I guess I am feeling concerned about the harshness of tone I am hearing
about the qualifications for the exam.  Melissa, I don't know the nurses
involved in your post, and I am sorry to hear that they seemed to be
mocking the value of real knowledge about breastfeeding.  However, I
believe that by setting yourself so forcefully in opposition to them you
are making it more difficult to influence them for the better in the
future, and also jeopardizing your opportunities to work together with them
to improve the opportunities for good breastfeeding help in your
hospital/town.  They can hardly fail to sense your disdain for them.  You
can catch more flies with honey, someone reminded us on Lactnet recently,
and I would use that idea in this situation.  Why not set yourself a
challenge to see how you might go about effecting a change in the attitudes
of these nurses, rather than bashing them?  Share your best resources
(names of books, videos, articles, journals, conferences) with them.  Treat
them as colleagues with a common goal. Try to listen to them with a more
open mind, and hear where they are coming from.  What obstacles have they
encountered to set them in such a negative mindset about breastfeeding?
What were their personal experiences with breastfeeding in growing up, with
their own children, in their nursing education, and in their work setting?
Set up some joint study sessions or case presentations to discuss.  As a LC
you will find yourself in many, many situations in which you need to work
cooperatively with skeptics and physicians/nurses/nutritionists/family
members/friends/etc. who are less than knowledgeable or helpful, if you
want to help create a more supportive climate for breastfeeding in your
community. Your situation right now is a typical one that you will have to
deal with in real life as an LC.  Model for these nurses how a professional
LC should behave.

A few years ago in our city we tended to each see the breastfeeding
situation with our own narrow, tunnel vision.  LLL members, LCs,
physicians, WIC, hospital nurses, childbirth educators, outpatient support
people all were quick to place the blame for problems on the other groups.
Once we met together and shared the frustrations we all faced in common,
we were able to form a more cooperative group to promote, protect and
support breastfeeding.  It was the LLL leaders who first invited the WIC
director, hospital and public health nurses to meet together with us and
share our situations, goals and frustrations in trying to provide
breastfeeding help.  But it is WIC that now coordinates our local
breastfeeding coalition, and keeps us meeting on a regular basis.  We now
know each other, refer to each other, provide continuity and help for
mothers across different settings and help educate all the segments of the
care continuum.  We still have a long way to go, but we have made a
beginning, and it has been good for our community.

As for a college degree, no matter what field, shortening the number of
practice hours required to sit for the exam, I think there are several
things that can be assumed of such graduates.  They have had to learn to
budget their time, plan and complete assignments, read and understand
materials at a sophisticated level.  They have had to work toward a goal
over a period of several years in order to graduate.  They have had to
learn to listen to and consider others' ideas and articulate their own in
both oral and written presentations.  They have had to take and pass lots
of tests.  It may be that these challenges correlate with greater success
in passing the IBCLE exam. This does not mean others without this would not
be able to pass it.  It is just one way to help insure success for those
who invest all that is necessary to try.

I do not think that RN's with no breastfeeding knowledge would be able to
pass the exam.  Having been an RN, a pediatric nursing instructor, an LLL
leader for over 5 years (when I took the test), attended several
breastfeeding workshops and conferences and a week-long course, and having
read widely, I still found it a difficult test. As for the money you feel
you are having to put out to pursue your goal of being accredited, I
strongly feel that those who are most knowledgeable and committed have all
invested a lot personally in time, energy and money.  I don't know too many
who have become rich at this career, either.  I also chafed at the expense,
the need to travel and stay in an expensive hotel to take the test, the
inconvenient timing.  Each person has her/his own reason for deciding to go
through with this.  For some it is a personal challenge.  For others, a
desire to help support the professional character of the LC field.  Why is
it so important for you to pursue IBCLC status?  If it is just to satisfy
others' expectations, maybe it is not worth it right now.  I also can
emphasize that passing the exam is not an end of learning.  There are
stringent requirements for those who use "IBCLC" to continue their
education in breastfeeding to maintain their certification.  I doubt that
anyone could sit through all the breastfeeding conferences and workshops,
mingle with the true advocates, read the studies, etc. and not become a
real believer.

Anne Altshuler, RN, MS, IBCLC and LLL leader in Madison, WI  (All of the
titles represent a lot of hard work, expense and sacrifice, and each in its
own way has added to the depth and breadth of my knowledge and my
commitment).  And still learning a lot every day!