Pat, I have been our Hospital LC for the last 7 years. I have worn many
hats in the last 15 years at our community hospital. I have always been a
strong advocate for birth as a natural process, informed decision making,
and support for women, babies and families. I have the Lamaze Childbirth
Educator Code of Ethics and ILCA standards and Lactation Consultants Code
of Ethics hanging in my office.  I work hard with consumers and nursing
staff.  I have a strong teaching staff - 4 casual time masters educated and
Lamaze certified educators who have research at their finger tips. We make
change. The thing about it though is it doesn't happen overnight.
I think sometimes we want just that. We must be creative and prioritize. It
has to be profitable for a hospital to change. Because change in a hospital
setting requires inservices, policy changes, coordination, liason work,
consumer education, med. staff education, tracking for positive outcomes
and collaboration with groups/services outside of the hospital.  Our
hospital is doing all of this. I predict a timetable of 5 years. I am
coordinating change.\
It is ambituos at a time when emphasis is being put on liability, cost
cutting, capitation, staff cuts, etc. etc. We must empathize but not
compromise. I would willingly communicate with anyone who is interested in
affecting change in their hospital environment. It can happen! I encourage
everyone on Lactnet to become very familiar with Baby Friendly USA and the
Mother Friendly Childbirth Initiative. If you are having difficulty
organizing - using both documents as your guides as your starting point -
you might want to consider making them your goal. I am sure Mother Baby
nursing is the answer in hospitals with doula
service. That will be our goal although we have not even proposed it. We
are working on staff values and beliefs right now. We have administration
support to investigate and make change. It is a "group process" though.
Change cannot be made by LCs alone. Everyone has to buy in. I hope we can
keep this discussion going. I part for now - "the eternal optimist" Sue

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