This diagnosing things drives me simple.   Has for a long time.  Diagnosing
became more and more of a problem as nurses were given for responsibility
for assessing patients.  "nursing diagnoses" were invented to get around
saying in plain English what was going on with the patient...like not
enough air is "impaired gas exchange related to altered oxygen supply"  or
"potential for suffocation." or "ineffective breathing pattern related to
xyz".  Like you can't say the kid is wheezing and can't breathe.  Oh my,
that is a diagnosis.  Nursing wastes a tremendous amount of time on this
nonsense.  Whole careers have been developed to create and promote
"nursing" diagnosis.  I would really hate to see lactation go down this
path.

diagnosis, in my Taber's, is the term denoting name of the disease a person
has or is believed to  have.  2. The use of scientific and skillful methods
to establish the cause and nature of a sick person's disease.  This is done
by evaluating the history of the disease process, the signs and symptoms
present; laboratory data; special tests etc....The value of establishing a
diagnosis is to provide a logical basis for treatment and prognosis.

In my mind diagnosis of this sort is a medical/health care professionals
area of expertise (disease).  We are diagnosing something different.  We
are using the same process  and providing logical basis for treatment and
prognosis, we just don't deal with disease as LCs.  I agree with  Barbara's
way of communicating with doctor's.  This baby vomits all the time vs.I
think this baby  has reflux. If you know the doctor well  you know which
way to say it.  Isn't it inefficient that we have to resort to  that? (but
there are egos to protect.)

As an advanced practice nurse (new name folks, for a nurse practitioner in
NJ, as of June 1) I diagnose all the time.  if I can't figure out the
diagnosis I go  find the dr I work    with.  FYI, I believe an experienced
LC ( like many on Lactnet - I won't bother to  name you all, might miss
someone :-) functions on the same level as an advance practice nurse, just
in  one special area of expertise.  I think  others are recognizing this
too, hence the stiffer educational requirements for LC.  We do assess and
diagnose BF/lactation problems.  If this means we have to get "magic
initials"  then that is what we have to do.  The problem with LCing is that
we discover it after we've prepared for other things.

The profession of LC is enriched by all the people we have participating
from so  many different disciplines.  I know it will be a hardship for some
from these other paths to have to  get the formal A & P etc., but where
there is a will, there is a way.   I started out as an LLLL, no college
degree and 5 kids. When the kids were little my college course per semester
was my "night out".

Well I have a cold and cough (oops that's a dx) and it's getting tough to
breathe up here on my soap box so bye for now.  Sincerely, Pat in SNJ

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