Re: Consents for Breastfeeding Support Group?

[Guest guest]

No you can't separate the two. Sent from my iPhone

My point is you're not "being" a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM

The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone

Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM

No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone

Ladies, Some food for thought…. If a mother cannot afford a necessary consult and she comes

to your support group where you end up providing an individual assessment of

the problem for her, such as evaluating the oral anatomy of the infant or providing

any other “individual†advice, are you in compliance with the “dutiesâ€

in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for

mothers and families by: • performing

comprehensive maternal, child and feeding assessments related

to lactation • developing

and implementing an individualized feeding plan in consultation

with the mother IBCLCs have the duty to report truthfully and fully to the

mother and/or infant’s primary health care provider and to the health

care system by: • recording

all relevant information concerning care provided and, where appropriate,

retaining records for the time specified by the local jurisdiction IBCLCs have the duty to preserve client confidence by: • respecting

the privacy, dignity and confidentiality of mothers and Families IBCLCs have the duty to act with reasonable diligence by: • assisting

families with decisions regarding the feeding of children by providing

information that is evidence-based and free of conflict of interest • providing

follow-up services as required • making

necessary referrals to other health care providers and community support

resources when necessary • functioning

and contributing as a member of the health care team to deliver

coordinated services to women and families • working

collaboratively and interdependently with other members of the health care team Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

Phone Fax

Reply to sender |

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(9)

[Guest guest]

My group is a "drop in support group." there is a suggested donation. I try to get to each individual mom if there is a latch problem. Babies are weighed. sometimes I look in a baby's mouth, but I don't do a major exam. I answer questions and recommend a full visit if there's a concern--especially if baby hasn't gained much weight. but really it's for check in and support and moms love to weight their babies! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Consents for Breastfeeding Support Group?To: Date: Friday, November 18, 2011, 6:37 PM

I am having a hard time figuring out how you can do full

visits (as in items 1 and 2) to accomplish all the needed items per our scope

of practice at a meeting. You must be there for hours. And then you have to go

home to do all the paperwork and correspond with the physicians. So if you have the mom attending your group for free or a minimal

fee are you doing the following per our scope of practice?

1. performing comprehensive

maternal, child and feeding assessments related to lactation

2. developing and implementing an individualized feeding plan in consultation

with the mother

3. reporting truthfully and fully to the mother and/or infant's primary health

care provider and to the health care system by: recording all relevant

information concerning care provided and, where

appropriate, retaining records for the time specified by the local jurisdiction.

AND relevant to the above, a. making necessary referrals to

other health care providers and community support resources when necessary

b. functioning and contributing as a member of the health care team to deliver

coordinated services to women and families

c. working collaboratively and interdependently with other members of the health

care team

4. Getting a signed HIPPA

agreement - respecting the privacy, dignity and confidentiality of mothers and

Families

5. providing follow-up services as required and if so are you charging then?

Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

Phone Fax

[Guest guest]

To be honest probably not and if I am required to do that, I will discontinue it. What point would that serve?Sent from my iPhone

I am having a hard time figuring out how you can do full

visits (as in items 1 and 2) to accomplish all the needed items per our scope

of practice at a meeting. You must be there for hours. And then you have to go

home to do all the paperwork and correspond with the physicians.

So if you have the mom attending your group for free or a minimal

fee are you doing the following per our scope of practice?

1. performing comprehensive

maternal, child and feeding assessments related to lactation

2. developing and implementing an individualized feeding plan in consultation

with the mother

3. reporting truthfully and fully to the mother and/or infant's primary health

care provider and to the health care system by: recording all relevant

information concerning care provided and, where

appropriate, retaining records for the time specified by the local jurisdiction.

AND relevant to the above,

a. making necessary referrals to

other health care providers and community support resources when necessary

b. functioning and contributing as a member of the health care team to deliver

coordinated services to women and families

c. working collaboratively and interdependently with other members of the health

care team

4. Getting a signed HIPPA

agreement - respecting the privacy, dignity and confidentiality of mothers and

Families

5. providing follow-up services as required and if so are you charging then?

Judy

Judith

L. Gutowski, BA, IBCLC, RLC

135 McGrath Lane

P Box 1

Hannastown, PA 15635-0001

Cell

Phone

Fax

[Guest guest]

interesting... i disagree, but i'm not a nurse, so I don't have that perspective. but I know a birth doula who's a midwife by training, but she is a doula on the job. For many years I did more postpartum doula work even though I was IBCLC and definitely had to wear a different hat. it's not easy, for sure.i see groups as for general support--not having the same scope as a private consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:39 PM

No you can't separate the two. Sent from my iPhone

My point is you're not "being" a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM

The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone

Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM

No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone

Ladies, Some food for thought…. If a mother cannot afford a necessary consult and she comes

to your support group where you end up providing an individual assessment of

the problem for her, such as evaluating the oral anatomy of the infant or providing

any other “individual†advice, are you in compliance with the “dutiesâ€

in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for

mothers and families by: • performing

comprehensive maternal, child and feeding assessments related

to lactation • developing

and implementing an individualized feeding plan in consultation

with the mother IBCLCs have the duty to report truthfully and fully to the

mother and/or infant’s primary health care provider and to the health

care system by: • recording

all relevant information concerning care provided and, where appropriate,

retaining records for the time specified by the local jurisdiction IBCLCs have the duty to preserve client confidence by: • respecting

the privacy, dignity and confidentiality of mothers and Families IBCLCs have the duty to act with reasonable diligence by: • assisting

families with decisions regarding the feeding of children by providing

information that is evidence-based and free of conflict of interest • providing

follow-up services as required • making

necessary referrals to other health care providers and community support

resources when necessary • functioning

and contributing as a member of the health care team to deliver

coordinated services to women and families • working

collaboratively and interdependently with other members of the health care team Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

