Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 I'll page the service if it's after hours and I think it warrants an immediate evaluation. I've had a few occasions to refer infants to the ED, and I definitely phone the MD in that case. Otherwise I will ask to speak with them. I work with Docs on a daily basis in my hospital role, so it isn't intimidating to me at all to consult with them. And yes, I have had occasion to disagree with them. I think if you approach the circumstance with a collaborative spirit, it wont be a problem. And I'm certain to discuss what the evidence/research shows, which means we must be prepared to provide it. I have had lengthy discussion regarding medication and indications for intervention etc. I think it is a component of our work we should be satisfying, particularly if the infant is in distress and requires immediate evaluation. > > > Hi Ladies, > When you call doctors about a patients condition, do you just call and ask them to call you back? Do you choose the menu option that you are a doctor's office or you want to speak to the nurse? I'm very timid to call docs. I've read that some of you educate them on frenulums and was never a waiste of time. How would you approach this type scenerio or even the one about the squeeky bf thread? Would you post some dialogue? > Thanks, > June , RN, IBCLC > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 If I see something that I cannot quite explain or wonder if it needs an evaluation, this is what I do. I would call that mom back today. (You know this kid is nagging at you that something isn't right) and ask her how everything is going. "By the way, I noticed the baby making a noise when I saw him feeding. Is this still continuing? Has the doctor observed this at all?" If not, I would ask her to call the doctor and tell him that you are concerned about the baby making a funny noise when he is eating. In a newborn, this should perk the doctor's ears up. He will ask her more questions and make an assessment as to whether or not the baby should be evaluated immediately. Sometimes pedi's will see a newborn first in the office. In this case, if there is a question of breathing/swallowing difficulty, I would imagine he would send the baby to the E.R. for an oxygen saturation monitoring and evaluation of input/output, respirations, etc. If the mom agrees to call, be sure to document your advice and follow up later this evening to see what happened. You can ask the mother if you can call the doctor as well. I find they agree to that because they feel you can better describe something more than they can (especially when they are nervous something may be wrong). I call the answering service and ask for the on-call physician I ask them to have the on-call physician paged and tell that I am the lactation consultant who saw this baby in the home (now, this morning, yesterday) and can he/she please call me back? The doctor is going to check his pages pretty frequently and may even be in the office on a Sunday for acute visits (ear aches, fever, etc) When the doctor calls back, I identify myself (remember you are an essential part of the pediatric care team) and tell that you just saw the baby (ex: jones, date of birth) and this is what you saw. I don't know that I would go into too much detail about the amount of feeding other to say you are concerned about the baby's ability to transfer. I would also say something like, I wanted to report to you that the baby had a squeaking noise when he was feeding. I did/did not observe that when he was at rest. His color was such. His breathing was such. The mom was also concerned but is going to see on this day and thought it could wait. I was concerned enough about this noise that I thought I should make you aware of it. The doc will probably/hopefully thank you and I would guess the next call would be to the mother. The doc may or may not have seen this baby in the hospital or office or may not know the baby at all. Once you call the doctor, document document document! Ask for the spelling of the name if you have to, time and date of call and what you/he said). Follow up with the family tonight or tomorrow with a phone call.PS if you get a phone tree message, push either the emergency option or the doctors/pharmacy line. This will get you to the answering service after hours. If it is during hours, this will bring a doctor or nurse to the phone. Don't be embarrassed. Just have your information in front you. You may save a baby's life someday - you are there with the baby being the doctors eyes and ears. That is valuable!Dana Schmidt, BS, RN, IBCLC, CLEDana Schmidt, BS, RN, IBCLC, CLECradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.netwww.facebook.com/cradleholdhttp://twitter.com/cradleholdwww.meetup.com/Wednesday-Afternoon-Weigh-InsProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and babyHidden Booby Trap: Is Your Lactation “Specialist†an Imposter? http://www.bestforbabes.org/2010/03/hidden-booby-trap-is-your-lactation-specialist-an-imposter/--- Subject: Re: Calling DocsTo: Date: Sunday, February 6, 2011, 6:13 PM I'll page the service if it's after hours and I think it warrants an immediate evaluation. I've had a few occasions to refer infants to the ED, and I definitely phone the MD in that case. Otherwise I will ask to speak with them. I work with Docs on a daily basis in my hospital role, so it isn't intimidating to me at all to consult with them. And yes, I have had occasion to disagree with them. I think if you approach the circumstance with a collaborative spirit, it wont be a problem. And I'm certain to discuss what the evidence/research shows, which means we must be prepared to provide it. I have had lengthy discussion regarding medication and indications for intervention etc. I think it is a component of our work we should be satisfying, particularly if the infant is in distress and requires immediate evaluation. > > > Hi Ladies, > When you call doctors about a patients condition, do you just call and ask them to call you back? Do you choose the menu option that you are a doctor's office or you want to speak to the nurse? I'm very timid to call docs. I've read that some of you