NURS 3731 Clinical Journal

Name: Timothy Erskine

Date of clinical experience: 9/24/18

Clinical location/setting/agency: Boardman St E’s/Lactation Consult/Mercy Health

Beginning time: 9:30 am End time: 3:30 pm

Agency contact/nurse (if community site): Lynn (RN Lactation consult)

1. Overview of clinical experience:

I had a very good experience overall and learned a lot about breast feeding and new moms. I

shadowed my nurse, Lynn who had a very busy day. There were only two lactation nurses there

throughout the day and they were responsible for 26 patients on the Mom/baby and Labor and

delivery side. I saw discharges, new admits, experienced moms, and new moms which was

interesting to see the differences between all of them. We recommended ways to get the baby to

latch better, informed them of cluster feeding and things to expect within the first few weeks of

breast feeding. They had a big push of no pacifiers and absolutely no bottles and to just have a

mom exclusively breast feeding, which as you can imagine, is extremely tough to do. The nurses

were there not only to educate these moms but just to encourage them and try and keep them

going.

a.) Identify nursing skills and competencies observed/utilized for the day
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I saw the nurse assessing babies for a lip tie to see if that was the reason the baby was not

feeding. I also saw the nurse always assessing the mother’s breasts’ and nipples to see if they

were filling and that the nipples were erecting correctly. The nurse has to be an advocate for the

new family. For example, they try and get the moms an adequate breast pump as well as all of

the equipment they need in order to breast pump properly. This is a big deal because it could

change whether or not a mom continues to breast feed which is the ultimate goal for these nurses

and the hospital. The biggest thing these nurses do is educate the moms/partner, especially the

new moms. They try and warn them of all things they may encounter or run into. They are very

busy overall.

b.) Describe the most significant event or learning experience of the day that you either observed or

participated.

The most important thing I learned is how dedicated and educated the mother has to be to have

complete exclusivity. I never really thought about hard it might be and if they slip up even just

once and give a bottle, then it no longer is included. That’s why it is extremely important for all

mothers to be completely educated. I never really thought about how difficult this may be for

parents, especially the mother. Whenever a parent is only breastfeeding it puts a lot more stress

and pressure on the mother. If the baby wakes up at night the dad can’t just give the baby a bottle

of formula while the mother sleeps. It starts to get more complicated and just adds more stress.

That’s why it’s very important to reiterate all the benefits and goof things of breast feeding for

the baby.

c.) Identify course and clinical objectives and describe how you met those objectives for the day.

See course packet for specific community site objectives.

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The nurse as the lactation counselor has a lot of responsibility. She has to consult each mom who

is breastfeeding in the hospital, and they are to encourage all mothers to breast feed. They

attempt to get something that’s called exclusivity, which is where mothers only breast feed. They

do not take a binkie or use any supplemental formula. It I extremely difficult for hospitals to

attain this status and these consultants work very hard to try and reach it. It is the holy grail for a

hospital to have for their OB and maternity wards and it is highly regarded.

One of the main things a consult is brought in for is problem latching or having pain

while latching. To help this the nurse could show a certain technique or way to hold the child in

order for better latching. You can also massage the breast that way it is full and ready for feeding

before the baby even latches. Mothers who are experiencing pain or discomfort are encouraged

to use a nipple shield to not only protect their nipple and areola but to help the baby latch. Many

ladies used these at some point in time and they helped a lot. The nurses are also brought in just

to answer any questions from the new mom. They can tell them feeding patterns and things to

expect within the first week of life.

All mothers breastfeeding has the opportunity for a free pump through their insurance.

These nurses have to ensure the mother has all the necessary equipment in order for the mother

to properly breast feed. They get the mother and physician to sign the form and then fax it out to

the correct people. This way, every mother can have an adequate pump. There are also nipple

shields, pumps, bottles, as well as many other hospital resources the moms can get to take home.

In order to ensure exclusivity, it’s imperative to ensure the parents are prepared for everything.

They also offer a weekly support class with other breastfeeding mothers and ask any questions or

concerns that anyone may have, while also weighing the baby. I think this is very important as it

could ease the mothers mind about their child and how they might be feeding.
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