Hi Cheryl,

I think you raise some good points about the LC role.  I am not an academic of teaching or patient care but I think what you are describing is task orientated care as against patient orientated care. Every day I observe the physio go in to post c/s mothers and give a big blurb about what to do and what not to do - these mums are in a haze of post-op pain killers and take in very little of what the physio says.  I wonder why they bother!  To me, this is a task orientated approach and does not meet the mothers need at all, yet the physio department can say they see X amount of post c/s mothers each week.

I too, am part of a 2 person LC team (my colleague is part time) in a busy maternity hospital.  As we are a BFHI facility, a lot of our focus is staff teaching, which includes bedside teaching to help the staff support mothers and babies with the establishment of breastfeeding.  Our focus with a consultation is to; take a history, observe a feed, ask questions, give suggestions and work out a plan of action that the mother can manage herself.  The aim is for the mum to do most of the talking! Giving anticipatory information can be part of this, keeping in mind retention of information when just given birth and sleep deprived is very limited.

You are obviously uncomfortable with how you are required to fulfill your role and maybe wondering how effective you are being.  Perhaps turning around what you do to ask more questions and give less overload of information may be more effective.  You can always write a discharge booklet with the standard information in it to give prior to discharge (although this too is often ineffective), unless it also contains a feeding/output diary for the first 10 days.

If you need to convince management you would like to change how you work, ask if you can do a months phone feedback survey to ascertain how much information these mum's retained.  This could be a catalyst for a change of style.

Karen Palmer
IBCLC, RM
NZ


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