Vickie Milazzo, a Legacy in Legal Nurse Consulting

Profiles in Nursing

Vickie Milazzo, a Legacy in Legal Nurse Consulting

What do lawyers know about medical practice? Nurses can do better analysis

By Elizabeth Hanink, RN, BSN, PHN
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Statistics on medical errors vary, but one thing is clear: There are a lot of them. As a result scores of attorneys keep busy with malpractice cases that involve millions of dollars a year. Yet, you might ask, what do lawyers know about medical or nursing practice? Or about hospital systems, physical therapy or the other services that contribute to patient care? Not that much. Furthermore, finding the answers is expensive and time consuming. A law clerk can do some of the work, but as Vickie Milazzo, RN, MSN, JD, has been saying for close to 30 years now, nurses can do it better.

Since 1982, when she started her legal nurse consulting business, Milazzo more than anyone else has defined this nursing specialty, shaped its body of knowledge and trained the bulk of practitioners — 18,675 and counting.

Her entrepreneurial success did not happen overnight, nor is it the first path that she took. Originally a graduate of an associate degree program, she later earned a BSN from the University of St.Thomas in Houston and, later still, a master’s in nursing education from the Texas Women’s University. Her work in intensive care satisfied her but she realized that excellence would have to be its own reward. Even her advanced degree would not result in more money or much advancement.

Analyzing the Medical Chart

As she began to explore her options, including health education, a friend mentioned work on a medical legal case. Hearing about it opened her eyes. Nurses could be much more than expert witnesses; Milazzo knew they could offer unique insight and analysis.

Where to start? Today CLNCs have recognition as knowledgeable professionals, but it is largely because of Milazzo’s efforts. There were no curricula to follow, no standards, no supporting professional organization. But she plunged ahead, learning as she went. During her first case she offered to work at a discount, but soon the attorney offered her more pay, recognizing the worth of her analysis. She could read a medical chart and provide invaluable knowledge about what had happened and what should have happened.

Success came, but not easily. For years she worked at her dining room table, unpacking her workbox each morning and repacking it each night. Legal nurse consultants, unlike most practitioners, have to prove their worth and sell themselves as providers of value. It was hard to work full time as a nurse and to still market and consult in the off hours, but it was risky to walk away from a secure job to attend law school at night.

Five Promises to Success

However, Milazzo, who has also gained prominence as a motivational speaker, stuck to five promises she now promotes as the fuel to her success: “I will live and work a passionate life; I will go for it or reject it outright; I will take one action step a day to work my passionate vision; I will commit to being a successful student for life; and, lastly, I really believe, as a woman, I can do anything.”

At one point, she pursued her law degree thinking she would like to practice as an attorney. But during her studies she discovered legal nurse consulting and teaching were still what she really loved. So — and this is a key point about her — she finished the course, used it to enrich her skills and continued to follow her original path. Her willingness to test herself, take chances and stay the course are all part of what have made her a success. “I jumped off the accepted track, defined a new profession and its standards, and put my own train in motion.”

Nurse, Lawyer, Entrepreneur

Today, the Vickie Milazzo Institute is a multimillion-dollar company that trains nurses to become legal nurse consultants. It has won Milazzo multiple honors, including a place on Inc.’s list of the top 10 entrepreneurs and the Stevie Awards Mentor of the Year. She still teaches most of the institute courses and is in frequent contact with graduates. Her book Inside Every Woman: Using the 10 Strengths You Didn’t Know You Had to Get the Career and Life You Want Now earned recognition by The Wall Street Journal and is in its eighth printing; it continues to sell in the top ten percent of business books.   


Elizabeth Hanink RN, BSN, PHN is a freelance writer with extensive hospital and community-based nursing experience.

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