Here is a letter from a long-time subscriber that I found very interesting
and accurate, although it causes me some pain on reading it.

"Kathleen, I think that one of the problems, of late, with replying to the list
is the seeming eagerness to take a phrase or part of a reply or someone's
experience and, with a sense of superiority, attack the position with an
air of, "whoever would do such a thing" or "whoever would say (or think)
such a thing," Or "Have you read the standards of practice of our
organization?"

I usually reply privately to questions that I feel I have some experience
in.  I am usually pretty tough skinned, but after enough humiliations--some
to myself, but mostly to others, I don't reply to the list much.  If I do,
I spend a long time composing what would be a "sterile" post that has
little to pounce on. Of course, that leaves a "sterile" reply, which
benefits few.

I don't know why this tendency has become so prevalent. If a problem
question is asked, few reply.  If a philosophical or opinion question is
posted, there are weeks of replies.  Of course, the most popular are the TV
shows.

When I read back over Lactnet in prior years, I see very little, in any, of
this personal criticism of working style or personal experiences in one's
work. It seems as if we were freer to share openly and without caution. We
were freer to say, "I don't know for sure what is going on, but this has
worked for me." Is everyone running scared in their workplace these days,
which creates a sense that "I _must_ be right"?

One of our favorite children's books was Best Friends for Frances. She is a
Badger.  She and a friend had a conflict and Frances asked, "Do you want to
be careful, or do you want to be friends."

Is some of it the embracing of "evidence based practice"?  Like in today's
post about saline soaks: <Is this an "evidence based  practice" or an"
expert based practice" ?

There have been other posts that were written after a person shared what
she did in a case, in which the replier questioned the LCs good judgement
by using the evidence based practice rule.

An example of things getting out of hand is Dianne Wiessinger's Name Game.
That thread soon got very critical of her and her list and how she arrived
at that list.  What started out as a light-hearted list, grew to "my list
is broader, more profound, better thought out, etc. than your list."

I don't know how we can regain the trust that if we ask a question, others
will feel free to reply based on their experience and not have to have that
experience verified by a peer-reviewed journal. And how we can regain the
trust that if we reply freely, in a conversational manner, we will be seen
as a learner who found a given procedure to work for us, and maybe it will
work for you.

That's part of the problem...we have moved from "learners" to "knowers."

If we are going to have evidence based practice as a criteria for posting
our replies, it certainly will limit our replies and our friendly exchange
of ideas. And narrow our creativity in solving problems.

I've tried to discern what the change is and I think that it is
multifaceted.  I've thought that it may be competition to show that I know
more than the other person. Or just a habit of being critical. Or posturing
to show that I am "professional" and you are not.

I don't know.

What I find for myself, is that the less I reply to the list, the less I
care about a person's request for help on a problem.  It is similar to the
fact that the less one gives of herself to her children, the less she wants
to care for them.

But I just don't feel "safe" replying to the list.  My practice is not
especially evidence based.  It is experienced based, which is what almost
everything was a few years ago.  If I am just out of sync with the
profession, then I don't want to continue to show this "flaw" to 2500
members of Lactnet. So I play it safe.

I am very grateful for the "seasoned" Lactnetters who are still faithful
writers. But where is the "playful" Jan, or the practical, creative Dianne,
or others from whom I learned so much about trusting my instincts?

Just some thoughts, today, on a topic that has me puzzled."

***

So folks, that about sums it up. I have never said that Lactnet is an
evidence-based, peer reviewed journal. It is nice to share that information
when we have it, but I think that we should consider the author's words.  I
vote that we think this note over seriously.

Kathleen

Kathleen B. Bruce, BSN, IBCLC co-owner Lactnet, Indep. Consultant
Williston, Vermont
mailto:[log in to unmask]
http://together.net/~kbruce/kbbspin.html
LACTNET Archives http://peach.ease.lsoft.com/archives/lactnet.html

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