I have two arrangements that I have been lucky enough to get that help me to
obatain QUALITY practice hours.  I will take time to explain a little anout each
since this is such a hot topic and issue that needs serious attention.

The first arrangement I have is with a breastfeeding friendly Ped.  I was
talking to her via e-mail about my second arrangement and she offered to
precpetor me in connection with her private practice and has even persuaded
other Peds. and the hospital to allow me access (of course access to her
patients).  I have seen only one patient and aside from the fact that I was
extremely nervous about how RNursing staff would handle my presence and because
I am unfamiliar with hospital procedure, it was great.  Yes, I did make a few
mistakes but nothing so terrible.  Isn't that what mentoring is about anyway.  I
have also help create a drop in chart for LC reports (because I am not allowed
to write on the chart as a student) for use in this situation and keeping the
doc informed.  Now we are working on developing a lactation policy/program and
kicking around ideas to get the program to pay for itself (this makes it easier
for hospital budget people to approve).  If you have created such a program at
your facility, PLEASE e-mail your suggestions and maybe I could bounce ideas off
of you.  Anyway, I have been lucky to find this Ped, she has been great and is
starting to changed my opinion of Peds in general if you can believe that!

The second arrangement that I have is with a hospital in the not-so-local area.
I will be preceptored there by the IBCLC who works in the nursery.  The great
part about this one is that they have a WONDERFUL lactation policy already in
place.  They do not give ANY bottles to a breastfeeding baby NO MATTER WHAT!  I
almost fell over, that's unheard of in this area!  I have not offically started
this volunteer/mentoring relationship but I have been invited to attend their
lectures (using Georgetown Material) on hospital breastfeeding initation.  I
even get CERP's for my attendance!  The IBCLC works 3-11 pm so I don't need to
hire a sitter to attend and after my brief training, I will be working hours
opposite her.

Both of these arrangements costs me for travel but that's all.  I do not have a
real opportunity to make $ during these arrangements.  The IBCLC arrangments
forbids me to mention any businesses or referrals to patients (this is the same
for all staff, I think its very weird), and with the other, maybe I'll get a
occassional pump rental or something.  But the point is they are happy to do it
and I am grateful for the experience.

In order for me to get these arrangements, I sat down with Riordan and mapped
out an outl;ine of what I wanted to do, put a breif cost blrub beside each and
mailed it to every hospital I could find within a 100 mile radius.  I heard from
3 but only one took me up on it.  If you do this, beware that I have had
problems with hospitals using my info to have their staff do the work, leaving
me out in the cold.  If you go for interviews watch them carefully.  One of the
signs that you are being used for info in my experience has been if you have the
mat/child director, heads of nursery, maternity and Ped. there and they all want
to know how other hospitals are doing it or even if they are doing it.  I had
traveled FAR to a hospital, had an interview and had been given the impression
that I was in only to find that they sent 4 of their RNs to Georgetown and are
impletmenting my ideas!  I was MAD!  That cost me $ and time I could have spent
elsewhere.

One thing that I did notice is that IBCLCs in this area were either willing to
mentor but didn't see enough clients, not able to mentor because of insurance
reasons with employer (home health type situations, or were not receptive
because they weren't benefitting from doing so.  I think that this is wrong!
Don't you get credits toward recertification for mentoring a student?  Believe
me, it cost the student much more for those practice hours you are mentoring
than you could be making with clients!

In closing (finally), this profession will become what we make it.  If we do not
nurture the up and coming properly the professionas a whole will suffer and
reflect badly on you, the IBCLC.  I see it as your decision, I will be as
educated as I can be but only as experienced as you let me be.

Speaking of hitting a nerve.....what have I hit?

Melissa Brancho
Mom of four, BSC student and IBCLC hopeful for 1998!