I I've been thinking about the idea of diagnoses and professional practice
standards.
In my practice, I do not diagnose problems per se, or medical
conditions...but I do use the expertise, experience, and information I
have to think clinical problems over in a thorough and intelligent way. If
I come to some set of likely answers to specific problems, then I do
present those thoughts to clients. By not doing so, I would be remiss in
giving my client the full benefit of my experience. I don't dummy up, as a
tv character in the US used to tell his wife to do. I clearly state my
thoughts. I would be remiss if I did not do so.
I don't limit myself to giving only a specific response, because I am a
nurse, and an IBCLC and not a physician. Sometimes, it is a fact that my
conclusions and thoughts will add to the client's well being and eventual
recovery from whatever breastfeeding problem is limiting them. Sometimes,
my assessment is a valuable adjunct to the medical care that the client is
receiving. I work to work WITH the professionals in my area. I admit
freely that I do not know everything, and I hope that I am open to
learning new things. I strive to admit when I have erred.
While I agree that we must be careful to avoid "diagnosing" problems, since
we are not physicians, we should also realize that as IBCLCs, we have
strengths, in experience with regard to breastfeeding, and in clinical
knowledge. To keep those observations to ourselves is as much of a "sin"
as appearing to be more competent than we are, professionally. It is a
fine line, but I wish to avoid the idea of having nurses or IBCLCS,
etc keep to their "places," because they are nurses, or **just** IBCLCs,
somehow lesser than others with different initials.
We all have clinical expertise to offer our clients, ..we all make mistakes
at times...and it is up to us as professionals to work respectfully, and
harmoniously, alongside our colleagues, whether they be RN, IBCLC, MD, DO,
RD, PhD, etc, as we work to further the cause of breastfeeding women in
general, and for the comfort of the individual mothers we work with in
specific.
It is not useful for us or our clients to draw the line around our
specific initials, and place our private concerns above the big
picture. I have seen professionals put down too many times for working
outside the scope of their practice when in fact, the ones who make
these claims are working from a fear of having their own power bases
toppled. It all does boil down to power, doens't it?
We need to identify turf issues as power struggles, and sometimes, who is
"right" is not as important as what is going to "work" for that particular
mother and baby.
Kathleen
Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
mailto:[log in to unmask]
http://homepages.together.net/~kbruce/kbblact.html
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