Again, this is the type of discussion that those not in the US might not
find useful/interesting...but I thought I'd give some insight from my
experience.

When a union is involved, there are additional issues besides licensing and
scope of practice.  

Our scope of practice and our licenses might say we can do xx or yy - but if
the union agreement says we ONLY do this or that based on our job
description as was agreed to in the contract between the union and the
organization we work for, we are obligated to stick this agreement (unless
we get a special arrangement) - or we could be branded as "scabs" and "union
buster" and the employer can get into very hot water!

Unions try to keep positions separate so that they can protect and/or
increase the number of positions and assure jobs and salaries for their
members.  If you can hire an IBCLC who will also do the work (some of the
work) of a nurse, then you need (in the aggregate) fewer nurses.  

Of course in emergency situations, there is usually not a problem (in fact
in my Union's agreement with the Department of Health, it clearly states
that we can be asked to do ANYTHING in an emergency - as long as it does not
go beyond our scope of practice or put us at risk (in other words, they need
a translator, or they need someone to direct traffic, not a nurse - I do
that job even though I'm employed as a Public Health Nurse).

Is there a way to discuss this with the union rep and management so that you
CAN take orders?  It depends on the Union and Management - but it's more
complicated than just what you're licensed to do!

Jeanette Panchula, BSW, RN, PHN, IBCLC
...and union member because I'm REQUIRED to be one in both of my last two
jobs...
California, USA

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