Phone Fax

Reply to sender |

Reply to group |

Reply via web post |

Start a New Topic

Messages in this topic

(9)

[Guest guest]

Dana, I just referred someone to you in the tongue tie fb group. i hope she calls! Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support

Group?To: " " < >Date: Friday, November 18, 2011, 6:42 PM

To be honest probably not and if I am required to do that, I will discontinue it. What point would that serve?Sent from my iPhone

I am having a hard time figuring out how you can do full

visits (as in items 1 and 2) to accomplish all the needed items per our scope

of practice at a meeting. You must be there for hours. And then you have to go

home to do all the paperwork and correspond with the physicians. So if you have the mom attending your group for free or a minimal

fee are you doing the following per our scope of practice?

1. performing comprehensive

maternal, child and feeding assessments related to lactation

2. developing and implementing an individualized feeding plan in consultation

with the mother

3. reporting truthfully and fully to the mother and/or infant's primary health

care provider and to the health care system by: recording all relevant

information concerning care provided and, where

appropriate, retaining records for the time specified by the local jurisdiction.

AND relevant to the above, a. making necessary referrals to

other health care providers and community support resources when necessary

b. functioning and contributing as a member of the health care team to deliver

coordinated services to women and families

c. working collaboratively and interdependently with other members of the health

care team

4. Getting a signed HIPPA

agreement - respecting the privacy, dignity and confidentiality of mothers and

Families

5. providing follow-up services as required and if so are you charging then?

Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

Phone Fax

[Guest guest]

I agree about the groups. This is just way to complicated!Sent from my iPhone

interesting... i disagree, but i'm not a nurse, so I don't have that perspective. but I know a birth doula who's a midwife by training, but she is a doula on the job. For many years I did more postpartum doula work even though I was IBCLC and definitely had to wear a different hat. it's not easy, for sure.i see groups as for general support--not having the same scope as a private consult. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:39 PM

No you can't separate the two. Sent from my iPhone

My point is you're not "being" a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM

The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone

Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM

No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone

Ladies, Some food for thought…. If a mother cannot afford a necessary consult and she comes

to your support group where you end up providing an individual assessment of

the problem for her, such as evaluating the oral anatomy of the infant or providing

any other “individual†advice, are you in compliance with the “dutiesâ€

in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for

mothers and families by: • performing

comprehensive maternal, child and feeding assessments related

to lactation • developing

and implementing an individualized feeding plan in consultation

with the mother IBCLCs have the duty to report truthfully and fully to the

mother and/or infant’s primary health care provider and to the health

care system by: • recording

all relevant information concerning care provided and, where appropriate,

retaining records for the time specified by the local jurisdiction IBCLCs have the duty to preserve client confidence by: • respecting

the privacy, dignity and confidentiality of mothers and Families IBCLCs have the duty to act with reasonable diligence by: • assisting

families with decisions regarding the feeding of children by providing

information that is evidence-based and free of conflict of interest • providing

follow-up services as required • making

necessary referrals to other health care providers and community support

resources when necessary • functioning

and contributing as a member of the health care team to deliver

coordinated services to women and families • working

collaboratively and interdependently with other members of the health care team Judy Judith

L. Gutowski, BA, IBCLC, RLC 135 McGrath Lane P Box 1 Hannastown, PA 15635-0001 Cell

[Guest guest]

Add to the goal of the SoP to discourage support groups? This makes no sense to

me at all.

Pam M.

Pam MazzellaDiBosco. IBCLC

[Guest guest]

:(Sent from my iPhoneOn Nov 18, 2011, at 10:00 PM, "Pam MazzellaDiBosco" wrote:

Add to the goal of the SoP to discourage support groups? This makes no sense to me at all.

Pam M.

Pam MazzellaDiBosco. IBCLC

[Guest guest]

IMO; you MUST separate your RN and IBCLC in PP or LLL or volunteer groups. As an RN you work under standing orders of a physician ... CAN RNs work independently like LC's?? You can assess the mothers situation utilizing your RN background but you are NOT working as an RN in PP so to protect your license you should separate the 2 real fast. If I'm out of line please feel free to respond, as I am so sick of hearing RN IBCLC vs non RN Ibclc , just because a certain percent of LC's are RNs it is NOT required Instead why don't we say non doulas or non child birth educators....or non.???? Sorry struck a nerve.... Oh and please remember what it was like as a new LC and please remember you were not in the room during others consults so you have NO idea what was said or presented.... Taking a mothers word is a dangerous and I feel unprofessional approach to judging your fellow LC ... New OR old......this is a common occurrence in the dental world ...folks getting second opinions bc the dentist said..,xyz.... I listen but say okLet's move forward with today... Sent from my iPhone

:(Sent from my iPhoneOn Nov 18, 2011, at 10:00 PM, "Pam MazzellaDiBosco" wrote:

Add to the goal of the SoP to discourage support groups? This makes no sense to me at all.

Pam M.

Pam MazzellaDiBosco. IBCLC

[Guest guest]

I know what you mean! I am so sick of hearing RN IBCLC vs non RN Ibclc , just because a certain percent of LC's are RNs it is NOT required Instead why don't we say non doulas or non child birth educators....or non.???? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re:

Re: Consents for Breastfeeding Support Group?To: " " < >Cc: " " < >Date: Friday, November 18, 2011, 8:51 PM

IMO; you MUST separate your RN and IBCLC in PP or LLL or volunteer groups. As an RN you work under standing orders of a physician ... CAN RNs work independently like LC's?? You can assess the mothers situation utilizing your RN background but you are NOT working as an RN in PP so to protect your license you should separate the 2 real fast. If I'm out of line please feel free to respond, as I am so sick of hearing RN IBCLC vs non RN Ibclc , just because a certain percent of LC's are RNs it is NOT required Instead why don't we say non doulas or non child birth educators....or non.???? Sorry struck a nerve.... Oh and please remember what it was like as a new LC and please remember you were not in the room during others consults so you have NO idea what was said or presented....

