How to SLP: SLP Skills

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Meet Cristina Ramos and Rene Robles, two longtime speech-language pathologists and the founders of Five Oaks Speech Therapy Services in California. During this week’s episode, these two walk us through how they met and why they decided to pursue speech pathology in the first place. They also share how they’ve come to own four practices and counting and offer what they’ve learned from interviewing and mentoring burgeoning SLPs over the years. They provide insights for students and new clinicians who want to make a good first impression and gain the skills they need to grow within the field.

Discussion & Reflection Questions 1. Tell us about who you are, your background, and why you decided to become a speech-language pathologist. 2. How did the two of you come to open a business together? Tell us a little bit about Five Oaks Speech Therapy Services. 3. Can you talk about the importance of networking and offer some networking advice for new students or new graduates? 4. You’re both responsible for many employees at Five Oaks. Can you tell us how you handle conflict resolution? 5. Do you have any words of advice for a new or transitioning SLP who’s interviewing for a position? 6. What are some words of advice you can give clinicians who come in lacking confidence? 7. What are some problems new graduates and clinicians can run into when starting their careers? 8. Can you share an experience where you felt like you impacted someone’s life through speech pathology, whether it was a client or fellow SLP?

Quote Of The Conversation “I think if your intentions and your passion for the field are there, you're going to pick it up. You're going to get it. I promise you will. Because you have the will to want to learn it and want to be better for the sake of the profession because you love the profession so much. And so, I think you can at least gather some confidence in saying, "I love this field. I love learning. I'm an active learner. And I love helping people.” -Cristina Ramos, SLP

Rene Robles & Cristina Ramos, SLP

Speech-Language Pathologists and Founders of Five Oaks Speech Therapy Services

Rene L. Robles (pictured left) has more than 20 years of experience as a speech-language pathologist. Many of those years were spent in the public school setting, but she has also been fortunate enough to work and supervise SLPs in private practice settings. Rene obtained her Master's of Science from the University of Redlands in Southern California. She is currently the President and CEO of Five Oaks Speech Therapy Services, which employs over 50 professionals and services more than two thousand patients.

Cristina Ramos (pictured right) is an SLP whose experience includes working for one of largest medical facilities in Southern California. She has had a variety of experience working with medically fragile patients and with patients with a wide variety of communicative disorders. She obtained her Master's of Science from Loma Linda University in Southern California. Cristina is currently the Vice President and COO of Five Oaks Speech Therapy Services.

Keep the Conversation Going Guest Speaker Information Rene Robles & Cristina Ramos, SLPSpeech-Language Pathologists and Founders of Five Oaks Speech Therapy Services

Website - www.fiveoaksspeech.com

Email - info@fiveoaksspeech.com

Thank you for listening to The Missing Link for SLPs podcast! If you enjoyed the show, I'd love you to subscribe, rate it and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links to help them feel confident in their patient care every step of the way.

Follow me onInstagram, join the Fresh SLP community on Facebookor learn more at FreshSLP.com. Let's make those connections. You got this!

Do you have a question you'd like answered on the show? Interested in sharing your experience as an SLP with our audience?Send a message to Mattie@FreshSLP.com!

Not a substitute for a formal SLP education or medical advice for patients/caregivers.

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Focus This SLP, who specializes in pediatric speech-language pathology, shares why she started making videos about How to SLP on YouTube. She delves into her experience working with children with speech and language disorders and covers how SLPs can use resources, like her videos, to keep parents and caregivers involved in treatment. During the episode, Kelli also tackles what SLPs interested in starting their own channels or passion projects can do in order to pursue those goals and dreams.

Discussion & Reflection Questions 1. Tell us about who you are, your background, and why you decided to go into the field of speech-language pathology. 2. Tell us about your YouTube channel. Why did you decide to start making videos? 3. How do you feel having resources, like YouTube videos or podcasts, helps parents and caregivers stay involved in treatment? 4. What are some things you wish you’d known when starting your YouTube channel? 5. What’s your favorite video that you’ve made so far? 6. Tell us about how you make treatment fun so that kids will want to actively participate in it. 7. What words of wisdom do you have for the SLPs thinking about starting their own passion projects, whether they’re interested in YouTube channels, podcasts, or something else entirely?

Quote Of The Conversation “I would say to try to get your feet wet in as many different fields as you can, or settings, in the whole realm of speech-language pathology. And then, whatever you're shining in, whatever your heart is in, whatever you care about the most, that's where you're going to find success.”

- Kelli L. Slemp CCC-SLP

Founder & Speech-Language Pathologist, Speedy Speech

Kelli is a pediatric speech-language pathologist who also manages a YouTube channel focused on the subject. Her channel, called Speedy Speech, strives to give parents and caregivers the resources and tools they need to care for children with speech and developmental disorders. Her content covers everything from pointing to speech hand cues, and she strongly believes that “ALL parents can be the therapist.” Her goal with Speedy Speech is to incorporate therapy into children’s everyday lives by educating their loved ones.

Download the episode transcribe and study guide

Keep the Conversation Going Guest Speaker Information Kelli L. Slemp CCC-SLP Founder and Speech-Language Pathologist, Speedy Speech

Email - kslemp18@gmail.com

Website - www.speedyslp.com

Facebook - @speedyspeechpath

Instagram - @speedyspeechYouTube - Speedy Speech

Upcoming SLP Spotlight Guests * Ebony Green, Executive Director

CASA Speech Therapy, LLC

Kristen Winter, Landing Your Dream Job

Thank you for listening to The Missing Link for SLPs podcast! If you enjoyed the show, I'd love you to subscribe, rate it, and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links to help them feel confident in their patient care every step of the way.

Follow me onInstagram, join the Fresh SLP community on Facebookor learn more at FreshSLP.com. Let's make those connections. You got this!

Do you have a question you'd like answered on the show? Interested in sharing your experience as an SLP with our audience? Send a message to Mattie@FreshSLP.com!

Not a substitute for a formal SLP education or medical advice for patients/caregivers.

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Episode Focus

Today’s episode features an SLP who has a passion for dysphagia! Wanting to further collaborate with others who share his passion in dysphagia, he started a Facebook Dysphagia Journal Club and in 3 days, had over 1800 members join! Here is his story on why Dysphagia Journal Clubs are so important in keeping current in our practice as SLPs and how to start one.

Discussion & Reflection Questions 1. Tell us about yourself and what you do. 2. Why did you want to start a Dysphagia Journal Club? 3. What are 5 reasons an SLP needs to be in a Dysphagia Journal Club? 4. How do you start a Dysphagia Journal Club? 5. How did you get started in your career as a medical SLP? 6. Tell us a story of success as an SLP. 7. What words of advice do you have for the new SLPs?

Quote Of The Conversation “Research is always changing and new studies are what guide our treatment approaches. There was a time when everyone universally was taught that a chin tuck improved swallow and it was through thorough, current research that we discovered that for some patients, it’s actually contraindicated at protecting their airway. We owe it to our patients and to ourselves to be providing the most credible, evidenced based treatment possible. ”

Tom Dixon, MS, CCC-SLP

Guest Speaker Bio Tom Dixson, MA, CCC-SLP

My name is Tom Dixon. I graduated with my Bachelors and Masters degrees from the University of Central Missouri. My wife and I currently live in St. Louis. I work full time in an inpatient rehab facility and PRN in acute care. I also serve as the brain injury team coordinator at our inpatient rehab hospital. I have a passion for oral health and dysphagia management and am currently in the process of applying for my BCS-S. In my spare time, I enjoy running, exploring new coffee shops, and traveling with my wife.

Downloadable Resources * 5 Reasons You Need to Be in a Journal Club * 5 Steps for Creating a Successful Journal Club

Download the episode transcribed and study guide

Guest Speaker Information Tom Dixson, MA, CCC-SLP

Email - dixonslp90@gmail.com

Facebook - Tom Dixson

Upcoming SLP Spotlight Guest Topics * Conversation with an SLPA * Conversation with a Director of Clinical Services and Mobile MBS Services * Conversation with a CF in a day school working with children with severe disabilities

If you enjoyed the show, I'd love you to subscribe, rate it, and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links to help them feel confident in their patient care every step of the way.

Follow me onInstagram, join the Fresh SLP community on Facebook, or learn more at FreshSLP.com. Let's make those connections. You got this!

Do you have a question you'd like answered on the show? Interested in sharing your experience as an SLP with our audience? Send a message to Mattie@FreshSLP.com!

Not a substitute for a formal SLP education or medical advice for patients/caregivers.

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—> Download this episode’s “study guide” and show notes <—

Hello, and welcome to “The Missing Link for SLPs” podcast. Today's episode starts the first in a series called “Hey Professor.” I'm calling it that because I can't tell you the number of times I'll be walking down the hallway and the student will run up behind me, “Hey, Professor, one more quick question!” Or at the end of the class, “Hey, Professor, one more thing.” And these are some times where the best discussions come from. So, I really wanted to start capturing some of these questions and discussions in these episodes here. So look for the “Hey Professor” series.

This is the first episode in that series, and today I thought we would tackle what I call SLP Scripts. Now we know what scripts are, with our work with language kids and adult clients, and things like that. And the script is a way of planning what you're going to say in given scenarios. I developed scripts working with my students, because I had so many students who would say, “Hey, Professor, what do I say to a family member? Or what do I say to a doctor? What do I say here? What do I say there?” So today is going to focus on scripts.

And the important thing about scripting is keeping those conversations Lean and Agile, not long and convoluted and going in every shape and direction. It's knowing what you want to say at the start of your conversation, and having those first clear thoughts articulated because then once you say that, then the conversation is going to take its natural course, and then you can follow the conversation wherever it needs to go from there. So SLP scripting is how to start those Lean and Agile conversations.

