Oops! I forgot to answer the second, and more important half of the question.
My partner that I job-share with and I function solely as LCs. Some of the
nurses were actually surprised that I actually "know" nursing stuff and could
function in the role of a critical care nurse on a medical mission!!!

We are not expected nor asked to perform any nursing tasks, although as
Advanced Practice Nurses working in a consulting capacity, we certainly
perform numerous nursing functions (education, collaboration, consultation,
expert clinician). We also participate on various hospital task forces or
committees.

Because we were not originally working as staff before being hired as LCs, I
think that it is easier for staff to view us solely in that role. We
previously worked with a third LC who was a staff nurse, given "lactation
hours" one-two days/week. She had a terrific problem getting to see patients
and generally act in the LC role on those days as the staff  "knew" her in
the nurse role, and always asked her to do other things. The most they ask me
to do is watch the desk, answering the door and phone for a few minutes if I
am charting and no one is at the desk. (I actually change diapers, do a lot
of newborn teaching to the moms, and other patient-oriented tasks but am not
"expected" to do so).

I think that if you changed roles within the same unit, it is much more
challenging to establish yourself as an LC. It may help to collaborate with
the nurses, discussing the care plan of the pt with the nurse as a colleague.
You can bring up concerns and ask their opinions (the other day I picked up a
baby who was noticeably jaundiced when it was only 18 hours old--I went to
the primary nurse and asked her to look at the baby and see what she thought,
We then discussed what this could mean, and she contacted the MD for
bloodwork--made her look good to the doc, too!!).

I think the hardest part is getting them to see that you are performing a
vital role--that you are not doing "nothing" while they are working their
tails off on a busy day. Perhaps offering to go in to a new delivery and get
that mom started with BF will free the nurse up to do her charting on the
delivery. She may then perceive you as more helpful to her when she is busy.
Or running an errand when the unit is busy--answering the phone or door ro
call light, or running something to the lab is often very helpful and seen as
considerate. Just talking about the patients with the staff, before you go in
to see a mom, or afterwards, helps to establish that you are all there for
the same purpose. I like to go into the NICU and talk to the nurses before I
see moms with babies there. They give me their expertise on what the baby's
condition is, and I can then act as a go-between to the mom as well. I am
sure there are many more suggestions that people can share on this topic.
Good luck!!

Kathy in NJ IBCLC
RN C (Maternal-infant), APN C (Family Nurse Practitioner)
PhD student hoping to study labor and lactation issues

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html