Theresa writes....
There are excellent IBCLCs and scary ones. Excellent MDs and
scary
> ones. Excellent RNs and scary ones. Excellent teachers and scary
> ones... the list goes on. The point is, what is your solution to the
> problem? How can any credentialling body really ensure that the
> people whom they credentialed are not giving wacky advice that may
> actually be harmful? Man, I can tell you I've seen some IBCLCs give
> some truly harmful advice, doctors and nurses, too. So, what's the
> answer? We recertify, take ed hours, re-take exams...
> but none of that is an insurance policy.
>
The answer is not simple by any means - would annual peer review
help? Using the professional model of the New Zealand College of
Midwives I'll explain.
Every year midwives use a set format for data collection and submit
this report, along with random client records and samples of client
handouts, to a review committee comprising equal numbers of
midwives and consumer representatives.
The process is at a cost to the midwife and it's a lot of work for both
midwife and committee. It's purpose is reflective and educative not
punitive. For example, if a midwife sees her collated exclusive
breastfeeding rate is way below the national average or she has a
high ecbolic rate or a high ultrasound uptake etc. she can look at
each client and justify to herself and/or the committee what happened
and if it was justifiable.
Conversely she may realise or be encouraged to update on a certain
area of her work. Obviously the committee itself needs to be well
briefed, skilled and knowledgeable in order to improve the midwife's
practice if necessary. Again, support by the committee is essential to
enable the midwife to come out stronger and better not burnt out!
Many years ago I drafted some forms for IBCLC peer review and did
a conference session on the topic but the idea never took off. I'd still
welcome being "undressed" at an LC peer review to gain support,
encouragement and assurance that my practice is OK or wanting!
When some kind of the peer review, attached to practising
certificates is undertaken, could it be perceived by the community
that the profession (NZLCA in our case) protects its consumers by
periodically monitoring the standards of it's lactation consultant
members thereby adding value to the credential?
Marcia Annandale, IBCLC, LLLL, Christchurch, New Zealand
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