As a medical SLP, there are three different scenarios where you're going to want to become a master at SLP scripting.

One of them is with the patients themselves, and how do you introduce yourself? How do you explain what you're doing?
Another situation is with other teams, the members of the medical team, like what do you say to a radiologist when you're starting your video swallow study? What do you say at rounds?
And the third situation or setting is what do you say to family members or caregivers and so we're going to cover those today. We're going to cover them more in depth as we go along as well. But today, we're just going to provide an overview of some of these.

SLP Scripts for Working with Patients and their Caregivers

Leveraging “AIDET”

Since the patient is who we are all about, I'm going to start with what to say when you walk into a patient's inpatient room, or video class, or to a swallow study, or when you start an outpatient evaluation. The outline I like to follow is an acronym called AIDET and it is well known in the medical communities that I work in. A stands for acknowledge, I stands for introduction, D stands for duration, E stands for explanation, and T stands for Thank you. This will be up on my website, you should be able to go download an example of what it is pretty soon [inserted below post-production]. You can also go find it anywhere on the web, AIDET. So all of the scripting that you're going to do when you first meet your patient or their caregiver Is with AIDET in mind.

AIDET

AIDET is a well known tool used throughout medical facilities, improving communication with patients, families, and visitors.

A cknowledge

Acknowledge the patient and any family/friends/caregivers in the room with eye contact, a smile and an appropriate greeting.

I ntroduction

Introduce yourself, your role, your expertise.

D uration

Give the patient and others in the room an idea of how long the evaluation or session will take.

E xplanation

Establish clear expectations by providing an explanation of your evaluation or session.

T hank You

Be sure to thank the patient and their family/friends/caregivers for working with you, for letting you take care of them, and for their time.

Five Essential Medical SLP Scripts for Introductions

So here are five essential medical SLP scripts when you're entering a patient's room for an evaluation or a therapy session.

To introduce yourself to an inpatient for clinical bedside swallow evaluation, you would say, “hello,____” and use their name. “My name is Liz. I'm a speech pathologist who works with swallowing difficulties and I'm part of the medical team here at Sacred Heart Hospital. Your doctor wants me to evaluate how safely you're swallowing. I'm going to give you a variety of things to eat and drink and discuss with you how you can eat and drink safely, avoiding choking and pneumonia. This will take about 20 minutes. Any questions before we start?” You look them in the eye, you get at their eye level. You say it slowly and clearly and be approachable as they ask those questions.

If you want to introduce swallowing therapy - so somebody else has already done the evaluation and you're coming in to do the session or you're returning the next day to get the swallow therapy evaluations done - you would say, “Good morning. My name is Mattie, and we're working together today because of your swallowing problems. I'd like to introduce you to some ways to eat and drink more safely, and without choking or feeling like something is stuck. We're going to be working together today for about 30 minutes. And I'd like you to talk with me while we're working together and let me know what you feel is going down okay, and what isn't. But before we start, is there anything that you want to talk to me about today? Any troubles that you're having with eating or drinking? Any other questions before we start?” And then wait for that patient's response. So you've told that person who you are what you're going to be doing, about how long it's going to take, and you ask them if they have any questions.

The next one, introducing yourself to an inpatient for a speech language or cognitive evaluation. “Hi, my name is Bailee. I'm a speech pathologist and a part of the team here at this hospital. I'm here to work with you today and see how well you're able to talk and understand what people say to you. I also want to check out how clearly you're thinking. I'm just going to ask you some questions and have you do some things for me. This is all going to take about 20 minutes. Any questions before we start?” And then pause and wait for the questions; it's important, especially with the cognitive evaluation. People are worried that if you test cognition, you're going to somehow rule them incompetent. Those are most of the questions that come back at me after that. They're worried that you're going to take away some of their rights, their freedoms or privileges. And so those are the questions that come after I introduce myself.

The next script is introducing yourself for speech language or cognitive therapy. “Hi, Liz, my name is Leah and I'm a speech therapist. Because of your stroke, your ability to talk, think and understand is changed. And I'd like to show you some ways to talk and think more clearly. This will help you understand more of what is happening around you, and help you use your words to communicate what you really want and need. Ready?” At this point, you can ask if she has any questions or he has any questions, but you've given a short brief introduction of what you're going to do.

When you introduce yourself to a caregiver, slightly different approach, you're communicating with somebody who is very concerned about the person in that bed, hopefully. And you say, “Hello, my name is Rachel. I am a speech pathologist and part of the math team here at the hospital. My job is to make sure your family member is eating and drinking as safely as they can to avoid pneumonia, and to be able to communicate his basic wants and needs. I'm going to be working with Jim for about 20 minutes. Do you have any questions?”

If the patient is alert, ask your patient if they would like their caregiver to stay or if they would prefer their privacy. If the patient is hinting at privacy, then encourage the caregiver to take a break and return when you're done. Lean and Agile conversations are the key to scripting because the purpose of scripting is just to give that introduction, tell who you are, what you're going to be doing, how long it's going to take, and then go from there with the questions.

Three Essential SLP Scripts for Wrapping Up

Still working with the patient, here are three essential SLP scripts for when you're wrapping up your evaluation or therapy session.

So option one, this is the option that you'll use if another speech pathologist will be returning for further therapy. “Thank you, Jim, for taking the time to work with me today. We've just finished our evaluation. I'll be back to see you again tomorrow, [or state who else will be back], and we will continue on working on improving your ability to swallow more safely [or name what you're going to be working on.] Do you have any more questions for me?” Short, sweet, and to the point, you're stating clearly that you're done. You're stating what your next plan is and who's going to return and when they're going to return. And you're stating what you're going to work on when you do return. And you're following up with questions.

Now, if you are not returning for further intervention because there is not warranted, you would say something like this. “Thanks, Greg, for taking the time to work with me today. We've just finished our evaluation and based on how well you did, I would not recommend that speech therapy come back and work with you anymore. Would you agree?” And then wait.

If they agree, (they should agree if that's what you're recommending), continue the conversation, saying, “great, great, I'm glad you agree. Again, my name is Susan, and I'm a speech pathologist with the rehab team. Please reach out to anyone on the medical team such as your nurse or another therapist, if you have any further questions or concerns, and have a great day.”

If the person does not agree, then address those concerns. But you see how that script opens up those conversations? And again, the script is - you're wrapping up, you're just confirming what you did, what the next step is, and where you're going to go from there.

So when you're working with a family member and talking with the family member, and you're wrapping up a session, it can be a little bit different. And often these conversations take place because the family because the patient is not doing as well medically, and is not alert enough. And so your direction, your conversation is now going to be directed more at the family member.

You always think whether you're talking directly with the patient or with a caregiver, you do that last part of the ADEIT acronym, which is the “T” which is “Thank You!” And here is a script for wrapping up a session with a family member. “Thank you for letting me work with your family member today. At this time because he is recovering from his stroke and his level of alertness is so low, it's not safe to complete the evaluation as ordered by his doctor, but I'll check back on him later today.”

Say what you can check back on them. “I'll make a note of this in his chart and let his nurse and medical provider know, do you have any questions for me now?” “Again, my name is Susan and I'm a speech pathologist with the rehab team. Please reach out to anyone on the medical team such as your nurse or another therapist if you have any further questions or concerns for me, and have a good day.”

So it's common sense. But sometimes when you're in new settings, your mind just doesn't think clearly. And that's why I created the SLP scripting. There's nothing magic about it. You walk in, you say who you are, what you're doing, how long it's going to take. And your conversations are just Lean and Agile, they're clear, and they're kind. So those are conversations that take place with patients and the family members.

When you are introducing yourself to a patient for a video swallow study, you're going to be either in the room when the patient comes in and the med tech brings the patient in, or you enter the room after they're ready to go. And here again, you introduce yourself. I say, “I'm Mattie, I'm part of the team here that's going to be doing this swallow study. And we're going to take a look and see where the food goes down. And if it goes down the wrong way, why and what we can do about it.” And then you go from there.

The next sentence is to explain what I'm going to do. And I'll say, “I'm going to be giving you some food and drink mix with barium. And this is our camera. And this is our monitor, and we're going to be able to see when it goes down where it goes down. And if it goes down the wrong way, why? So just follow my directions. You're going to hear the radiologist and I talking a bit in the tech and I talking a bit and we'll be throwing some terms back and forth. But at the end of our study, when all is said and done, I'm going to review these videos with you and go over the recommendations and everything that we have found. And we'll go from there. Do you have any questions for me before we start?”

And that is the final conversation or SLP script that we're going to work on today with the patient.

2. SLP Scripts for Working with Medical Personnel

I wanted to briefly touch base with SLP scripts when you're working with other medical personnel, such as introducing yourself at rounds. So here you're talking to the patient, but you also have other members of the medical team present.

So, “Hey, Professor, what do you say at rounds?”

Option one is if you're going to be performing an evaluation. You say, “Hello, my name is Ali and I'm a speech pathologist working with you today. Today, I will be taking a look and testing how safe you're eating or drinking, or fill in the blank here with what you're going to be evaluating. I will also be looking at how well you're able to talk and understand what's happening around you.”

Option two is if you're going to be completing a therapy session, not an evaluation. “Hello, my name is Anne and I'm a speech pathologist working with you today. Yesterday we evaluated how well you were eating and drinking. And today we will be working on ways to make sure you continue to eat and drink safely.” So do you see how it's very short and sweet and to the point? Who you are, what you do, and what you're going to be targeting.

I have two “Hey Professors” left that I want to target before we are done with this episode for today. And one of them is what do you say to a nurse when you walk up to the floor?

