Hi,

Denise said:
"by giving advice over the phone (you mentioned something about this in
women you weren't intending to take on) you have actually legally accepted a
professional relationship with the woman - and doing a phone assessment and
giving even minimal advice is pretty scary. "

Thanks, Denise, for asking my opinion on this. ("Opinion" being the key
word here.)  This conversation really has me thinking.  To me, the lines
are very blurry.  I work in a hospital setting, so I think this would be
much different than someone in private practice.  Outside of the hospital
setting, I believe a professional can be held liable for any advice
given...to a neighbor, family member, etc.  Is this liability any different
if we are an RN as well as an IBCLC?

Part of my job involves calling moms who have gone home to see how
breastfeeding is going.  I try to ask specific questions about diapers,
number of feedings, etc, but it can be very hard to get a clear picture
over the phone.  If there is any question in my mind, I ask the mother to
come in or to see the pediatrician.  Sometimes, they don't take my advice,
so what then?  I guess the mom has some accountability too.  I always
document the conversation and my advice.

When a mom brings her baby in for help and I feel the baby is in trouble
with something out of my scope, like jaundice, I tell the mom I'd like to
call her pediatrician.  I do this with the mom still here, making it more
convenient for her if the baby needs labwork done.  So far, I haven't had
any moms refuse and the peds seem glad to be notified.

My area of concern is our documentation.  It is not part of the legal
chart.  We keep our records on file in our office.  I've been wanting to
speak with the hospital attorney about this for awhile.  Maybe I'll push a
bit harder on this issue.

In the end, I think I have more questions than answers!

Billie

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