Legal Nurse Expert, Dr. Leah Elliott

[00:01] Michelle: I have to admit, before I interviewed Leah Elliot, I knew very little about the legal nurse expert role. With Leah's thorough explanations about the process she goes through from accepting the case to researching and finally to the presentation, I have found this nursing specialty to be fascinating. I love that she says "participating as a legal nurse expert is a little like solving a mystery." Being a lifelong learner, Leah feels strongly that nurses should belong to professional nursing organizations, and she utilizes these organizations in her expert research of best practices and standards of care. In Leah's role as a nursing professor, she's thoughtful about sharing what she has learned as a nurse expert with her students to help them in their future practice. In the five-minute snippet, Leah shares her story of an act of kindness during the pandemic. Here is Leah Elliot. You're listening to the conversing nurse podcast. I'm Michelle, your host. And this is where together we explore the nursing profession one conversation at a time. Oh, good morning, Leah. Welcome to the show.

[01:22] Leah: Thank you for having me.

[01:25] Michelle: Yes, it is my pleasure. I was so excited when your colleague and your friend and mine, Dianthe Hoffman, said, you need to have Leah on your show, she's amazing. And I've not met you, but just reading your bio, I was kind of blown out of the water. I said this is somebody that has so much to offer and so much information and so much experience that our listeners are going to be really in for a treat today. So thanks again for being here.

[02:01] Leah: Oh, my pleasure.

[02:03] Michelle: So the kind of way that I do things is I just kind of like to jump right in. And so tell me a little bit about your background and then how you got into the nurse expert role.

[02:19] Leah: Well, I have lived my entire career in Maternal Child Health in one form or fashion. I have done everything from being a doula and running a doula project to being an RN at the bedside to being a nurse educator in the specialty. And so it was just I wouldn't say a natural profession, but it did make sense that I could then offer my opinion when asked to do so for looking at a case to decide if the standard of care was met by nurses in that field.

[02:58] Michelle: Okay. And so the cases that you take this might seem like a silly question, but they're all, like, maternal child-focused cases.

[03:09] Leah: Those are the ones that I'm really only qualified to speak to. They've asked me to do some other types of cases, and I usually have to abstain from that because I don't know, for instance, medical, or surgical nursing. Like, I know obstetrical nursing, so I stick within my specialty.

[03:30] Michelle: I like it. You stay in your own lane.

[03:33] Leah: That's great.

[03:34] Michelle: Well, you certainly have a lot of expertise. And like you, my entire career has been in Maternal Child nursing, pediatrics, and NICU in particular. I did a little bit of postpartum in there for a couple of years. But it's a very interesting field, I think, and I love it. So take me through, like, a case, first of all. How do you get a case?

[04:09] Leah: Well, the way people find me, and I don't exactly know how it first started happening. I think it was from my LinkedIn profile. And then I was approached by an organization that houses experts and their CVs and background and experience. And then if there's a case that meets my profile, they'll ask me if I want to offer an initial opinion. And then the attorney will look at my answers to it, usually four or five questions in the beginning. And I think it's really maybe a weed-out process to try to determine if I do in fact, have some experience in that field. And so then after we've gone through that initial process, we usually have an interview and they will give me some just very specifics of the case. I have to make sure that I don't know anyone or have never worked with anyone or at any of the facilities that are being represented, because that's a conflict of interest, and I have to abstain at that point. And so then after that point, I'm retained and I sent the medical records. And it's a little like piecing together a mystery, a puzzle trying to determine what happened at what time. And of course, I have the benefit of knowing what the end result of the situation is, but I kind of work backward. And so for me, I pretend like I'm the nurse caring for that patient. I take all the information. I give myself a little report by going through the medical record, and then I will actually evaluate the fetal strip all the way up to the point of whatever the condition or incident is if there is any. Sometimes there isn't an actual point that we know something went wrong. And then I will either give a verbal or a written opinion to the attorney and then if I am asked to, I will provide a deposition and or become a witness in a court proceeding.

[06:17] Michelle: Oh, wow. Okay. That's a lot. That's so interesting. I saw that you had said that you kind of became interested in the legal nurse expert role following some time that you served as a juror. Tell me about that.

