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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