“Hey, Professor, what do I say to the nurse?” So you introduce yourself, “Hi, I'm Nikki, the speech pathologist who will be working with the patient to room 243. I have orders for a swallowing evaluation. Is now a good time? Is there anything I need to know before I start? How's the patient doing today?” So you're just opening up that conversation with that nurse. You're telling her who's going to be going into the room. She should be watching very closely who goes in and out. She's gonna tell you if there's any other testing things going on like x rays or anything like that. She'll tell you how the patient's doing. She'll tell you her concerns.

This is also a good opportunity for you to then turn around and ask her how the patient's taking their medications, if they're having any swallowing difficulties and things like that. But you see how SLP scripts really narrow those first two, three sentences down into what you're doing.

3. SLP Scripts for When a Patient Passes On

The last “Hey Professor,” that the students often ask me is, “Hey, Professor, what do you do if you walk into a room and you find a dead body?” And there are three different scenarios for this. And it's happened to me a few times, but not a lot of times.

The first scenario is if you walk in and you believe a person has passed on and you're the first one to find that person, you want to quickly turn around and go notify anybody at the nursing station. It doesn't have to be that person's nurse. Preferably it is. But you've already checked with the nurse to see how that patient's doing. It could be the charge nurse, somebody who is going to be able to respond to you. Don't run down the hallway, don't run screaming or anything else like that. But you do go notify somebody ASAP and say, “I believe the person in room 219 needs you to go look at them.” And then that nurse will go and take it from there.

We are not qualified as speech pathologists to call the time of death or anything else like that. You do need to know DNR/DNI, in my opinion, before you go into a room, you should know that about your patients and then be able to respond appropriately.

A second scenario is, there have been times when I've walked into a patient's room and the patient has just passed, and nursing is in there and they are attending to things. And at that point in time, it's clear that the person has passed. You just ask nursing if there's anything that you can do to help.

And the third scenario is you can walk into a patient's room who's passed, thinking you're going to do therapy, because something hasn’t been communicated down to you. Or you go just to touch base with the family because most likely a swallowing patient and you stick your head in there, you realize what's happened then, and you offer your condolences.

In all of the SFP scripting that you do, in summary of today's episode, make sure that your communication is lean, agile, clear and compassionate.

So, there's our first episode of our “Hey Professor” series.

Follow me onInstagram, join the Fresh SLP community on Facebookor learn more at FreshSLP.com. Let's make those connections. You got this!

Do you have a question you'd like answered on the show? Send a picture of a Post It note or message to Mattie@FreshSLP.com!

Not a substitute for a formal SLP education or medical advice for patients/caregivers.

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Hi, everyone, and welcome to The Missing Link for SLPs podcast. I'm Mattie, your host, speaker, and very passionate speech language pathology advocate. If you are new to the field of speech pathology, or just want to stay fresh, this podcast is for you! Here I will share with you my wisdom and experience of more than 23,000 hours of one-on-one skilled intervention working around the world as an in-the-trenches medical SLP. And now as an assistant professor for an accredited CSD program, I want to help you see the big picture of what you're doing and connect those small dots of what you know and how to apply it in your practice. Those missing links, helping you be the best, most confident and most effective SLP you can be! There's no better time than now to freshen up. You totally got this.

---> Download this episode's "study guide" and show notes <---

Hi and welcome to this edition of the missing link for slps Podcast. I am with Dr. Lynn Fraley today who's a good friend of mine, and she is a neuro psychologist. I'm excited to have her here today to explain to us what goes on in her world as a neuropsychologist. Welcome, Lynn. Thank you, Mattie.

I am happy you're here. So a lot of the students I work with do not know what a neural psychologist is. Would you explain to us who you are, what your credentials are, and what you do?

Sure. Okay, so technically a neuro psychologist is a PhD in clinical psychology that has additional specialty training, usually a couple of years depending on how you do that. I happen to do my specialty training as part of my PhD program, so I didn't have to do it as a postdoc as much. What that means is, in addition to the clinical psychology curriculum, spend roughly two years of education focused on brain structures and brain functions, and what that means in terms of psychological functioning for patients. So it's the regular therapy type information with neuroscience added to it.

So excellent. And you are Dr. Lynn Fraley. What is your scope of practice as a neuropsychologist? Who do you see? What types of patients do you work with?

Well, as a neuropsychologist, I'm also a clinical psychologist. So my practice has been around for 21 years this year, and I started my life as a developmental specialist. So my practice ranges from early childhood like 2, 3, & 4 year olds on into the geriatric population. Our oldest patient right now is 82 years old, and it's a full spectrum practice. So in addition to knowing science specific things, like head injuries and dealing with things like ADHD and brain structural problems, we also have all the the whole spectrum of regular clinical psychology things like mood disorders and depression and anxiety and eating disorders and that sort of thing.

personally specialized as a trauma therapist early in my career. So we get a lot of suicidal patients here and a lot of people who have gone through all kinds of traumatic experiences of war veterans or survivors or witnesses of violent crimes, but also people who have survived things like car accidents and things that have crushed their brains. We do the most here, which is not typical for neuro psych practice, to combine clinical psychology, more like clinical psychology informed by neuropsychology.

So what that means is we do a lot of work and helping people understand how to sustainably change their neural network so they change the way their brain functions which affects how they feel and how they function. For example, bipolar patients have the ability to eliminate the symptoms that go along with their mood disorder if they know how to construct the neural network that will support healthier brain functions so that they can live their lives without the medication without experiencing those symptoms and can be healthy and happy again. So we do a whole lot of that kind of work here.

Typically, probably the majority of the neuropsychology field is involved in conducting assessments, writing reports and interpreting those results. Forensic neuroscientists do that a lot in terms of assessing damages from car accidents or head injuries and the outfall or the the fallout of strokes and assults or exposure to toxic substances. Most neuroscientists that I know of do not do clinical practice as well. In most neuroscience today, they don't do as much of the spectrum as we do here.

So I know, as a speech pathologist that has sat on onccussion teams, a state concussion board and worked with many concussion patients, we often get reports from a neuropsych. Ccan you share us what types of assessments might be on that neuropshychological evaluation and insights from the evaluationthat it would be helpful to a speech pathologist?

Sure, I think, I think would probably be the most effective to go back that out what kinds of assessments a neuropsychologist uses? There are dozens of assessments you can choose from. So it depends depends on the referral question a lot. So let's say there's a concussion involved. The assessment will depend on what part of the head was hit.; in terms of what brain section you want to assess. Generally , there's some there are some tried and true favorites out there in the clinical psych end.

We have MMP for personality assessments, and that's kind of the gold standard for neuropsych. There's a whole standard batteries of tests. It's up to the individual neuropsych, whether they use a standard battery or whether they put their own together specific to the evaluation.

I think the biggest difference there often comes between whether you're working for an agency or if you're in private practice. So what the neuropsych will do is bring the person in, hopefully under circumstances where we're going to get the best sort of response and best kinds of answers, and then interpret those test results in terms of what the test results tell you about what part of the brain might be injured. What part of connection which connections in the brain might be injured, whether they're repairable or not are questions we ask. What the odds on that are and that has a lot to do with the type of the severity of the injury or the concussion and the age of the patient. So the normal cycle gets specific,

I'm looking at memory or speech and language things or auditory things or processing reasoning or any of the executive functions, and then try to assess whether those are going to be treatable and to what degree they're going to come back. This has changed a whole lot recently with the massive movement towards understanding neuroplasticity and what that means and we're just now really starting to actually apply what we've known for a long time, which is brains can reconstruct themselves if we treat them appropriately. So what you get from your question, there's a concussion team and you send someone out for a neuropsych assessment who will get a battery and test results in a written up. It shows you what's injured and how badly it's injured and how likely it is to recover.

One of the things I enjoy most about you is, you are able to take a simple subject and explain it well. We were talking the other day about or this just before we jumped on here. Tell us your "bean" story.

Right. So being in the process of practicing clinical neuro psychology, it's very much like being back in kindergarten or first grade, when you planted those bean seeds in those little Styrofoam cups and the teacher gave you a cup and a little bunch of dirt and you pushed your little seed in there and covered it up. The teacher told you that that little hard chunk you put in the dirt was going to turn into a plant that actually made vegetables you can eat, if you would just give it sunlight and dirt and water, and you totally believed it. And so for some days you water, the dirt with no evidence of anything at all, until the day comes that you'll see is sprouted. Everything you thought was going to happen actually happened and then the plant grows and you get beans, and it's wonderful.

And that's very much like working with a patient in in repairing whatever sort of brain damage has gone on or reconstructing neural networks. Tell the patient there is this brain that you can't actually see. And that if we apply consciousness and if we apply certain activities to it, and we move in a certain direction, that this brain is going to grow networks, and we will know that because you will feel better your symptoms will go away. But very much like that being said you water for a while and you're kind of trolling a while but then the day comes when a patient walks in says, "I remembered where I put my keys. And I slept through the night and I haven't had a panic attack." It's like seeing that first little belief coming through the soil and you're like, "Oh, this is it, we're good. It's going to be great." And from there, it just goes on once a patient learns how to manage their own brain function that way, truly, there's there's nothing they can't do in terms of getting themselves to think and feel the way that they want to so they can live the life they want to live. It's pretty fun.

That parallels so much of what we do in our speech pathology world, because we will have patients who come for example with word finding difficulties and they have troubles even walking up to a counter to ask for, you know, where's such and such located in the store. And when they start a therapy session with us, it's like that being it's planted in the soil. Well, we tell them that their brain is going to get better. We give them strategies, which is like the water and and the sunlight. And we then teach them how to use those strategies. And in a world that's functional for them, I see a lot of parallels with what we do, which is why it's exciting.

That's exactly right. That's why that would happen even more often, if more neuropsychologists and clinical psychologists, actually, after doing the assessment, made a treatment plan and work with that patient. I think, at least in this part of the country, that doesn't happen a lot, because mostly because insurance reimbursements. And speech pathologists are the ones who are reimbursed in cognition and cog-com. while neuropsychs are not. So most neuroscientists don't do that, which is fine.

