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Subject:
From:
Glenn Evans <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 29 May 1997 09:17:21 -0700
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1.  The list should also include infant CPR.

Whether an LC is hospital based or not, or an RN, or other medically trained person, or not.  IMO, anyone providing hands on care to infants needs to know this, where ever they practice. 

2.  Regarding the thread of RN training, and requiring hospital based LCs to be RNs as well:

Being an RN myself, and trained 20 years ago, I know how little RN's learn 
in nursing school re BF.  On the other hand, a very, very small portion of 
graduates then go on to OB.  Once on a unit, hopefully they are given at 
least a six-week orientation to the policies and procedures of that unit.
(Yes, I know in some hospitals they're just shown the door, and must figure
 it all  out themselves.)

But as we all know, regardless of our backgrounds, picking up the subtle comes from practice, not books.  As to who picks up what faster, the RN learning breastfeeding, or the IBCLC learning the stuff necessary to work at the bedside, I think we could carry on the discussion for years without a final resolution.

The IBCLC in private practice, not in a doctors office, or without a medical backup, as I understand things from peoples' posts, has a fair latitude in suggesting interventions, but doesn't prescribe meds.  She may or may not inter -act directly with the dyad's primary HCPs.  She can suggest that mom talk to her doctor or pediatrician to request a certain course of tx.

In the hospital, the LC must interact with neonatologists, both on the mom side and the baby side; must work with nursing supervisors, RNs, LVNs and CPs (Care Partners, once called Aides); must establish a plan of care for the infants and moms -- which in California,  only the RN or parallel licensee can do.  I'm sure there are also insurance problems -- like under whose aegis does the LC fall.

I find that my two credentials complement each other.  My patients in the hospital want to see the LC, and I can tell them that I function in that capacity as well.  People I talk to  outside
as a mother/wife/CLC (not yet IB) are reassured that I also know the medical side when they here RN.  Others are reassured by the fact that I also breastfed.  Some people believe what I say only cuz I say it in their language.

I think there are not going to be that many LCs in hospital, hired in that capacity, at any rate.  With hospitals cutting back on the numbers of personnel in general, we are having to fight very hard just to have LC's in the hospital in sufficient quantity to fill or needs.  I will not quibble if they limit it to
        IBCLC/RNs, just as I do not argue with the fact that some jobs
I would like to have require BSNs, and I am  an Associate Degree RN.

I think if hospitals do not have a  pool of IBCLC/RNs; then they definitely    should probably make their requirements more encompassing.

Sincerely, Chanita, San Francisco

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