This sounds like a very difficult, and unfortunately a typical, situation.
Here are some ideas:
1. Have the docs agree on a standard ref to use for phone triage. It should
be current and research based. This could be Ruth Lawrence book, LLL BF
answer book, Jack Newman's book, Riordan & Auerbach, Marie Biancuzzo's book,
just as some good examples. There used to be a phone triage little book out
there at one time, but I think it is out of date or was it provided by a
formula co?
2. Use the AAP 1997 policy or find out if ACOG has a similar policy or
booklet. Look at it first to see if it's bf friendly.
3. Ilca has Evidence for the 10 steps to successful bf and Evidence-based
guidelines for the for bf management during the first 14 days. You can order
these in the last pages of the JHL and I believe thru ilca website.
4. Find one or more good ob articles that are bf friendly and in an ob
journal.
5. Find out what the most common calls are about. Then convene a committee
of these nurses to each research the topic(s). You could have each of the 5
nurses each take one of the above texts and come back with their research
and then develop a protocol for the most common calls.
Hope some of this helps.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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