[06:38] Leah: Well, without saying too much about that, I was just a juror, like a regular person called off the street in a murder trial. And I was there for a good period of time. I think it was maybe four or five weeks. And so I saw the expert witnesses that would come and talk about the medical aspect of the case. And it was fascinating to see how the attorneys worked in the courtroom and how they interacted with the witnesses. And so it was all new to me. I'm really happy that I've served my time and I'm not going to jump on the next year. It was definitely interesting, I mean, of course, I would appear, but ever since that time, every time I have appeared, I've been dismissed. And I think they kind of feel like I've done my duty and they don't necessarily expect me to do that again. But it was a very interesting process all the way through and so that's kind of how I got interested in thinking about how could I serve as an expert in these situations. Because you know that when you talk to people that don't have any medical background, we talk to each other and we completely understand the lingo and the verbiage and the ideas, but the average person that doesn't have any medical training does not understand any of that. They just haven't learned it at that level. So it has been nice to be able to take my skills as a nurse and my skills as an educator and then be able to educate the attorneys on different aspects of evidence-based, care and the standard of practice and then present that to the judge.

[08:24] Michelle: Wow. Yeah, that is fascinating. It sounds really exciting. So back to when you were talking about your jury summons and so forth. Do you divulge that you are a legal nurse expert?

[08:41] Leah: Yes. Okay.

[08:42] Michelle: And then they're like, bye.

[08:44] Leah: Exactly. So if you want to get out of jury summons, maybe that's just me right now.

[08:53] Michelle: My experiences with jury summons, of course, I've got summoned like everybody else, and most of the time I've gotten excused and there's been a couple of times that I've gone in and one of them was a case, was a child abuse case and I'm saying I'm a pediatric nurse. And they said, yeah, you can go now, but I don't have a lot of experience in that. But it sounds really kind of fun and like you said like you're solving a mystery. Do you have to have a law background to be an expert legal nurse?

[09:33] Leah: They actually prefer that you don't. When they hire me, they are asking me to provide a medical nurse expert opinion and they are the ones that have the legal expertise and I defer to them quite a bit. It's very different than what we're used to as far as the legal aspects of chart and conversation and HIPAA rules and that sort of thing. So I often defer to them. So for instance, we do a lot of things, we talk to each other a lot, and don't put things in writing because then it becomes discoverable if you put it in writing, meaning they can then subpoena that into court. They like to have conversations between, you know, just verbally and then there is an attorney-client privilege so the client can tell the attorney thing that doesn't have to go anywhere. And sometimes they're asking me for an opinion that has been uninfluenced by anything. They don't give me a lot of information in the beginning because they want me to look at it with fresh eyes without any influence. And then when I bring my opinion to them, then we can discuss it pretty openly. But in the beginning, I actually get just it's like a few clues, and that's all.

[11:02] Michelle: And so these cases that are coming to you, they're from all over the country?

[11:09] Leah: Yeah, correct.

[11:10] Michelle: Okay. Yeah. Because you had said prior that you have to recuse yourself if it's a hospital that you worked for or somebody.

[11:21] Leah: That you worked for and even location, even area. So I wouldn't be able to take anything in good conscience, even if it's a hospital in my locale that I haven't worked for because I just know too many people in this area.

[11:36] Michelle: Right.

[11:37] Leah: So it just wouldn't be a good idea.

[11:40] Michelle: Right, okay. I know you're in the Maternal Child field, but are there any really hot spots in particular for legal nurse experts?

[11:53] Leah: Maternal Child?

[11:55] Michelle: Yeah. Right.

[11:56] Leah: Yeah. Unfortunately, because there are a lot of moving parts in labor and delivery, and when we have an injured child or a baby with certain disease processes that happen that they think to have been caused by a birth injury, then they have a long statute of limitations up to 20 years that they can actually come back and look at the care of the child. I have seen quite a few cases kind of come up recently about nurse-like discipline within the organization. So I think these are cases that are looking at discipline against their license. I am not an expert in that field, but I think since the very publicized case in Tennessee, we're seeing more of this. And I've seen a couple of those. Actually. I actually was offered one, and I said no, I didn't want to get involved in that.

[13:05] Michelle: What's the oldest case talking about the statute of limitations? What's the oldest case that you've been consulted on?

[13:13] Leah: For me, it's been four or five years out is the oldest. I haven't seen any of the older ones, but I know it's possible.

[13:25] Michelle: Yeah, well, you're right. With the statute being so long, you could definitely get some that are beyond ten years or whatever. So who are you working for? Are you working for who calls you up for a case? Is it an attorney? Is it a hospital? Is it an insurance agency? Who are you working for?

