Hello All,
  I too, have attended conferences where I was told that it is outside the
LC's scope of practice to prescribe.  For the last 9+ years, I have had the
good fortune to work in a freestanding birth center with nurse midwives who
are extremely supportive of what I do.  We have developed a set of standing
orders that the LCs use when dealing with mastitis and thrush.  The
accompanying protocol also states that the LC will consult with the CNM on
call within 24 hours of starting the patient on treatment (and whenever the
patient's condition fails to respond as expected to Rx).  This set-up has
worked quite well for us and our patients, who get the treatment they need
promptly without the need to involve another HCP.  All our LCs are RNs,
because we also serve as labor and delivery nurses, maternity case managers,
and do a bunch of other job functions as well.
  I am interested in hearing what is done in other practices,if anyone else
is using standing orders, and what the Wise Ones think about standing orders
and the LC scope of Practice.  Please respond to me privately, as well as
posting to the list.
TIA---
Martha Johnson RN IBCLC
Eugene, Oregon, USA.

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