Jan B (student)'s comments on justifying her postion with her nurse manager
b/c she spends all of her time holding hands and giving support hit a nerve.
So I climbed up on my soapbox (a rare occurrence for me since I am afraid of
heights), and when I had written my response to her, decided to share it with
all of you in case it helps someone else having a similar dilemma (or just
gives you a reason to continue, as it does me!).
Take a chapter from the nursing literature on the role of the Advanced
Practice Nurse, as this is what I also see as the role of a Lactation
Consultant ( wrote a paper on this topic that was rejected--maybe I will
resubmit elsewhere!): The APN/LC role is to function as an "expert clinician,
consultant, collaborator, educator, researcher and administrator". Think of
all the things that you do in this respect:
Expert clinician & consultant/collaborator-- goes without saying -- we all
know how little most MDs and nurses learn about lactation in their school
programs...YOU are the expert in this field. Surely, you intervene and
collaborate with MDs, anesthesia, radiology, nutrition when any patient needs
to take a med, have a procedure or has dietary questions while breastfeeding.
Educator -- besides the bedside teaching that you do with moms, dads and
other family members/visitors (if you are like me, you extend your teaching
to include infant and parenting issues such as jaundice, circumcision,
co-sleeping, pacifiers, sibling issues, nutrition, etc--probably even teach
diapering)....you also provide 1-to-1 education to the nursing staff every
time you come into contact with them and report how your moms are doing. You
can also give 1:1 education to the MDs as an advocate for your moms. If you
are not already doing so, why not offer an inservice program for your nurses
or offer to speak at your monthly MD meetings (working with your hospital
edication dept, it is very easy to apply for CMEs or CEUs to make the
conference more worthwhile to the audience, even if only 1 hour). You can
also provide educational outreach to the community.
As a researcher, you do not have to actually DO clinical research. You can
share journal articles in a Journal discussion or on a bulletin board. You
can send copies of articles to nurses, MDs, etc related to their patient's
questions or as "FYI" on topics you know they deal with, such as thrush/yeast
or new drug info. You may identify interesting cases to present to Grand
Rounds or in an article. Or you may keep statistics on numbers and types of
patients seen (NICU moms for example). (We were actually able to increase our
hours on our unit by documenting how many patients were NOT being seen due to
early discharge and our staggered days).
Administrative roles include keeping statistics as well as serving on
hospital committees such as Critical Pathways or Policy/Procedures, and
making sure that breastfeeding issues are included (such as why C-section
moms should be able to have their babies with them in recovery).
There are many more examples that all of us could come up with--this is just
the tip of the iceberg, to reassure you that you are certainly doing more
than "just holding hands" (Not that holding hands isn't important in and of
itself--just don't sell yourself short)!!
Kathy in NJ (climbing down from that scary height as fast as I can to retreat
into my corner)
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