Angela says:
<<As an RN/BSN, I am aware that I cannot tell a
mother to take or use a medication, that would be out of my nursing
scope of practice as well as IBCLC. I can tell her that many mothers
have found a medication to be helpful and advise her to ask her
physician if that would be appropriate for her, give detailed
information to give to the MD, or even speak to the Md myself to give
evidence based information to them but I cannot tell her to use it
because that is legally prescribing. Those of us that are doing so,
should not be>>
Relook at the definition of prescribe. It is completely different than
"recommend". An RN may not do anything that ONLY A PHYSICIAN MAY DO (IL Dept of
Professional Regulation). I, as an RN, may not write a prescription and have
it filled. However, if a mother asks me if she should take Tylenol or
Advil, I am perfectly free to give her my recommendation -- she may then go do
what she wants. That is not only within my scope of practice, but is also
within the scope of practice of the pharmacy technician who may or may not have
ANY medical training (according to my dh, the pharmacist). This is the
definition of "prescription":
prescribe
verb
To set forth expressly and authoritatively: _decree_
(http://www.answers.com/topic/decree) , _dictate_ (http://www.answers.com/topic/dictate) , _fix_
(http://www.answers.com/topic/fix) , _impose_ (http://www.answers.com/topic/impose)
, lay down, _ordain_ (http://www.answers.com/topic/ordain) .
*************************************
Now, I can probably "prescribe" a nap for a mom who is tired, "prescribe"
some orange juice for the child with a cold -- "prescribe" cabbage for the
engorged mother, or for the child that has just had his wisdom teeth out...
When is it not "prescribing" and when is it "recommending?" ANYONE can
recommend an OTC medication -- including the mother for herself. A
"prescription" is something that is written for a patient by a licensed HCP that has
"prescriptive" authority. My daughter, a Family Nurse Practitioner can prescribe.
I cannot. So if she "diagnoses" someone with vaginosis, she can
"prescribe" Flagyl. However, if someone says to me that she has a headache -- or a
cold -- or a cough, and what would I recommend, I can ask her about
allergies, what she usually takes, and "prescribe" any OTC medication.
Definitions are important things. And to put into a Scope of Practice that
I cannot "prescribe" (when I know full well I can't) doesn't make sense.
There are only certain practitioners that can "prescribe." My daughter has a
DEA number and a license to "prescribe" (and she has prescription pads w/ said
numbers and her name on it).
Anyway, food for thought.
And the IBLCE should rescind the current S of P (which is the first one, by
the way. The other things they have had up are Standards of Practice (what
you are expected to do) and Competencies (what you should be able to do), but
the Scope is new) until they have it sorted out, so we aren't legally bound
to something that is inappropriate. Please continue to send your letters to
them so they understand this.
Jan Barger, RN, MA, IBCLC
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