Diane W's excellent post re: touching serves as a perfect antidote to all
our recent talk about lawsuits and assault & battery r/t the LC's job, etc.
(Also all excellent posts, and unfortunately very necessary for all of us to
know about and keep on top of, but doesn't it just make you want to go take
a shower? Or even - perish the thought - throw up your hands and say, "Well,
I'm just going to go live in a cave somewhere and never venture into the
world of real people again?")
What she says points up a very important distinction, though, between
working in a woman's home (or your own home, if you can keep your bathrooms
clean enough to dare such a thing, which I can't!) and in a "medical-ish"
setting - a medical office, a hospital, a clinic, a WIC office, whatever...I
think this thread started with a question about an LC working in a WIC
program, and whether or not she can/should do hands-on consults in her
office @ WIC. Having done both (and hosp. as well), I can say it feels to me
like a HUGE difference in "tone".
When you're in someone's home, presumably you're there because they've asked
you there, or sought you out; that means you're basically working for them -
they pay you, they can end the relationship at will, and in a sense they
have the power in the relationship. (We have the *authority* that comes from
our specialized knowledge, perhaps, and frequently the psychological
advantage of not being the new mom, often exhausted and tearful, with a baby
for whom things aren't going well, but that's different.) Legally, it may
not make any difference, but we all know what it's like to be on the "not in
charge" end of a transaction with a HCP: you're sitting (or even lying)
there, part of your body exposed, the rest covered up with some little piece
of tissue paper or an ugly shapeless gown, while someone (and we won't even
go into the gender thing!) stands over you, or sits across from you, fully
clothed, armed with "professional" expertise, often in a uniform or wearing
a name tag (if you're lucky enough to even know their name!), maybe with a
title in front of or a bunch of initials after the name. And you're feeling
vulnerable to begin with, because things aren't going that well for you &
your baby; if you knew what to do, you'd have done it, and you wouldn't be
here now. Add in the really blatant "imbalance of power" aspects that are in
play (no matter how wonderful your LC or hcp is!) if you're in, for example,
a WIC clinic or other public health setting, or if you're low-income or
less-educated, or young, or don't speak the same language, or come from a
culture with different assumptions than your own (you suspect - you might
not even KNOW this, even if you speak the same language, or you might
realize it but not know what those assumptions and cultural variations
consist of). You perceive (correctly or not, doesn't matter) that if you
don't accept what "they" ("she", the lady at...", whatever) tell you and
follow the recommendations, "they" can withold your benefits (WIC checks,
child's immunization, welfare check, health care, pain med, whatever the
pertinent object seen to be at stake might be), and thereby "punish" you.
Like it or not, accept it or not, this is the set-up implicit in an awful
lot of interactions that happen in offices, clinics, agencies, programs,
whatever, no matter how sympathetic, supportive, "equal" the caregiver tries
to be. And, to some extent, that perception is correct: for example, a nurse
in a clinic (in the US, anyway) is a "mandated reporter" of child
abuse/neglect, and if you are BFing your baby and the baby is failing to
thrive and you refuse to offer your child ABM, and if the nurse believes
that the baby's well-being is endangered, she *must* report you to the
"authorities". Now, that's an extreme example, but I've been part of that
scenario myself. So anyway, you all get the idea ... there is such an
extreme imbalance of power (even if only "perceived" power) that the LC
sometimes needs to go to almost artificially extreme lengths to not abuse
that "power". It changes dramatically, in feel if nothing else, when you're
at home with a mom & her baby - her turf (if you're at her house), or at
least a more "normal", comfy environment, her (& baby's) schedule, much more
control of environment, etc. It's so much easier at home to become two women
(or more - there's often lots of "helpers" present!) doing one of the most
natural, time-out-of-mind activities on the planet - admiring the baby,
talking about how to help, seeing what's going on, figuring out solutions
together, providing comfort, maybe sharing a laugh...you all know the scene.
And in that context, touching (sensitively, with permission, etc. as we've
all said previously) may be natural and is almost certainly less likely to
give rise to offence. And I agree with Diane & other "touchers" that
spontaneous, natural, comforting touch of other moms & babies is part of the
glue that keeps us human, and in this line of work!
Like evrything else, it's all in the context! And, by the way, I HATE any
work I've ever done where I don't get to touch babies; I may talk like a
"hands in the pocket" LC, but I bet anyone who knows me would say that I'm
pretty hands-on, since I can't even talk without my hands! If my arms were
broken I'd be speechless (OK, maybe not such a bad thing...)
Cathy Bargar, RN, IBCLC (wishing she could get her hands on a sweet
delicious baby - business has been slow & I'm suffering from
baby-withdrawal!)
|
