I'm anxiously awaiting comments on this topic - because I have seen this
also, and wondered if it was just "me"...

I always used to say that my degree in Social Work was more useful to me
than the nursing degree - the "medical" information I need to know to help
a mom usually can be found in a book...but the counseling skills and the
development of priorities, the awareness of what one client can deal with
and what needs to be delayed until a later time...these are more social
work than nursing...or maybe now I should consider them "IBCLC" skills...

There are nurses who have similar-type positions - at least in our county,
I see our Public Health Nurses work as evaluators, priority-setters and
decision makers - they can't wait until the next doctor's appointment.  In
fact they make the decision whether the situation they observe can be
addressed with interventions they recommend, if there are other resources
that are more appropriate, whether to make a follow-up appointment to mo
nitor the situation, or whether they need to help the mom get to an MD
right now.  They of course cannot prescribe, but many times the mother has
decided to do x or y and they address this by educating the client and
helping her learn to advocate for herself with her doctor.

IBCLCs do similarly - and as I have been recieving training about Public
Health from the Nursing Director in our county, I find that my job as an
IBCLC meets many of the goals of Public Health, which are wider in scope
than patient care.

I'm often not just dealing with THIS mom and THIS baby - I've realized the
importance of developing a "systems" approach to resolve repeated problems
(like not learning of mothers' crises until 2 weeks after discharge, or
being unable to get an MD who will cut frenulums).  Our county
breastfeeding coalition has evolved thanks to the work of MANY different
specialties who work together to the community's betterment.  As IBCLCs who
see the trees AND the forest - we can help to develop Public Health
priorities in our communities.

I'm interested in hearing others' viewpoints.


Jeanette Panchula, BSW, RN, PHN, IBCLC

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