It's taken me some time to put together my thoughts on the lesser
credential, but I'd like to share them. I am a CLC, and am just beginning
practice, under the supervision of an IBCLC. I think there is tremendous
value to this system, and hope it is the intention of IBLCE to strongly
recommend, or better yet, *require* that all lesser credentialed
individuals practice under the direct supervision of an IBCLC. I think it
is OK to leave the degree of supervision up to the IBCLC - for example, if
the individual is very competent and well-educated, the IBCLC may be
satisfied with a weekly review of cases and/or chart review (like an NP
practicing under a physician's supervision), while someone just starting
out will need much more in-person supervision. We are fortunate enough
that both me and the IBCLCs at our clinic are able to get paid during the
time I am being fully supervised. Kathy Eng posted that she thinks this
kind of situation will be rare, but why not shoot for the ideal? I mean,
can an LPN practice without RN or MD supervision? Can a paralegal practice
without the supervision of a lawyer? I don't know the answer, but I don't
think so. Why not make IBCLC the same way?
Two more thoughts:
First, IBCLC itself MUST incorporate some clinical competency standards. I
could pass that test tommorrow, becuase I'm a good test-taker. I've had
about 50 hours of direct clinical lactation experience, and over 100 L-
CERPS. I could pass the test, and if I worked maternity or somewhere there
was someone to (unethically) sign off on my hours, I'd be IBCLC this
summer - which I don't think is right. But I don't think practicing
unsupervised for 2000 hours is going to improve my level of care either -
I'll just keep doing the same stuff I've been doing. There needs to be a
combination of mentoring AND assessment of clinical skills to the
certification. The number of hours is meaningless without these things.
And there are certainly individuals who could be at appropriate IBCLC
skill-level with far fewer hours, if the hours were truly learning
experiences, not just repetition of the same old stuff "learned" years
ago.
Second, here in Vermont, we are working towards licensure, which I believe
is necessary. The fact that anyone (myself included) can use the
title "Lactation Consultant" leads to the kind of confusion among
consumers that degrades the profession. If the "lactation consultant" in
the hospital told you one thing, the "LC" at your pediatrician's office
something different, then the private practice IBCLC really doesn't have a
leg to stand on as the authority in the situation. Someone can be
an "assistant" or "student" LC, or a "breastfeeding assistant" or whatever
the lesser credential is called, as long as it's not something like "CLC"
that is so easily confused with IBCLC or RLC. This will have to progress
state by state, but I encourage all U.S. IBCLCs to keep pushing for this.
Freely confessing my ignorance, what states have already done this? What's
the feedback? Were IBLCE credentials accepted as sufficient for state
licensing?
OK, the windbag is done. I support the lesser credential as a formalized
training system. It also provides an important mechanism for organizations
that simply can't have 10 IBCLCs on staff, but can manage to get 9 people
through the lesser training with an IBCLC overseeing the work and
consulting on difficult cases. This ensures at least a minimum standard of
care from the lesser credentialed "assistants". Formalizing the heirarchy
of levels of care, I think, can help clarify the mish-mash of titles to
the public.
Thanks for hearing me out!
Kirsten Berggren, PhD, CLC
www.workandpump.com
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(R)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|