Debbie said:
  
> I felt that I  got a descent MEDICAL education, 

I surely hope not.  In nursing school you get a nursing education.  You
get a medical education in medical school.  And if you think you have a
medical education then you may be unclear on the differences.

So... Why might RN and IBCLC go together?  

In hospitals, lactation has lain within the scope of nursing practice
forever.  There is so very much to know that yes, some things receive
short shrift in nursing school.  A basic RN is a basic general education
with specialization coming after.  For example, all of our local
hospitals have encouraged or required their postpartum unit staff to get
certificates in neonatal nursing and breastfeeding, so that they
actually do have _advanced_ education in these areas.  (The same
certificate that I got in preparation for my IBCLC).  So the perception
is that a nurse with postpartum and lactation skills will serve the
mother and baby dyad in a scope that is beyond that of LC only.

I think that the public accountability is another reason.

And while WE may believe that IBCLC is the gold standard, who else out
there does so?  

>There is no other profession that I  am aware of that
>re-tests every ten years.  

Um, well certified Family Physicians for one have to write an exam every
7 years.  And no option for education credits in place of it.  And
that's in the US.  In Canada it's every 5 years.  I believe RN's in the
US are required to show evidence yearly of education credits, and I
fully expect that to become a requirement.  Ontario RN's are required to
do an assessment annually of their practice. 

I certainly do NOT believe that an IBCLC must be an RN.  I do believe
that my four years of university had substantially more content than my
eight week certificate program, dozens of hours of workshops and 2000
hours (or whatever it was) of experience.  

Like Susan Burger I work in public health.  I do breastfeeding promotion
and I run a baby clinic.  At that clinic I am a lactation consultant,
but I am also a public health nurse.  The questions that come my way are
not remotely limited to lactation.  I became an LC because *I*
identified my knowledge deficiencies and because I wanted to provide my
population with that service locally.  

Judith

Judith Hayman, RN, IBCLC, BSc, BScN
Public Health Nurse & Lactation Consultant

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