You’ve fulfilled your requirements, studied for months, passed your IBLCE™ Exam. But you’re still having a hard time finding a job. Even with an IBCLC certification, some facilities won’t hire you as an IBCLC-only individual “because you are not a recognized healthcare professional.”
Employers look at economics
Before you take this personally, see the situation from where employers sit. Employers (hopefully) realize that the IBCLC-only individual has a fairly limited scope of practice. Compare this to, for example, the scope of practice for the registered nurse (RN).
The RN is authorized to accept verbal orders from a physician, give or withhold a medication, start an IV infusion, or sign off on a client’s discharge instructions. And, from time to time, bosses may (and do!) require RNs to do those tasks, even though their primary responsibility is focused on lactation. Yes — a few weeks ago, an RN who is the lactation consultant for a fairly large hospital told me she was called to the NICU to deliver a medication via IV infusion to a baby. (The NICU was short-staffed.)
In crude terms, I’m saying that the employer can get more mileage out of — in this case, the RN. (I could give different examples but make the same point about the registered dietitian, the speech pathologist, the occupational therapist, and others.)
In short, it’s largely a matter of economics.
The lactation consultant might not fit into the organizational structure
Employers often don’t know where IBCLCs fit into the organizational chart. Do they report to the unit manager? Or to someone else? What are appropriate criteria for their annual performance? And, if they’re doing an exemplary job, how are they promoted, or at least rewarded? What is their involvement in the system (e.g., committees, etc.) if any?
Try to imagine yourself being an employer. This lack of clarity in hiring an IBCLC-only individual could make you uneasy.
It may raise some legal questions for the hospital
I’m not an attorney, so I can’t explain this well. But I absolutely know that many hospitals (and presumably, other facilities, too) have not planned for — and are not willing to — accept legal liability for one person who has a certification that is unlike that of anyone else in the organization. I’d be quick to say that such willingness seems to differ substantially from one locale to another.
Again, if you’re the employer, you’d be uneasy with this large looming question, and it would be a deterrent for hiring the IBCLC-only individual.
It may raise some issues for The Joint Commission (TJC)
Most hospitals in the United States are accredited by The Joint Commission®. And the issue that may be raised relates to what I was talking about earlier: a reporting structure.
I am acutely aware of one hospital where an IBCLC who was not an RN was the supervisor of the lactation department. (It’s a HUGE hospital.) I heard that TJC did a site visit and said that RN-IBCLCs could not report to a non-RN. The IBCLC-only who was supervising the RN-IBCLCs lost her position. (I also heard that the hospital retained her in some role, but not in a supervisory role.)
IBCLCs are likely to have little or no understanding of the system
When I was a young nurse, I soon realized that being an expert at one-on-one client care wasn’t enough to get me more job opportunities. Luckily, I realized it myself, but my boss was quick to rub my nose in that fact. In order to effect best practices throughout the system, I needed to have a full understanding of the system.
Having taught my Comprehensive Lactation Course for over a decade, I can say with certainty that attendees who do not have a long, strong background in healthcare don’t understand even the most basic “system” level issues. They don’t understand the criticality of policies and procedures, compliance issues from the State Health Department, or the politics of interdisciplinary healthcare.
Can they acquire that understanding over time? Of course! Are most employers willing to wait? Maybe. Maybe not.
Co-workers often look down on IBCLC-only co-workers
Often, IBCLC-only people complain to me that they don’t feel respected by the RNs or MDs they work with. Okay I get that.
I’ve been an RN for about four decades. Despite my advanced degrees and certifications and years of experience, I am often looked down upon as “just a nurse.” I get it, believe me! More than you might know, I get it!
Certainly, those who have only an IBCLC certification can find ways to gain credibility, and even make themselves invaluable to others in the healthcare field. I’ve made some specific suggestions on ways to lose credibility and ways to GAIN credibility.
Some hospital policies simply forbid hiring IBCLC-only personnel
First, let me be quick to say that hospital policies differ. And, what’s the norm in one city or state may not be the norm in a different city, a small town, or another state.
However, I’m aware of many, many hospitals that will not hire individuals into a lactation role unless they also have a government-issued license to deliver healthcare. And I’m aware of several WIC offices that will not hire an IBCLC-only job candidate. But again, that’s not the case in all locations.
I’m not saying it’s right or wrong. I’m just saying, at the present time in some — not all — locations in the United States, IBCLCs who are not on the IBLCE’s list of recognized healthcare professionals may not even get an interview when they apply for a job.
Have you found employment as an IBCLC-only applicant? What helped you get the job?