> The official "bean counters" are looking at the big picture and
> they are juggling a lot of aspects of it. They have accounting or
> business versus clinical backgrounds. The official bean counters
> haven't a real clue regarding individual departments' needs nor
> should they. That isn't their job.

Perhaps there is confusion over who was referred to by the term "bean
counters".  To clarify my post, I was referring to administration of the
hospital whose decision it is to cut this or that in order to maximize
profits or minimize losses.  Not accounting personnel.  I'm talking about
the CEO of a hospital, director of nursing services, and various department
heads.

In this day and age there should be no question that if a hospital has
breastfeeding mothers there should be lactation consultants employed.  Any
CEO of a hospital should be aware of this. Unless they prefer not to think
about it because not thinking about it makes it easier to live with their
tough decisions.  But breastfeeding *is* part of the "big picture".  The
data is out there, easily accessible.  They many not believe it, but they
cannot help but be aware of it.

As far as I'm concerned the only question should be how many LCs are needed
to provide good patient care.  Unfortunately, the answer to that question,
as with the non-question of whether or not to even have an LC, depends more
on whether that particular administrator puts profits over patient care.

Either breastfeeding is an critical part of patient care or it isn't.  There
is no gray area as far as I am concerned.  Not about this issue.  If a
hospital has to decide between which critical service to cut, then they
really do need to close.  Is it acceptable to provide good patient care --
'almost'?  Is good patient care a matter of degrees?

> Department management with the help of department eployees are
> responsible for determining the kind of staff the department
> needs and for validating via figures that need and the positive
> patient outcomes that are expected by implementing a proposal.
> The wise director will include plenty on how expected outcomes
> may be linked to maintained or improved department revenue.
> Department management is also responsible for advocating further
> if a proposal is turned down, because chances are they didn't do
> the greatest job of presenting the financial or other rationale
> to help the bean counters or Adminstrators "get" a proposal.

I reject the inference that it is the responsibility of the LC to provide
anything more than the data to administration.  That, to me, is akin to
requiring an abused (overworked) employee to work even longer hours without
pay to prove they should be working less hours.

However,
> we also don't always get involved to provide a Director with the
> info needed to develop or advocate for a proposal nor do we
> always use the communication channels available to us when we
> don't get the answer we want.

In our particular hospital, we *did* get involved in providing the director
with the info needed.  Much of it on our own time.  Because we were
overworked and were told no overtime.  It did no good.  Even going through
human resources and having a facilitator meet with us and administration.

> I know it would help the bean counters to walk a mile in our
> shoes, but it also can be a revelation to walk a mile in theirs.

I personally have no desire to walk a mile in a bean counter
(administator)'s shoes.  I can imagine how tough it is.  I also don't expect
them to walk even half a mile in my shoes.

To me, it all boils down to whether a particular administrator believes that
having an LC at a hospital is a *nice* thing to have.  Not critical, but
nice.  Good PR.  If so, then communication of information will make little
difference.

So... is the answer community activism?  That's where I'm leaning now.  If
breastfeeding is not considered critical patient care to administrators,
maybe educating the community to expect breastfeeding as a critical
component of their stay will convince these same administrators.  A long
haul, I know, but if I'm going to donate my time, I'd rather do it where I
might make a difference.

Regards,

Cindi Swisher, RN, IBCLC

             ***********************************************

To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]

The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html