I mean, it's great, and it's wonderful that there is this overlap, because essentially, we're doing the same kind of work. I do different assessments than you do but we both are doing the same thing in terms of trying to repair a brain that is struggling somehow. So I don't really think there's a great big gap between us. I think the letters after our names are different. And the classes we took might be different. But if we sat down with the same group of people, we will probably be doing a lot of the same things.

Well said, the neuropsychologists I've worked with in the past add more depth and dimension to what I can test as a speech pathologist. You as neuropsych, test more areas than I may and in more depth and you'll give me more specific directions on how and what this patient can actually do or not. So we do complement each other well.

I think what neuropsych might offer that is a little bit different than yours too, is that understanding of that relationship between brain structures, which has vastly changed since the Human Connectome Project has come along. We know now that the whole brain talks to all of itself all of the time. So it's not possible you can have a like a focal lesion in just one place where you can see there's tissue damage here. But what that means in terms of disrupting the connect the communication pattern within that brain is much bigger and much more complicated than that. So most neuroscientists who will do a more of a global look at what is being affected with an understanding and an injury in one part will affect function in another part that might be really discreet and something that you miss if you didn't specifically test for it.

That reminds me of the video you told me about when I first met you,the video on neuroplasticity that The Legend Devlopment Center made. How can our listeners find your video?

You can go to YouTube and put in Legend Development Center. And if you pull itup, there are two videos in there: one which is written more for educators and one that says social skills and neural plasticity. If you pull that up, it will, in a nutshell, explain how we're taking concepts that we know and putting them into practice in terms of helping people, children in particular, rewire their own. With the belief that if we brought up children, people to understand how to manage their brains and care for them, as much as they understand how to manage and care for their physical bodies, we would very likely not have so many people in clinical psychologists offices, getting help because they would know how to remediate those things themselves.

Well said! It'ss a good educational video that I've shown some of my adult patients even though there are children in it, but it's educating the patients we work with on how to help their brain heal, and how to help their keep their brain healthy. So, yeah!

You are developing and growing until the day you take your last breath. So we really need to get over the cultural belief that young brains are somehow more flexible and more plastic than older brains are. It's not exactly true at all. If that were true, I wouldn't still be working and making up new things all the time. Older brains are different than younger brains, but every brain is a plastic brain, and every brain responds to conscious demand. So it's a very exciting field to be in. It's a very fun work to do. And I think that it's a little daunting to say a neuropsychologist. I mean that's a lot of letters. You could win a Scrabble game with that one. It's mostly a person who cares about helping someone else get better who has spent some more time studying about how brains working safley. That's pretty much it.

What words or recommendations do you have for a new speech pathologist who is learning to read a neuropsychological report or wants to maybe meet and reach out to a neuropsychologist? How does she begin to decipher that report and then realize that neuropsychs aren't so scary and intimidating?

Well, I think she should do is just pick up the phone and call. Most of us sit here in our offices, largely unaware that people don't talk to us because you think we're intimidating and scary and I realize all the letters seem like a lot. But neuropsychologist, generally speaking are avid learners and been in school a long time and they love to discuss their topic like anybody does. Who's got a career like that? And so, to pick up the phone and make an appointment, say, Can I buy you coffee? Will you talk to me for half an hour so I can be better informed, and I can better understand your reports.

I can't imagine anybody who wouldn't jump at the chance to do that on my end, because it sometimes is frustrating when we know we put reports out and we know that it's sort of foreign material to a lot of people. Sometimes the terms aren't all that familiar. Sometimes what we mean when we're interpreting them isn't all that familiar. And it can be difficult to put it in everyday readable language without missing some of the details. So to have somebody who actually is interested, and wanting to know how to understand and neuroscience report better, is like a rare and happy find. So I would encourage anybody to pick up the phone and call and say that you just talk to me for a little bit. Then I can understand you better, because that's on my end of it. That is one of the biggest hurdles to get over is to take this knowledge that you have that would be really helpful and make sure people understand what you're saying, in a written report, which is tough, tough to pull off a lot of times.

Right. Well said. Any last words, any stories you want to share with us before we are done?

What I would like to say is approach your neuropsychologist. Remember, that's just a person there, who's been in school for a long time, and who is happy happy to have a conversation because behind the neuropsych part is the psychology part. Psychologists are famous for talking forever. That's how we make the connection. So you should never be afraid to have a conversation with somebody who talks for a living. Just forget whatever it is that scares you. Sit down with the person and ask what you need to know. I'm positive you'll get the answers you want.

Dr. Fraley, you are absolutely wonderful. Thank you for taking the time to talk with us today.

Follow me on Instagram, join the Fresh SLP community on Facebook or learn more atFreshSLP.com. Let’s make those connections. You got this! Do you have a question you’d like answered on the show? Send a picture of a Post It note or message to Mattie@FreshSLP.com!

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Welcome to episode eight, 5 Surprising Skills SLPs Need for the Unknown Future.

These are five surprising skills that speech pathologists need for our unknown future, because life is hard. Being an SLP can be hard as well. I believe we all entered graduate school with “stars in our eyes”, just dreaming of becoming a speech pathologist. yet here we are in reality.

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Hopefully many of us still love being a speech pathologist. But COVID-19 has taken a lot of I wouldn't say the joy out of it, but a lot of the certainty out of it. Humanity's been through hard times. But it's our actions and choices during these challenging times that determine our resiliency factor that translates into our ability to move forward.

The five skills are daringness, curiosity, authenticity, critical thinking, and perseverance. I know I had perseverance on last week's episode. And I kind of had to chuckle because I I obviously think it's important it's on there again, and the The supporting notes that I have for perseverance is different. So I'm going to keep it on there, because we do have to persevere through these times.

So let's take a look at our very first surprising need: daringness. Imagine you are at the edge of a cliff and the only way to get off this clip is to go down. That's kind of where we are with COVID-19. Right now, we have got to look at reality in the face and as speech pathologists we have to do the same. We have got to look at reality. But there is a difference between daringness and ignorance.

Daringness is being able to take that first step forward with confidence, not without being scared, but with confidence, knowing that we are going to be brave and move forward into where we need to move forward. Ignorance is not being prepared. Daringness means thinking through and taking a calculus to risk. Fun fact: I love to play cribbage. In fact, I play in cribbage tournaments. When you play cribbage, you count points in your hand and you decide which cards to keep based on the points that your hand is worth. You should know by the time you're done with the round and all the cards are laid out, you should know the value of your hand without recounting. You don't have to recount it from the beginning. You should know the point value of your hand as it plays out and then you account for your playing and respond to your opponent. It's the same as with chess, you know, you have some good ideas, two or three moves ahead of time.

It's the same with being daring to thrive as a speech pathologist, you need to push and develop a daringness factor. Daring does not mean senseless and short sighted. It means being brave. learning what you need to learn in stepping into those new frontiers such as teletherapy, such as considering a setting you never thought you would work in, simply to have a job.

I was in grad school, I did not have an interest in voice, I knew very clearly where I wanted to go and that was in the medical setting. Then 20 some years into my career, I had to change settings after my husband died. And I had to learn how to work with with voice clients. And I learned that I loved it and I never would have thought I would have loved it. I had to be daring though to adjust which is what we talked about last time to adjust to new settings. I had to be ready in step into that that new skill set and not be scared.

Another skill speech pathologists need to develop as a sense of curiosity. So why is curiosity important to resilience? One of the most important factors In working with a child with a language disorder is to create a sense of curiosity for that child. What happens if we do this? And what happens if we do that? And it gets that child's gears working in in her head. What if she says this? When we create our treatments plans when we create our home assignments, whether it's with adults, or peds, we have goal driven activities and we create this curious environment.

One of my favorite stories growing up as a kid was Peter Pan and Peter Pan grew old and he left the land of never Neverland, and he forgot to be curious. Some of us though, we need to go back and learn to be curious again and ask ourselves the question, “what if”, because when we are curious, we create ourselves - we create opportunities for thinking, learning, problem solving.

A few years ago, quite a few years ago, I guess I got a CD set from the library and it was entitled “How to think like Albert Einstein”. And I thought, “Wow, gosh, I'd love to be smarter!” You know, this man's a genius, and the whole CD, the whole CD series was, was simply how to develop a sense of curiosity. Albert Einstein always asked why does this happen? Why doesn't this happen? I don't know if it was Albert Einstein who wondered why water went down the drain one way in one hemisphere and the other way in a different hemisphere. Someone noticed and asked the question by being curiosity. “What if I do that? What if I do this?” And be curious as speech pathologists.

Authenticity is the third surprising skill. How does being authentic increase my resilience factor? Why is that a skill as speech pathologists we need to develop. Dr. Phil says (now normally I don't quote talk show hosts but and I haven't been watching him at home but I he does have some good points because he's been through life)

“Your authentic self is who you are when you have no fear of judgment before the world starts pushing you around, and telling you who you're supposed to be. Your fictional self is who you are when you have a mask on to please those around you.”

But when you go through times, like times that we're going through now, you have to be authentic. You have to take that mask off and be real. You have to go to your professors and say, “I'm struggling with remote learning.” Or you have to go to your director at the hospital and say, “I'm not sure how to do teletherapy” or another colleague and say, “I'm not sure how to pull together these teletherapy materials and what are BOOM cards and how am I going to do this?”

And to be resilient, you need to be authentic, first and foremost with yourself, because authenticity is the catalyst for resilience. When we're honest and true to the voice within ourselves, we begin to develop our resiliency.

