Kim,
Realistically, with 500-600 births a year, I doubt if you could
justify 24/7 LC coverage in today's world. That's less than 2
births per day and an average of 4-5 moms on the unit at a time.
Depending on your personal life outside the hospital, the ideal
schedule would be to spread out your 20 hours to 2-3 per day (which
would give you no days off!-not really practical). Less stressful
on you, but still allowing you to see most moms at least once would
be to come in every other day. When the nurses ask for 24/7 are
they expecting you to do all the breastfeeding teaching? help every
mom with the first (or every) nursing? Staff nurses should be able
to give the assistance and education needed for "routine"
breastfeeding (to the extent it is ever routine). The LC would be
there to help and work out care plans when nursing isn't "routine".
I firmly believe it is helpful to touch base with every nursing
mom. This isn't necessarily to cover what the nurses should be
teaching, but to clear up any questions, give advice/help when
needed and to let the moms know what help is available if needed
after discharge. I think mom is much more likely to call with
concerns when she can put a face with the phone number. We would
often have a mom call and ask for the LC who saw her in the
hospital, but in most cases was perfectly willing to talk with
whoever was there for the day.
When one is the "lone" LC, it is important to have some kind of
backup. This can be a "pool" LC (sometimes called "per diem"), LC
from a sister hospital or whatever. I knew one LC who was the only
one and she was never allowed to take a vacation, attend workshops
or conferences, etc. because there would be noone to do her job if
she wasn't there!
Often, LCs in your situation, if they are also RNs are asked to wear
both hats. While this may be better than no LC, it has many
problems. Often, the greater the need for LC help, the less
non-nurse time the LC has to meet those needs! Nursing duties take
precedence over LC duties, often to the detriment of the moms
needing help.
Good luck.
Winnie
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