educate them on frenulums and was never a waiste of time. How would you approach this type scenerio or even the one about the squeeky bf thread? Would you post some dialogue? > Thanks, > June , RN, IBCLC > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 And document! I'm familiar with a case involving an infant with elevated bilirubin who was instructed to seek help in an ED for evaluation and labs by a LC, and the parents disregarded this and went home. The LC was called into question during litigation(actually 2 of them 1 saw the patient and 1 took a phone call) for not following up to insure the parents actually followed through as this infant ended up with kernicterus. > > If I see something that I cannot quite explain or wonder if it needs an > evaluation, this is what I do. I would call that mom back today. (You > know this kid is nagging at you that something isn't right) and ask her > how everything is going. " By the way, I noticed the baby making a noise > when I saw him feeding. Is this still continuing? Has the doctor > observed this at all? "  If not, I would ask her to call the doctor and > tell him that you are concerned about the baby making a funny noise when > he is eating. In a newborn, this should perk the doctor's ears up. He > will ask her more questions and make an assessment as to whether or not > the baby should be evaluated immediately. Sometimes pedi's will see a > newborn first in the office. In this case, if there is a question of > breathing/swallowing difficulty, I would imagine he would send the baby > to the E.R. for an oxygen saturation monitoring and evaluation of > input/output, respirations, etc. If the mom agrees to call, be sure to > document your advice and follow up later this evening to see what > happened. > > > > > > > You can ask the mother if you can call the doctor as well. I find they > agree to that because they feel you can better describe something more > than they can (especially when they are nervous something may be wrong). > > > > > > > I call the answering service and ask for the on-call physician > > I ask them to have the on-call physician paged and tell that I am the > lactation consultant who saw this baby in the home (now, this morning, > yesterday) and can he/she please call me back? > > The doctor is going to check his pages pretty frequently and may even be > in the office on a Sunday for acute visits (ear aches, fever, etc) > > > > When the doctor calls back, I identify myself (remember you are an > essential part of the pediatric care team) and tell that you just saw > the baby (ex: jones, date of birth) and this is what you saw. I don't > know that I would go into too much detail about the amount of feeding > other to say you are concerned about the baby's ability to transfer. I > would also say something like, I wanted to report to you that the baby > had a squeaking noise when he was feeding. I did/did not observe that > when he was at rest. His color was such. His breathing was such. The > mom was also concerned but is going to see on this day and thought it > could wait. I was concerned enough about this noise that I thought I > should make you aware of it. > > > > The doc will probably/hopefully thank you and I would guess the next > call would be to the mother. The doc may or may not have seen this baby > in the hospital or office or may not know the baby at all. > > > > Once you call the doctor, document document document! Ask for the > spelling of the name if you have to, time and date of call and what > you/he said). Follow up with the family tonight or tomorrow with a > phone call. > > PS if you get a phone tree message, push either the emergency option or the doctors/pharmacy line. This will get you to the answering service after hours. If it is during hours, this will bring a doctor or nurse to the phone. Don't be embarrassed. Just have your information in front you. You may save a baby's life someday - you are there with the baby being the doctors eyes and ears. That is valuable! > > Dana Schmidt, BS, RN, IBCLC, CLE > > > > > > > > > > > > Dana Schmidt, BS, RN, IBCLC, CLE > Cradlehold, Director > Breastfeeding Education & Support > > www.cradlehold.net > www.facebook.com/cradlehold > http://twitter.com/cradlehold > www.meetup.com/Wednesday-Afternoon-Weigh-Ins > > Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 6, 2011 Report Share Posted February 6, 2011 The noise is called a strider. > If I see something that I cannot quite explain or wonder if it needs an > evaluation, this is what I do. I would call that mom back today. (You > know this kid is nagging at you that something isn't right) and ask her > how everything is going. " By the way, I noticed the baby making a noise > when I saw him feeding. Is this still continuing? Has the doctor > observed this at all? " If not, I would ask her to call the doctor and > tell him that you are concerned about the baby making a funny noise when > he is eating. In a newborn, this should perk the doctor's ears up. He> will ask her more questions and make an assessment as to whether or not> the baby should be evaluated immediately. Sometimes pedi's will see a > newborn first in the office. In this case, if there is a question of > breathing/swallowing difficulty, I would imagine he would send the baby > to the E.R. for an oxygen saturation monitoring and evaluation of > input/output, respirations, etc. If the mom agrees to call, be sure to > document your advice and follow up later this evening to see what > happened.> > > > > > > You can ask the mother if you can call the doctor as well. I find they > agree to that because they feel you can better describe something more > than they can (especially when they are nervous something may be wrong). > > > > > > > I call the answering service and ask for the on-call physician> > I ask them to have the on-call physician paged and tell that I am the > lactation consultant who saw this baby in the home (now, this morning, > yesterday) and can he/she please call me back?