This is an interesting discussion.  I worked as an IBCLC before becoming a
nurse, and after.  I know, personally, how much is taught about breastfeeding
in nursing school - and how little attention is paid to it.  A mere 3 years
ago, I received 1 (one) hour of breastfeeding education at a highly reputable
University School of Nursing.  That was in the same seminar that we nursing
students were informed that newborns *need* to cry it out to strengthen their
lungs.  I'm not kidding, that was 3 years ago.

But, I become defensive when the process of becoming a nurse is devalued.
 True, I changed a lot of sheets, cleaned a lot of excrement, counted a lot
of IV drips, and I do a great bedbath.  I also learned to calculate drug
dosages, read a cardiac strip, understand acid-base balances, and do a neuro
check on a stroke patient.  I understand skin care for an AIDS patient, I
know what to look for in a hemophiliac, and I know that ROM can have three
meanings, depending on which department you're in.

Learning is never wasted.  We have all collected our knowledge by individual
routes.  So, What does the LC need to work in a hospital setting?  If a
community based LC needs to learn some skills, that should be fairly easy to
accomplish.  If I were suddenly to work in Cardiac Care, I'd need to take a
refresher course.  Let's put ourselves through the paces and hone our skills.
 There are a lot of advantages to keeping our skills sharp.  We should
require it of ourselves.

I think we can better advocate for having a non-RN IBCLC in the hospital if
we can show that her skills are equal to the task.  On a practical level, we
need to educate the people who write the job descriptions so that the job is
not posted for RNs in the first place.

Jeanne Fisher
Austin, TX