I have no algorithm to share, and I am smacking my forehead because --
again -- we have an IBCLC challenged on her scope of practice.  You saw a
red flag and told the mother to go have it checked out.  Why is this so
dang threatening?

I suggest you send to your supervisor (with a copy to the physician) a
letter that does the following:

* encloses a copy of your IBLCE Scope of Practice
http://www.iblce.org/upload/downloads/ScopeOfPractice.pdf
* encloses a copy of the Clinical Competencies
http://www.iblce.org/upload/downloads/ClinicalCompetencies.pdf
* encloses a copy of the IBLCE Code of Professional Conduct
http://www.iblce.org/upload/downloads/CodeOfProfessionalConduct.pdf

Explain -- since your clinical knowledge and skill to consult the mother is
being challenged to **your supervisor**, and this has now turned into a
not-very-nice employment action that could have disciplinary or job
performance review consequences for you -- that you were performing well
within your rights and skills as an IBCLC because:

* an IBCLC is an internationally certified allied health care professional
specializing in BF and human lactation;
* IBCLCs have a duty to collaborate with health care providers
* IBCLCs have a duty to inform the mothers (and HCPs) about matters
affecting lactation, and
* IBCLCs have a duty to support the breastfeeding mother to meet her BF
goals

These duties are most  specifically laid out at the 2nd and 6th DUTIES --
these are DUTIES fer cryin' out loud --  in the Scope of Practice, and
expanded upon in the correspondingly-numbered Clinical Competencies.  All
of which fits nicely under the DUTY we have at Principle 2 of the IBLCE
CPC, our ethical code.

That these documents don't say the words "assess for signs of hormonal
imbalance" is irrelevant.  It would be impossible to list out every
biological, cultural and social factors that has a bearing on lactation.
 Instead, they tell us the system works like this:  the mother is seen by
an expert (the IBCLC) who works within her range of expertise (per enclosed
documents) to assess matters affecting human lactation (suspected hormonal
imbalance) so the mother is informed about matters that may need further
care from her primary HCP (get those hormones checked) in a professional
environment where all of this assessing and informing is being shared with
everyone: the mom, the IBCLC and the rest of the health care team.



-- 
Liz Brooks JD IBCLC FILCA
Wyndmoor, PA, USA

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome