Dear Megan,
This issue has been a HOT one in our unit for a long time.  We have a unit
clerk who is very knowledgeable about BF, and a shift of RN's who are
uncomfortable with their BF skills.  So what happens is that they rely on
her to do their work...teach the patient...make assessments about
progress..everything short of charting.  I see two things wrong with this
1.  The patient deserves an assessment by the RN, with the nursing process
it intails..ei: evaluation, planning, implementation, evaluation.  2.  The
RNs' BF skills do not improve.

I think it is wonderful to have any knowledgeable, supportive BF staff
available, but I would urge you to be sure that the RN is included,
informed, of any BF teaching you do.  Find out if teaching is part of your
job description.  If you find a problem with BF alert the RN, encourage her
to investigate, offer the patient the opportunity to talk with the RN, and
then offer what skills you feel comfortable with such as:  "I can help her
reposition the baby, would you like to talk with her later to see if she
needs further info?"

If your job includes charting- CYA !- by charting RN notified of any
perilous conditions. And find out what policies are in place that support
any of your interventions.

Good luck
Lucy

----------
> From: Megan <[log in to unmask]>
> To:
> Subject: A job!
> Date: Tuesday, January 27, 1998 2:47 AM
>
> Dear Lactnet,
>
> In a few weeks, I will start my first job in the area of Maternal Child
> Health.  I am a student nurse in my last semester of school.  I will be
> in the Maternal Child float pool.  (my title is Patient Care
> Assistant).  In the interview, I was careful to state that I understood
> I was being hired as a PCA, not a staff LC, but that I would like very
> much to help with BF teaching.  Any tips on how to let nurses know that
> I would be more than willing to help without making look like I am a
> "know it all"?  I will be working nights at a HUGE county hospital.  As
> far as I know, they do not have any LCs on staff at night.  One thing I
> am taking into very careful considereation is the fact that I would like
> a job there after I graduate with my RN, so I certainly don't want to
> offend anyone, but of course I want to help BFing mothers all I can.
>
>
> Megan Schmidt, LLL, SN, IBCLC
>