Hi, Jennifer:  I've been doing lactation for almost 25 years and for the
last 18 have restricted my nursing practice to infant feeding.  And the
acceptance of breastfeeding management ignorance by the medical/nursing
community has been the bane of my existence for all that time.  The ability
to manage breastfeeding by any HCP who works with mothers/babies is a
MANDATORY clinical competency, yet it is OK for a maternal-child nurse to
say "I don't do breastfeeding" when she hires on to work a maternal/child
unit.  But it is unthinkable for the same nurse to hire on to work a
medical/surgical unit and think she can get away with saying "I don't do
IVs, or dressing changes, or Foley care, etc."  She would be laughed out of
the hospital if she approached any other clinical competency issue the way
she is allowed to approach breastfeeding management.  I don't get
it...well, I do but my mind is trying to refuse to get it.  And I don't
think anyone else in the medical/nursing community will get it either until
a lawsuit happens.  A new nurse on our unit who was shadowing me yesterday
asked me how I came to be doing what I do.  I thought about it a few
seconds and told her "I do what I do today because I didn't like feeling
ignorant in front of patients when they were asking me for breastfeeding
help 18 years ago and I realized I didn't know what I was talking about,
even tho by then I had already nursed one baby successfully.  I realized
that personal experience alone wasn't going to cut it.  At the time Pat
Bull had just moved to the Chicago area and came to the hospital I was at
and inserviced us on breastfeeding.  She mentioned that UCLA had just begun
offering a certification program - myself and another nurse were literally
on the next plane to California to become certified in lactation.  I hold 2
master's level certificates in lactation education/consultation and here I
am years later, hopefully a little wiser."
So, I guess I'm trying to say that even though it's frustrating, all each
of us can do is chip away in our own little corners of the world making it
better one mom/baby at a time.  I know it will be time to retire when I no
longer get satisfaction knowing that maybe I helped just one mom/baby nurse
just a little bit longer.
Good luck to you, Jennifer, with the important work that you do.
Happy New Year to all!

Pam Hirsch, RN,BSN,CLC
Clinical Lead, Lactation Services
Advocate Good Shepherd Hospital
Barrington, IL  USA

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