differ, as do the governing bodies. Choosing your certification path is an important step in your legal nursing career. Both certifications highlight experience and education within the field of legal nursing, but are exclusive of one another. For instance, a nurse who has passed the CLNC exam cannot obtain the LNCC certification by reciprocity, and vice versa.


The American Legal Nurse Consultant Certification Board, or the ALNCCB administers the LNCC examination. This board is a subsidy of the American Association of Legal Nurse Consultants, which is a not-for-profit professional association. The ALNCCB requires at least five years of experience as a registered nurse including 2,000 hours in legal nursing for eligibility to test. The certification of LNCC is then used following the professional’s nursing credentials. This certification lasts for five years at which time you must attest to ongoing experience within the field as well as continuing education hours within legal nursing topics. The ALNCCB does not endorse or sponsor any testing preparation, such as seminars, prior to taking the LNCC exam.


The copyrighted term, Certified Legal Nurse Consultant, is owned by the National Alliance of Certified Legal Nurse Consultants. This alliance is owned by the Vickie Milazzo Institute, a for-profit entity sponsoring seminars, preparation courses and education aimed at passing the CLNC examination. The Vickie Milazzo institute offers multiple packages teaching both legal nursing material as well as business strategy, encouraging the registered nurse to work as an entrepreneur in the field upon passing the certification course. Similar to the LNCC, the CLNC designator is used in the nurse’s title after successfully passing the certification examination.


Although both examinations carry a hefty testing fee, some of the packages for the CLNC include both the testing fee and preparatory materials, such as a seminar or CD-ROM educational course. The fee associated with the LNCC examination does not include any preparatory materials; the nurse is expected to have both the experience and the education needed prior to applying for the examination. Conversely, the Vickie Milazzo Institute does offer a CLNC challenge test, where the eligible nurse may apply to sit for the CLNC exam without purchasing any of the VMI prep materials or courses. Eligibility for this challenge test is based on experience, which should include at least 3,000 hours of documented experience as a legal nurse consultant and three years in nursing.

LNCC and CLNC Eligibility

Two certification tests support the profession of legal nurse consulting including the Legal Nurse Consultant Certified (LNCC) exam and the Certified Legal Nurse Consultant (CLNC) exam. Passing each test results in a certification as legal nurse consultant, although the credentials awarded vary by test. Both tests have specific eligibility requirements, which are not similar and are regulated by the accrediting bodies of the examinations. If you are considering certification in legal nurse consulting, read on to see which examination criterion fits your needs.

Registered Nurse

Regardless of which examination you choose, you must possess a current, unrestricted license as a registered nurse in either the United States or Canada. Proof of a valid license is required to apply to either the LNCC or the CLNC examinations. If you have questions regarding the status of your nursing license, contact your state board of nursing.


The American Legal Nurse Consultant Certification Board, a part of the American Association of Legal Nurse Consultants, sponsors the LNCC examination. This not-for-profit organization sets forth the education and experience regulations required to sit for the exam. The LNCC is designed to test the knowledge of experienced legal nurse consultants, and awards a certification in the specialty upon passing the exam.

There are no specific education requirements other than an active RN license; a bachelor’s in nursing is not required at this time. Nurses may take electives or courses in legal nurse consulting, but it is not completely necessary to pass the exam. The nurse must have at least five years of experience as an RN, with 2,000 hours spent in legal nursing within the prior three years to application.

Candidates must have proof of the 2,000 legal nurse consultant experience hours. The rules governing how these hours are spent are very specific; the experience must fit into the criteria set forth by the ALNCCB. Acceptable experience hours must be considered billable, be requested by a client and have relation to a medical claim. The hours cannot be the result of extraneous duties performed while working in another focus area of nursing, such as medical chart review for shift supervision duties.


