STill a few days behind ya'll but I wanted to comment on Lisa's post
<<I call the moms my "clients", not my patients. I make "assessments", not
diagnoses (this gets really fun when I must determine a
differential.........uh, assessment?). And then I make "suggestions" for a
care plan, which may be practical or of a pharmaceutical
nature.>>
This is reminiscent of the old "SOAP" charting method, which I've always
liked. Is that still used?
S- subjective data [nipple pain 8 on 0-10 scale;pain decreased to 3 with
deeper latch]
O- objective data [scabs blisters bruises noted, describe latch, swallows
etc; ]
A-assessment [shallow latch]
P-plan [taught optimal position/latch, etc]

By the way I believe the prescribing discussion has been very fruitful and
this is a "slippery slope" or gray area in our practice. Personally, in re
herbs, I offer this as one option but recommend that the mother discuss it
with her primary provider {physician} first. I do recommend ibuprofen for
engorgeemnt, first asking about allergies, then if they usually take this
for headaches or other aches, then saying "yuou can take 400mg every 4 to 6
hrs if this is ok with your physician." Yes seems a little strange that she
could do this on her own becuase it is an over the counter drug, but from my
interpretation of nurse practice, prescribing, etc I feel this is the safest
thing to do.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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