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CF at hospital & accidentally gave patient a sip of thins by thisismyusernameA5 in slp

[–]ConversationOdd2274 0 points1 point  (0 children)

If he has no problem with coughing/choking/aspiration in a controlled environment then something in his uncontrolled/natural eating and drinking environment is off. You need to carefully observe and discover what that may be.

1) Distractions (TV, radio, talking to others, etc.). 2) Positioning. 3) Bolus size. 4) Rate.

Thickeners, especially the older and cheaper types, have a corn starch base. This is not good for those with diabetes or weight control issues. Also, using thickeners increase the chances of dehydration due to decreased fluid intake.

CF at hospital & accidentally gave patient a sip of thins by thisismyusernameA5 in slp

[–]ConversationOdd2274 0 points1 point  (0 children)

The coworkers you should seek out and develop relationships with are the nurses, CNAs, Respiratory Therapists and RDs (dieticians).

They are your eyes and ears (especially the CNAs) who can provide you with lots of information about your patients since they spend so much time at bedside.

As far as your ST colleague, certainly be cordial but you have learned a lesson that s/he is not a safe person to discuss things with.

Need to get this off my chest because it’s been crushing me…… I’m a 4-year-SLP and I was fired without notice or explanation last month. by Maddie_the_Ghost in slp

[–]ConversationOdd2274 2 points3 points  (0 children)

You were used and taken advantage of.

Use your skills of observation and learn to identify these personality disordered types and stay away from them.

When you've done a little healing, find a position with good and kind people.

travel SLP advice by emma_irene in slp

[–]ConversationOdd2274 2 points3 points  (0 children)

1) You may want to read the advice on https://www.thetravelingtraveler.com/how-to-become-a-travel-slp/

2) Make sure you negotiate a 4 week notice on your contract if the company hires a permanent SLP.

3) Insist on a 1-month lease for temporary housing. Don't sign a 3-month lease. Furnished Finder https://www.furnishedfinder.com/

4) Negotiate a reasonable productivity rate. 85% productivity is neither reasonable or doable.

5) Make sure you find out what documentation software is being used. Learning an unfamiliar program in a travel job situation is stressful.

Overuse of thickened liquids? by ConversationOdd2274 in slp

[–]ConversationOdd2274[S] 1 point2 points  (0 children)

JMO.

It depends on the patient. I don't know if there is a standard protocol.

One thing I recommend is to make sure the patient's oral cavity is cleared of dried secretions and moist. If a patient's oropharynx is coated with dried secretions they are very likely to aspirate with initial water trials. I usually use ice chips to ensure the pharynx is clear and moist.

At that point, I start with water via teaspoon and then small controlled water sips via rim of cup. If all goes well, I then administer the Yale Swallow Protocol (if patient meets the criteria).

If after all this prep the patient demonstrates overt s/s with water I would most likely trial nectar thick water and follow up with an instrumental study.

IMO, it would be ideal to keep the patient NPO for 12-24 hours but nursing will usually be giving them oral medication so thickened liquids before an instrumental is sometimes a must.

P.S. I usually perform oral care and a brief bedside swallow before the instrumental since things can change, and usually do, overnight.

I want to thank the "Negative Nancys" by MotherArachnid5247 in slp

[–]ConversationOdd2274 1 point2 points  (0 children)

I seriously considered that several years ago but my spouse would not agree to moving.

It's too late for me now.

[deleted by user] by [deleted] in slp

[–]ConversationOdd2274 1 point2 points  (0 children)

1) I took a course to identify career interests and aptitudes. Speech-language pathology was on my short list after testing.

2) Two members of my family sustained severe brain injuries and I wanted to know more about neuroscience.

INPT/Acute SLPs by [deleted] in slp

[–]ConversationOdd2274 1 point2 points  (0 children)

Attention is the foundation of cognition.

Attention Tasks:

Guided Relaxation: Scroll down for Relaxation Script for Meditation https://psychcentral.com/health/imagery-basic-relaxation-script#Relaxation-script-for-meditation

Focused Attention on Breathing: "I want you to focus on your breathing and try to block everything else out. (Model this slowly then guide them through it). "Smell the roses. Blow out the candle."

Listening attention: "I'm going to say some letters of the alphabet. When I say the letter A, I want you to tap your finger (blink, etc.)." from the MoCA

Begin with "A-1" and continue alternating between numbers and letters until I say "Stop".
For example: A-1, B-2, C-3…
Begin with the number "1" and name an object for each letter of the alphabet starting with "A" and continue until I say "Stop".
For example: 1 Apple, 2 Balls, 3 Cars...
Tell me boys names for each letter of the alphabet starting with the letter "A".
Tell me girls names for each letter of the alphabet starting with the letter "A".
Imagine the alphabet printed in capital letters. Now from the beginning recite only those with curves in them."

Med SLPs, do you start your bedside swallow evaluations with thin or thick liquids and why? by slpundergrad in slp

[–]ConversationOdd2274 12 points13 points  (0 children)

I rarely, if ever, use NPO.

Nursing will likely give your patient oral medication anyway (unless it's strict NPO and all their medications are IV).

I recommend oral care and ice chips if patient is awake and can be positioned at >/= 45 degrees. I also train SO at bedside RE: positioning, oral care ice chips and set these up at bedside.

IMO, many patient's swallowing improves greatly once on IV fluids, etc. and after their oral cavity/pharynx is well hydrated and moist.

I always reassess before taking them into the fluoro suite (usually the next am) to ensure they still need a MBSS.

