Dear all:
I've had a bad week, bad month, bad year because I thought I joined a sisterhood that
would be expanding through camraderie (and perhaps a little competition which hones
one's skills). Unfortunately, what I have seen since I joined a profession that I thought
would be a culmination of far too many years in school seems to be dwindling before my
eyes. One practice of the old school that had come up through LLLI has gone out of
business. Another colleague has moved away. Two colleagues are writing books; one
starting a book, another finishing a book and on the conference circuit. It has finally
pierced my thick-headed denial that while I think the hospitals in Manhattan are
understaffed when it comes to lactation services, the private practice sector is even
worse. There are just a handful that do private practice and with the demise of one
group practice it really is not enough. Because I am pig-headed, I won't give up on trying
to figure out a way to make things better for the handful of us that do continue to work in
private practice despite a scope of practice that makes it a huge legal liability to work.
On top of this, I have just had some of my careful evidence-based gentle comments
questioned. I sent an article from the Journal of Neonatology in response, only to receive
the comment from a health care practitioner, but what I did with my child was ..... And I
thought, but did not say, that I did too but that doesn't mean that I would recommend that
practice myself because I know better now. And it is a practice for which there has
already been one lawsuit due to the negative consequences. Between having my IBCLC
yanked and getting sued because a baby dies (OR MORE IMPORTANTLY, knowing that a
baby might die because I did not provide accurate evidence-based conflict of interest free
information), I prefer the former.
Some have excused the poor scope of practice and I can't help but go back to the books
of my childhood. A section of Black Beauty came to mind. Talk about moral values, it is
a total indoctrination in the old school model of novels that include a moral lesson in
every chapter! This little section stuck with me...
After Black Beauty almost died because of a stupid mistake, his groom responds to a
comment about the mistake being only ignorance with:
"ONLY ignorance! only IGNORANCE! how can you talk about ONLY ignorance? Don't you
know that it is the worst thing in the world, next to wickedness? --- and which does the
most mischief heaven only knows. If people can say, 'Oh! I did not know, I did not mean
any harm,' they think it is all right. I suppose Martha Mulwash did not mean to kill that
baby when she dosed it with soothing syrups; but she did kill it, and was tried for
manslaughter."
I cannot, in good conscious, even though I may not ever be able to practice again
because some other health care practitioner might have done things differently with her
own child, withhold information that I know to be true, evidence-based, and conflict of
interest free when it may have an impact on the health of the baby involved.
Best regards, Susan Burger
PS. I am on an I mac and per others suggestions I have checked this and I am sending it
in plain text, not HTML so I have no idea how to rid my posts of the =20.
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