This certainly is a sticky subject with good points on all sides.
I do take exception to Valerie's view that hospitals should not be
renting pumps.  Perhaps this argument can be made for Level 1
hospitals.  However, as a hospital with a Level 3 NICU, I feel this
is at least as much a service as a profit-making venture.  Moms are
encouraged to learn hand expression (especially for use if needed in
the first days of a full supply).  However, not everyone is going to
opt for that as the only means of expressing for a baby who is not
able to nurse yet.  In some cases, mom will board until her baby is
ready to go home and will continue to use a hospital pump.  However
most, especially those with very early babies,  will go home needing
to express milk.  This mom is already under a lot of stress and
getting adeqaute rest is a big challenge.  Going to another source
for pump rental may be one too many challenges.  Then, she needs to
either go to a place that rents the same brand or be out the expense
of another personal kit.  Sure, she might send someone else to rent
the pump, but unless it is precisely the same as the model she has
used in hospital, she will need additional instructions.  Having
those instructions relayed through another person isn't that
practical or reliable.
Then there are those moms who seek a pump as the solution to
whatever problem she is facing when the pump isn't the best answer.
On many occasions I have "talked a mom out ot" renting a pump by
identifying and helping her solve the problem or even assuring her
that there is no problem in the first place.  She would NOT get this
from a commercial rental source.
I always offer our service as ONE source for rentals.  Especially if
I note that a mom lives some distance from the hospital I will
suggest a closer source or refer her to the 1-800 phone number to
find a source.  Mothers who live in a nearby county that has much
better coverage through their public health service will always be
referred there first.
Another advantage, at least in our area, is that pumps are not
available from any commercial source from noon Saturday until Monday
AM.

Yes, we do need to be careful that we are not promoting use of a
product with the thought in mind that it will be a finalcial source
for us.  We have to be sure we are not grabbing a "gadget" too
quickly to solve a problem.  On the other hand, even without
anything to sell, there is a danger.  Not every mom with a question
needs a consult.  We also have to be careful not to encourage a
consult so we can charge the mom.  Our supervisor recently asked why
we didn't have as many outpatient (chargable) consults in the last
quarter as in the one before.  I would like to think that maybe it's
because we're doing a better job at helping moms get off to the
right start as inpatients!  We all resisted loudly the implication
that we should be "looking for" more outpatient appointments.

There will always be ethical questions and grey areas.  It is great
that we have this forum to hash them out.  Let's all try to be open
to listening to all facets of these questions.  By open-mindedly
listening to viewpoints counter to our own, we may find reason to
alter our views or we may find reinforcement for the views we
already hold.  Either and both are good outcomes.

Winnie

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