There are several issues here.
One of which is the assumption that the competency level of the
environment of the poster, is the same competency level of all such work
places.
Realistically, this cannot be true. Management determines the
competency level of any complex organisation. If you have incompetent
and ill-informed management, you will have incompetent and ill-informed
staff operating. No matter how good individual performance is, when the
shift rota changes, someone less informed, and less able, can walk in
the door.
So comments about incompetent staff in any individual situation, may be
accurate. As can comments about incompetent processes within an
institution. Many of us could furnish the walls with personal
experience of such incompetence.
The fact that good practice, and practitioners, exist, does not negate
those working at less than an acceptable standard.
The other major issue, is informed consent. The parents in this case,
which sparked this discussion, had no idea that their babies were being
supplemented at all, never mind with powdered milk fortifier. On no
level is this supportable professionally.
Likewise, all those balance of risks on giving powdered milk fortifier,
versus not giving it, need to explained out carefully with parents, and
consent forms obtained. It's not our decision.
We all spend an incredible amount of unpaid hours supporting babies.
And the more common experience of us as intelligent, responsible people,
is lack of knowledge and understanding on risk factors in baby health by
using powdered infant formula, and lack of informed consent by parents.
And no matter how much we also know there are pockets of excellent
practice, it behoves us to speak up, and speak out, when ill-informed,
and incompetent practice, is found.
And no one should see that as a personal insult, or slight upon them,
and their own competent work. Simply, not everyone does want the best
outcome for the babies in their care. Some just want the shift to end
so they can crawl home and contemplate how they ended up in a job they
hate, and which they aren't actually that well cut out for. It would be
nice is we did live in a world where every single medical professional
is a dedicated, well informed, competent and responsible professional.
It's just impossible to have. Medical personnel are subject to the same
unevenness of intent, training and competency, as every other
profession, trade and menial job. And it's no slight on the huge
numbers of well trained, competent and professional medical workers, to
both acknowledge, and act, upon the former.
Morgan Gallagher
[log in to unmask] wrote:
>
> We are constantly looking for and testing other ways to improve ALL we do in
> the NICU. We all want the best outcomes, including nutritional outcomes,
> for our infants, and spend an incredible number of unpaid hours in continuous
> quality improvement efforts like VON, iNICQ, CPQCC, writing articles and
> books. I am very disappointed at some of the cavalier statements on LACTNET by
> otherwise intelligent, responsible people.
>
>
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