*I also agree with Liz, having a manager that is an IBCLC in larger 
IBCLC groups is important. Below is more of the information I recieved 
from the  Hospital Based Special Interest Group in 2004.
Karen Querna, RN, BSN, IBCLC
Spokane WA USA
*

*Hospital Based IBCLC Roles/Issues  positive and negative.*


1. Patient Responsibility
          a. See all post-partum inpatients
                   1. See patients after first 24 hours unless referred 
for sig. problems
                   2. Floor nurses delaying baby at breast until IBCLC sees
          b. See all mothers and babies on MBU by referrals from staff 
nurses, MD's,  CNM's mother's request
                   1. Other IBCLC's as staff nurses
          c. Develop feeding plans and arrange for pumps when needed
          d. See mothers and babies in NICU
          e. See BF Babies admitted to pediatrics
          f. See lactating mothers admitted to other services in hospital
2. RN's are expected to initiate and assists with positioning and 
latching and basic BF information and too initiate pumping supplementing 
if needed.
3. RN's rely on LC's for as much help as possible with breastfeeding
4. Visit Antepartums
5. Out Patient care
          a.  Staffed to see OP
         b.  Leaves MBU floor to see OP
           c.  Outpatient consultations
                   3 days a week
                   5 days a week
                   7 days a week
d. Post-partum Care Center -
          a. 2-day post-discharge FU for all babies
          b. Call back patients within 5-7 days of birth (3)
          c.. FU phone calls on high risk mothers and infants
          d.Answer warm line
6. Professional education
          a. Staff education
                   1. Quarterly
                   2. During staff meetings
                   3. Teach 18 hour BFHI course twice a year
          b. Informal
          c.. Resident Education
          d. Nursing Student Education
          e. Undergraduate Nursing student education
          fi. Graduate Nursing Student education
7. Pump rentals and sales and assist in Lactation Boutique
          a. Staffed by Medical Assistant, LC may assist as needed
          b. Develop retail rental program
8. Patient education
          a.. Post-partum discharge class
          b. Teach inpatient breastfeeding class 7 days a week for 1-½ 
hours.
          c. Prenatal
          d. Monthly Classes
          e. Community Seminars 3 times a yr.
6. Support Groups
          a. For discharged families'
          b. "Mommy and Me"
          c. 1-3 times per week
7. Free Weight checks
8. Support groups for NICU moms
9. Present on hospital committees
          a. Develop and revise policies and protocols, patient 
handouts, documentation and forms
          b. Breastfeeding Committee
          c. OB Committee
          d. Peds Committee
          e. Conference Committee
          f. NICU Committee
          g. Policy Consolidation Committee
10. Professional Responsibilities
          a. Attend ILCA Affiliate meetings.
          b. Attend local coalition meetings
11. Program development
          a. Office
          b. Space
          c. Visibility
          d. Marketing
          e. JCAHO
          f. Documentation and statistics
 12. Other
          a. Acts as relief staff nurse
          b. Unit Educator, relief staffing
          c. NRP CPR Educator
          d. OB Educator
          e. Prenatal bereavement
          f. Child Birth Education
13. Issues
          a. Revenue
          b. Making Budget
          c. Reimbursement
          d. Not charging for OP-visits
          e. Increasing revenue
          f. Too much formula given out
          g. Workday/ Staffing
          h. Need out-come data
14. Goals
          a. Increasing breastfeeding rates
          b. Increasing quality of care
          c. Baby Friendly
15. Salary/Benefits scale
          a. Salary
          b. LPN IBCLC paid less than RN IBCLC
          c. Paid one dollar more an hour
          d. No educational reimbursement
          e. Overtime - day usually last longer than 8 hours
          f.  No coverage when LC on vacation or at conferences
          g. Union vs. non-union (east coast in us less likely to be 
unionized
16. Job Description
          a. RN vs. IBCLC requirement


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