Taking a mothers word is a dangerous and I feel unprofessional approach to judging your fellow LC ... New OR old......this is a common occurrence in the dental world ...folks getting second opinions bc the dentist said..,xyz.... I listen but say okLet's move forward with today... Sent from my iPhone

:(Sent from my iPhoneOn Nov 18, 2011, at 10:00 PM, "Pam MazzellaDiBosco" wrote:

Add to the goal of the SoP to discourage support groups? This makes no sense to me at all.

Pam M.

Pam MazzellaDiBosco. IBCLC

[Guest guest]

I now do consent forms for my group. I started this before a JD, now IBCLC

started training with me. Actually she is one of those trainees that didn't

really need training and so now she comes and we have a great time bouncing

ideas off each other. She is planning on doing a whole workshop for us on

paperwork as a follow on to a great day long session with Liz . It is not

your typical workshop -- more like a training course where we are actually going

to write our own paperwork --- or improve the paperwork we have.

I have no qualms about referring mothers to other practitioners including the

pediatric ENT who evaluates what she does NOT consider to be posterior tongue

tie, but does consider to be a jaw configuration that makes it challenging for

babies to open -- for which opening the connective tissue under the tongue

improves the ability to open. The end result is the same. The reason why I

have no qualm about it is because we are considered health care practitioners in

our own right. I don't diagnose, I refer to someone who is capable of

diagnosing this condition far better than any IBCLC (except maybe Genna)

or pediatrician.

It is a pretty simple thing to ask for a consent if you have a special

circumstance in a group that requires talking to a client's doctor. I now do it

routinely to CMA because of a doctor for whom I see at least 2-3 really bad

failure to thrive cases a year that he has declared perfectly fine. And by

failure to thrive I don't mean " a little slow growth " . I mean six weeks and at

birth weight or 10% below birth weight at three weeks or falling off the charts

because " the baby needs to sleep and that's why the baby isn't growing " . Then I

can write a report and make it clear that I've noticed the growth and what I've

recommended in case the recommendation is to tough it out and make that baby

sleep for 12 hours so she or he can grow. Fortunately most mothers find that

advice ridiculous when their babies are in such poor shape. They KNOW.

Best regards,

E. Burger, MHS, PhD, IBCLC

[Guest guest]

Neither if those are state licensed. My RN is my license, my IBCLC is my certification that shows my area of expertiseSent from my iPhone

I know what you mean! I am so sick of hearing RN IBCLC vs non RN Ibclc , just because a certain percent of LC's are RNs it is NOT required Instead why don't we say non doulas or non child birth educators....or non.???? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re:

Re: Consents for Breastfeeding Support Group?To: " " < >Cc: " " < >Date: Friday, November 18, 2011, 8:51 PM

IMO; you MUST separate your RN and IBCLC in PP or LLL or volunteer groups. As an RN you work under standing orders of a physician ... CAN RNs work independently like LC's?? You can assess the mothers situation utilizing your RN background but you are NOT working as an RN in PP so to protect your license you should separate the 2 real fast. If I'm out of line please feel free to respond, as I am so sick of hearing RN IBCLC vs non RN Ibclc , just because a certain percent of LC's are RNs it is NOT required Instead why don't we say non doulas or non child birth educators....or non.???? Sorry struck a nerve.... Oh and please remember what it was like as a new LC and please remember you were not in the room during others consults so you have NO idea what was said or presented....

Taking a mothers word is a dangerous and I feel unprofessional approach to judging your fellow LC ... New OR old......this is a common occurrence in the dental world ...folks getting second opinions bc the dentist said..,xyz.... I listen but say okLet's move forward with today... Sent from my iPhone

:(Sent from my iPhoneOn Nov 18, 2011, at 10:00 PM, "Pam MazzellaDiBosco" wrote:

Add to the goal of the SoP to discourage support groups? This makes no sense to me at all.

Pam M.

Pam MazzellaDiBosco. IBCLC

[Guest guest]

I hear your point and this is why I support the licensure/registration process

for IBCLCs at the state level to strengthen our ability to function within the

healthcare team.

However on the same hand it is important to recognize that there are other

professions that practice within a discipline who are not 'licensed', yet they

are certified.

For example there are Certified Professional Midwives CPMs, who are not licensed

within states that do not offer a licensed midwifery option, and they may still

legally practice. This varies by state. I have worked as a Registered Counselor,

which does not require licensure.

The credential which provides evidence of the ability to perform lactation

evaluation and assessment is the IBCLC, not the RN. Clearly there are thousands

of IBCLCs performing the job functions of lactation support who do not possess

the RN credential.

For liability purposes I can see where it would be difficult to distinguish your

'role', I suppose this is a good question for a JD, or the insurance company

which holds your liability policy.

>

> > I know what you mean!

> >

[Guest guest]

Exactly!Sent from my iPhone

I hear your point and this is why I support the licensure/registration process for IBCLCs at the state level to strengthen our ability to function within the healthcare team.

However on the same hand it is important to recognize that there are other professions that practice within a discipline who are not 'licensed', yet they are certified.

For example there are Certified Professional Midwives CPMs, who are not licensed within states that do not offer a licensed midwifery option, and they may still legally practice. This varies by state. I have worked as a Registered Counselor, which does not require licensure.