So how does this apply to be truly resilient? Look at your heart and what you want to do. And search for those lives that you want to impact. When you're doing what you feel called to do, you will be life changing and empowering. But you have to be authentic, open and real. And now is the time to do that.

Critical thinking is another skill, the core of being a good SLP. As SLPs, we've got to take our skill set off automatic, and get back to active critical thinking and get back to evidence. Well, we should be doing evidence based practice too anyways. But get back to take ourselves off the automatic and get back into the critical thinking mode, which is the core of being a good SLP

These are the skills you use to prioritize and make key decisions. PICO questions is the pneumonic used in evidence based practice:

Look at your Population
Look at your Intervention
Complete a Comparison
Analyze Outcome

Get back to those critical thinking skills.

And last but not least, apparently because I like it so much, perseverance is the final surprising skill set that came up again and again in the research I did in preparing for this podcast.

The Little Train That Could is one of my favorite stories and it’s about this little train that was loaded with all the toys for children and it was trying to make it up the hill and couldn’t. The big trains would come by and say “Oh, I can't help you.” And the little train always said, “I think I can. I think I can. I think I can!”

Perseverance almost always leads to success. No matter what goals you have to do, if you persevere, you will succeed. Your persistence has helped you to learn to walk and talk and write and read.

Persistence usually means learning something new in order to achieve that main goal. And these times right now going through COVID-19, we are going to have to learn something new. It's those first steps, though, that are hardest.

Dale Carnegie said, “The most important things in the world have been accomplished by people who have kept on trying, when there seemed to be no hope at all.” I have been learning teletherapy along with everybody else. There's been some amazing speech pathologist coming forward and just lifting up the profession in so many positive ways: creators of BOOM cards, people who are good with content writing and financing and behavior management. So many people are coming forward in this time and persevering and we are all pushing that engine up the hill saying, “I think I can. I think I can. I think I can.”

I think I've told you a little bit of my story: I ended up single mom with five kids 15 and under working as a speech pathologist, and a lot of people always say, “Wow! You are so strong!” And my response back to them has never been, “Yeah, I'm really strong.” It's always been, “I'm as strong as I need to be.”

The skills that you need to develop are the skills that you need to develop. They are the skills that will keep you moving forward and help you create these opportunities. So when we do come through COVID-19, when we are able to look back over our shoulders, you can say,

“I was strong enough, and I embraced that opportunity to learn those new skills, become a better speech pathologist and make the world a better place by the people and the patients that I work with.”

You just have to have enough. You have to be brave enough to battle your own battles, and you will get the career you want to live the life you want, leaving the legacy you want. These are the important things.

Tips for Success: Find someone, another speech pathologist, possibly and form a symbiotic friendship with her or him and identify ways which you can help each other get through these challenging times. And maybe focus on some of the skills that I've talked about such as a sense of curiosity, persistence, and daringness. Discuss on how you can support one another in emulating these skills.

Quote of the Week: Falling down as a part of life. Getting back up is living. Jose N. Harris

TIme to get back up. These skills I've talked about will help you get back up on your feet. I look forward to having you with me for the next episodes, which are:

The Seven Secret Linings of This Pandemic
The Surprising Opportunity We Call Teletherapy.

Tip for Success

Catch one negative thought today and turn it around with a positive. So instead of saying, “I can't do that.”, change the phrase to, “What if I…”, and then complete that phrase. It's a curiosity question, which, interestingly enough, is a positive trait. Curiously enough, that’s also something we're going to talk about in our next episode ;-)

Thank you for listening to The Missing Link for SLPs podcast! If you enjoyed the show, I’d love you to subscribe, rate it and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links to help them feel confident in their patient care every step of the way.

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Welcome to Episode Seven, where we talk about the six must have skills that slps need for surviving COVID-19. So in this episode, we're going to be talking about more resilience techniques, strategies, mindsets outlooks.

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Resilience is defined as the capacity to recover from difficulties. When I first started the missing link, it was meant to be a podcast for graduate students for fresh slps for those getting back into the field, who wanted to make those connections between what they had learned in graduate school, and how to actually apply it. I think I had gotten three episodes in and bundled in in set for launching when COVID 19 hit. So I've had to reformat and re plan all of my podcast episodes, because everybody's had to shift their skillset. Everybody's had to shift their skill set.

And so today's episode, and episode eight is going to be talking about the skills that we need to have. New skills, not the hard clinical skills and these are the soft skills that will help us be resilient through COVID-19. And help us keep moving forward with our careers in the field of speech pathology.

There's so many unknowns out there, but the one thing I do know is that the field of speech pathology is not going to go away, people are still going to need us, we are still going to have a passion for what we do. And that's why I'm changing the kind of the focus of these missing links for the next.

So launching into today's topic, I will be talking about six of the must have skills that slps need for surviving: mindset and soft set skills.

There's a book out there I read it quite a few years ago, called Who Moved My Cheese and it's, it's an inspirational book. This book is about a study where they set two mice up in a maze. And the mice learn their way through the maze to find their cheese, and the cheese was their reward and it was what kept them going and nourish them.

Once the mice learned the maze, one of the mice had an operation and the researchers took out the portion of this little guys brain that allows him to learn new things. Both mice are then put back into the maze, but the maze has now been rearranged. The mice had to learn new ways to get to the cheese.

Well, as you can predict the mouse that learned the new pathways, learn to use all of his senses to climb, see smell, find the new cheese did indeed survive and go on thrive because he was he was able to feed himself. The mouse who had a portion of his brain removed and he could not develop the neural plasticity. He could not find his way through the new maze and because he couldn't find his way, this mouse dies from hunger. As like most of you, I have such a soft heart I don't like to think of mice even dying, but to think of a mouse, trying to find his way through a maze, to survive and then becoming weaker

and weaker - it just kind of breaks my heart. We are like the mice - we need to know how to survive and find our way through our new maze - our new pathways.

I know there are people out there going through COVID-19 as speech pathologists, and they're just not sure how they're going to move forward in their careers, because everything has shifted so much. So the next two episodes I am dedicating the time to the skills outside of the hard skill set that we learned in grad school in applying or settings, but the soft skills that speech pathologists need to have for surviving COVID-19.

Today, we are discussing six of the skills slps need:

Developing perspective
Positive psychology
Self reliance
Resourcefulness
Perseverance
Adaptability.

Developing perspective

Why is that important? Developing perspective is an important skill to develop because life is hard sometimes. and resilience is a muscle to be developed. Resilience is a choice. And if you can understand and see the big picture, see down the road, it will help you be resilient. So take a step back, zoom out, you know, when you look up a place on your Google Map and you can get deep in and see the details, and it's fun to zoom back out.

Through COVID-19. I want you to practice zooming back out on your life and seeing the big picture because we are going to get through this as a society and as a profession, as people, as families as cohorts.

One of the things that will be helpful in developing your perspective is to understand where your strengths are and where your growing edges are. There is a website www.viacharcter.org. Go find it and do your own character assessment which takes about 10 minutes. And it's a wonderful website. It takes about 10-12 minutes and you answer a series of questions and then wait a couple of minutes for your score. You have to give them your email but other than that, it's free. And you learn about yourself. It rates your top 24 character traits.

Following my husband's death, my life was shattered. And so I had to pick myself up and figure out how I was going to get through everything. I’d lost sight of myself and what I stood for. This was one of the things that I did and I took the test and it reminded me again. It reinforced where my strengths were. I also looked at the back end of the ratings where my weaknesses or what I'd like to call my “growing edges” were.

So, learn to understand the big picture and develop your perspective of who you are and where you're going and start setting some goals. And I know this all seems like a big thing for developing perspective.

When my kids were little we used to read Where's Waldo books, and my little kids would crawl on my lap and they'd have this big book Where's Waldo and we’d look for Waldo. And oftentimes, Waldo was right literally under their thumb. Literally - not in the middle of the page as we often would first start looking. The Where's Waldo designers must have must have done some research because it was right where you weren't looking, which is right by your thumb. But looking back, developing that big perspective is so important for resilience and a skill that we need to develop moving forward.

Positive Psychology

Now another skill that we definitely have to focus on is positive psychology. Neuroplasticity is the understanding that our brain is not a static organ. It's a dynamic organ,and we can rewire the way our brain think. The positive thoughts that we think get reinforced, and so it’s important to change the negative thoughts.

Go on YouTube and do a search for the Legend Development Center. It is a very successful center in Spokane, Washington and they have a wonderful YouTube video regarding neuroplasticity and the power of positive thoughts, being mindful of your negatives and catch those negatives.

Instead of worrying about what you can't control, shift your energy to what you can control and what you can create. Train your mind to see the good and everything because positivity is a choice. The happiness in your life depends on the quality of your thoughts.

Self Reliance

Number three, self reliance. When I was a little kid, I, I guess I was one of those buckaroos that, when the rest of the world went right, I would go left. My favorite thing to do on playgrounds nas a kid? I would get a running start and I would run/climb UP the slide. I loved the challenge. Just my feet, you know, would keep sliding out from under me, but I would grab the sides and climb right up that slide.

And that's kind of what self reliance is. It's learning how to climb up that slide even though your feet are slipping but you grab on and do whatever you need to get to the top. It's when you have a question: don't ask others right away, but try to find the answers yourself. You can do this and when you become more self reliant, you become more confident in your own skills. Because you realize you can do this and you've shown it to yourself. So seek out those opportunities for self reliance.

Resourcefulness When I was little, I used to love to make paper airplanes and I would be very exact with the folding. And I would fold it a certain way and it would sometimes all wonky and other times I would throw one

and it would go straight and just glide beautifully and land. One time corkscrew through the air and another time gliding just right.

Resourcefulness is learning how to make those folds and make the airplane do what I wanted it to do. It's figuring things out and finding my resources and and trying again and coming up with a way of doing things and my goodness, are we ever being resourceful with all of our resources here during COVID-19?

