June,
I work at a Hospital with 12 LDRP beds, 43 Post Partum beds, and  Level II 
NICU.  There is NO way that I can see every post partum mom.  The nurses are 
required to take a 2 hour (with CE credits) with me and follow at the bedside for 
2 hours.  Back when the budget was much better they took a 4 hour class and 
followed us at the bedside for 4 hours.  We also had two LC's on duty during 
the days Monday through Friday.  One on the weekends and Holidays.  Now we have 
one LC on duty Monday through Saturday. (There used to be 4 LC's, now we have 
2, one moved and one started her own business, but they had cut our hours 
drastically.) I am trying to work a little mother-baby regular RN bedside duty to 
get back some of my skills and maintain them.  As we started getting pulled to 
work the floor whenever they needed us.  My Director dictates when I teach 
classes as the budget doesn't call for much "non productive" time.  Hmmm.  I am 
teaching this week and later in September.  I already taught earlier in the 
year.  I try to send emails to the unit.  I am sure as soon as some of the 
nurses see they are from me, they delete before they even read them.  But most do 
read them and are very appreciative.  

I work 36 hours per week, some weeks I spend 12 hours as a regular nurse.  
The other LC works 20 hours per week.  We rely on the nurses to triage for us.  
I know we miss a lot that way but some are really getting better at their 
skills and we love when they are working.  There is NO way we can see everyone 
they are begging us to see let alone every mom.  I am not supposed to work more 
than 8 hours a day as an LC but can't help go over time just a little 
frequently and still feel badly that I am leaving.  I can see patients on an outpatient 
basis up on the unit, they pay in Women's Serices/Radiology outpatient area.  
But we refer a lot to our preferred providers outpatient LC services. 

If the staff can step in and see what I am doing I encourage it, but they are 
usually busy doing 10 things at once.  Sometimes I will go and get them so 
they can see what I have done.  Especially if it is a new nurse.  I prioritze by 
who is going home, we need beds constantly for the newly delivered moms.  Oh, 
and I might get called to Peds, Peds ER, ICU, adult ER, or one of the other 
med/surg floors for re-admitted patients, etc.

Time to go to work!!
Pam Hendrix, RN, IBCLC
South Florida Hospital Based

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