Laurie:  It sounds like you are the solo LC in your hosp. It's difficult
when you have no sympathetic person to talk to. And I understand your urge
to split for greener pastures. May I offer a couple of suggestions?
1. Take the breast pump, kit, & supply of gradufeeds with caps to each mom
yourself & teach mom how to use them. Inform staff that milk will be coming
& they should assist mom with properly labeling & storing the milk. Make
sure they know how to properly defrost / warm it. The fact that mom CHOOSES
to breastfeed, and you clearly document that in mom's and baby's medical
record, should be enough. List your recommendations in the Progress Notes
for pumping procedures you want mom to follow. It gives the nursing staff
directions that they must follow because it's in permanent record - or they
have to document why it was not followed. Talk to mom again the next day to
verify. Those instructions should include acceptance & use of ANY amount,
not discarding a few ml of colostrum.
2. Review all hosp policies & procedures related in any way to BFing.
Politely inform your supv that you wish to update them. Get yourself
attached to your P&P Committee. Where P&P is good, but being ignored,
publicize it. Case by case, note that "P&P #123 says.... It does appear to
apply for this mom/baby. Is there any medical reason why we should deviate
from P&P on this case?" etc...
3. Join other committees: Patient Education, anything related to
Maternal-Child: Peds, Perinatal, NICU, any related collaborative
committees, etc. Ask around for dates & times. It helps develop a
'presence' for you and for your work. And you gain some influence &
visibility, albeit slowly.
4. Identify anyone who is even slightly in favor of BFing: staffers who are
BFing, your supv because she 'said' she wanted changes. ALWAYS include your
supv. Then start a BF Task Force in your hospital. Secure a room with
whoever does the scheduling. Then talk personally to each person you wish
to invite. Ask for referrals to others. Keep a contact list. Not everyone
who wants to, can come to the meetings. First meetings: brainstorm ideas.
When other people come up with ideas, they are more likely to want to work
on them. Better than you telling them what's wrong. Ask for ideas for
solutions. Ask them to ID roadblocks & ways around them. Basically, you be
the facilitator with an occasional suggestion. From these ideas come
working committees. DON'T let them hand all these activities over to YOU to
do them. They need dates to return & report the progress of their actions.
Write up reports of meetings & send to all who expressed interest in the
Task Force, whether they were there or not. List names of attendees. Get it
printed in a newsletter. Start your own newsletter. Hang it on bulletin
boards, bathroom stalls, wherever it will be read by everyone, not just the
Tast Force members.
How about this idea? Invite the complainers! Do it personally & with a
smile. My philosophy is always that the loudest complainer gets to Chair
the Committee next year - or at least a public nomination for the position.
It's a 'Put Up or Shut Up' challenge - with a smile!
Maybe your Task Force could start rewriting your hosp P&P. Maybe you could
begin with the AAP Policy on Human Milk - line by line - to see how hosp
processes can be adjusted.
No matter how 'down' you feel, SMILE!  You can say more things with a smile
than you can with a frown or an angry face. At the very least, it makes
them nervous & wonder what you're up to now!
But still keep your silent feelers out for other LC opptys whether at other
hosps or private practice. Start planning & writing your business plan at
home. Just this activity can aid your outlook knowing you're working toward
something positive. quote: Luck is when preparation meets opportunity. If
you know what's happening out there, where the openings are about to
appear, what your options are for private practice, and you already have
your ducks in a row -  you can be ready to jump when it's right for you and
well thought out.

I'll shut up now...  :-)

--- Phyllis Adamson, IBCLC
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