Hi! I work ata hospital and Milk Bank in NC and am not a RN. I have 2
associate degrees-one in Mental Health and one in Early Childhood Education
and a BS in Community Health Education. If you look at the history of
credentialing LC's it began ( I think ) as a way of providing for further
training and credentialing for La Leche League Leaders. I have been a LLL
leader for 19 yrs and a IBCLC for 10 yrs. I have worked in public health for
7 yrs as a bfing coordinator and 2 yrs as the Education Administrator.  If
the person at your hospital says that the LC's are doing something that is a
RN duty, perhaps you need to look at your program more closely and more
clearly define roles.  I sometimes see this in our program with the LC's who
are RN's --they tend to perform more nursing duties and I try to remind them
they are not working as nurses. One of the differences is that RN's tend to
be more take charge more physically ( more hands on) ( sorry for the
generalization -I know there are individual differences) and have less
counseling and educating skills.
An example of this is when a LC came in and said she was going to get a blood
pressure cuff because she thought the mom's BP was up and she ws going to
take her BP.. I reminded her that we need to refer this mom to her OB for
that  because that is outside our scope of care.  I tend to do more teaching
and directing the mother to perform her own care (and the father). After all,
it is their baby and I',m not going home with them . They need to learn to
breastfeed on their own. I don't change diapers-I teach the dad to do that by
talking him through the process.
 And  the other skills of a Health educator is critical for the development
of the program. Needs assessment, data collection and intepretation,
grantwriting, program development, staff training, development of patient
education materials, etc are areas in which health eduators have education
and training. I find my LLL training in counseling and listening is
invaluable.
We all bring in to Lactation our individual backgrounds, experiences,
education and preferences. However, we need to remember who will are, remain
within our scope of care. And when doubt, ask how would this situation look
in a malpractice hearing.
There are several sources for information on the roles of an IBCLC. There is
a chapter in  Riodan/Auerbach's book, Linda Smith has a book, the IBLCE code
of ethics, etc are a few that come to mind. LLL has had several good articles
in Leaven ( journal for leaders) on role deliniation. The Peer Counseling
Training program for Administrators also has information on defing roles and
responsibilities.

Barb Whitehead, BS, IBCLC
Eastern NC

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