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"I work full-time all day seeing sick
and well children.  In between, I run to the phone and return bf phone
calls.  I squeeze in lactation consults wherever I can...Is there a more
efficient way to do this?"

Seems to me that you are at a place where you & the doc(s) need to have a
"come to Jesus meeting". If your Lactation Consultant service is bringing in
money into the office (which I'll bet it is, both obviously - from visits to
see you in your LC hat - and less obviously - I'm sure there are pts. who
choose your ped practice because it's known that they have LC services),
then it should be recognized for the value it gives and compensated. Sounds
like it's not more pay you need, but more time, or a better division of your
time.

Can you establish BF call hrs (like the docs do with "sick call" phone
hrs) - specific hours when your one & only job is to take those calls/see
the BF pts? Maybe they need to have another nurse do the "regular" office
stuff during those times. Maybe they need to add someone, at least
part-time, or give one of the other nurses more hrs, or whatever would free
you up for X hrs/wk.

Right now, the docs are getting something for nothing - they are able to say
that they have LC services, without making it a specific time/dollars
commitment. You just squeeze it in among everything else you do. (This is a
lot like the hospital nurses who are the BF specialists *in addition to*
everything else - they too wear 2 hats at the same time. It's what women all
too often do in the workplace - I know, 'cause I've done it!) Your services
need to be valued differently than they were before, which means time/work
load have to be managed differently. Everybody wants to *say* they offer
these services, but most want them at no cost. There has to be a way to
either free up time for your LC services, or money to cover hiring other
RN/PNP services.

I don't say it to drive a wedge between you & the doc (who sounds like a
good one), but because that is the situation I see locally as well; they
recognize that it's a plus to be able to offer this to their pts (and it
draws pts, there's no doubt about it), but they don't want to pay for the
benefit. Well, they need to make it possible for the LC to function as such,
and somewhere it's gonna cost 'em!

Cathy Bargar RN IBCLC Ithaca NY (where there is no pediatric practice,
family practice, OB, birth center, midwife, hospital, WIC program, Public
Health nsg. svc, or home care program that has a position for an LC. And
this is in a town that has both me & Diane W., plus 2 other IBCLCs who work
in "regular" staff nurse positions at the hospital, and a PNP
(non-certified) who is doing exactly what Candace describes as "wearing 2
hats". And Ithaca touts itself as being progressive & "enlightened", can you
believe it?)

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