Perseverance

Number five, perseverance is another skill we have to develop for perseverance is the ability to stick with a task until we get it to the point where we want it to be. There is a quote that says: “Everything will be okay in the end, and if it's not, okay, it's not the end.” So this can be true with teletherapy or any other skill you are learning.

It's so hard in the beginning, learning an initial skill, but don't give up because the beginning is often when it's the hardest. I know stepping out of the clinical setting and into the academic setting was hard! I had to learn a ton of new skills, most of them with technology and Thank You to my very first voice class, you students know who you are. You were so patient as I learned D2L!!

I kept saying, “Just remember me when you step into your clinical fellowship!” because they saw the struggles I was having. They also saw the positive mindset that I had, and that's so important, but persevering, and sticking through with the tasks to the end is how you get that perseverance.

I was talking to my graduate students the other day, and we're working on Simucase, and they're like, “Oh, man, this is so hard”. We had done a client named Audrey, and she was a video swallow study and the imaging was not optimal. It was really hard to see some of the soft tissue landmarks. I encouraged my students to stick with the case study and persevere to the end. That is needed and earned them their 2 hours towards their certification.

Adaptability

Number six, adaptability. Have you ever put on a swimsuit at a hotel and you're ready to go swimming, anticipating a great swim. You step into the water and it's just like shockingly cold. And you're like, “eee”. You start walking in slowly. But then once you get in and you're swimming around, you realize it's not so bad and you're actually having a lot of fun and now the water seems actually warmer. And what has happened is the water actually hasn't gotten warmer, you have gotten used to it and you've adapted. That is what we have got to do during this COVID-19 time. A lot of speech pathologists are being furloughed or reduced hours and they're picking up shifts elsewhere. I know two of my colleagues at

one of the clinics I worked at are taking duties at the door at the front door screening patients coming into the hospital.

Adaptability is the ability to adjust. It's that mouse who was able to find the new routes through the maze and find our new route as well. We have got to be adaptable because the world doesn't revolve around us. We've got to revolve and be in the world and adapt.

So those are six of the must have skills SLPs need for surviving this COVID-19. This and hopefully the only COVID-19 we ever have to deal with.

We have to develop a perspective and see the big picture. We need to develop the habit of positive psychology. We need to understand self reliance and search deep within ourselves and search for the resourcefulness that we've may not have had to call on before but we've got it in there. We've got to stick through it with perseverance to the very end. And we have to learn to adapt.

Quote of the Week

Your quote of the week: “The future belongs to the curious, the ones who are not afraid to try it, explore it, poke at it, question it and turn it inside out.”

Tip for Success

Upcoming Episodes

Episode 8 is Six More Surprising Skills That You May Not Have Considered that a speech pathologist will need in these coming times.

Episode 9 is The Seven Secret Linings of COVID 19.

Episode 10 is The Surprising Opportunity We Call Teletherapy.

So I have great plans in store! Keep tuning in, and remember, BE THE MOUSE that goes after the cheese and finds its way through the new maze, learning as she goes.

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In this episode of The Missing Link for SLPs podcast, I want to describe to you how my day's playout as a medical speech pathologist in a variety of different settings.

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I have had over 25 years working in the medical speech pathology field, around the world, in a variety of settings.

I thought it would be fun just to explain how my day rolls out in each one, and the feeling, the flow and the excitement, or the non-excitement, of my days in different settings.

Medical Unit in a Level 2 Trauma or University Hospital in a Major City

So the first setting that I want to introduce you to as a speech pathologist is probably one of my favorite settings and it’s on a medical unit in a level two trauma hospital in a major city. My day starts off early when I climb into my car and I drive to a parking garage where I catch the bus into the city.

My drive to my bus is probably 10-15 minutes. My bus ride into the city is maybe 35minutes. I love the bus time because I put my headphones on – there’s Wi-Fi on the bus – so I read my emails, I cruise the internet, I listen to audiobooks, all of those things. I don’t talk on the phone, however, that’s considered quite rude on those buses. So, I get myself ready for my day on my bus ride in. I wear scrubs, I wear tennis shoes, I wear super comfortable clothing because I am going to be moving, moving, moving all day. When I arrive, I throw my purse in a drawer and I put my coat over the back of a chair where there may or may not be another coat, and throw my lunch into a small refrigerator. I go clockin’. After I clock in, I punch in on the computer and I pull up my schedule and print my schedule off.

Based on an eight hour day, I will usually have seven patients on my caseload. Some of them are evaluations and some of them are therapy sessions. I’ll start organizing my schedule for the day.

At the hospital I worked at, each of the patients come with a priority level. So the patients that are high on my priority list I will put those patients at the top of my schedule, and I’ll make sure that I go see those first. The reason why I need to see those first because in a medical setting, such as this, medical care is first and foremost, and there are so many activities going on for that patient during the day. Getting a speech pathology evaluation done is one of the many things that needs to happen during the day. But we can be lower on the totem pole simply because there are procedures that have to be done and those results need to be collected for medical decisions to be made. Ours is included in that. So those evaluations are at the top of the list, but I need to work around a very busy schedule. I then prioritize the rest of my patients. I try to group them together on the units when I can. And if not, that’s why I’m wearing my tennis shoes and I hit the ground running. When I first arrive on an inpatient floor, I’ll walk up to the nurse and I’ll talk to the nurse and see how the patient’s doing. I’ll introduce myself. I say, “Hi, I’m Mattie. I’m a speech pathologist and I’m working with your patient in room 224. Can you tell me how she’s doing today and what her schedule is like for the day?” The nurse will give me a brief rundown on how the patient is doing medically and the other procedures they have going on for the day. If there’s any more information she feels I need to know or if I can think of anything I need to ask, that exchange will take place at that time. I then walk into the patient’s room and introduce myself to the patient and the caregiver, explain who I am, why I’m there, how long what I’m planning on doing will take and then begin my evaluation or therapy session. I try to do as much charting as I can in the room with the patient’s comments and caregiver’s comments as appropriate. Following my evaluation, or therapy session, I’ll then step out in the hallway to finish my charting. Sometimes I will leave some of the trickier parts of the evaluation to be done in the hallway because I can then think and problem solve and take just the extra few minutes that I need to complete my whole picture evaluation. Interesting point is in trauma units and level two medical centers, you’re going to have a lot of medical activity going around you.

There’s going to be gurneys going up and down the hallway, there’s going to be a physician sitting beside you with possibly organs in a cooler waiting for an organ transplant. Family and nurses will going by, you’ll hear codes being called. You’ll hear announcements over the speaker system. Very busy, very active unit. I then finish my charting for that patient and then I move on to my next patient. If by chance one of my patients is not ready for a procedure or is NPO, pending a test or something, then I will move them to later on my list and then I’ll go to my next patient trying to double back and get all of my patients seen during the day. At the end of the day when I’ve seen everybody, I will then go back and put these patients back on the docket for the next day with their priority level so when the next speech pathologist comes in the next day, she’s ready to print, organize and go. These hospitals cover speech pathology seven days a week. So if you do get on a team at a Medical University, be prepared to work weekends and holidays.

Rural Hospital – On Staff and Private Practice

The next setting that I want to tell you about is working as a speech pathologist in a rural hospital. I have worked as a speech pathologist in this setting both as a private practice clinician, and as an on-staff speech pathologist. The difference is, as a private practice speech pathologist, I have my own private practice, where I carry my own insurance liability, I do my own taxes and I contract my care with the hospital versus being on staff, where everything is carried by the hospital. I’ll talk to the pros and cons of each one that you need to look at as you consider working in those situations. The day rolls out the same. To start, in a rural setting you will get a variety of patients and caseloads. You will have inpatient care and outpatient care. You may see adults and pediatrics. All I saw were adults at my particular inpatient hospital, but working at a rural hospital you’re going to get more of a mix. There’s usually only one or two speech pathologists at the most working in a setting like this, versus a university hospital, where there might be 10 or 12 SLPs on a day in an outpatient therapy setting. I have my own desk and my own cubby hole for my materials, a lot more relaxed laid-back atmosphere. At the rural hospital, I have specific start times and stop times. So usually I’ll clock in at nine. My first outpatient appointment arrives by 9:15. And then I hit the ground running, and I will have outpatient therapy sessions every 45 minutes and hour-long evaluations, and then30-minute inpatient treatments as needed. Some days I’ll have an inpatient, some days I won’t. Some days I’ll have video swallows for an inpatient. Some days I won’t. My outpatient video swallows are scheduled two per day. So I can get an average of 10 in a week. Those spots are always filled. The schedule at a rural hospital is a lot slower. When I walk up to the floor, it’s usually one floor away, versus the six or seven floors away at the University Hospital. I walk up onto the floor. Nursing is usually sitting, the atmosphere is relaxed and calm. I walk up, I know the nurse by name, she’ll greet me by name. She’ll know the patient I’m coming to see and she’ll tell me how that patient is doing. I will walk into the room and explain to the patient who I am, what I’m doing, how long this will take and then complete my evaluation or therapy session. Again, I try to document as much as I can in the room. It’s not hard to do. Then I step out and finish documentation, usually down at my own desk.

