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From: Lactation Information and Discussion
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Subject: LACTNET Digest - 1 Nov 2006 - Special issue (#2006-1245)
There are 6 messages totalling 380 lines in this issue.
Topics in this special issue:
1. reporting to HCP
2. HCP reports and consent
3. Fabulous study: IBCLCs = increased BF
4. PT vs. CST
5. Scope of Practice
6. What the moms say...
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Date: Wed, 1 Nov 2006 21:01:27 EST
From: Maggie Payne <[log in to unmask]>
Subject: Re: reporting to HCP
I have another question about reporting to HCP. With the HIPPA laws the
ways
they are in the US, our HCPs are questioning the advisability of our
interactions. It has gotten so confusing that the HCPs are asking the
Mothers to
hand carry the 'reports' (similar to BWC) that we used to email directing to
our
HCPs. Any ideas? Even with the consent forms, trying to get communication
between HCPs is next to impossible because of HIPPA in our community.
Peace,
Maggie Payne
LLLL Oshkosh, WI
Dream Now so that your children learn to Dream for Tomorrow!
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------------------------------
Date: Wed, 1 Nov 2006 21:08:57 -0500
From: "=?ISO-8859-1?Q?Micky_Jones,_LLL_Leader?=" <[log in to unmask]>
Subject: Re: HCP reports and consent
To quote Kathy :=20=20
"This is why phone or email helping is problematic and can border on=20
unethical for IBCLCs. My understanding is that when an IBCLC talks to a=20=
mother about her problem, whether in person or on the phone, our duty is=20=
to communicate with the HCP afterwards. With phone or email helping, one=20=
can not easily get written consent to send an HCP report. Plus, once you=20=
talk to a mother on the phone, you own the problem and are responsible=20=
for follow up. The other problem with phone or email helping is you can=20=
not weigh the baby or see the baby and really know what is going on. You=20=
just have a one sided explanation that may or may not be what is going on=
."
Whoa...now I am really confused. "unethical" to do phone and email consul=
ts?
So CLEs, CLCs, peer counselors, LLL Leaders, AABA facilitators,masters or=
phD trained lactation professionals can all answer phone questions or ema=
il
but IBCLCs can't or shouldn't? LLLL help over the phone the majority of t=
he
time and help mothers solve problems at various levels of complexity.
Weighing the baby is not always that important - don't many LC's opperate=
without a scale? Mothers get real answers by phone and email from LLLL - =
it
may be more difficult but in many cases it is not. What if a mom has a
question that does not really necesitate a visit? Do you refer her to LLL=
L,
AABA or a peer counselor? I would be irritated if I had to run to an LC f=
or
every little thing.
I am a little confused as to the professional benefit of being an IBCLC -=
seems like a lot of red tape going on to do the job that others with othe=
r
titles do. That is so scary to me as I always thought I would become an
IBCLC and in the near future. I am trying to soak everything in, so pleas=
e
continue to share. I am truly interested in different perspectives, learn=
ing
what others do, etc.
There seems to be some difference in how private LCs practice from hospit=
al
based. Right? I do not intend to be a nurse or work in a hospital setting=
so
I am very interested in that perspective.
thanks for the continued discussion, ladies. I am learning alot, learning=
I
have a lot to learn!
Micky Jones, BS, CLE, CLD, CHBE
Mama of 3
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------------------------------
Date: Wed, 1 Nov 2006 21:21:58 -0500
From: =?windows-1252?Q?Emily_Lindsey?= <[log in to unmask]>
Subject: Re: Fabulous study: IBCLCs = increased BF
Although I agree that most IBCLC's have the ability that the gold standar=
d=20
means, there are many of those that serve as a lactation educator or CLC=20=
that perform just as well with moms at the hospital level. What this stud=
y=20
shows is that having a lactation counselor present helped mothers which i=
s=20
great! We need all the support we can get. However, there are those that =
do=20
not want to sit for the exam for multiple reasons and it should not be=20=
assumed they know any less than an IBCLC. My mentor was one. Although I=20=
plan to sit for the exam I could only aspire to have the depth of knowled=
ge=20
and experience that she had with a CLC. Most of the teachers I had at my=20=
Reports to health care providers are a wonderful opportunity to educate
providers about breastfeeding. I always include a summary of my plan of care
and rationale for my recommendations along with overall goals. The docs are
very interested and often comment to the mothers about receiving a report
from me. The mothers in turn tell me about their doctors comments. Everyone
becomes engaged in conversation about geting breastfeeding to work. I have
even heard some of my advice now being given by the docs. What this does is
create a positive support team that leds towards the ultimate goal of
supporting breastfeeding. Even docs who I would have suspected as not
interested in the past have come around and are at least curious about what
I might suggest. I have seen attitudes on topics like tongue tie really
change. Follow up reporting to appropriate providers is covered in my
consent form. Ann Anderson,RN,IBCLC,NJ
------------------------------
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