to follow the thread on RN job req'mt for LC position...... As an RN who has
practiced in a hospital setting with 9000+ deliveries/yr., large NICU etc. I
have some thoughts on this.
I must say that I am very thankful for the diversity within our
practicing LC group and would never want to alter the wide scope of
experience and thus information shared and available to us all. I do also
think, however, that an RN with extensive mother/baby experience could offer
some unique adavantages over the non Rn LC within the hospital setting,
particularly the hospital setting described which includes a NICU. So much of
the hospital LCs time is spent trying to expand the thinking of the staff RNs
and MDs and this, it seems to me, can OFTEN only be done with a practicing
knowledge of the basics of what they do and why they do it. Several examples
might help to illuminate this point; take for instance the NICU baby, just
starting to nurse, I am consulted to assist with a feed and offer suggestions
to all involved, this baby is now 34 wks gestation is still on a monitor has
an NG tube for the feedings he can't take by mouth, has a runnining IV and is
in an isolette for temp control. I arrive to find the Mom attempting to feed
with the baby 6 inches from the breast d/t a pile of blankets, hat etc.,
tethered to the leads from the monitor,IV, and the babe asleep with the nurse
and Mom saying "he really is too tired to eat, I think we should try the
bottle or NG feed him" How comfortable would the non RN be to make
appropriate suggestions or even ask relevant questions at this point?
Questions aimed to assess the necessity of the use of the monitor for fds, or
a suggestion to remove the blankets with an experiential based knowledge that
the baby will maintain his temp well but will wake up and be physically able
to latch with certain interventions.
Another example; you arrive to assist a 24 hr. old baby who has yet to
latch and find the baby asleep at feeding time , wrapped again in several
layers with hat and upon suggesting to the MOm that we strip the baby and
offer skin to skin you are told that the baby has had some temp instability
and must stay wrapped or in the isolette at all times. How comfortable would
you be to question this intervention or even know the appropriate questions
to ask? An experienced LC could certainly cite the research and might know
just as much about that in theory as the RN but applying that knowledge to
this specific instance w/o the medical background might be difficult or even
impossible.
As a hospital based LC you spend so much of the time bucking currents
practices, in order to be an effective advocate for breast feeding you often
need to know and understand the basis for the current practices in order to
change them. Does this make sense? RNs with hospital experience have a unique
perspective, experience, knowledge base that can be an integral part of the
hospital based LC role, as recognized by the people posting this position.
Do you have to be an RN to be an LC?, God no.... Do you have to be an RN to
practice as an LC in the hospital? In some settings-no, in some settings-
maybe, and in some settings- definitely!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts
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