Medical-Legal Partnerships: The Community Health Nursing Contribution

Background and Issues:

Social issues have a profound impact on health (Smith, Hatcher, & Wertheimer, 2002; Williams, Costa, Odunlami, & Mohammed, 2008). Our current healthcare system ignores the social conditions that are at the root of many illnesses (Lawton, 2007; Zuckerman, Sandel, Smith, & Lawton, 2004). Many patients, especially those with low incomes, face significant legal challenges that directly impact their health, although few patients (and providers for that matter) recognize this connection (Williams, et al., 2008). When physicians, nurses and other providers reach out to other professionals (e.g., lawyers), the root problems can frequently be mitigated (Das, 2007; Fiscella & Epstein, 2008; Fleishman, Retkin, Brandfield, & Braun, 2006; Gillespie & Groves, 2007; Kane, 2008; Lawton, 2007; Pullen, 2008). Multidisciplinary collaboration between healthcare providers and lawyers, and trans-disciplinary thinking around medical and legal issues, has the potential to ease the burden of patients receiving services from disparate venues, encourage collaboration in development of care planning, and mitigate social factors that are responsible for illness (Retkin, Brandfield, & Bacich, 2007).

Medical-Legal Partnerships (MLPs) have been developed throughout the United States that bring together clinicians and lawyers to advance individual and population-level health. Unfortunately, nursing involvement with MLPs has been minimal, and a current challenge is to engage nursing, particularly community and public health nursing, in the MLP process.

Description:

This presentation will describe a transdisciplinary MLP model that presents unique opportunities for nursing engagement through transdisciplinary education. Nurses with graduate-level training in Community Health Nursing and Public Health have been leaders in this effort. Lessons Learned:

Nurses have been difficult to engage in active participation. One reason for this is the absence of professional Registered Nurses in many of the primary care settings where MLPs are located. Another potential reason is a lack of self-efficacy among nurses when dealing with social issues impacting health.

Recommendations:

The transdisciplinary model described in this presentation presents a unique training opportunity for nursing students and practicing nurses to develop skills necessary to actively participate in medical-legal partnerships. Recommendations about how nurses can be engaged, and potential challenges will be discussed.