Margery,  I did think that the letter was written quite nicely I can see the
need for extra qualifications within the hospital setting, especially if the
job description includes direct handling and care of neonatal, sick and
newborn infants that need initial assessments. The RN needs to be well
versed in the equipment that may be used. An RN working with newborns,
prems. etc. is also required to be certified in neonatal resucitation.

Sometimes I think it shouldn't make a difference but at other times I
realize that when thinking as an obstetrical/Labour and Delivery nurse it
has been easier to confront other nurses or doctors. Especially when I'm
teaching workshops to these folks and they say you know how busy we are, we
don't have time for this or that. Usually I'm able to explain quite kindly;
been there! done that! so don't give me too many excuses. Try it, you might
even like it and in the long haul it might be easier. Sometimes I'm not that
nice. But often does help to see the browder picture.

Often there may also be an issue of being part of a nurses union as part of
the job description.

However If an LC is required in just an outpatient clinic setting, I feel
that whether she be an RN. or IBCLC through other qualifications, I feel
that a certain amount of experience as an IBCLC is more important than what
track she followed to get it. Passing the exam is not all that it takes to
be a good LC. I have heard inapropriate and/or  wrong information given by
RN, IBCLC's who have not kept up with current research or were not
practicing LCs. A breastfeeding course is often taken around here to try to
keep a job with more courses under their belts.

Sorry I was lengthy but I hope others respond as well. This has been one of
my pet peeves.

Attie Sandink RN. IBCLC. (Ontario, Where spring finally seems to have sprung)