Myriad pathways will take you to the CLNC certification – it is up to you to choose which one fits your budget, needs and experience. This certification exam is sponsored by a for-profit organization called the Vickie Milazzo Institute. This institute owns the National Alliance of Certified Legal Nurse Consultants, who governs all aspects of the CLNC test. All CLNC candidates must hold an unrestricted RN license in the United States or Canada.

If you have little or no legal nurse consulting experience, you can take one of three Vickie Milazzo Institute CLNC training courses offered in online, CD-ROM or seminar format. Upon completing any one of these three courses you will be deemed eligible to sit for the CLNC examination, offered either at Prometric sites across the nation or on the final day of the seminar. There is no experience needed as an RN prior to taking these courses.

The second option for experienced RNs includes challenging the CLNC test. You must have an unrestricted RN license with three years of experience, as well as 3,000 hours working in legal nurse consulting. The Vickie Milazzo Institute does not guarantee eligibility, however, and each candidate will be assessed on a case-by-case basis.

LNCC and CNLC Exam Content

LNCC and CNLC Exam ContentBoth the Legal Nurse Consultant Certified, or LNCC, and the Certified Legal Nurse Consultant, or CLNC examinations test your knowledge of the medical-legal aspect of nursing. Legal nurse consultants are neither attorneys nor paralegals; they are registered nurses with experience and education in the intricacies of the legal system. These professionals are used to help attorneys through medical cases, while decoding the medical terms, charting and ramifications of the case. Both the LNCC and the CNLC exams will result in a certification in legal nursing. Learning the exam content details for each test will pave a path to help tailor your studying needs.


The American Association of Legal Nurse Consultants sponsors the LNCC exam, which is offered four times annually through Schroeder Measurement Technologies as a computerized exam. Professionals practicing within the field extract the exam content from professional experience using over 15 reference texts. A list of these reference books is available on the AALNC website, found under the LNCC Certification Information Handbook and Application.

At least 2,000 hours practicing as a legal nurse is required to sit for the LNCC. These experience hours will help with your application of the knowledge on the test. However, the purpose of this examination is to prove your capability to function independently as a LNC upon passing. The defined scope of the examination provides a definitive list of competencies that you should be able to perform independently upon gaining your LNCC. These competencies include collecting case-related information, analyzing relevant data, facilitating communications between involved parties, creating attorney’s drafts, such as deposition questionnaires, providing education to attorneys on the medical process involved and providing or locating expert witnesses relevant to the case material.

The exam content is divided into eight disparate sections, with the heaviest emphasis placed on your medical malpractice knowledge. The remaining sections are divided into personal injury, liability/toxic tort, worker’s compensation, life care planning, elder law, criminal and forensics, and administrative health law and compliance. For more information on how to tailor your study efforts for the LNCC, see the article titled, “Preparing for the LNCC or CLNC”.


The Certified Legal Nurse Consultant examination is owned by the Vickie Milazzo Institute and offered through Prometric computerized testing centers nationwide. There are two approaches to taking the CLNC exam; applicants can either complete one of the Milazzo preparatory courses, such as a six-day long Certified Legal Nurse Consultant seminar, or choose to challenge the examination with proof of 3,000 hours of experience within legal nurse consulting. The preparatory courses for CLNC are created to prepare you for both the business of working as a legal nurse consultant as well as the certification examination.

The scope of the CLNC exam is to test your ability to effectively function as a legal nurse upon certification. The test content is divided into two categories, with questions that test your knowledge and questions that test your application skills of legal nursing concepts. The CLNC exam covers multiple objectives including litigation overview, scope of practice, medical records functions, marketing and interviewing techniques, testifying, legal and ethical concepts, and the understanding of medical malpractice, personal injury, liability, environmental and worker’s compensation cases.

The test content breakdown includes 19 areas of focus within the CLNC exam, with the largest focus of 10 percent awarded to the role of a CLNC. The subsections are broken down into vocational, theoretical and legal topics of legal nursing. These sections include questions on litigation, liability theories, personal injury, product liability, toxic tort, worker’s compensation, screen cases and report writing, medical record tampering, standards of care, role of testifying experts and interview techniques to name a few. The complete breakdown with associated percentages of focus is located on the Vickie Milazzo Institute web site.