[13:51] Leah: I think you could be called by any of those. I do almost exclusively work for the plaintiff. So these are the attorneys that are working for the families that are working for the injured child. But some nurse experts will actually work for the defense on the other side. And I've come across them in trials. I'm sometimes asked to read their depositions for the plaintiff side so that if there's anything in there that needs to be discussed medically. They sometimes ask me just my opinion on the medical questions that were asked. So you can do either. I think it's been my experience so far that we typically choose to work primarily with one side versus the other. And yeah, because they ask me how gives me a percentage of how often you work for the defense and how often you work for the plaintiff.

[14:50] Michelle: That's really interesting. I had no idea that you could choose that, working for the defense. Would you feel like you're working against a nurse?

[15:06] Leah: Yeah, my role is to look at the care provided by the nurse, but I often see, and I usually put this in my opinion, and then I turn around and give this information to my nursing students so that they can put that in their back pocket as they're developing their professional practice. But I often see that it probably wasn't a lack of care or not following the standard of care, but a lack of documentation. And it always comes back to the documentation. And that is so important because that's all I have to piece together the story. So I feel like every nurse needs to know that they at some point may be asked to represent themselves in the care that they provided and the only thing they'll be able to fall back on is the documentation of the care that they gave.

[16:10] Michelle: It's been a saying since the beginning of time as if you didn't chart it, you didn't do it. Is that kind of still holding true?

[16:21] Leah: Kind of. So if I was a nurse documenting today, I would want to document in a way that five years from now I would understand what I was trying to say, because I'm not going to understand next week what I was documenting about. But if I put it succinctly enough and tell a story, who did you tell, and what did you tell them? What was the response? Then at least I'll be able to come back later and testify to that. So you have the opportunity as the nurse in a deposition, to look at your own documentation and hopefully, that will jog your memory. But if you didn't do an assessment at that point. But you remember doing it. You can testify under oath that you did do that assessment and that's appropriate. But are you going to remember that if you didn't document it? That's really the idea of it you are documenting now for your future self and to tell every other caregiver what care has been provided to this patient.

[17:28] Michelle: Yeah, that's a really good point. On documentation, have there been any just like cringe-worthy moments when you're looking through documentation and you just get like a sinking feeling, like, oh, man. Is there anything that comes to mind?

[17:45] Leah: I can't be specific about certain cases, but I can generalize. Sometimes I will see, especially in labor and delivery, because we are often interpreting strips, fetal heart rate monitoring strips. And it is imperative in this field, in this area, that you understand fetal monitoring at a very deep level so that you know what you're documenting is correct because I often find improper documentation of those fetal monitoring strips. And it's unfortunate because you know as well as I do that's the only kind of you into the womb that we have during labor and delivery. And so if you're improperly interpreting that, then you're not providing the care. And I would say 90% of the time when I'm looking at a fetal monitor strip, I end up disagreeing with the interpretation of what was provided by the nurse. So as a nurse in the labor and delivery field, you absolutely must know what the strict interpretation is, and what it is you're actually looking at. I think that's probably the biggest, what I see most often. And then the other part is not informing the provider of what you're seeing, because that's really our role as nurses. Prompt recognition and then getting someone involved in the care immediately so that we can fix whatever is going on, whether that be expediting delivery or what have you.

[19:31] Michelle: Do you think nurses, do you think labor and delivery nurses are getting sufficient training and interpretation of those strips?

[19:42] Leah: I am concerned that maybe they are not. I can't speak for every hospital, of course, and I know that my local hospitals do put in the effort, and in nursing school we do attempt. But I think it's one of those things that you have to always stay up on what the newest standard of care is, and a great way to do that is, whatever your specialty, to join that professional organization. So for Maternal Child Health. It's the Association of Women's Health Obstetric and Neonatal Nurses. So AWHONN, and they keep up on the current research. Unless that is your full-time job, you can't just read every research paper that comes out, but if you can go to an organization that's kind of putting it all together for you, then you can stay up on the current research. And I think it is each individual nurse's responsibility to do that. That's not a popular opinion, but just from what I'm seeing, I do believe that we have to care about our license the most because honestly, no one else does as much as we do.

