Lisa, 

 

I totally agree with your whole message!  I was an IBCLC first, so had only
heard the "thou shalt not" part of the message.

Then I went to nursing school and realized that Nurses had "Nursing
Diagnoses" "developed based on data obtained during the nursing assessment.
In other words, the right to diagnose according to THEIR
training/profession: 

 http://www.kc-courses.com/fundamentals/week2process/nanda2012.pdf 

 

Note that the phrasing of their diagnoses: : 

*         Insufficient breast milk

*         Neonatal Jaundice

*         Risk for Neonatal jaundice

*         Ineffective infant feeding pattern

*         Impaired swallowing

*         Ineffective breastfeeding

*         Interrupted breastfeeding

*         Readiness for enhanced breastfeeding (?)

*         .and a whole lot of "risks of".

Here is a short version of the design of the Nursing diagnoses - in
Wikipedia, of course! https://en.wikipedia.org/wiki/Nursing_diagnosis

 

Now that the standard documentation is linked to ICD10 codes, important for
billing.  Other professions have linked their own profession's diagnoses to
them.  For example: 

 

A Physical Therapist has to provide: 

Diagnosis: Indicates level of impairment, activity limitation and
participation restriction determined by the physical therapist. May be
indicated by selecting one or more preferred practice patterns from the
Guide to Physical Therapist Practice.  

Here they describe the separation of the MD and PT diagnoses.

http://www.interfysio.com/blog/physicians-medical-diagnosis-versus-physical-
therapists-diagnosis/

 

Occupational Therapists have: 

http://www.aps.edu/student-family-and-community-supports/accountability-medi
caid-operations/documents/ICD-9%20Codes%20for%20Occupational%20Therapists.pd
f 

"The following codes/symptoms may be assigned by you without a medical
diagnosis."

 

Social workers have: 

http://www.naswma.org/?page=ICD10 

 

I put in Social workers because I often feel THAT if more what I am often
doing, rather than medical interventions - and because they, like us, often
see patients not as a referral from an MD but directly to us by patient's
choice.  Then they, like we, may need to communicate to a physician the need
for their intervention (medications, etc.)

 

Surely we can create a list that would be equivalent and useful in
communicating to physicians in a way that would not have us "stepping on
their toes" but recognized for our specialty.  

 

Jeanette Panchula, BSW, RN, PHN, IBCLC

Vacaville, CA

 

After being a La Leche League Leader since 1975 and an IBCLC since 1985 I
feel qualified to confirm the statement:

"Half of the information we teach today is wrong.the trouble is, we don't
know which half!"

 

Home: 707-469-0705

Cell: 707-290-8200

 


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