----- Original Message ----- 
From: "Jaye Simpson, IBCLC" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 09, 2008 5:56 PM
Subject: Re: [LACTNET] Competent LC's - polarizing - long


**Hi Jaye (and others),

First: thank you for your passionate post! I loved it. I would like to add a 
few cents here and there.

> Like many of you out there, I too see moms who tell me all sorts of weird 
> stuff the hosp LC (who may or may not be IBCLC) told them or the PPLC told 
> them or the lactation nurse, or the BF advice nurse or the LC Dr at the 
> hosp she was sent to see (who actually isn't an LC but is BF supportive) 
> who just handed her a nipple shield and said give this a try.

**I recognize this and to me, it would be very disrespectful to the moms if 
we would all say: "Well, it probably wasn't meant that way. The mom must 
have been confused due to labour and stuff." Even if this may be true... it 
is part of our professionality to *know* that this may happen and to 
anticipate by using a different attitude or way of couseling. If the mom has 
experienced us in a certain way, than that is how it was, by definition. 
This is hard to hear, to everyone; hearing that someone didn't like the way 
you went about something, is always hard. But a newly pp mom *needs time* 
spent on her and her baby. Giving a consult in a rush is not consulting *at 
all*. What seems to be primary knowledge to us, may be totally new to the 
mother. And what should be primary knowledge to an lc, sometimes isn't at 
all... :-(

> "My experience is that you LC's suck." !!??!!??  This absolutely KILLS me.

**I agree; badly practising lc's are a disservice to the *whole* profession, 
not just to the single mother. If people tell eachother that bad care is 
what to expect from an lc, then that is what the profession gets to mean to 
the general public. It will take many, many good experiences to get rid of 
one bad one.

> And look folks, when we are talking about our frustrations with people on 
> Lactnet we are not naming individuals here!  We'd get tossed off the list 
> if we did.  There is no need to take anything said by anyone as a personal 
> attack.

**I don't know... I would like to refine this to: "Those who know they spend 
time and energy on dyads, should not take the comments personal. Those who 
read Lactnet-posts and conclude that their way of dealing with problems is 
very far from the suggestions the really experienced collegues come up with, 
should take it *very* personal and get themselves better educated."
I may have mentioned them before, the learning stages: unconsciously 
incompetent - consciously incompetent -  consciously competent - 
unconsciously competent. It is very important to regularly return to the 
second stage and motivate yourself to learn and read and study and practice 
with new competencies again. This is what makes me very modest: the more I 
learn, the more I realize how much I still don't know... (It also means that 
I even start to doubt whether I will pass the exam...) The hardest stage is 
the first one; it is probably this stage that we talk about when commenting 
on collegues who give suboptimal or even really bad care. They think they 
know it all, but in fact, they don't even know how much they don't know and 
therefore feel no need to enlarge their personal body of knowledge and 
insights. I find it hard to 'break through' to someone in this stage. 
Sometimes, I'm just so angry and frustrated for the moms and babies who get 
hurt by the bad care they receive. This is definitely an area where I have 
to learn more: how to address a lack of knowledge I perceive in others. (And 
as a counterpart: learn to take in feedback that might mean I have a lack of 
knowledge/competency myself!)

> As an aside:  I work in Private Practice.  There is no way I could ever 
> work in a hospital - I'd get fired the first day.  I am not politically 
> correct, I do not play the game - I tell it like it is and can back it up.

**Hahaha, same goes for me! ;o)) Sometimes that gives me the feeling that I 
am a bad HCP; shouldn't I be able to cooperate within a routine? At other 
times, I am grateful for the fact that I am able to work on my own, 
independently, as moms often only hear from me what they need to hear, sadly 
enough...

> Then I get called and while validating their feelings, try to gently 
> explain that often times others just work differently, or have a different 
> education, or in the hosp just don't have the time to take with mom like 
> they would probably like to, trying to be politically correct while 
> sometimes wondering why I continually have to clean up that mess that 
> shouldn't have been made in the first place (imo). It gets old - for me 
> and the moms.

**Yep, hard to be saddened by this feeling, time and again. I don't get used 
to it, which, in a way, is a very good thing.

> Thank you for reading/listening this far if you got to the end.

**Not that hard, to read to the end! ;-)

Warmly,

Marianne Vanderveen, Netherlands 

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