[20:55] Michelle: I love to hear you talking about and promoting professional organizations. I was a member of NANN, the National Association of Neonatal Nurses for over ten years and a member of ILCA, even though I'm not a lactation consultant like yourself, I am a certified lactation counselor, and there is a big difference in our scope of practice, obviously, but I don't know why nurses get so turned off about joining a professional organization. There are just so many resources that can improve their care, and most organizations will reimburse you for your yearly membership, which is not that much for what you get. So yeah, I'm a big fan as well. And I saw the Legal Nurse Consultants. They have several professional organizations. There's the American Association of Legal Nurse Consultants, the National Alliance of Legal Nurse Consultants, and the International and American Association of the Legal Nurse Industry. And are you a member of any of those or can you speak to anyone?

[22:12] Leah: I am not a member. I have looked at all of those organizations and that is something I'm actually interested in pursuing a little more about. I feel like my nurse consulting is not my primary role, and to be honest, I don't think I could make it my primary role because each case that I look at takes so much out of me mentally and emotionally because I'm not dealing with sunshine and roses over here. These are all situations that really play heavily on my heart. And then going through the deposition or trial process, it's uncomfortable to be in an antagonistic conversation with people. I like to avoid conflict as much as I can. It was kind of a unique place to be, but I feel like I'm serving the families, but I don't think I could do it all the time because of the things I just mentioned. So I have no organizations, but they are very interesting and I highly recommend professional organizations to anyone interested.

[23:16] Michelle: While talking about the time that it takes because you have to do a real thorough deep dive into the research and everything. Can you average out like, how much time a case would take you, depending?

[23:32] Leah: On how many medical records there are? So if I have 500 pages of medical records, I start by just giving a cursory glance over everything and making notes of things that I want to find. And then I go back and I actually read all 500 pages, I would say, and then I'll think about it for a little while and then I'll maybe look something up or make sure that I'm remembering that aspect of the care correctly and do a little research. So I would say that each initial look into a case is going to be anywhere from three to 10 hours before I start to form an opinion.

[24:13] Michelle: And is there a deadline when they give you a case or when you accept the case? Do they say, you know, you have to have everything done by a certain time?

[24:22] Leah: Yes. And that's one big difference between healthcare in the legal field they'll contact me today and say I need it next week and we sometimes need a little more time than that. And so I'm not sure on their end why it happens so late in the game. I should ask some time why we don't get the information sooner. But yet it seems like you'll hear from them, you'll go through the process, they'll decide that they want to retain you, and then they're like, okay, yesterday, we need this information yesterday. So that's been my experience.

[24:58] Michelle: Years ago, (I talked about this with Dr. Nelson, a pediatric hospitalist that I had on) I had my first and only deposition. And so that was really interesting, really educational and informative, but it was exactly like that. It was like, okay, you have to appear on this day and you have to have this done. And yeah, there's like some really hard timelines and going back to the documentation and talking about cringe-worthy things. This case happened before electronic documentation, so it was when we were still doing paper charting. And it's really embarrassing when you are sitting before an attorney and trying to read what you wrote because your handwriting is illegible. It's not fun as a professional. So I'm happy that nobody today has to go through written records. Everything's electronic, but along those lines, there are so many different electronic medical records and I imagine that in your practice, you use one particular one, but there might be a hospital where they use a different one. So how do you familiarize yourself with those different records?

[26:29] Leah: Electronic medical records are very difficult to read back through and I actually prefer handwritten notes because it tells a story in a way that you can kind of piece things together in an easier fashion. But the records we end up getting from the electronic medical records all look similar. So it doesn't matter what system they come from. It all ends up being this kind of printed sheet, but it doesn't flow. So one part of whatever you're trying to read might be on page one and then the next section of that might be on page 30. And so you have to try to piece it together. And there is some legal something happens because I see something written on the bottom. Each page of medical record has to be approved by someone in the hospital that's releasing it once it's been subpoenaed. And it's interesting how that all goes. So that becomes part of the puzzle-solving mystery part of it. I lay it out on my kitchen table and I just try to piece it together first so that I can make sense of it when I am starting to evaluate it.

[27:51] Michelle: Yeah. Wow. Okay. So you have to know as the expert, you have to know the standards of care and the best practices. So what resources do you use? You probably know so many of them just because of your expertise and your experience. But if you are unfamiliar with something, where do you go to find the answers?

