I am an IBCLC in a Medical Center that has 2 sites.  One campus does approx 1200 deliveries per year and the
other campus does about 1000/year.  We are in the process of merging the 2 units, and in 3 years we will be on the
same campus.  Prior to the merger, both sites had 48 hours per week of lactation coverage.  I worked at the site
that does 1200 deliveries.  I job shared with another IBCLC.  We each worked 2 -12 hour lactation days and 1- 12
hour staff day per week.  We were increasingly expected (mostly by co-workers) to cover as staff prn on the
lactation days.   At the other site, they had 6 - 8 hour shifts of LC coverage each week.  Several months ago,
management changed the budgeted hours.  We now have 60 hours per week lactation total and have to see pts on
both sites. The hospital provides a shuttle between the 2 sites and travel time is approx 15 minutes each way, plus
the time it takes to walk to the shuttle and wait for the shuttle to leave.   The good thing about this is that we no
longer have to do staff backup on our lactation day.  Management does not think that we need to see every pt
each day, only those having difficulties or staff or MD referrals.  The problem with that is that a majority of our
breastfeeding pts (we have approx 70--72% bf rate) expect to see anLC, even if there are no problems.  The other
issue is that the staff on both sites are used to having the LC do dismissal teaching, help with latch on (even
when there is no problem), and to see all pts.  We also are expected to do staff education, and we are currently
working on starting a support group and possibly breastfeeding classes.  We also do outpatient visits, and home
medical would like us to be more involved in breast pump sales and rentals, rather than having their staff do it.
Needless to say, there is not enough time in the day.  We have just got a new manager who is very supportive of
our position.  I believe that after we show her the data on how many patients we see plus those who we were
unable to see because of time constraints that she will up our lactation hours.  It's just a matter of being patient until
that happens.

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