Hi Pat -
"I have wondered if I should do anything about the lack of knowledge of
appropriate bilirubin levels in this nurse, who is most likely not alone in
her belief that the level of a baby on abm is the normal level..."
I think maybe I've burnt out some since I was last on Lactnet, but you know
what? I suspect that that nurse doesn't *actually* think that a baby's bili
"should be" 0. She was probably stressed out, or in a hurry and didn't
really feel like getting into a whole long discussion with this mom, or had
something else on her mind, or wasn't really sure of the answer (and we know
that the best "answer" to this question involves a bit of explanation and
discussion about the difference between "should be" - to which in fact there
is no "right" answer - and "what we see in normal healthy babies") and was
afraid she'd stick her foot in it if she tried discussing it with more depth
so she copped out with a quickie response.
And my opinion, FWIW, is that you did *exactly* the right thing in what you
told the mom. You remembered that you were there to help THAT mother, not
try to be the Universal Educator To Hospital Staff About Breastfeeding. Some
*other* day you might take on that role, but at that time you were there for
the mother, and you did brilliantly.
I've gotten more than a little weary (and leery) of taking on the entire
medical establishment, or even just the one in my home town. Some days I
feel guilty about it; other days I just think, well, I can't do it all, and
I will put my energy where I *know* for certain that it does the most good
(supporting moms & babies 1:1). Not that the problem of appropriate
education of other professionals is unimportant - it's extremely
important! - but I guess I'm learning that I can't do it ALL, at least not
on the same day and without an extra bowl of Wheaties under my belt for
fortification!
You might mention what happened to the hospital's IBCLC, if you have
occasion to talk w/her. But you did what you were there to do, and heck,
that's good enough for one day anyway!
Cathy Bargar,RN, IBCLC
Ithaca NY
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