Being an SLP- Better Speech and Hearing Month
If you follow my on Instagram, I have been doing a post series about the various settings in speech pathology I have worked in over the past two years. I will put those posts at the end of this blog post in case you haven't seen them, but I want to start with highlighting three speech pathologists who work in other settings of speech pathology! They were all sweet enough to take some time to share insights into what their setting looks like, and I'm excited to share their experience with you.
**Disclaimer: My posts, as well as the posts of my contributors are one person's opinions of the various settings of speech pathology. If you would like to contribute your opinion, let me know! I would love to have more guest writers here on the blog!
SLP #1: Chelsea Z. (insta: @chelseaalma). She works in a hospital (acute care) and is training to work in the NICU!
1) How long have you been (or were you) in your setting?
SLP #2: Brittany H. (insta: @brittnhines) She currently works in a school, but wrote about her experience in a private practice.
1) How long have you been (or were you) in your setting?
**Disclaimer: My posts, as well as the posts of my contributors are one person's opinions of the various settings of speech pathology. If you would like to contribute your opinion, let me know! I would love to have more guest writers here on the blog!
SLP #1: Chelsea Z. (insta: @chelseaalma). She works in a hospital (acute care) and is training to work in the NICU!
1) How long have you been (or were you) in your setting?
- I have been working in acute care ( infant to geriatric) with here and there outpatient since July 2017, I moved from Pennsylvania to Omaha, Nebraska transitioning from inpatient rehab, outpatient rehab, and early intervention ( birth to 3 in the homes). It was a tough transition at first but onboarding at my hospital required signing off on more complex tasks such as PMV inline with the vent and Modified Barium Swallow studies. I was fortunate to have a really good trainer who worked me up to speed to become independent. However, I still am training with her for NICU and infant feeding/dysphagia as those babies remain more difficult and it is of utmost importance to be clinical competent before evaluating and treating such patients.
2) What is the main focus of treatment in your setting, and what might a typical day look like?
- The main focus varies between receptive/expressive language, cognitive linguistic, and feeding/dysphagia. The day starts by going over new orders, dividing them amongst our team of 11 inpatient staff members to make sure all the new orders are accounted for as well as any planned MBS’s or FEES. We also are involved in a lot of educational and non clinical work here so we account for any projects we may have such as pediatric rounds, neuro grand rounds, presentations, and grant work. We have over 800 beds and 4 towers, so since we are not unit based we chart our review our case for the day try to plan our days accordingly. There are two of us that see both pediatric and adults on a regular basis at the hospital, most recently I have had an even split between pediatric and adult. Sessions can range from 10 min to 60 min depending on the patient and their tolerance or deficits. Often, I come back from the hospital to our clinic to provide outpatient services. Throughout the day our schedules may be thrown by patient’s status change, procedures that are off the floor, or new evaluations that may come in.
3) What are the main pros/cons of your setting?
- Since we are a hospital, weekends and holidays are your number one average con. Depending on the person, the idea of having a schedule that can constantly be changing may be a con or a pro. The medically complexity of our patients and collaboration with RDs, OT/PTs, and MDs continues to be a great aspect of the job. Coming from outpatient, where I put all my heart soul, time, and own money into my patients, the acute setting gives me a little more work/life balance , leaving at 430 knowing I did all I could to help my patients but they might be discharged or not appropriate for intervention the next day. We are also extremely fortunate to be tied to a University, therefore the additional time and education we are encouraged to put in our field is a big positive, as we are always growing our skills, keeping up with EBP, and learning new information to better serve our community.
SLP #2: Brittany H. (insta: @brittnhines) She currently works in a school, but wrote about her experience in a private practice.
1) How long have you been (or were you) in your setting?
- I was in the private practice for a little over a year. I started there fresh out of college, completed my CF there, and then moved on to the school setting.
- I worked with birth to 18. I was considered to be a contracted SLP through the private practice. I would start my days at private/charter schools and then finish in the clinic setting. I saw kids for both speech and language.
- Pros: More money, I know money is NOT everything, but that's how we will live in life (bills gotta be paid). Another pro for me was the one-on-one therapy. I really got to know my kiddos and was able to see more progress because the therapy was so focused and individualized. I also loved that I was able to work with the parents, not that they always did what I suggested to do at home, but it was nice to be able to share daily progress with them. Being in the school I have group therapy and I feel that it is not as effective as one-on-one especially because there is not caseload cap. I am seeing a group of SEVEN kindergartners for 30 minutes and I feel like I am not accomplishing much because they all have different goals.
- Cons: The hours were AWFUL!!!!! I was working 8:30am-7:00pm. It was like a revolving door of seeing kids. I had ZERO control of my schedule my boss would just pile kids on. I was constantly having to write reports at home. Also the time constraints that were placed on me were difficult to manage. I would have ONE WEEK from the time I completed the assessment to have it scored and the report typed and turned in. In the school setting I have 60 days from the time consent is signed to completed testing and write the report, it is much more manageable and I feel that the quality of my reports are much better in the school setting versus private practice simply because I have more time.
SLP #3: Erin S. (insta: @erin.luise)
1) How long have you been (or were you) in your setting?
- I’ve been working in inpatient rehab since I graduated from grad school, so about 2 years! I was offered the position during my summer internship in outpatient rehab through the same hospital I currently work for! Ask me Junior year of undergrad and I would have said “get me out of here”, and now this Colorado girl is turning into a Texan!
2) What is the main focus of treatment in your setting, and what might a typical day look like?
- I work primarily with adults/geriatrics that have had strokes, brain injuries, and other neurological conditions. Most patients stay in our rehab anywhere from 2-4 weeks and sometimes longer if they are making good progress. I go from evaluating a patient, to treating a patient, then planning discharge and finally discharging patients. Our inpatient rehab is a 24 bed unit and we have an interdisciplinary approach. The therapies (physical, occupational, speech and recreational), nursing staff, physicians, and social workers all work extremely close to develop a treatment plan, carryover goals, and set discharge plans. Treatments typically targets- cognition, language, motor speech, dysphagia (swallowing), and voice. My day starts at 7:00 am with patient care ending at 4; however with documentation, I’ve stayed as late as 8pm making sure everything is completed! Although theses are late nights and may want to pull my hair out at times, I wouldn’t trade this job for the world! It’s so fulfilling to see a patient from start to finish and see the drastic improvements made in such a short amazing of time..
- Pros: *interdisciplinary approach makes for greater carryover and faster progress seen. *being in within the hospital setting in case of medical emergencies, as well as, easy access to radiology for MBSS. * 3hr rule- each patient has to achieve 3 hours of therapy a day. This intensive therapy allows the patient for greater potential for quicker progress and leave being more independent and decreasing caregiver burden.
- Cons: *documentation. Since we admit and discharge patients, we have to see their whole stay. With weekly team meetings, On a Monday, I have to FIM (our way of rating patients progress to be reimbursed) patients, wrote their treatment note, and write a team summary on each patient. Add any evals that might come in and you’ll find yourself hearing the evening prayer as all the patients are falling asleep...
Below are my three posts about the schools, skilled nursing facilities, and early intervention. Check them out and let me know what you think! And a HUGE thank you to our guest contributors!
xoxo
Love,
Laura
xoxo
Love,
Laura
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