FWIW, I do think that for hospital work it would be very helpful to know 
more about medicine and surgery and nursing, not to mention hospital 
hierarchies, than I do.  In a perfect world, I think hospitals should 
absolutely hire IBCLCs who aren't nurses, but all IBCLCs should also have 
some education in their specific practice setting.  So, those working in 
hospitals would have to do some coursework or orientation that would 
briskly cover a wide range of pertinent material including hospital 
administrative structures & routines, basic childbirth management (in 
hospitals -- and out of them), the bare-bones basics of anesthesia & 
radiology, etc.  If we want all hospital personnel who might work with 
breastfeeding mothers/babies to have a basic idea of lactation, it seems to 
me LCs could reasonably be expected to understand how their work intersects 
with the rest of the hospital.  It's too easy to make silly mistakes, 
otherwise.  LCs who aren't RNs need all the credibility they can get.

I've had people say to me "how does your hospital dare to have a non-RN 
doing hands-on clinical work with patients?"  I don't know why this would 
be a problem when (as others have pointed out to me) occupational 
therapists and physical therapists, for example, are not nurses either.

Elise Morse-Gagne
LLLL, IBCLC 

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