Working just a few hours a month per diem on the floor as an LC really opened my eyes to the reality of what is going on before I usually see moms, which is in private practice.  My shift is 4 hours long.  A typical morning involves working with anywhere from 5-10 moms, usually at least a couple have babies in the SCN.  Last time, one needed to rent a pump before going home and another needed a starter SNS and some training.  For me, a really long session is 20 minutes - many are much less.  All visits must be charted and often I must try to touch base with the nurses so that they know what the care plan is for each mom.  Sometimes I have to try to return to the floor later to catch the mom/baby at a more convenient time.  Sometimes the babies have just been circed and are totally shut down.  After the floor, I check for messages on the hotline - there are usually at least one or two.  Then there are all of the follow-up phone calls to the moms who have gone home - everyone gets at least one, many get several, some turn into a long-term relationship.  Sometimes a mom comes in for an office visit.  There is hardly time to catch one's breath.  This is the usual routine, I think, for most hospital LCs.  The floor nurses are just as busy, doing labor and delivery as well as post-partum care on the same floor.  It is crazy.  What a shock after the leisurely 1-2 hour visits I was accustomed to in private practice.  It is very fulfilling to watch these moms get started, but also frustrating as there are many problems and always the feeling that there is so much more that I should be doing.  We also refer out as well as doing our own follow-up.  It would be so great if we could all walk in each other's shoes for a short time - all the different practices that we have in so many different countries.  At least Lactnet gives us a nice glimpse into each other's lives and widens all of our perspectives on a daily basis.

Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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