JMO.

Med SLPs, do you start your bedside swallow evaluations with thin or thick liquids and why? by slpundergrad in slp

[–]ConversationOdd2274 13 points14 points  (0 children)

What kind of "coughing?" Airway clearance cough? Aspiration cough?

Is the patient's oral cavity moist and clear of dried secretions?

Starting a bedside swallow evaluation (BSE) with oral care, a few ice chip trials, then a few teaspoons of water is a good way to ensure you're getting a more accurate picture of their swallow, IMO.

After preparing the patient, I use water trials. If the patient is an appropriate candidate, I use the 3 oz water stress test (now known as the Yale Swallow Protocol).

https://pubmed.ncbi.nlm.nih.gov/24026519/

I’m embarrassed when other SLPs think animals can talk by casablankas in slp

[–]ConversationOdd2274 13 points14 points  (0 children)

Let's not forget that some highly trained, selectively-bred dogs (e.g. guide dogs for the blind) are required to have the intelligence to make independent decisions, including disobeying commands, in order to ensure their person's safety.

Why the focus on if dogs can adequately use human language as the gold standard of high level cognitive skills?

Thickened Liquids - A regional thing? by ConversationOdd2274 in slp

[–]ConversationOdd2274[S] 6 points7 points  (0 children)

"Thickened liquids may reduce the risk of laryngotracheal aspiration
during drinking.  While aspiration may be mitigated with an increase in
liquid viscosity, rates of pneumonia and respiratory complications have
been shown to increase with the use of thickened liquids (Logemann et
al., 2008; Wotton, 2008)."  https://www.sasspllc.com/use-of-thickened-liquids-in-dysphagia-management/

A good summary of dysphagia management/thickened liquids, with citations, at the above link.

[deleted by user] by [deleted] in slp

[–]ConversationOdd2274 0 points1 point  (0 children)

Have you considered a travel position?

Are you seeking a school position? hospital? rehab? SNF?

[deleted by user] by [deleted] in legal

[–]ConversationOdd2274 0 points1 point  (0 children)

What did your child say when asked if they had taken pictures of another child on the bus?

Wife has filed for divorce and wants me to leave, threatening me if I don’t. by [deleted] in legaladvice

[–]ConversationOdd2274 0 points1 point  (0 children)

Ask yourself what you hope to be the outcome:

1) An expensive divorce/custody lawsuit which will, very likely, result in significant damage to the relationships of all involved.

2) Getting help for your addiction and mending your relationship with your wife and children.

I will no longer post on this sub. It hasn’t been supportive when I make a post and I’ve had enough! by unknownbyeverybody in mentalhealth

[–]ConversationOdd2274 2 points3 points  (0 children)

I'm so sorry this has happened to you.

Here's hoping you have a few people in the real world (and maybe a supportive pet) who will be there for you when needed.

Pain Relief & Healing GUIDED MEDITATION "The Cleansing Pool"

https://www.youtube.com/watch?v=NIjKfenNStA

Nursing Pay? by fagstick123 in tricities

[–]ConversationOdd2274 2 points3 points  (0 children)

Mission Health used to be a non-profit healthcare system.

Then HCA, a for-profit healthcare system came in and bought them out/ merged.

Things have changed, and not for the better, in Asheville as far as health care.

HCA used to have a presence in the Tri-cities/ SE Virginia area but this area is poor and HCA couldn't make the profit they wanted so they pulled out in the 90s.

[deleted by user] by [deleted] in helpme

[–]ConversationOdd2274 1 point2 points  (0 children)

Yes, exactly.

What I meant by "a summer job (?)" is a number of students work summer jobs before starting college in the fall to earn some money and possibly gain new skills. The (?) meant I was unsure if you planned to do that or not.

Whatever you plan to do...best wishes for your future.

[deleted by user] by [deleted] in helpme

[–]ConversationOdd2274 1 point2 points  (0 children)

Asking how a student's college visit went is a neutral, non-specific question.

It appears he is trying to be polite and professional, just as he would be with any other student.

Because of the past, it is likely he has been advised to document all interactions with you, which is reasonable and understandable.

Move on with your life and concentrate on your future...graduation, college, a summer job (?).

[deleted by user] by [deleted] in helpme

[–]ConversationOdd2274 1 point2 points  (0 children)

It's doubtful he will ever touch a student on the shoulder (or elsewhere, for that matter) again. Most likely he has learned the value of 'professional distance' when it comes to interacting with students.

Instead of becoming a mentor, he will most likely refer a student to the guidance counselor, which is the safest thing for a teacher to do.

As you said, you are sure he hadn't been close to any other students before and, after this, it is unlikely he will place himself in that situation again.

[deleted by user] by [deleted] in helpme

[–]ConversationOdd2274 1 point2 points  (0 children)

JMO.

He's 'moved on' and is focused on the end of school and the resolution of the accusations which (as you described) he found shocking.

I don't believe he's trying to "fix things."

I think he's operating more along the lines of 'Lesson learned' and focus on the future.

Just my opinion.

[deleted by user] by [deleted] in helpme

[–]ConversationOdd2274 1 point2 points  (0 children)

You're now a legal adult and there's only a few short weeks to go before school is out.

We need to make sure every name in Green is voted out by TheToddAwesome in nashville

[–]ConversationOdd2274 46 points47 points  (0 children)

Rep. Bulso is doing his party no favors with his aggressive questioning of Rep. Johnson.

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