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Subject:
From:
Glenn Evans <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 27 Jan 1998 19:05:05 -0800
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On the one hand, I agree that even in the hospital, the LC position should not require, necessarily, an RN license.  And as you all know, I am rarely an apologist for the hospital.  

I have read the posts of many LC's, and even some IBCLC's, unfortunately, which indicate that they while they know lots and lots about breastfeeding, they have a lot to learn, yet, about diseases of pregnancy, the labor and delivery process, and the newborn period beyond just breastfeeding issues. (I am not talking about the obscure diseases and problems,  I am talking about the "normal", through slightly to moderately abnormal situations.)  But they are going to have to interact with and teach obstetricians, pediatricians and nurses as well as the moms.  They will also, at least regarding breastfeeding, be supervisors of RN activities.  They have to understand much of the physiology, as well as what is going on in the hospital, in order that their hospital based practice also conforms with the hospitals policies and procedures.  Just as understanding and teaching breastfeeding is not something learned with just a few weeks practice (how many thousands of hours must one have to take the IBCLC?), neither is understanding the physiology and technology of everything else before and after birth, and in the newborn period, learned just like "snap."

Most of the time, it is not just an RN background required, but one in OB or NICU as well, for precisely the reasons above.   If someone comes in from another department to LDRP or NICU, it takes a good year to start feeling knowledgeable regarding the combinations and permutations of the natural and pathologic processes involved.  It takes at least a year to start feeling comfortable with one's practice in the area, as well.  How quickly would a non-RN learn all of this stuff?  And is it the hospital's job to teach her?  They want someone versed in all aspects of the perinatal period, not just breastfeeding.

I am not saying non RNs don't have this knowledge.  Our own membership shows otherwise.  And ideally a hospital would look at a person's understanding in all of these areas, even if they aren't RNs.  Perhaps administration is looking for a shortcut in the interview and hiring process by requesting that their LCs have an RN background.  I am sure when they say it is okay if applicants are "only aspiring" IBCLC,   they don't mean someone who is just starting to accumulate her hours of practice, but someone who is about to take the exam.  And maybe, once more hospitals have quality LC programs in place; and hire many LCs, not just one or two; and provide more than three hours a day of hands on help; and aren't fighting their own staff to be baby-friendly, they will be able to expand their parameters and not need to limit their hiring to only LCs with RN licenses as well.
 
Chanita
San Francisco  

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