Yes, it's true that administrators  and nursing managers view LCs in a  
totally different context.
Here in SFl we have the luxury of 5 IBCLCs and only one is deemed the real  
LC....she is currently on FMLA and may not return.  We all offered to fill  in, 
but "NO" was the reply.
But when a VIP patient requested specifically for a consult....they asked  me 
to see her...then when someone else asked they sent the lady who teaches MB  
and CPR and Infant Masage classes because I had a full patient load.  If  
someone needs to be seen on the floor I am assigned to as a staff nurse and I go  
its "OK", but we have a PT and one per diem nurse who would do rounds as LCs 
but  "NO"...staffing can be too tight...either we have not enough staff or we 
haven't  enough patients. The rule until Renee went out on FMLA was to pull her 
to do  patient care because the budget was tight. Now the instructor LC is 
going out on  vacation for about 3 weeks or taking an FMLA as well and that even 
spreads  resources more thinly.  
Management doesn't put a premium on breastfeeding because she doesn't have  
children and doesn't think its important. The only thing that gets their  
attention is the patient satisfaction surveys and when they come back and give  
poor numbers and bonuses are not coming....then they may get intuned.
As a nurse I really don't like taking 5 couplets and running to see  patients 
becs as we know its time consuming (like it's supposed to be ) to see  Moms 
with problems and I certainly wouldn't want to be seeing LC patients and  then 
get pulled to do patient care.  No one wins. 
All I can do suggest give me fewer patients and let me see patients on the  
side I am assigned but then my coworkers get stuck with bigger assignments and  
that is a definite no win situation. 
So at the next staff meeting on Tuesday we plan to address it. Might  get 
shot down (won't be first time) and see what the new plan is...will also  take it 
to the Patient Satisfaction Committee meeting where we review the  surveys 
and try to come up with ways of improving the scores....My feeling  is the more 
people know about why the patients aren't getting what they deserve  and 
request the more the blame will be centered on the problem and if its becs  someone 
won't address the need one way we will another. Until then any patient  who 
leaves our unit is given the number of an outside IBCLC or WIC helpline  for 
followup after discharge and its written down.
Frustrated as much as  everyone else.
Leanne Jewell RNC, IBCLC, LCCE, FACCE
SFl 
 

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