Jan writes:
<If it  were left up to us RNs, this profession would -- words fail me.>

In 1950 when I was still in nurses training, respirators came into the
hospitals, and their use was assigned as one more nursing treatment. Look at
the development of the Respiratory Therapy profession since then. I still
remember when as an OB clinic nurse, I had to do the dietary counseling and
the absolutely necessary social work along with the nursing care. In the
ensuing years, the appropriate professionals were hired to plan, direct and
provide this care. Maternity nurses (and I speak from 50+ years as one) had
the opportunity for decades to "get it right" on their own in hospitals and
public health to get moms and babes off to a good start. Using the old
rules, I stopped at 5 days with excruciating pain with my first three
children. I got personal help from LLL with my fourth child 47 years
ago, and after returning to work on postpartum, then had to fight for years
to get some of the policies changed by the 1970's. It finally only happened
then because others retired and I got promoted into a position where I could
actually help make some of the policies. Each different hospital, public
health department and WIC project has it's own battle stories to tell.

In the same vein, I received my 2006 recertification newsletter from NCC and
note that the Breastfeeding Specialty Certification exam has been
discontinued. I don't know how that came about or why-perhaps too few
signing up to take the exam??? Nursing certification is moving full speed
ahead in many specialty areas, but breastfeeding appears not to be one of
them, and perhaps rightly so, because it ought to be a part of the core
knowledge of all NCC nurses who certify in in-hospital and/or NICU
specialties.

But I can't help thinking that besides LLL's mother-to mother pioneering in
the U.S., their foresight in facilitating the establishment of the IBCLC
credential, and particularly the earnest work of ILCA, has been a
major force helping to turn the tide somewhat, at least in U.S. hospitals.

We are a young profession, and our organizations are young organizations. I
would hate to see this current scope of practice challenge fracture this
momentum. Maureen's post gives me the impression that we are being heard and
will continue to be heard. We need to be patient, take one day at a
time, and find a way to stick together to move forward in all the arenas
where we will continue to be needed by moms and babies.

Jean
*****************
K. Jean Cotterman RNC, IBCLC
Dayton, OH,

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