Good questions especially in  these difficult economic times. Hospitals are 
not hiring or not replacing those  nurses who do leave. I am a hospital based 
LC and have always been since I  started 11 years ago. As hospitals look to 
trimming budgets, LC services are  always the 1st to be trimmed. Currently, the 
hospital I work in has trimmed our  budget by reducing hours  and the manager 
for women's services oversees us  rather than having our own coordinator. 
Recently, our retail business was placed  under a retail umbrella which takes all 
our control away. This has many reasons  for concern that I won't go into as it 
will only make by ulcer worse. One  concern I have is that the new managers 
will start to order products that we as  LC's have never condoned. SO I have a 
long letter to write.
      That said, I need to share a little bit  about myself. I was a L&D 
nurse by training that "fell" into the LC world. I  became certified and worked a 
couple days a week as LC. People would always come  to me with questions and 
problems in L&D. 8 years ago we moved and I am in a  different hospital. IN 
this hospital we do less deliveries and staff is cross  trained to do different 
sections of maternal-child care. I do L&D,  mother-baby, and work as a LC 
several days a week. I am also one of the  main charge nurses. Sometimes I feel 
pulled in many different directions. I joke  about my 2 different brains warring 
with each other when we are busy and I am in  charge and need to get families 
home so new families can take that bed. When I  work mother-baby, I felt at 
1st like I was always getting the most difficult  assignments since I was the 
LC. Now the staff is fabulous and have learned a  great deal over the years. 
When I have my patients I find I spend a lot of time  with them as I would as 
just the LC. Sometimes, this leads to me not getting  other tasks done in a 
timely fashion. When I work as LC , I see mother baby  couplets on the unit, take 
phone calls, and see outpatients who return to  us in the hospital  for a fee. 
( What is the joke? Jack of all trades but  master of none?)
      Now, to refer to my 1st thought--my fear is  now with the cost cutting 
going on the LC's will lose our separate budget. We  will be incorporated into 
the general staff. The hospital can always say they  have IBCLC's on staff. I 
fear our little department will disappear. I love my  many job 
responsibilities but i am concern that with budget cuts, I will  expected to work more on 
mother baby because I am a LC and this way the patients  will still have a LC to 
consult with them but the hospital won't have to float  that department in 
the budget. I just see this as the best care for our  patients. It is very 
frustrating.
 
 
Allyson Michaels RN, IBCLC
Charlottesville, VA
Where the cats are romping and climbing the Christmas tree.
 
P.S. I would like to echo Ms. Bermans sentiments. I want to wish all of you  
a wonderful holiday season, wherever you may be. I too have learned a lot from 
 all of you that has impacted tremendously on my practice. I have grown over 
the  years thanks to all of you.   Peace, my friends.
 
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