[28:15] Leah: I will try to go to the professional organization. So I spend a lot of time in ACOG, the American College of Obstetrics and Gynecology. And I am just looking at the standards. And then if I am moving away from what the nursing standard is into more of the provider standard, I will have to defer that because I'm not hired as a provider expert. I'm hired as a nurse expert. And so I look at the policies of the hospital, I asked for those to be presented, and then I look at the resources that were used for those policies. So when nurse managers and nurse educators are writing those policies, know that they do get looked at some point and evaluated at some point, if need be. So it's important when writing those. But I try to stick to the standards for the specialty and stay within those guidelines.

[29:18] Michelle: That's such a good approach to take, knowing what you know. And in this role as the legal nurse expert, it must just enrich your practice as a nurse, as a professor of obstetrics for your students, because you're seeing all these documents, you're seeing the policy, you know what the best practices are, you know, the standards of care are, you know, when they're not being met. So your students are pre-licensure but they're not at that point yet where they're practicing. But how do you relay that information, like in your day-to-day didactic or clinical with your students?

[30:12] Leah: I always try to go back to, well, in Maternal Child Health and nursing school, we're really just scratching the surface of the specialty. We're not building specialty nurses, we're building generalist nurses, but those that are interested in coming to the specialty. I talk a lot about knowing your normal values so that you'll recognize your abnormal values. Always, always document what you have asked for or you have reported and what the response was that our primary role in this job is early recognition. So we go back to knowing those cues, knowing the things that are leading us down that path of abnormal. It's not our job as the nurse to diagnose, but we have to recognize that we are veering away from what is expected and then acting upon that. And if the person that they're calling, the provider that they're calling doesn't hear them for whatever reason, then we need to go up to the chain of command, because our role is to get someone else involved that can actually make some changes so that we don't continue down this path. All of this legal nurse work and knowing the standard of care and being at the bedside for so long actually prompted me to go back to school to finish my nurse-midwifery degree. And so I am finishing that up because I want to be part of the solution. As I start to see the sunset of my career ten or 15 years from now, I want to be part of that solution. So that's actually what I've decided to do.

[31:54] Michelle: Well, along those lines, well, congratulations. First of all, that's amazing. And along those same lines. So you have to kind of have an expectation of what the provider, whether that's a midwife and nurse practitioner, a physician, what their role is, and if they, I don't know if I could quote, unquote, say messed up or didn't meet the mark. Is that true? Is there a physician expert that they call to evaluate the best practice for the OB or are you also involved in that?

[32:37] Leah: So they definitely will also retain a provider expert and sometimes multiple provider experts. And so I have to stop myself because the judge doesn't want to hear an opinion for me that I'm not an expert at. So I stay in my lane, although I kind of am bridging those waters a little bit with the new education that I've gained. But I do, at least in this role, I have really stayed in my nurse expert because I'm a new provider, not an expert provider, but I'm an expert nurse. So I stay over there. But I do have to know what the standard of care is. So recognizing if that was something that the provider just thought of on the fly or if that is what the standard care, meaning, that is what most providers would do in that same situation, that's really what they mean by that. It's been interesting to see throughout the country how we don't have a standard of care nationally in some circumstances, but it's more of a regional or the culture of the facility that does things in a different way. And that's been very interesting. But thinking back to the conversation we've been having, I think the most common thing I see is either miscommunication or lack of communication between nurses and providers. Maybe the nurse not feeling comfortable enough to speak up boldly and say, I see this and I think this is where we're headed, or the provider not responding to that. So it's not that they're not providing good care, they just are not communicating well enough to be on the same page. Does that make sense?

[34:24] Michelle: Absolutely makes sense. And again, I'm going to go back to the interview with Dr. Nelson. She's a professor of clinical pediatrics at the UCSF branch at CRMC and a pediatric hospitalist. For decades I worked with her and we discussed physician-nurse communication. And you just said verbatim what we talked about and what she wishes is that more nurses would speak up and say she said, I know that nurses are not supposed to make diagnoses, but we all know they do. And she said, I'm not advocating for all nurses to start diagnosing, but I want them to be bold. I want them to advocate more. I want them to put themselves out there more and say, this is what I think is happening, this is what I'm seeing. Or if the provider disagrees with them, tell me what you're thinking, tell me why you think that's, not to have those conversations. Because I pointed out that the Joint Commission, talk about communication and they say that's the reason for sentinel events with patients and it just can't be emphasized enough how important communication is.

