I am so frustrated by a situation that happened last night at work that I
just need to get it off my chest.  I work 12 hr night shift in a level 2 scn.
 We rotate through the nursery and post-partum when needed.  I worked in the
nursery last night with a per diem RN. for the first four hours (7pm-11pm).
 She only works about 1 or 2 shifts a month.  She went to the postpartum unit
(which is down a hallway from the nursery) to check on the babies.  When she
came back she was angry because she felt that a visitor was interfering with
her parent teaching.  This nurse told a mom who's baby was about 6 hours old,
that the baby was starting to get jaundice and she should give the baby  a
bottle of glucose water.  The visitor questioned that and said she nursed 2
children and after her baby got a bottle she had a real hard time with nipple
confusion.  The nurse said this is between her and the parents.  The mother
was concerned and then questioned the nurse who said she didn't have to but
if she doesn't the baby will probably get more jaundiced and need treatment.
 The mother asked if she should nurse first and then give the water.  The
nurse told her since it had only been 2 hours since she nursed she should
just give the water.  When she told me this she was annoyed at the visitor
and I tried to explain to this nurse that we no longer give newborn babies
who are breastfeeding supplements unless it is medically necessary and that
glucose water does not decrease jaundice, especially in a baby who is only
six hours old.  If the baby is jaundiced this early than there is something
else causing it, not breastfeeding.  She then told me she has been a nurse
for a long time and that glucose water will get the baby to void and stool
and decrease the jaundice.  At that point she refused to listen to me.  I had
just gotten a new admission and got not get out to the mother immediately
because there are only 2 nurses in the unit.

As soon as I could I went out to try and get to the parents to explain to
them to not give the bottle but they had already done so. By the way the
night nurse and I both looked at the baby and didn't think she even looked
jaundice.  I spoke to the charge nurse about it (luckily she is also an
IBCLC) and she was also upset about it and said she would speak to the nurse
and give her some information about breastfeeding, jaundice and our policies.
 After she spoke to the nurse (explaining that the mother and guest
 commented to her about it to try and avoid a confrontation between me and
her), The nurse then came in to the nursery and yelled at me that I had no
respect for her knowledge, she has been a nursery nurse for 16 years and she
knows a lot about babies and helping breastfeeding mothers.  I told her she
in fact showed no respect for my nursing knowledge and my knowledge of
lactation which is based on much study and experience.  It was 15 minutes
before the end of the shift and she left.

I am so frustrated by working with people that have probably never read
anything about breastfeeding and go with information that was given to us
10-15 years ago.  I have been and RN for 13 years and in nursing school and
in my orientation to OB and Nursery and ICN I learned nothing about lactation
so I am sure it was the same with her.  10 years ago I might have given the
same advice.  I didn't learn anything until 6 years ago when I nursed my
first child and became very interested in the subject.  I started reading,
attending seminars and helping all the mothers that were having problems on
night shift because most of the other nurses didn't have the knowledge and/or
the patience to do it.  I still feel with many of these nurses that I am
banging my head against the wall.  They refuse to believe in nipple confusion
or the hazards of ABM.  I wonder how many others have this problem.  The only
way I feel I have helped these nurses is that they won't sneek a bottle inot
a breast fed baby at night when they know I am working.  I do know that they
do it when I am not there.

I guess I have gone on long enough.  Thanks for listening.
Caren Goldstein RNC, IBCLC