Outpatient Clinic

The third setting I want to explain is that is in an outpatient clinic. I drive to the outpatient clinic, park in the parking lot – no bus here – and walk right on in. I do share a cubby area with other speech pathologists. There’s four of us at this hospital. Two SLP’s specialize in pediatric and two of us specialize in adults. The schedule is very specific. I start my day at 7:00 and from 7:15 to 8:00 is my first session. 8:00 to 9:00 is an evaluation slot, 9:00 to 9:45 therapy session.9:45 to 10:30 therapy session. And the day clicks through like that. Therapy sessions are usually 45 minutes. Occasionally they’re 30 if my schedule is tight and someone’s wanting to squeeze in. Most of the time there are 45 minutes and evaluations are an hour. I will see eight patients to nine patients during a day. I have 15 minutes in the morning free for documenting and 15 free in the afternoon for documenting and I have a half an hour lunch. I work my way systematically through my patients. I arrived early in my day to prepare for all my patients during the day but I really disciplined myself that at the end of an evaluation when my plan of care is written, my goals are established. That’s when I pulled together the datasheets that I want to use and my treatment materials that I want to work with. So outpatient clinic is very structured and very linear as we work our way through the day.

Home Health

The next setting is the home health setting. This was a job I worked when my children were younger because my day was so much more flexible. As a home health patient speech pathologist. I could drive into the home health office if I needed to pick up forms to pick up materials but most of the time, I would climb in my car and drive to my first patients house. Home health agencies will contract most of the time to speech pathologists some of the time we’re on staff, but our direct orders come from the Home Health office where we are given a list of patients and orders for evaluation and treatment. We will be working with a team. The nurse goes and does the intake prior to our first visit ever and then we work in around the other therapies. We will call the patient directly to schedule and on the phone. We’ll explain who we are and what we’re coming out for and approximately how long our visit will take. And then we hope that that patient remembers that we’re on their schedule, and they’re there when we show up. Sometimes they are. Sometimes they’re not, I would say probably 20% of the time they aren’t. I enjoy working as a home health speech pathologists because one, I don’t mind the drive too I enjoy walking into a person’s home and seeing who they are and what I can work with and seeing who they are and what I can work with because for example, if they are aphasic, then the items that we’re going to do are confrontational naming tasks with things right on their, their TV tray, and things that they keep beside them when they watch TV, their items in their room are right there. If there are dysphagia patient, well, then I get the thickener off of the cabinet and I take their favorite drink and I show them this is how you mix it. This is where you should be sitting. This is how you should be sitting up. So the environment is much more functional and the skills are easier to generalize in the home health setting. I will do evaluations and therapy sessions there. The atmosphere is much more laid back. And, chatty, I guess is the right word. You’re not under the stress of a medical setting. You’re in the patient’s home. They’re happy to see you. They’re happy to be home because they’ve just been discharged from somewhere. And they almost always welcome your advice and your recommendations.

Skilled Nursing Facilities (SNFs)

I’ve also worked in skilled nursing facilities, where I’ve been pulled on staff by a contract agency who contracts therapists to the skilled nursing facility. Most speech pathologists, physical and occupational therapists are not hired directly by the nursing facility itself. They are hired by an outside contract therapy company and that company is the one that drives the productivity rates and determines a lot of the setting that the speech pathologist works in. Here the schedule is flexible as well. I will walk into my day there, I’ll have a desk area that I share with other therapists. I will work off of an iPad, where I have my list of patients that I need to go see. In the settings I’ve worked at a SNF, the patients are not scheduled on a time, but rather there is the list of patients that I need to go see. And I need to get them in their evaluations and treatments during the day. I work around meals, I work around other therapists, I work around family activities and things such as that. It’s more of a laid-back setting in regards to therapy. However, the demands can be very, very high in regards to productivity, In this setting, I’ll see patients who are in a transitional care unit and both long term as, as well. So with a variety of level of patience, almost all of the patients that I see in this setting are 50 and above, definitely in the adult population.

Wrapping it up

So these are the main settings that I’ve worked in. And that’s how my days have played out in those different settings. I’ve explained how I start my day, how I end my day, how I get my schedule created. I’ve hopefully discussed the flexibility within each of these settings. The only thing that I haven’t discussed yet is activities that I do in addition to my speech language therapy. In the medical setting, the trauma level two setting, most of my time is spent in the trenches as a working speech pathologist. In these busy settings, I did not have the time to step out and serve on concussion groups or things like that. When I transferred to a rural hospital in an outpatient clinic that is when I had the time to then be a little bit more mindful of how I spent my day and say, I would love to send out a concussion team and work on improving our concussion intakes, or the dysphasia team where I’m training staff in the hospital as we transition to the IDDSI standards. So different settings, different challenges, different ways the days roll out. I hope you’ve enjoyed sharing my thoughts as I’ve recalled back on my different days as a speech pathologist in a variety of different medical settings.

Challenge

As promised, my challenge of the week for you is this week, I want you to think about what medical setting would best meet you, your needs and interests. There are a variety of medical settings that a speech pathologist can work in which one interests you? Which one do you think you might enjoy working at?

Quote

“Successful people are not gifted, they just work hard, then succeed on purpose” by G. K. Nelson

Tip for Success

Be mindful of what you enjoy and what you don’t enjoy at work over the course of your career. You want to be doing what you enjoy over and over. So if you are doing something in your setting that you’re not so keen about, work on shifting that it’s in your control. Please head on over to FreshSLP.com and check out our updated website. Download the show notes, follow me on Instagram. We’re doing phenomenally well on Facebook so join our community!

Our next topic is discussing Impostor Syndrome and how to improve your confidence as a speech pathologist. I hope today’s conversation has created some aha moments for you and motivated you to become a better SLP, continuing to connect some of those missing links between what you know and how to use that knowledge. Thank you for listening to The Missing Link for SLPs podcast!

If you enjoyed the show, I’d love you to subscribe, rate it and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links help them feel confident in their patient care every step of the way.

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Ever wondered what it's like to be an SLP in a medical setting? Listen and learn with Mattie as she gives an overview of what it's like being a medical SLP! ---> Download this episode's "study guide" and show notes <---

In this first full episode, I want to talk about what a medical SLP is. A lot of my students will ask me, what's the difference between a medical SLP and a school-based SLP? Who do you work with? What are your days like? So, I want to share with you some of the fun times I've had, and not so fun times that I've had, over my career as a medical SLP.

I was very fortunate in the fact that I always knew that I wanted to go into the medical side of things. In fact, I grew up at the feet of a famous physician, always wanting to grow up and be a great doctor myself. But I am of the age where that just was not encouraged, especially in my family. In fact, I have a sister, it's funny, we both laugh about what great doctors we would have made. But we are not doctors. We are medical speech pathologists and we both just love what we do. So we're happy where we are at. But that's probably why we are so intense on the medical side of things.

My first degree was as a technical writer, and one day I went to pick up my sister from work. We were meeting her in, we had driven to, Colorado, Denver specifically, and she was just finishing working at a skilled nursing facility where she was. I saw her working with her patients and I thought, "Wow, that is something I would just love to do." So I'm sure later that evening and then for the next few days, I peppered her with questions about what is a medical speech pathologist and what do you do? And sure enough, I decided to follow in my older sister's footsteps and I became a medical speech pathologist. And I tell you, it is just one fun area of Speech Pathology to work in!

I love it because it's a challenge and it is so fun thinking on my feet, and it's always a puzzle every day when I arrive at work, it's never a dull moment. So it's a great field. Today let me share with you some of the nuances of being a medical speech pathologist.

One of the 'Post It note questions' that frequently comes across my desk is "where does a medical speech pathologist work?" Well, obviously, one of the primary settings we work at is in hospitals. This is where the patients are there all day, all night for as long as they need to be and then we go and see them. You can work along the continuum of care anywhere from inpatient care, to acute care to rehab units which are inpatient units. The level of skills needed for medical SLP shifts along the continuum of care. For example, an intensive care medical speech pathologist working with respirators tricks, things like that head injuries. The skill set will be different for a medical speech pathologist who's working, for example, in a rural hospital, simply because one's not better than another but the skill sets are different because the complexity levels of the patients are different. So know that a medical speech pathologist can work in a hospital anywhere along the continuum from intensive care, acute care on out into rehab, into rehab. Now rehab units are inpatient care as well. And this is a unit where a patient is medically stable. Intensive care in some of those inpatient hospitals is where the patient is working on becoming medically stable. Once they're medically stable, they then shift to a rehab floor or a rehab clinic and care changes here a little bit differently. The medical speech pathologist now has more of a firm schedule.

I should go back to the intensive care setting, the acute care setting or just the general hospital setting. The schedule of a medical speech pathologist can vary. When I worked at some of my big University Hospitals, I would walk up to the rehab office we called "The Barn," where all the computers were and I had a spot for my purse and coat, and I'd sit at a computer. I would open up my schedule for the day, print off my schedule, and then wearing my scrubs and tennis shoes, I would hit the ground running. My patients would be all over the hospital, and I would go to them. Sometimes they were concentrated on some floors - like I might have two on the sixth floor, three on the seventh floor... And their schedule was very dynamic, meaning that so many things had to come before speech pathology such as MRIs and radiology and doctors rounds and things like that. So my schedule for working the inpatient floors was busy, busy, busy. I moved all over the place, always talking to nursing before I would go see the patient because I had to know what was on that patient's schedule. I had to know how they were doing, if it was appropriate for speech therapy intervention or not. So working on an inpatient floor in a bigger hospital can be very busy, very demanding with not a lot of structure time.

When you shift out to rehabilitation units, it changes because now the patient, instead of being medically unstable, is medically stable. They've discharged from their inpatient place and they're now the therapist's and everybody else has deemed it appropriate for them to step into rehabilitative care, meaning that they can tolerate now up to three hours or more of therapy a day. So the schedule here is much more regimented. There's breakfast at a certain time, there's lunch and dinner at a certain time. Therapy you will likely find, as most of the places I've worked at, therapy has a schedule. All the therapies have a schedule so the patient understands and knows and is responsible often for getting to those scheduled appointments. The intensity and this level is not quite as high as it is for the inpatient cares a lot more. It's a bit more...relaxed isn't the right word...but it's a lot more patient centered versus medically centered if that makes any sense. We are working with a patient who's alert and talking back with us and giving us input on their goals. So this is the setting of the rehabilitation unit.