[35:48] Leah: I thought as a whole we were moving in that direction of just culture and what the IHI really talks about of the mutual respect between providers, but you've been a nurse a long time and you know, the culture that we grew up in nursing in is that there is a hierarchy and we are not equal. And I'm not saying that we should be considered equal as far as the care of the patient, but we each have a job to do and we each have a role to perform and those are equal in the care of the patient and the provider has a role which goes down one way and the nurse has a role which goes down another way. But somewhere along the line, it became a hierarchy that has been almost an insurmountable bridge to cross in healthcare. And I see that, especially in high tense situations, high acuity patients. Now with the nursing shortage and the burnout on all levels, it's all been intensified. So I thought that pre-pandemic, we were moving in the right direction and I don't feel like we are anymore, unfortunately.

[37:09] Michelle: Yeah, man, I echo that. I feel like we're on a backward slide.

[37:16] Leah: In nursing schools and looking at how the hierarchy has been in nursing schools and then it builds in that new nurse idea. They often feel like they don't have a voice or that their voice is not respected and that nurses eat their young ideology that's been around for a long time. Unfortunately, that's still present in a lot of places and it's going to be up to the nurse management and the nurse educators on the floor to change that culture and just not tolerate anything else. But with the nursing shortage and the nursing burnout, they're so desperate to staff their units, I don't see this being a priority, unfortunately.

[38:02] Michelle: Yeah, it's a multifaceted problem and it's going to take a multifaceted approach. And that's exactly what Di Hoffman said, is it has to come from the administration, it has to come from the management that this is not going to be tolerated, that there's going to be discipline, that there's going to be terminations. And you're absolutely right, they're not at that point because of where we are and we're desperate to hold on to everybody and so we tolerate it. And we have nurses leaving the profession that have barely begun and we have nurses that have, you know, been, that are seasons, that are also leaving because they just can't do it anymore.

[38:53] Leah: I see that. I think everyone in nursing sees that.

[38:58] Michelle: Well, let's say I'm a nurse and I know I want to become a legal nurse expert. So what can I do right now to start my journey into that role?

[39:11] Leah: The first step would be to join your professional organization for your specialty and really start looking critically at your own charting your own documentation, and what the standards of care are. Go back and read every policy in the hospital. Use that as your downtime. Read your policies, and what they actually say you're supposed to be doing, and then maybe put it on your LinkedIn profile that you're interested in being called as an expert witness and just jump in with both feet kind of like I did.

[39:46] Michelle: That's great advice. How do you get paid? Are you paid, like, an hourly wage, or is it per case? How does that work?

[39:56] Leah: Yeah, it is per case. And so most experts will ask for a certain number of hours for the initial review, and then you have a conversation with the attorney or whoever has hired you with what else it will take to provide the deliverable. So if they want something in writing, how many hours it will take to provide that? So it is hourly, but typically, for instance, I have a minimum of a three-hour retainer to start the process.

[40:25] Michelle: Got it. Okay. That's good information. And then do you always go to court and testify, or are some of these cases settled out of court?

[40:39] Leah: I think I've done every option. Sometimes I just have a conversation with the attorney, and then I never hear from them again. And then sometimes I have provided written deposition. I've had video deposition, and then I've been called all the way to court and have come back multiple times for that case. So I've had all options.

[41:05] Michelle: Wow, very interesting. Okay, one last question, because as you talk, I keep thinking of things. So along those lines, have you had to travel to a physical place to give a deposition?

[41:21] Leah: Right now, everything is in Zoom, and so I've actually given my depositions on Zoom, but it is official court proceedings. I have to raise my right hand and agree to all of the legal proceedings. And so it's a very unique time to be doing this sort of thing.

[41:48] Michelle: I honestly had very, very little knowledge about your role as a legal nurse expert, and you have just blown me out of the park with your knowledge and your expertise and all your information, and I know our listeners are getting the same kind of experience. It's got me excited, and I'm like, Where do I sign up? This sounds so cool.

[42:18] Leah: It is. It's very interesting. But like I said, there's that other side of it that is also very sad.

[42:26] Michelle: Oh, wow. That's a good point that you make. So you have to be prepared for that emotionally. All right, well, I thank you for coming on and giving your perspective and all the information that you've provided. You're certainly cut out for this. Just talking to you and knowing what I know about you, I think you're perfect for this role, and I think a lot of nurses will, after hearing this will also be very interested. But are you ready for the five-minute snippet?

[43:02] Leah: I am, and thank you so much for having me. The pleasure has been all mine.

[43:06] Michelle: Oh, thank you, Leah. Well, the five-minute snippet is just a little taste for our listeners to kind of get to know your more off-duty side. So I'm going to bring up my timer because we actually just go five minutes and then we'll just start. It's fun so you know the answers to all these questions.

