> Ok, forgive me, but I just can't be quiet any more!  I have been very
> interested in this discussion, and have been holding my tongue for a few
> days, but just HAVE to jump in!  This discussion reminds me very much of
> the entry level to nursing debate in the US.  (To those who are
> international, bear with me).  In the US a person can sit for the RN
> boards with three different levels of education, 2 years (ADN), 3 years
> (diploma) and 4 years (BSN).  Another entry is as an LPN with 1 year of
> training.  This is hotly debated in nursing circles and has been since I
> began nursing school in 1975.
>
> The other issue here is the comment about many RN's on OB floors knowing
> less than a non-RN IBCLC.  This is true, however, keep in mind that the RN
> grants ENTRY into practice.  Most experience in the specialities is gained
> from working the floors, CEU's, reading, etc.  With the limited amount of
> time an RN spends in school, she cannot come out a specialist.  She should
> come out as a generalist, with exposure to other specialties.  From there,
> she gains her specialization.  Yes, I believe basic breastfeeding concepts
> need to be covered in nursing school, however, further learning comes
> after graduation.
>
> As a hospital based LC, I do support the theory that LC's in hospitals
> need to be RN's.  At least at my hospital the LC provides home visits with
> physical assessments of both the mom and baby 48 hours after discharge.
> We have picked up so many problems on the hv that RN assessment skills are
> a must.  In fact, we require the home visit RN to have at least 5 years of
> OB experience before she can work in our program.  This is because there
> are no "seasoned" experts out in the homes with her, and she has to be
> able to assess and refer.  Just this last week we had a wound
> evisceration.  We have seen thrombophlebitis, newborn sepsis, and have
> found a number of heart murmurs in newborns.
>
> I am not saying that ALL LC's need to be RN's.  What I'm saying is that
> each job is individual, and requires a different skill mix.  I think non
> RN IBCLC's have much to offer in many settings.  I have learned much from
> Allison Hazelbaker and Kathleen Auerbach.  I think as we debate this issue
> we need to be careful not to "throw the baby out with the bathwater."
> There is not only room for all of us, our profession is richer indeed with
> diversity.  Ok, off my soapbox!
>
> Linda J. Tandy, MSN, RN, IBCLC
> Cedar Rapids, Iowa
>

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