Cheryl,



I cannot stress enough how important I think your role is. and it is NOT to
relieve the nurses of their responsibility to deal with the "normal".



When you do that, you reduce your own specialty (do you have an ophthalmic
surgeon check everyone's vision, or a physical therapist to help every child
walk)???



In our effort to become accepted and "liked" by the nurses.AND because we
KNOW they are over worked . LC's working in hospitals eventually overwhelm
THEMSELVES trying to see all the moms being seen by all the nursing staff
(usually 3 - 4 of them to one of US) - and unable to provide the
individualized in-depth care that is essential when mothers REALLY need an
LC!



I agree that it would be good to complete a "needs assessment" and
"evaluation of current practices" by doing a "study" to identify:

               What do moms already know when they come in

               Where they get their information - so you can identify other
ways to educate them such as:

* create a handout that the OBs can give when they CAN understand the
information)

                              * provide a video such as Pam Wiggins'
(Breastfeeding: You can do it)

* create a website in your hospital that moms can use to link to good
resources (or to reach you when they are home).

               What they remember and what was useful of what they learned
in the hospital



I also recommend that you meet with the nurses and the supervisor and see
what can be done so that nurses can feel more confident in helping mothers
with the "normal" so you can be available to them for the more complex
"abnormal" that REALLY take a lot of time!  (I LOVED when I was in Stanford
Hospital with my daughter in law that the young nurse who walked in was not
the least bit threatened by me. she KNEW she knew her stuff - and she DID!)



If you can "problem solve" with the nurses, identifying all the different
needs of the patients (NICU, at home and in the hospital) they can help you
and become part of the solution!



Again, gathering data of what you see and what the moms needed can help you
to identify where your time is best spent. (If it's worth doing, it's worth
measuring!)  Talk to the hospital Quality Improvement (QI) staff - have them
help you with this!  Now that JCAHO is going to be asking about the hospital
breastfeeding discharge rates, they have a reason to get involved!



As a nurse who makes home visits, I can tell you that a lot of handouts and
booklets never come out of the bags they brought home from the hospital - so
Keep It SIMPLE!



Jeanette Panchula, BSW, RN, PHN, IBCLC

California, USA


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