[43:29] Leah: Okay.

[43:30] Michelle: All right, finish this sentence. My dog is the best at________________.

[43:37] Leah: Being at my feet. No matter what I'm doing, she is at my feet. Most loyal companion.

[43:46] Michelle: And you said she's a Border Collie Australian shepherd. She must be beautiful.

[43:52] Leah: She is loyal to a fault.

[43:56] Michelle: What's her name?

[43:57] Leah: Kalli.

[43:59] Michelle: Oh, Kalli. Okay. That's cute. Okay, what ethical or sustainable food habits do you try to maintain?

[44:08] Leah: I try to eat organic as much as I can, and organically grown from a farmer that I can actually talk to, like, from a farmers market. I know that they have good practices for the way they grow food, and I have always been interested in it. And depending on where I am in my life, I'm better at it that goal than at other times.

[44:35] Michelle: We could say that about so many things.

[44:37] Leah: Right.

[44:39] Michelle: Okay, during the COVID lockdown, remember that? Did you experience any food insecurities?

[44:47] Leah: I did not experience any food insecurity. I was thankful that we had large supplies, and there were just two of us in the house and the dog and cats, so we were okay. But in my neighborhood, I was sure to look out for some of our elderly neighbors that were not able to get to the store because even a simple act of going to the grocery store, felt like it was dangerous. So we took up we made lists, and actually, my husband does all the shopping, so I made the list and then gave it to him, and then he brought it back, and then we passed out what people had ordered.

[45:26] Michelle: That is such a great thing to do. That is such an act of kindness. Yeah. I didn't really have a lack of food, but I was worried about two things, butter, and sourdough bread. Right. And so my daughter and I learned to make our own butter in the Vitamix, and that was a really interesting experience. It did turn out really well, and we did make our own sourdough for a while, but it wasn't always that good. Oh, my gosh. What's your favorite way to learn and why?

[46:05] Leah: I used to say that I was visual, but now I've kind of moved into visual and auditory. And one of my favorite things is to learn on YouTube because I can see and hear whatever it is that I'm trying to learn. And my favorite phrase is you can learn anything on YouTube. It is all there for the asking. And so that's one of my favorite ways to look up a new pattern or something that I'm trying to, you know, a technique, I'm trying to perfect it's all there.

[46:36] Michelle: You are 100% accurate in that. I have utilized YouTube. I'm a crafter. I'm a cardmaker. It's great to just go along and be able to pause and do that step. I fix things around the house using YouTube, so it is great, for sure. Who is someone that you would like to trade places with for a day?

[47:00] Leah: I would want to be Ina May Gaskin for a day. She is a midwife that has been around since the 1970s. She lives in a commune in Tennessee, and she has spent her entire life surrounded by birth and birthing women and midwives. And I would just love to be her for a single day.

[47:23] Michelle: She sounds amazing. What was the most special handmade gift that someone gave you?

[47:31] Leah: Someone gave me a quilt, actually, that we didn't know was made from my own clothing. As children, I was helping my mom move, and she said, this is a quilt that Manny? made. Do you want to take it home? And I said, absolutely. I don't have one in this pattern. And she also gave me pictures at the same time. And my daughter and I discovered as we were sitting looking at the pictures that the clothing I was wearing in the pictures is the clothing in the quilt, and it is one of my most prized possessions. And when I told my mom, she said, oh, I think you should give that back. Sorry. It's mine now, mom.

[48:10] Michelle: Nice try. No. Oh, my gosh, that sounds so special. Okay, this is a this or that. We have about 10 seconds. Embroidery or cross stitch?

[48:22] Leah: Embroidery.

[48:26] Michelle: Me too. I hate those little X's, my eyes can't see them. Oh, my gosh, that's so great. Well, Leah, I have so appreciated you coming on and sharing everything Legal Nurse, expert, and also your little personal side of you. I love your YouTube channel. I'm going to link all those in the show notes because they're just excellent for any nurse, whether you're a seasoned nurse or just starting out. I know you do them for your students and for nurses new to the profession, and they're just expertly done. So I'm definitely going to link those and how people can get a hold of you, because I know they're going to want to have some of their questions answered.

[49:13] Leah: Absolutely.

[49:14] Michelle: Thank you so much.

[49:15] Leah: Thank you so much. Bye.