Legal Nurse Consulting

Regardless of their medical malpractice experience, attorneys do not work in the medical field. A growing number of medical malpractice, tort and worker’s compensation cases have stimulated growth in the profession of legal nurse consulting. These medical professionals work together with attorneys on varying medical cases, providing medical insight and expertise.

Registered Nurses

Legal nurse consultants require a registered nurse state licensure. Licensed practical or vocational nurses are not eligible for legal nurse certification. Registered nurses must attend an accredited school of nursing, which may result in an associate’s or bachelor’s degree in nursing. They are then eligible to sit for the NCLEX-RN, which is the licensing examination for the registered nurse. State boards of nursing govern these tests, and all associated testing fees and maintenance of the license is dependent on your state board’s requirements. LPNs or LVNs who are interested in legal nursing must first obtain their RN license through additional schooling and examination.


A legal nurse consultant will start her career gaining experience in nursing, patient care and documentation. Similar to any other nurse, a legal nurse need hands-on experience within the field before his opinion carries any weight. This experience may be gathered in a hospital, doctor’s office or outpatient medical center. The Legal Nurse Consultant Certified, or LNCC, requires five years of experience as an RN whereas the Certified Legal Nurse Consultant, or CLNC needs only three. The LNCC certification requires a minimum of 2,000 hours spent within the actual field of legal nurse consulting with documentation attesting that fact.

Those without legal nurse experience may take the CNLC certification course, which then allows eligibility to take the CLNC examination. Upon passing either certification examination, the registered nurse may use the title Legal Nurse Consultant (LNCC) or Certified Legal Nurse Consultant (CLNC), dependent on the certification exam they completed. You may also choose to take a course in legal nurse consulting before seeking job experience. Many colleges offer certification courses, which may get you ready for your first job as a legal nurse. Although experience in the field is needed for the LNCC, you do not need a certification to start working as a legal nurse.

Job Expectations

Legal nurse consultants typically work independently, as a consultant on individual medical cases for attorneys. These RNs are paid on an hourly basis and are responsible for their own hours and billing system. Legal nurses may also work in a legal firm that carries a heavy load of medical cases, or for insurance companies as a salaried employee. Similar to any career niche in nursing, the more experience and education you have, the more you will earn.

A typical day in the life of a legal consultant can be spent in a variety of work locations. You may sit at your desk pouring over medical records for hours, or you could be in court as an expert witness for your attorney. Legal nurse consultants may help arrange inquiry for a deposition in one case while gathering associated medical data and research for another. If you work independently, you will be in charge of your case load and income.

Preparing for the LNCC or CLNC Exams

Preparing for the LNCC or CLNC ExamsTwo certification examinations are both intended to verify your knowledge of legal nurse consulting and prepare you for an independent career in this industrious nursing field. The Legal Nurse Consultant Certified, or LNCC, as well as the Certified Legal Nurse Consultant, or CLNC examinations result in a certification used behind your professional title of RN, written as RN, LNCC or RN, CLNC. Although they are deemed for the same purpose, these tests are governed by different sponsors and do not possess the same blueprints. Once you have chosen which examination you will take, study the content outline for that examination to help secure a passing score.

Assess Your Readiness

Both the LNCC and the CLNC examinations come with a hefty price tag. Ensure you are ready before applying to take the test by studying the exam content, references and any other material you find suitable for preparation. The American Association of Legal Nurse Consultants sponsors the LNCC, and they do not endorse or provide any test preparation materials. The Vickie Milazzo Institute governs the CLNC exam and provides three types of preparatory courses for the test, or you can choose your own study method. Test content outlines are available online for each test, allowing you to tailor your studying efforts to your areas of weakness.