The credential which provides evidence of the ability to perform lactation evaluation and assessment is the IBCLC, not the RN. Clearly there are thousands of IBCLCs performing the job functions of lactation support who do not possess the RN credential.

For liability purposes I can see where it would be difficult to distinguish your 'role', I suppose this is a good question for a JD, or the insurance company which holds your liability policy.

>

> > I know what you mean!

> >

[Guest guest]

I’m an RN and an IBCLC, and I do think it’s possible to separate the two. I don’t worry about my licence as an RN when I’m doing a consult, because everything that I do as an IBCLC falls within my scope of practice as an RN. Perhaps it’s different in the US, but here, it is possible for RNs to work independently (in private practice). I could have started a private practice doing lactation consultations as an RN, even without my IBCLC certification (although I chose not to do that). You do not need to have doctors orders for everything you do as an RN. Although everything I do as an IBCLC falls within my scope of practice as an RN, it is my certification as an IBCLC that gives me the knowledge I need to help with breastfeeding. I received very little training on it as an RN and yet it was part of my job on the obstetrical unit to help with breastfeeding! There are things that I may do in my private practice such as listening to a baby’s heart or lungs, taking moms blood pressure, examining an incision site for signs of infection etc. (and referring appropriately if needed) that fall under my scope of practice as an RN, that I would not be able to do if I was a non-RN IBCLC, but my ability to help with complex breastfeeding issues is thanks to my training as an IBCLC.Warmly,Fleur Bickford BSc., RN, IBCLCOttawa, Ontario From: [mailto: ] On Behalf Of CradleholdSent: November-18-11 9:40 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? No you can't separate the two. Sent from my iPhone My point is you're not " being " a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone Ladies, Some food for thought….If a mother cannot afford a necessary consult and she comes to your support group where you end up providing an individual assessment of the problem for her, such as evaluating the oral anatomy of the infant or providing any other “individual†advice, are you in compliance with the “duties†in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for mothers andfamilies by:• performing comprehensive maternal, child and feeding assessmentsrelated to lactation• developing and implementing an individualized feeding plan inconsultation with the motherIBCLCs have the duty to report truthfully and fully to the mother and/orinfant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, whereappropriate, retaining records for the time specified by the localjurisdictionIBCLCs have the duty to preserve client confidence by:• respecting the privacy, dignity and confidentiality of mothers andFamiliesIBCLCs have the duty to act with reasonable diligence by:• assisting families with decisions regarding the feeding of children byproviding information that is evidence-based and free of conflict ofinterest• providing follow-up services as required• making necessary referrals to other health care providers and communitysupport resources when necessary• functioning and contributing as a member of the health care team todeliver coordinated services to women and families• working collaboratively and interdependently with other members of thehealth care team JudyJudith L. Gutowski, BA, IBCLC, RLC135 McGrath LaneP Box 1Hannastown, PA 15635-0001Cell Phone Fax Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (9)

[Guest guest]

These both sound similar but different. Both require reporting to the health care provider. To make a long story short, if I address a breastfeeding "problem" at a group and the mom is not there simply for socializing, they will become my client. They will fill out all of the paperwork and consents as a client does. And I will file a report to the doc. period. Because the truth is the general public perceives RNs as having deep pockets. They would come after my license and my liability if I did not have a MD overseeing what I do. There is no way I would ever consider myself an independent stand alone provider even if I could. For me personally, I could not be an IBCLC if I were not a nurse first. AGAIN FOR ME. With that being said and with the

state of the economy as it is, I can never lose my nursing license and all that that offers me (not to mention how freakin hard it was to become a nurse and pass those boards - nurses you know what I mean). FOR ME, I have to document, document, document so that's what I'll do.The CT nurse practice ACT Sec. 20-87a. Definitions. Scope of practice.

(a) The practice of nursing by a registered nurse is defined as the process of diagnosing human responses to actual or potential health problems, providing supportive and restorative care, health counseling and teaching, case finding and referral, collaborating in the implementation of the total health care regimen, and executing the medical regimen under the direction of a licensed physician, dentist or advanced practice registered nurse.Scope of PracticeforInternational Board Certified Lactation ConsultantsIBCLCs have the duty to report truthfully and fully to the mother and/or infant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, where appropriate, retaining records for the time specified by the local jurisdiction. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby From: Fleur

To: Sent: Saturday, November 19, 2011 7:29 PM Subject: RE: Re: Consents for Breastfeeding Support Group?

I’m an RN and an IBCLC, and I do think it’s possible to separate the two. I don’t worry about my licence as an RN when I’m doing a consult, because everything that I do as an IBCLC falls within my scope of practice as an RN. Perhaps it’s different in the US, but here, it is possible for RNs to work independently (in private practice). I could have started a private practice doing lactation consultations as an RN, even without my IBCLC certification (although I chose not to do that). You do not need to have doctors orders for everything you do as an RN. Although everything I do as an IBCLC falls within my scope of practice as an RN, it is my certification as an IBCLC that gives me the knowledge I need to help with breastfeeding. I

