>>> Lisa Updike wrote: "Apparently a person (not a Dr.) in a supervisory role had told her that only "hospital personnel" were allowed in patient rooms and that I was a risk to the patients because I had not been tested for TB !?" Lisa, I agree with you that policies such as the one you encountered make it difficult to gain supervised clinical practice. However, don't think you were singled out because you aren't a doctor. The rules likely apply to them, too. The difference is that the medical and nursing students not only have a practice pathway -- they have a bureaucratic pathway (for lack of a better term). Facilities that "allow" clinical observation usually have policies (red tape) setting out guidelines that must be followed. It is prudent for hospital administrations to have a way to control who is allowed access to patients. It is easy to see how unrestricted access could lead to problems -- for patients, personnel, administration, and trainees. In providing patient care, the hospital is also responsible for protecting patient confidentiality and assuring safety. I had my last baby at a large teaching hospital, and I (the patient) had to sign -- on my admissions packet -- whether or not I would allow myself to be observed or cared for by medical staff-in-training. In the facility where I presently work I cannot have anyone shadow me who hasn't been "vetted" by the administration. There is a sheaf of paperwork that must be filled out by the applicant detailing the extent of access allowed. A TB test is required. And the OK is a decision that has to pass a committee (all non-US 'netters must be ROFL at this point). Medical and nursing students are (generally) ushered into medical facilities through their schools. We LCs, at this point, don't have many facilities open to us via this "traditional" pathway. We need to find ways to do this. There may be places here in the USA that still "hang loose" -- but in this CMA (a.k.a.: litigation conscious) society I think there must be very few. A discussion on this subject (i.e., pathways, red tape, what has worked at your facility) would be valuable. How about those of you in private practice? What formal policies do you have? Margery Wilson, IBCLC Cambridge, Massachusetts, USA [log in to unmask]