After you apply for the LNCC through the ALNCCB web site you will need to schedule an examination date. The information needed to complete this task will be forwarded to you by the ALNCCB. If you need special testing considerations you must notify the ALNCCB during the application process, not after your test is scheduled.

The ALNCCB provides a set of practice examination questions and over 15 reference texts used to create the LLNC exam. The test scope, content and outline is available on their web site. Candidates can purchase study materials such as practice CD-ROMs, study manuals or attend preparation classes for the LNCC. However, the ALNCCB does not endorse any product made to study for the LNCC examination.


If you wish to take the CLNC examination you have several different options for preparation. Nurses with experience in legal consulting may wish to purchase a review course, as opposed to those in-depth courses offered by the Vickie Milazzo Institute. Nurses with less or no experience will need to take one of the certification courses provided by the institute. Successfully completing one of these courses deems you eligible to take the CLNC test – the certification is not automatically awarded upon completion.
The quickest way to prepare for your CLNC examination is to take the 6-day course offered live by Vickie Milazzo. These seminars are held quarterly in four different large cities. The last day of this seminar is used for the CLNC exam. The other options are a learn-at-your-own-pace variety, including CDs, DVDs or online instruction. These modules include 40 hours of instruction broken into 19 modules. Upon purchasing one of these packages you will have one year to finish the program and take your CLNC.

Careers for Inpatient Obstetrics Nurses

Unlike their OB/GYN counterparts who may care for any woman, inpatient obstetric nurses only care for pregnant women after their 20th week of gestation and their baby upon delivery. These specialists have myriad job responsibilities through the antepartum and postpartum periods. They will interact with family members, doctors and many paraprofessionals while advocating for their patient’s needs. Dependant on the hospital you work for, sometimes licensed practical nurses, or LPNs, may work in obstetrics along with registered nurses, or RNs. However, if you desire certification in this elite area of specialty you must obtain your RN and a bachelor’s in nursing science, or BSN for eligibility.

To get started in nursing you must complete a nursing program through an accredited school of nursing for RN or a vocational school for LPN and then pass a state licensure examination. Upon licensure, nurses may start applying for jobs in obstetrics, although this is a highly desirable field for nursing and it may be difficult to get your foot in the door. Work your way into the inpatient obstetrics field by starting with entry-level positions in nursing in the outpatient specialty units such as birthing centers, physician offices or health departments. Grow your knowledge and experience in obstetrics and set career goals while you are awaiting your dream position. An excellent long-term goal would be to get certified in your area of specialty – the National Certification Corporation provides a certification exam for inpatient obstetric nurses that can set you apart from your peers by showcasing your drive and knowledge.

Typically, inpatient obstetric nurses will work a 12-hour shift within the Labor and Delivery, abbreviated L&D, unit in a hospital. These shifts run from 7 a.m. to 7 p.m. for day shift L&D or from 7 p.m. to 7 a.m. for night-shift nurses. A typical workweek in obstetrics will account for four shifts on followed by three days off. You may also have to attend training classes for ongoing education as mandated by your department or arrange and upkeep your continuing education units, or CEUs, at home to maintain your professional licensure outside of work. At the very least, obstetrics nurses also maintain a certification in basic life support for healthcare providers, which is the CPR for nurses. Other desirable, yet not always mandated, certifications include ACLS, or advanced cardiac life support, PALS, or pediatric advanced life support and NALS, or neonatal advanced life support. Emerging certifications include the fairly new ACLS for OB, which is a certification tailored to emergency care of the pregnant woman and her unborn child due to their special needs.

The majority of the time, an inpatient obstetrics nurse is dedicated to advocating for a healthy mother-baby unit throughout an uneventful delivery and postpartum care. However, this is not always the case and a healthy mother-baby is not always the end result. These nurses have the extremely challenging position of sometimes seeing mothers and/or newborns die and must be able to deal with on a personal level while maintaining professional composure to help the remaining family through the initial stages of grief.

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