Laurie,

I sympathize with your impatience, but I hope you can be satified with
making haste slowly in order not to burn yourself out. Focus on a few
central priorities for now and ration your energy so you can stay in for
the long haul. I fear there is really no quick fix.

Having been in a position somewhat analogous to yours many years ago,  I
agree with Cathy that one more piece of paper among the tons they have to
shuffle is not likely to get the attention you hope for. It might even
backfire by fueling resentment.  "Mandatory" things often create backlash
like passive aggressive behavior on the part of affected staff. You catch
more flies with honey than vinegar.

Have you considered providing the patients with cards with NO RUBBER
NIPPLES PLEASE,  etc. for the client or her S.O.'s to request to be
placed on the crib or isolette? They, after all, are the consumers of the
services, and the employers of the staff.

And don't overlook the longterm. There is power in suggesting to families
that since this is a newly added service, you are asking them to write
letters to the CEO, complimenting someone on the staff (tell them not to
make it just you, but name the particular nurse, doctor, nursing
assistant etc.) for their positive contribution toward a successful
breastfeeding experience and whatever else they especially liked.

The CEO usually sends copies to the unit. Supervisors have been known to
post them, sometimes in the bathroom where there is a captive audience!
There is nothing like the power of praise for one's named colleague to
help change the attitudes of some others. Peer pressure, in a positive
way.

If there are any complaints or suggestions, it's best to have them
sandwich them briefly in the middle, with positive "strokes" for the
staff at the beginning and end. Our local childbirth agency emmployed
this method and made a terrific impact on staff morale and attitudes at
the time they were switching over to Family Centered Maternity Care and
husbands in the delivery room in the 1970's.

Please remember, despite the special knowledge you have in lactation
management, the personnel on the nursing and medical staff have multiple
areas of expertise which you may not be able to imagine, that they must
continually update themselves on. So they need you there for balance.
Maybe if only by a "journal club" approach.

Those who are really interested in improving may devote the time on duty,
if and when a few moments are available, to reading a few expert
references that you select to make your most important points. "Clinics
in Perinatology", a very respected reference in this field, devoted the
entire Volume 26, No. 2 june 1999 issue to (subtitle) "Clinical Aspects
of Human Milk and Lactation." It was priced very reasonably and is
availabe from W.B.Saunders. Just be sure to tag it with your name, or
your department's name to keep it from "walking"!

Hang in there girl, and "Illegitimi non carborundum!".

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA


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