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Subject:
From:
Patricia Young <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 11 Dec 1996 12:54:31 +0000
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Someone commented on new moms being in the novice stage.  I totally agree
that's why they want minutes per side, which breast first, how many times.
To just nurse ad lib is SCAREY to a novice.  The new mom wants to do
everything RIGHT.
Perfect example of a novice.
Another new article-Imaage: Journal of Nursing Scholarship, 28,4, p.331-337,
Sandra K. Hanneman, "Advancing nursing practice with a unit-based clinical
expert."  The article deals with an advanced practice nurse, specializing in
pulmonary in an ICU, however it would be very easy to substitute
"hospital-based LC" in the article. The author discusses Benner's theory of
novice to expert, as a continuum that a person moves along, with years of
experience being the key. However, the author found that length of time was
not necessarily the key to why someone progresses along the continuum.  She
found that active work on the part of the novice and presence of a catalyst
(expert) on the unit appeared to be necessary for progress to occur.  Over
the 6 mo. of observation in this unit, 2/3 of the novices progressed along
the continuum, working with the expert, as catalyst. 1/3 didn't, which begs
the question - why?  Which probably leads into Roger's diffusion of
innovations theory and the personalities he describes (which unfortunately
means that there will always be a certain portion of staff, who can't ever
catch up).

Another very interesting result noted in the study was that expert practice
was guided by decisive action and a strong patient-outcome orientation and
nonexpert practice was strongly task oriented.  This was well illustrated
with several vignettes.  Another observation was that "expert practice often
results in early and aggressive interventions."  The end result was that
"outcomes of expert practice included prevention of complications,
purposeful recovery, and humanistic care."  In other words, they had better
patient outcomes, which results in higher patient satisfaction and decreased
time in hospital.

The article validates the need for a lactation expert on the unit, so if you
need some research to help justify a lactation position, this article is a
winner.  If you can't get a copy, contact me with your address and I'll
snail mail it.

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