Could those of you who have comprehensive hospital based programs
 inpatient and outpatient consults, pumps, warmline, supportgroup, classes
etc) let me know under what department you operate and how you are funded.

I am the LC for an outpatient breastfeeding resource center based at a small
(800 deliveries a year) rural hospital.  It is driving me batty that
everyone in the tri-county area that wants to can use the service except the
women and babies currently patients in our institution.  There are two
nurses on OB who are certified but you know what their day is like and have
no dedicated inpatient LC hours.  Currently I am under the community
education branch of the hospital which is under the human resources VP.
Starting to understand my frustration?  We feel extremely fortunate to have
been allowed to grow this program to its current state but we keep hitting a
brick wall when it gets to inpatient/outpatient stuff.  I am really out of
my league when it comes to the hospital politics and funding things.  I am
driving my supervisor crazy because I just don't understand.  I had actually
started doing rounds because I have an intern  which was a great opportunity
to show the value of inpatient services but my boss thought I was going to
do "professional rounds"  review charts and talk with the nurses but not
actually see the patients.  My argument is that I can't possibly give
instruction to the nurse if I haven't seen the patient.  My idea of rounds
was to take the intern to each breastfeeding moms room and if there was no
problems or baby was snoozing to just talk and then move on, if anyone
needed help we could do what needed to be done and then document in the
chart.  This is what the nurse manager and I had discussed.  Of course since
she is not paying me what does she care what I do, as long as my being
around makes it easier on her staff not harder.  I have a great repore with
the day shift and was much looking forward to rounds as I understand them.
How do those of you with inpatient hours handle rounds?

Sorry this is so long.  I'm just really out of my element.  I just want to
do what is in the patients best interest at the time.  Breastfeeding moms
and babies often can't be put off.


Oh well,
Lori Werrell, BA, IBCLC

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