Hi Joyce
These phone deals scare me. The nurse has to be such a generalist. Oh well I
think basically what the nurse needs to know is if the situation is an
emergency or not. If someone calls with chest pain, she has to determine if
it needs to be seen right away or not. I think lots of these phone services
also are there to generate referrals to docs, right? So I think the nurse
needs to know the "red flags" to look for and then make a referral. This, I
think, is critical. I think you should emphasize that, other than an easy
question about storing milk or how often to pump while at work, that moms
with bf problems need to be referred to a specialist (IBCLC). The focus
should be on identifying if this is an emergent situation or not. The red
flags the nurses should ask about would be (this list is not all inclusive):
fdg frequency or no. of feeds per day, swallowing, voids and poops, signs of
jaundice, wt gain if known, mom's supply, signs of poor latch such as pain,
cracks, bruises, blisters, engorgement. Engorgment can have a protocol as
long as not too severe and baby can latch and feed. Plug ducts/Mastitis can
have a protocol ,, etc. Hope this helps.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA


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