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From:  Larry Potts
Sent:  Thursday, August 27, 1998 10:29 AM
To:  'Lactation Information and Discu'
Subject:  RE: LACTNET Digest - 26 Aug 1998

I am new to Lactnet as of this June, post BSC conference, my name is Susan Potts, and work as a hospital based LC at an inner city teaching hospital in St. Paul, MN.  Four of us pp nurses/newly IBCLC set up our program in August, 97, with  freedom and blessings from two levels of supervisors, our dream come true!  This was a ten year dream of mine, and happened after 2 years of interdisciplinary committee meetings and a search for funding. This post is in answer to Mary Coyle from Aug.27.  We have one LC working every day of the week, or 1.4 fte, yes we cover weekends, and I personally love it because my dh (I hope that stands for dear hubby) is home with our three children.  We work 8 hour days, or sometimes longer if we just "can't get away" because of certain cases or outpatients or calls to handle. We give a courtesy visit to every breastfeeding patient which involves assessment of a feeding if at all possible,  teaching, giving our pamphlet with phone # and tips for getting off to a good start, and a first week breastfeeding log.  We are available to all areas of the hospital and clinics, and do follow-up telephoning 2 days post discharge.  We also have a private consultation room for outpatients having problems, and we average about 3 or 4 visits per week.  The delivery rate is about 1500 per year, our breastfeeding rate was 42% in 1994, and was 62% in 1997, initiation anyway. We take call from home the 16 hours we are away from the hospital, if we work longer than 8 hours a day, we take straight time for the extra time, not OT, and do get paid for on call time, just under $5.00 per hour.  A courtesy visit can take about ten min. or less with an experienced, motivated, or well-read mother, or 30 min if helping with a feeding or if there are lots of questions.  The courtesy visit is part of the post partum package and there is no charge.
A formal lactation consult is different and addresses a certain problem, such as need for nipple shield, special needs baby, baby who is not latching, use of SNS, etc, and usually takes at least an hour.  There is more paper work, an order is needed for the consult from the MW or doc for payment and to inform about the patient's status.  We use a special consult form, and a copy stays in the chart.  Once in a while I will draw attention to the nursing staff to read an interesting consult, that also includes a plan of care (for their learning).  Sorry this is so long and I hope it can be of help.  The paperwork for outpatients coming in for a consult is the same as for inpatients, plus a more detailed history.

Susan Potts, RN IBCLC

Date:    Thu, 27 Aug 1998 00:35:40 +0200

Date:    Wed, 26 Aug 1998 20:12:37 -0700
From:    Mary Coyle <[log in to unmask]>
Subject: STATICAL DATA
For months now I have been receiving Lactnet and have sent out some replies.
I have my first question but I will introduce myself.  I am a RNC, MSN,
Certified Lactation Educator (missed the Lactation boards by 1 point).  I
work Maternity at a Level II hospital about 1440 yearly births for the last
15 years. The  last year I have covered 2 days a week for our one IBCLC.
The Lactation Office has been up and running with multiple challenges headed
by our visionary IBCLC who has influenced me.  My question is: does anyone
working in a hospital have statical data on the time that is spent at the
bedside doing a Lactation Consult or can you refer me to an article?
Example X number of patients 0-15 minutes,  X number of patients 16-30
minutes, etc.     Thank you all, Mary