received very little training on it as an RN and yet it was part of my job on the obstetrical unit to help with breastfeeding! There are things that I may do in my private practice such as listening to a baby’s heart or lungs, taking moms blood pressure, examining an incision site for signs of infection etc. (and referring appropriately if needed) that fall under my scope of practice as an RN, that I would not be able to do if I was a non-RN IBCLC, but my ability to help with complex breastfeeding issues is thanks to my training as an IBCLC.Warmly,Fleur Bickford BSc., RN, IBCLCOttawa, Ontario From: [mailto: ] On Behalf Of CradleholdSent: November-18-11 9:40 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? No you can't separate the two. Sent from my iPhone My point is you're not "being" a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. Ladies, Some food for thought….If a mother cannot afford a necessary consult and she comes to your support group where you end up providing an individual assessment of the problem for her, such as evaluating the oral anatomy of the infant or providing any other “individual†advice, are you in compliance with the “duties†in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for mothers andfamilies by:• performing comprehensive maternal, child and feeding assessmentsrelated to lactation• developing and implementing an individualized feeding plan inconsultation with the motherIBCLCs have the duty to report truthfully and fully to the mother and/orinfant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, whereappropriate, retaining records for the time specified by the localjurisdictionIBCLCs have the duty to preserve client confidence by:• respecting the privacy, dignity and confidentiality of mothers andFamiliesIBCLCs have the duty to act with reasonable diligence by:• assisting families with decisions regarding the feeding of children byproviding information that is evidence-based and free of conflict ofinterest• providing follow-up services as required• making necessary referrals to other health care providers and

communitysupport resources when necessary• functioning and contributing as a member of the health care team todeliver coordinated services to women and families• working collaboratively and interdependently with other members of thehealth care team JudyJudith L. Gutowski, BA, IBCLC, RLC135 McGrath LaneP Box 1Hannastown, PA 15635-0001Cell Phone Fax Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (9)

[Guest guest]

Interesting, The scope of Practice for nurses in Ontario says nothing about being under the direction of a physician: Nursing’s Scope of Practice StatementThe practice of nursing is the promotion of healthand the assessment of, the provision of, care for, andthe treatment of, health conditions by supportive,preventive, therapeutic, palliative and rehabilitativemeans in order to attain or maintain optimal function.(Nursing Act, 1991) Obviously Dana, you have to do what you are comfortable with and what makes the most sense for your family. I do document everything, and I don’t run a support group at the moment, so I haven’t needed to worry about the logistics of that. We do have numerous breastfeeding support drop-in clinics in Ottawa, and I occasionally work at one of them. We are not able to take the time to do full consults on each mother, and we don’t report to the mother’s dr usually, but the visit is documented. So interesting to read about the differences in practice in different areas. Warmly,Fleur From: [mailto: ] On Behalf Of Dana SchmidtSent: November-19-11 7:55 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? These both sound similar but different. Both require reporting to the health care provider. To make a long story short, if I address a breastfeeding " problem " at a group and the mom is not there simply for socializing, they will become my client. They will fill out all of the paperwork and consents as a client does. And I will file a report to the doc. period. Because the truth is the general public perceives RNs as having deep pockets. They would come after my license and my liability if I did not have a MD overseeing what I do. There is no way I would ever consider myself an independent stand alone provider even if I could. For me personally, I could not be an IBCLC if I were not a nurse first. AGAIN FOR ME. With that being said and with the state of the economy as it is, I can never lose my nursing license and all that that offers me (not to mention how freakin hard it was to become a nurse and pass those boards - nurses you know what I mean). FOR ME, I have to document, document, document so that's what I'll do. The CT nurse practice ACT Sec. 20-87a. Definitions. Scope of practice. (a) The practice of nursing by a registered nurse is defined as the process of diagnosing human responses to actual or potential health problems, providing supportive and restorative care, health counseling and teaching, case finding and referral, collaborating in the implementation of the total health care regimen, and executing the medical regimen under the direction of a licensed physician, dentist or advanced practice registered nurse. Scope of PracticeforInternational Board Certified Lactation Consultants IBCLCs have the duty to report truthfully and fully to the mother and/or infant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, where appropriate, retaining records for the time specified by the local jurisdiction. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Saturday, November 19, 2011 7:29 PMSubject: RE: Re: Consents for Breastfeeding Support Group? I’m an RN and an IBCLC, and I do think it’s possible to separate the two. I don’t worry about my licence as an RN when I’m doing a consult, because everything that I do as an IBCLC falls within my scope of practice as an RN. Perhaps it’s different in the US, but here, it is possible for RNs to work independently (in private practice). I could have started a private practice doing lactation consultations as an RN, even without my IBCLC certification (although I chose not to do that). You do not need to have doctors orders for everything you do as an RN. Although everything I do as an IBCLC falls within my scope of practice as an RN, it is my certification as an IBCLC that gives me the knowledge I need to help with breastfeeding. I received very little training on it as an RN and yet it was part of my job on the obstetrical unit to help with breastfeeding! There are things that I may do in my private practice such as listening to a baby’s heart or lungs, taking moms blood pressure, examining an incision site for signs of infection etc. (and referring appropriately if needed) that fall under my scope of practice as an RN, that I would not be able to do if I was a non-RN IBCLC, but my ability to help with complex breastfeeding issues is thanks to my training as an IBCLC.Warmly,Fleur Bickford BSc., RN, IBCLCOttawa, Ontario From: [mailto: ] On Behalf Of CradleholdSent: November-18-11 9:40 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? No you can't separate the two. Sent from my iPhone My point is you're not " being " a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone Ladies, Some food for thought….If a mother cannot afford a necessary consult and she comes to your support group where you end up providing an individual assessment of the problem for her, such as evaluating the oral anatomy of the infant or providing any other “individual†advice, are you in compliance with the “duties†in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for mothers andfamilies by:• performing comprehensive maternal, child and feeding assessmentsrelated to lactation• developing and implementing an individualized feeding plan inconsultation with the motherIBCLCs have the duty to report truthfully and fully to the mother and/orinfant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, whereappropriate, retaining records for the time specified by the localjurisdictionIBCLCs have the duty to preserve client confidence by:• respecting the privacy, dignity and confidentiality of mothers andFamiliesIBCLCs have the duty to act with reasonable diligence by:• assisting families with decisions regarding the feeding of children byproviding information that is evidence-based and free of conflict ofinterest• providing follow-up services as required• making necessary referrals to other health care providers and communitysupport resources when necessary• functioning and contributing as a member of the health care team todeliver coordinated services to women and families• working collaboratively and interdependently with other members of thehealth care team JudyJudith L. Gutowski, BA, IBCLC, RLC135 McGrath LaneP Box 1Hannastown, PA 15635-0001Cell Phone Fax Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (9)

[Guest guest]

Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Saturday, November 19, 2011 8:41 PM Subject: RE: Re: Consents for Breastfeeding Support Group?