I've also worked at outpatient clinics with the patient who has a medical etiology both with adults and pedes. And here when I arrive at work, my schedule is already printed out for me. I start my day at 7:15 a.m. with patients at eight and then 8:45. I might have a 45 minute time block for video swallow study at 9:45 to 10:30, or it might be another outpatient, so I just clicked through my day like that at 45 minute intervals. The patients come in on a regular, predicted time frame, unless somebody doesn't show which occasionally happens. But I click through my day, I'll arrive early, and I'll prepare for the patients that I'm familiar with, and have already established plans of care. I'll prep, do case histories and get an idea of what I want to do for my new evaluations, and finish up anything that might need to be done from the previous day, which is not too often. And that's the outpatient clinic. I'll see adults and like I said, I'll see pediatric patients. A lot of my adult patients the primary etiologies are concussions, voice disorders, aphasia, dysphasia, dysarthria, a practice sia, and some AC devices. My pediatric caseload in the medical setting is heavy with eaters; eaters and feeders because I'm working with dysphasia and some aphasia, some dysarthria. But again, these are kiddos with a medical background; a medical etiology. So their treatment diagnoses are also going to have that medical etiology shadowing on it.

Skilled nursing facilities is another setting that a medical speech pathologist might work. Lots of changes in that setting in the recent months. A lot of these patients here are older. They are in this setting because they're transitioning out from their hospital. Their hospitals have discharged them following their acute medical crisis. And they're now coming to the sub acute or short term stays units of the skilled nursing facilities. And we'll also see some long term care residents. Our primary etiologies here are dysphasia, dysarthria, and aphasia. Some individual settings, some group settings. And I should say that in the inpatient world, I've never had a group in an inpatient world, it's all individual settings. In the outpatient setting, we do run some groups, we've got a Parkinson's Law Group that I worked in and aphasia groups. So, a little bit here and there.

Telepractice and private practice are two other settings that medical speech pathologists will work. Telepractices are governed very well by ASHA, covering how to set up your telepractice, how to abide by HIPAA, how to respect HIPAA, and how to do your evaluation and intervention via teletherapy. Private Practice is growing, and many more speech pathologists are stepping into the freedom of developing their own private practice. Some of them have their own brick and mortar office where the clients will come to them, the patients will come to them, and some of them will go much like a home health and go to the patient's home.

Home health as I just mentioned is another setting that a medical speech pathologist will work in. These patients have been discharged from their medical setting and they were recommended to be home health because they were not able to, they were not judged to be able to withstand a full rehab stay. Rehab units if the patient is up in busy and active in therapy all day long with rest in between. Home health patients aren't quite there yet. They don't want to go to a rehab unit, don't have the stamina for it or there are some other reasons as well. So they choose to go home. They stay home. We'll be picked up by a home health agency which has a nurse. They come and do an intake and speech therapy is recommended either upon discharge from the hospital or when nursing comes and says hey, you know, speech therapy is warranted. And here the speech pathologist will go out to the home spending time in that patient's home setting, working on evaluation and treatment sessions in that setting. Here the speech pathologist schedule is very flexible. She or he determines when they work with the patient's input when they're going to be scheduled for the day or the week. Sometimes these patients will be seen once a week, twice a week. Inpatients are usually seen seven days a week. Rehab unit patients are seen six to seven days a week. skilled nursing facilities. Most of them are seen five days a week to seven days. A week through holidays. And looking at my pile of post it notes I think that covers that Post It note question. But as I tell my students, if I've not covered something that you have a question for, just shoot me your own Post It note.

So the next Post It note here I have is, "what types of disorders does a medical SLP evaluate and treat?" We see just about everything on this big nine list. We see dysphasia, articulation, receptive and expressive language disorders. We see all cognitive aspects of communication including memory, attention seeking, sequencing, problem solving. We see voice disorders, fluency disorders, often following a TBI. We'll work with some AC devices depending on the severity of the deficit, some hearing and sometimes will work with social aspects of communication. Often with the TBI patients, that's where that's targeted. Primary etiologies include CVA, TBI cancer. I think those are the top things that I see along with voice disorders.

Next Post It note question, "How heavy is the caseload?" Interesting question. It depends on the setting. If you're in an inpatient setting, such as a big, big hospital, a lot of time is spent moving around on most floors, moving from patient to patient and seeing if that patient is ready. So if I were to work an eight hour day, for example, my productivity levels would probably be around probably six patients today. In an outpatient setting, it would be a little bit higher, probably around seven a day. In skilled nursing facilities, productivity rates are significantly higher. Home Health a little bit lower. Telepractice or private practice I am not sure about those.

So next Post It note question, "what type of hours and flexibility is there among the different settings in my inpatient?" For my inpatient work, I start super early in the day. I am down at the university or at the hospital, wherever, whichever one, usually by 7:15 in the morning. Rounds are starting early in the morning and I want to be there when those doctors are there. The days can start off very fast at a medical facility. In other settings, rehabilitation units, they may start a little bit later. Home health is definitely going to start later because patients at home are not up usually at the crack of dawn, ready for their therapist to walk in the door. Skilled nursing facilities don't start as early either.

As for flexibility, that's a trickier question. It depends on how many speech pathologists you have working at the facility that you work with, where you work, if you're at a hospital and you have no structured times that you have to be there to meet those patients for their scheduled time. You have a little bit more flexibility within your day if you need to arrive 15 minutes late, or 30 minutes late, depending on traffic, weather, childcare, a little bit more forgiveness there. Places like outpatient clinics, rehabilitation units, Private Practice -those hours are not as flexible because you have a mark that you have to hit you have a time that a patient is waiting for you. When you're looking also at a medical setting, many of the medical settings are moving from five days a week care to seven days a week coverage. So depending on the facility, you may have five to seven days a week coverage. If you're working at a facility where there's a lot of speech pathologists, you're going to have some speech pathologists that rotate in on the weekends and holidays. Weekends first, I should say. If you're working with other speech pathologists on staff, then each of you will take one weekend coverage a month where you go in and see the patients that are on caseload and then you cover any more that come in holidays. You will take your major holidays and you'll divvy them up and everybody works one or two major holidays a month and then you share some of the not so major holidays. Those are covered as well. But it all depends on the facility and where you work and the setting where you're working.

Those are some very good questions hopefully that had been raised in your head with this podcast today. And as we work our way through these podcasts, feel free to go buy a notebook and a pack of Post It notes to take notes and write your own questions down and send them to me. And then in your regular notebook, keep track of these questions, keep track of these notes. For example, if you're interested in going into the medical setting, these are some questions that you're going to want to ask in your interview: What is the weekend coverage? What is how are holidays covered? What amount of mentoring do I have? What resources are available to me? How can I advance my career here in this medical setting?

The final post to note that I wanted to address is, "what is the pay scale and opportunities for advancement?" ASHA I has some very good research on pay scales. And it totally depends on what part of the country that you're living in. And it totally depends on where you are working. So go do your research through ASHA. Look at their surveys, and reach out and learn what a good pay rate is for your area. In terms of opportunities for advancement in the medical speech pathology community and setting, there are many, many, many opportunities for advancement. It's really nice to be able to step into a general medical setting where you do general evaluations and general therapy. And then as you go through your career, figure out what you really enjoy. Do you like working with the TV eyes? Do you like working with dysphasia? Do you like working with adults or pedes? How flexible do you like your setting to be? If you really love working with patients and you really love dysphasia, the medical setting, or you can niche way down and work in a pediatric specialty clinic for pedes.

I've known some therapists who have worked down into this area of expertise and they are just phenomenal therapists. But whatever career path you chose, whether it's medical or school, be sure that you go and watch other speech pathologists working in this medical setting and learn about what they do and what they like and what they don't like. Also take a good look at some of the things that are difficult in this setting. We do deal with death. We do deal with some very hard conversations. And it's not for everybody. Reach out to others, do some research and look through some of ASHA's websites, or there's some phenomenal Facebook sites out there where some of these real discussions are happening.

This podcast today is meant as a tickler to introduce you to what a medical speech pathologist might do in her career, who we might see, where we might work, and I hope you found it interesting.

So before we're done with our episode for today, I want to give you a challenge of the week. And that challenge is to think about the type of medical setting you might like to work. Open your eyes and really think, would you want to work with intensive care, rehab units, inpatient, outpatient, adults, pedes? Think about where you might like to work as a medical SLP, and what you would find interesting.

Your quote of the week, "The secret to success is to be ready when opportunity comes," by Benjamin Disraeli.

And your tip for success is 'always look for those opportunities.' I have a great opportunity quote if you'd like to visit freshslp.com and there you will find a download for the opportunity quote, you'll also find the show notes for this episode, and the outline of the script for today's episode.

Please, if you have any more questions, send me some Post It notes. Post It notes to your professor right?! Or just send me an email (mattie@freshslp.com). Watch out for me on social media. I'm having a lot of fun and I'm really enjoying building up fresh SLP. Our next episode is 'A Day in the Life of a Medical SLP.' Until next time!

I hope today's conversation has created some aha moments for you and motivated you to become a better SLP, continuing to connect some of those missing links between what you know and how to use that knowledge. Thank you for listening to The Missing Link for SLPs podcast! If you enjoyed the show, I'd love you to subscribe, rate it and leave a short review. Also, please share an episode with a friend. Together we can raise awareness and help more SLPs find and connect those missing links help them feel confident in their patient care every step of the way.

Follow me on Instagram, join the Fresh SLP community on Facebook or learn more at FreshSLP.com. Let's make those connections. You got this!

Do you have a question you'd like answered on the show? Send a picture of a Post It note or message to Mattie@FreshSLP.com!

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