At our small Wisconsin hospital, (approx. 650 del/ yr),  each and every
staff member has an annual performance evaluation.  Input from myself and
the other IBCLC is sought on EACH RN.  This is our means of preventing
incidences that do not follow our detailed breastfeeding policy.  Of
course, if there is a problem, it is dealt with immediately, not waiting
for an annual review.  We used to have a problem with supplements during
the night (giving "colored water" as they called it), but not anymore.  An
extensive education program helped  immensely.  Fortunately, my Clinical
Coordinator and Director are very committed to breastfeeding and it's
endless advantages.  We've come a long way!  The nurse that Jay spoke of
would have been reprimanded at the very least, if not suspended.  Other
hospitals with similar difficulties may want to consider LC input in
performance reviews.

Barb Whynaucht, RN,IBCLC  on my 1st day of a four week, long -awaited
vacation.  YEAH!!!!