Interesting, The scope of Practice for nurses in Ontario says nothing about being under the direction of a physician: Nursing’s Scope of Practice StatementThe practice of nursing is the promotion of healthand the assessment of, the provision of, care for, andthe treatment of, health conditions by supportive,preventive, therapeutic, palliative and rehabilitativemeans in order to attain or maintain optimal function.(Nursing Act, 1991) Obviously Dana, you have to do what you are comfortable with and what makes the most sense for your family. I do document everything, and I don’t run a support group at the moment, so I haven’t needed to worry about the logistics of that. We do have numerous breastfeeding support drop-in clinics in Ottawa, and I occasionally work at one of them. We are not able to take the time to do full consults on each mother,

and we don’t report to the mother’s dr usually, but the visit is documented. So interesting to read about the differences in practice in different areas. Warmly,Fleur From:

[mailto: ] On Behalf Of Dana SchmidtSent: November-19-11 7:55 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? These both sound similar but different. Both require reporting to the health care provider. To make a long story short, if I address a breastfeeding "problem" at a group and the mom is not there simply for socializing, they will become my client. They will fill out all of the paperwork and consents as a client does. And I will file a report to the doc. period.

Because the truth is the general public perceives RNs as having deep pockets. They would come after my license and my liability if I did not have a MD overseeing what I do. There is no way I would ever consider myself an independent stand alone provider even if I could. For me personally, I could not be an IBCLC if I were not a nurse first. AGAIN FOR ME. With that being said and with the state of the economy as it is, I can never lose my nursing license and all that that offers me (not to mention how freakin hard it was to become a nurse and pass those boards - nurses you know what I mean). FOR ME, I have to document, document, document so that's what I'll do. The CT nurse practice

ACT Sec. 20-87a. Definitions. Scope of practice. (a) The practice of nursing by a registered nurse is defined as the process of diagnosing human responses to actual or potential health problems, providing supportive and restorative care, health counseling and teaching, case finding and referral, collaborating in the implementation of the total health care regimen, and executing the medical regimen under the direction of a licensed physician, dentist or advanced practice registered nurse. Scope of PracticeforInternational Board Certified Lactation Consultants IBCLCs have the duty to report truthfully and fully to the mother and/or infant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, where appropriate, retaining records for the time specified by the local jurisdiction. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby

To: Sent: Saturday, November 19, 2011 7:29 PMSubject: RE: Re: Consents for Breastfeeding Support Group? I’m an RN and an IBCLC, and I do

think it’s possible to separate the two. I don’t worry about my licence as an RN when I’m doing a consult, because everything that I do as an IBCLC falls within my scope of practice as an RN. Perhaps it’s different in the US, but here, it is possible for RNs to work independently (in private practice). I could have started a private practice doing lactation consultations as an RN, even without my IBCLC certification (although I chose not to do that). You do not need to have doctors orders for everything you do as an RN. Although everything I do as an IBCLC falls within my scope of practice as an RN, it is my certification as an IBCLC that gives me the knowledge I need to help with breastfeeding. I received very little training on it as an RN and yet it was part of my job on the

obstetrical unit to help with breastfeeding! There are things that I may do in my private practice such as listening to a baby’s heart or lungs, taking moms blood pressure, examining an incision site for signs of infection etc. (and referring appropriately if needed) that fall under my scope of practice as an RN, that I would not be able to do if I was a non-RN IBCLC, but my ability to help with complex breastfeeding issues is thanks to my training as an IBCLC.Warmly,Fleur Bickford BSc., RN, IBCLCOttawa, Ontario From: [mailto: ] On Behalf Of CradleholdSent: November-18-11 9:40 PMTo: Subject: Re: Re: Consents for Breastfeeding Support Group? No you can't separate the two. Sent from my iPhone My point is you're not "being" a nurse. You are being a LC. it's important to make that distinction IMO. that's when things get confusing to the public and LC's start arguing with one another. IBCLC is a stand alone cert. right? Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- On

Fri, 11/18/11, Cradlehold wrote:Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:28 PM The person who wants to sue me would care for working without doctors orders. I'm really not sure I can say what I do is not both a nurse and IBCLC. Yes I am an advocate and yes I look in baby's mouths but I still have to protect my license as a nurse. Don't any other nurses have the same concerns?Sent from my iPhone Yes...that's what I was saying. who cares if you're an RN? that's irrelevant. I'm a Reiki

practitioner and a special ed teacher, but that's not why the moms are coming to me. who knows? maybe I'm a brain surgeon. doesn't matter. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months. --- From: Cradlehold

Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Friday, November 18, 2011, 6:14 PM No I am not that comprehensive at a free group but now I think you're saying I should be and also being an RN has less to do with it than ring IBCLC ?Sent from my iPhone Ladies, Some food

for thought….If a mother cannot afford a necessary consult and she comes to your support group where you end up providing an individual assessment of the problem for her, such as evaluating the oral anatomy of the infant or providing any other “individual†advice, are you in compliance with the “duties†in the following items of the IBCLC Scope of Practice? Is this really helpful to the mother? IBCLCs have the duty to provide competent services for mothers andfamilies by:• performing comprehensive maternal, child and feeding assessmentsrelated to

lactation• developing and implementing an individualized feeding plan inconsultation with the motherIBCLCs have the duty to report truthfully and fully to the mother and/orinfant’s primary health care provider and to the health care system by:• recording all relevant information concerning care provided and, whereappropriate, retaining records for the time specified by the localjurisdictionIBCLCs have the duty to preserve client confidence by:• respecting the privacy,

dignity and confidentiality of mothers andFamiliesIBCLCs have the duty to act with reasonable diligence by:• assisting families with decisions regarding the feeding of children byproviding information that is evidence-based and free of conflict ofinterest• providing follow-up services as required• making necessary referrals to other health care providers and communitysupport resources when necessary• functioning and contributing as a member of the health care team todeliver coordinated services to women and families• working collaboratively and interdependently with other members of thehealth care team JudyJudith L. Gutowski, BA, IBCLC, RLC135 McGrath LaneP Box 1Hannastown, PA 15635-0001Cell Phone Fax Reply to sender | Reply to group | Reply via web post | Start a New Topic Messages in this topic (9)

[Guest guest]

Genuine question.

Being the case that you must have a MD overseeing what you do as you have

indicated, how do you operate a private practice (or do you work for a

physician)?

>

> These both sound similar but different. Both require reporting to the health

care provider.  To make a long story short, if I address a breastfeeding

" problem " at a group and the mom is not there simply for socializing, they will

become my client.  They will fill out all of the paperwork and consents as a

client does.  And I will file a report to the doc.  period.    Because the

truth is the general public perceives RNs as having deep pockets.  They would

come after my license and my liability if I did not have a MD overseeing what I

do.  There is no way I would ever consider myself an independent stand alone

provider even if I could.  For me personally, I could not be an IBCLC if I were

not a nurse first.  AGAIN FOR ME.  With that being said and with the state of

the economy as it is, I can never lose my nursing license and all that that

offers me (not to mention how freakin hard it was to become a nurse and pass

those boards - nurses you

> know what I mean).  FOR ME, I have to document, document, document so that's

what I'll do.

>

>

> The CT nurse practice ACT

>

>    Sec. 20-87a. Definitions. Scope of practice.(a) The practice of nursing

by a registered nurse is defined as the

> process of diagnosing human responses to actual or potential health

> problems, providing supportive and restorative care, health counseling

> and teaching, case finding and referral, collaborating in the

> implementation of the total health care regimen, and executing the

> medical regimenunder the direction of a licensed physician, dentist or

> advanced practice registered nurse.

>

> Scope of Practice

> for

> International Board Certified Lactation Consultants

>

>

> IBCLCs have the duty to report truthfully and fully to the mother and/or

infant’s primary health care provider and to the health care system by:

> • recording all relevant information concerning care provided and, where

appropriate, retaining records for the time specified by the local jurisdiction.

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

>

[Guest guest]

I work off a physician. I take physician referrals. If the patient self-refers, I always report back to the physician. That's my training as a nurse. If you are not a nurse, it may be different. I don't know. I was a nurse first. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the

minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Saturday, November 19, 2011 8:55 PM Subject: Re: Consents for Breastfeeding Support Group?

Genuine question.

Being the case that you must have a MD overseeing what you do as you have indicated, how do you operate a private practice (or do you work for a physician)?

>

> These both sound similar but different. Both require reporting to the health care provider. To make a long story short, if I address a breastfeeding "problem" at a group and the mom is not there simply for socializing, they will become my client. They will fill out all of the paperwork and consents as a client does. And I will file a report to the doc. period.   Because the truth is the general public perceives RNs as having deep pockets. They would come after my license and my liability if I did not have a MD overseeing what I do. There is no way I would ever consider myself an independent stand alone provider even if I could. For me personally, I could not be an IBCLC if I were not a nurse first. AGAIN FOR ME. With that being said and with the state of the economy as it is, I can never lose my nursing license and all that that offers me (not to mention

how freakin hard it was to become a nurse and pass those boards - nurses you

> know what I mean). FOR ME, I have to document, document, document so that's what I'll do.

>

>

> The CT nurse practice ACT

>

> Â Â Sec. 20-87a. Definitions. Scope of practice.(a) The practice of nursing by a registered nurse is defined as the

> process of diagnosing human responses to actual or potential health

> problems, providing supportive and restorative care, health counseling

> and teaching, case finding and referral, collaborating in the

> implementation of the total health care regimen, and executing the

> medical regimenunder the direction of a licensed physician, dentist or

> advanced practice registered nurse.

>

> Scope of Practice

> for

> International Board Certified Lactation Consultants

>

>

> IBCLCs have the duty to report truthfully and fully to the mother and/or infant’s primary health care provider and to the health care system by:

> • recording all relevant information concerning care provided and, where appropriate, retaining records for the time specified by the local jurisdiction.

> Â

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby

>

[Guest guest]

I do the same thing. it's a courtesy issue for me... as well as an opportunity to market myself and an opp. to teach physicians (or usually nurses). never been a nurse, never will be one... but always report. Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months.--- Subject: Re: Re: Consents for Breastfeeding Support Group?To: " " < >Date: Saturday, November 19, 2011, 6:06 PM

I work off a physician. I take physician referrals. If the patient self-refers, I always report back to the physician. That's my training as a nurse. If you are not a nurse, it may be different. I don't know. I was a nurse first. Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education & Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the

minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby To: Sent: Saturday, November 19, 2011 8:55 PM Subject: Re: Consents for Breastfeeding Support Group?

Genuine question.

