Linda,
I missed the original post , as I've been away at the BALA Conference(which was wonderful) and behind on reading.
It sounds as if you are stretched to the max, and most IBCLCs, who work in the hospital, will relate to your post. It is a time of fiscal belt tightening, a nursing shortage, and lots of other issues as well that impact our job. NICU impacts greatly as well.
Sounds like you have great BF rates in your hospital so pat yourself on the back. It takes lots of education of staff , physicians, patients and leadership/ resource from the LCs to impact your hospital environment. You are obviously doing that.
Our hospital does 240 a month with 1 LC FTE. 2 of us share it. We do not have 7 day a week coverage but are working towards that. We are interviewing for an IBCLC to be 1 FTE with the 2 of us part time(since we both do L& D as well)
(If anyone in the Westchester NY area is interested e-mail me off list please) 

We also have a NICU of 15 beds and keep almost all of our preemies25 wks and above
We do see outside consults a few times a week but find that hard to do because of all of the internal responsibilities. I find that I regularly refer to those in private practice, unless it seems like a quicker fix. I would love to see more consults but I must be realistic and if spread too thin, no one gets what they relly need. The phone calls can be upwards of 6-10 calls a day, and we also have a pump rental depot.

Jane Ciaramella
who is back to NY cold and snow after a lovely week in both San Francisco and lovely Sonoma county where the wine/ weather and scenery was great.Kids and hubby are happy to have a good meal again and they are appreciating Mom to the max tonight !!!

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