> > The doctor is going to check his pages pretty frequently and may even be> in the office on a Sunday for acute visits (ear aches, fever, etc) > > > > When the doctor calls back, I identify myself (remember you are an > essential part of the pediatric care team) and tell that you just saw > the baby (ex: jones, date of birth) and this is what you saw. I don't > know that I would go into too much detail about the amount of feeding > other to say you are concerned about the baby's ability to transfer. I > would also say something like, I wanted to report to you that the baby > had a squeaking noise when he was feeding. I did/did not observe that > when he was at rest. His color was such. His breathing was such. The > mom was also concerned but is going to see on this day and thought it > could wait. I was concerned enough about this noise that I thought I > should make you aware of it.> > > > The doc will probably/hopefully thank you and I would guess the next > call would be to the mother. The doc may or may not have seen this baby> in the hospital or office or may not know the baby at all. > > > > Once you call the doctor, document document document! Ask for the > spelling of the name if you have to, time and date of call and what > you/he said). Follow up with the family tonight or tomorrow with a > phone call.> > PS if you get a phone tree message, push either the emergency option or the doctors/pharmacy line. This will get you to the answering service after hours. If it is during hours, this will bring a doctor or nurse to the phone. Don't be embarrassed. Just have your information in front you. You may save a baby's life someday - you are there with the baby being the doctors eyes and ears. That is valuable! > > Dana Schmidt, BS, RN, IBCLC, CLE> > > > > > > > > > > > Dana Schmidt, BS, RN, IBCLC, CLE> Cradlehold, Director> Breastfeeding Education & Support > > www.cradlehold.net> www.facebook.com/cradlehold> http://twitter.com/cradlehold > www.meetup.com/Wednesday-Afternoon-Weigh-Ins> > Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby > > Hidden Booby Trap: Is Your Lactation “Specialist” an Imposter? http://www.bestforbabes.org/2010/03/hidden-booby-trap-is-your-lactation-specialist-an-imposter/ > > > > > > > > > > > > > > > Subject: Re: Calling Docs> To: > Date: Sunday, February 6, 2011, 6:13 PM> > > > > > > > > > > > > > > > > > I'll page the service if it's after hours and I think it warrants an immediate evaluation. I've had a few occasions to refer infants to the ED, and I definitely phone the MD in that case. Otherwise I will ask to speak with them. I work with Docs on a daily basis in my hospital role, so it isn't intimidating to me at all to consult with them. And yes, I have had occasion to disagree with them. > > > > I think if you approach the circumstance with a collaborative spirit, it wont be a problem. And I'm certain to discuss what the evidence/research shows, which means we must be prepared to provide it. I have had lengthy discussion regarding medication and indications for intervention etc. I think it is a component of our work we should be satisfying, particularly if the infant is in distress and requires immediate evaluation. > > > > > > > > > >>> >> > >> Hi Ladies,> >> When you call doctors about a patients condition, do you just call and ask them to call you back? Do you choose the menu option that you are a doctor's office or you want to speak to the nurse? I'm very timid to call docs. I've read that some of you educate them on frenulums and was never a waiste of time. How would you approach this type scenerio or even the one about the squeeky bf thread? Would you post some dialogue? > >> Thanks,> >> June , RN, IBCLC> >>> > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 7, 2011 Report Share Posted February 7, 2011 Yes, and could be an indicator of two immediate thoughts, tracheomalasia or laryngomalasia. Then you will need to know different postitioning to make sure that this baby can eat comfortably. Do you have any more experienced LC's in the area? Cheryl > > > Subject: Re: Calling Docs> To: > Date: Sunday, February 6, 2011, 6:13 PM> > > > > > > > > > > > > > > > > > I'll page the service if it's after hours and I think it warrants an immediate evaluation. I've had a few occasions to refer infants to the ED, and I definitely phone the MD in that case. Otherwise I will ask to speak with them. I work with Docs on a daily basis in my hospital role, so it isn't intimidating to me at all to consult with them. And yes, I have had occasion to disagree with them.> > > > I think if you approach the circumstance with a collaborative spirit, it wont be a problem. And I'm certain to discuss what the evidence/research shows, which means we must be prepared to provide it. I have had lengthy discussion regarding medication and indications for intervention etc. I think it is a component of our work we should be satisfying, particularly if the infant is in distress and requires immediate evaluation.> > > > > > > > > >>> >> > >> Hi Ladies,> >> When you call doctors about a patients condition, do you just call and ask them to call you back? Do you choose the menu option that you are a doctor's office or you want to speak to the nurse? I'm very timid to call docs. I've read that some of you educate them on frenulums and was never a waiste of time. How would you approach this type scenerio or even the one about the squeeky bf thread? Would you post some dialogue?> >> Thanks,> >> June , RN, IBCLC> >>> > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 8, 2011 Report Share Posted February 8, 2011 Both can be effectively treated, sometimes even to the point of disappearing using bodywork. You do not nee dot just wait for the condition to resolve on its own. Tow, IBCLC, Paris(currently), FR > > > >> > > > >> > > > >> Hi Ladies, > > > >> When you call doctors about a patients condition, do you just call and ask them to call you back? Do you choose the menu option that you are a doctor's office or you want to speak to the nurse? I'm very timid to call docs. I've read that some of you educate them on frenulums and was never a waiste of time. How would you approach this type scenerio or even the one about the squeeky bf thread? Would you post some dialogue? > > > >> Thanks, > > > >> June , RN, IBCLC > > > >> > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.