Being the case that you must have a MD overseeing what you do as you have indicated, how do you operate a private practice (or do you work for a physician)?

>

> These both sound similar but different. Both require reporting to the health care provider. To make a long story short, if I address a breastfeeding "problem" at a group and the mom is not there simply for socializing, they will become my client. They will fill out all of the paperwork and consents as a client does. And I will file a report to the doc. period.   Because the truth is the general public perceives RNs as having deep pockets. They would come after my license and my liability if I did not have a MD overseeing what I do. There is no way I would ever consider myself an independent stand alone provider even if I could. For me personally, I could not be an IBCLC if I were not a nurse first. AGAIN FOR ME. With that being said and with the state of the economy as it is, I can never lose my nursing license and all that that offers me (not to mention

how freakin hard it was to become a nurse and pass those boards - nurses you

> know what I mean). FOR ME, I have to document, document, document so that's what I'll do.

>

>

> The CT nurse practice ACT

>

> Â Â Sec. 20-87a. Definitions. Scope of practice.(a) The practice of nursing by a registered nurse is defined as the

> process of diagnosing human responses to actual or potential health

> problems, providing supportive and restorative care, health counseling

> and teaching, case finding and referral, collaborating in the

> implementation of the total health care regimen, and executing the

> medical regimenunder the direction of a licensed physician, dentist or

> advanced practice registered nurse.

>

> Scope of Practice

> for

> International Board Certified Lactation Consultants

>

>

> IBCLCs have the duty to report truthfully and fully to the mother and/or infant’s primary health care provider and to the health care system by:

> • recording all relevant information concerning care provided and, where appropriate, retaining records for the time specified by the local jurisdiction.

> Â

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby

>

[Guest guest]

So let me see if I understand this correctly.

In private practice I forward copies of my evaluation and assessments to

physicians when I see their patients but I'm confident that were they to be

asked they most certainly see me as a colleague because I have very

collaborative, functional relationships with the Dr.'s I refer to but I do not

believe I would consider the fact that I provide them a copy of my evaluation

and care plans as constituting working 'under' them in my private practice.

When I work in hospital yes, I could see this. But in a private practice you

would consider yourself as working under any MD you forward an evaluation,

assessment and care plan to?

Do you think those Dr.'s and their according organizations/business and

insurance providers would consider you as a private practice IBCLC RN who is

sharing an assessment as working under them? That is not how it works in my

area.

In , Dana Schmidt wrote:

>

> I work off a physician.  I take physician referrals. If the patient

self-refers, I always report back to the physician.  That's my training as a

nurse. If you are not a nurse, it may be different. I don't know. I was a nurse

first.

>

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

>

>

[Guest guest]

And how would this apply if your client's baby for example gets care from a

Naturopath, who is not a MD, or when they get postpartum care from a licensed or

certified professional midwife, also not a MD (in my area they LMs follow for 6

weeks postpartum and sometimes those mothers need breastfeeding support and they

don't even have an established pediatrician or MD for their baby's follow-up

care yet).

It's just interesting to me. Maybe you don't see those clients because of your

RN licensure?

Just curious.

Thanks,

>

> I work off a physician.  I take physician referrals. If the patient

self-refers, I always report back to the physician.  That's my training as a

nurse. If you are not a nurse, it may be different. I don't know. I was a nurse

first.

>

>  

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time

for maximum benefit to mother and baby

[Guest guest]

I agree , sharing the evaluation and assessment is a courtesy, and

marketing opportunity.

However it should be the standard of care for all IBCLC services because we are

part of the healthcare team and we should be collaborating with the patient's

physician to facilitate communication, and continuity of care.

I also work in a hospital and when we call in specialists (physical therapy,

ultrasound, anesthesia) for a consult, they always report back to the patient's

provider. Because we are part of the same team.

I report back to both the mother and the baby's provider.

>

> I do the same thing.  it's a courtesy issue for me... as well as an

opportunity to market myself and an opp. to teach physicians (or usually

nurses).  never been a nurse, never will be one...  but always report.

>

> Beebe, M.Ed., IBCLC

> Lactation Consultant/Postpartum Doula

>

> www.second9months.comwww.facebook.com/thesecond9months.

>

[Guest guest]

I see those patients but if that is the decision of the patient to have a naturopath as their primary care provider, I would report to them becuase they are still above me Dana Schmidt, BS, RN, IBCLCCradlehold, DirectorBreastfeeding Education &

Supportwww.cradlehold.nethttp://breastfeedinghomevisitservices.weebly.com/shop.htmlProviding the minimum amount of intervention for the minimum amount of

time for maximum benefit to mother and baby To: Sent: Saturday, November 19, 2011 9:40 PM Subject: Re: Consents for Breastfeeding Support Group?

And how would this apply if your client's baby for example gets care from a Naturopath, who is not a MD, or when they get postpartum care from a licensed or certified professional midwife, also not a MD (in my area they LMs follow for 6 weeks postpartum and sometimes those mothers need breastfeeding support and they don't even have an established pediatrician or MD for their baby's follow-up care yet).

It's just interesting to me. Maybe you don't see those clients because of your RN licensure?

Just curious.

Thanks,

>

> I work off a physician. I take physician referrals. If the patient self-refers, I always report back to the physician. That's my training as a nurse. If you are not a nurse, it may be different. I don't know. I was a nurse first.

>

> Â

>

> Dana Schmidt, BS, RN, IBCLC

> Cradlehold, Director

> Breastfeeding Education & Support

>

> www.cradlehold.net

> http://breastfeedinghomevisitservices.weebly.com/shop.html

>

> Providing the minimum amount of intervention for the minimum amount of time for maximum benefit to mother and baby