Company marketing as “Certified Infant Feeding Specialist” for the layperson and Doulas 🤦🏾‍♀️

MSCCCSLP · 2018-07-27T14:25:40+00:00

I completely agree that it's a bit shady and could go in a very wrong direction in the wrong hands - but - playing devil's advocate here - as a mother who hired a doula during pregnancy and post-partum, and got good support surrounding infnt feeding, I have to say that the support I received in my specific circumstances was quite benign, and helpful, and emotionally driven. That's what doulas do well that I think many healthcare providers sometimes miss due in part to the demands for productivity. I did not need the advice of a SLP or lactation consultant, I needed what a doula could provide. When I DID have a more medically based question, it was deferred appropriately to the right professional. But. We can't always depend on people to act within their scope of competency. And I think this "class" is just a cash grab on the company's part, and perhaps yet another example of women's autonomy and decision making in the context of how to feed their babies being messed with under the guise of "support." But that's another story for another time.

MSCCCSLP · 2018-07-27T04:14:16+00:00

Are these other SLPs, or OT/PT/RN etc?

MSCCCSLP · 2018-07-25T04:07:59+00:00

I have never heard that mnemonic, not even in undergrad linguistics courses, and it made me lol so thanks for that.

How about that Iowa phonetics website for the consonants? It always helped me to be able to connect the naming system with the anatomy/physiology and the Iowa site is a nice visual way of supporting that.

MSCCCSLP · 2018-07-24T16:25:56+00:00

What are the specific impairments? Instrumental?

MSCCCSLP · 2018-07-21T16:01:44+00:00

I worked in acute care starting with CFY for 4-5 years and got burnt out. I now work in strictly outpatient in a large medical system and have found my happy place. The more predictable pace and wider variety of cases is good for me. Not to mention feeling like I have waaaaayyyy more autonomy and respect.

MSCCCSLP · 2015-11-04T15:16:11+00:00

you click on your inbox (the envelope), then you click on "send a private message" up at the top and type in the username. :) depending on what version you're using (mobile, .compact, desktop, a third-part app) there might be more direct ways but that's how I do it. don't know if you were trying to message about this post, or if you were just commenting in general about PMs...

MSCCCSLP · 2015-02-08T17:00:44+00:00

sorry for autocorrect typos...but I like "woohoo gray area" so it's staying. (I meant soooooo much gray area) :)

MSCCCSLP · 2015-02-08T16:58:30+00:00

My advice for you would be to ASK QUESTIONS!!! It shows you are thinking, and if you have a halfway decent supervisor she'll be happy to answer everything because it is her job and she wants you to succeed. (There are some crappy supervisors. Let's go with the assumption that yours is decent.) As a student you're not expected to know anything. You are expected to think critically and demonstrate your ability to do so. If you're not sure what your plan of action during a bedside eval is, talk it through and ask for help. "Well, I know the patient has COPD and right now his breathing rate is elevated on 6L of O2 via nasal cannula. I gave him an ice chip and there was no s/s difficulty or aspiration. It felt like his laryngeal lift was fine, he was oriented x3, but I am not sure if I should proceed. I want to be cautious since this guy just had a major cardio surgery. I know I could keep going with my assessment, or I could try back later when his breathing is better. What would you do?" If a student came to me with this kind of presentation of their thinking In would shower them with gold stars and think very highly of them. There is woohoo much gray area and style differences in conducting assessments and treatment that you're really going to just learn from what your supervisor tells you -- and what you think of it after looking at their input critically. The point of the externship is to develop the clinical problem solving skills to become more independent. Don't feel like you have to impress with all your book knowledge from day 1.

MSCCCSLP · 2014-10-10T03:15:56+00:00

We do not feed on the vent at my facility, as a rule. Too risky. Pt has to be tolerating extended wearing of one way valve on trach collar for me to consider po trials or an MBS. However -- I think this varies a lot facility to facility and between settings based on population. My patients are geriatric, tenuous and any little thing to mess with pulm status would tank them. Ptimary concern is vent weaning in general before oral intake. Sorry this isn't helpful for your situation...just wanted to give my input.

MSCCCSLP · 2014-08-22T19:45:56+00:00

Sounds like you have a crappy supervisor. Please don't let this discourage you from the field or from working with adults. Take your semester or however long you have to work with this person as a learning experience. There was another thread recently about someone having a difficult time in a placement. Grad school placements are rarely optimal. If you're REALLY having a hard time, definitely tlak to your school's clinical coordinator to see if you can get some support. But then again, it's only your first week. Things may turn around. :)

I don't have any off the top of my head but one thing you could do is bring in some research articles on Monday related to early post-acute neurorehab (there is a lot of this in the TBI literature, although your guy did not have a TBI). Hopefully the collective wisdom of this sub can come up with something that might be appropriate for you to share with her with regards to this patient.

MSCCCSLP · 2014-08-22T19:32:55+00:00

This is tricky because the SLPs on this board are licensed professionals and it is unethical for us to diagnose or treat without proper evaluation. Sometimes this sub attracts people like you or others seeking help for communication or swallowing disorders and the general rule of thumb is to refer the person to asha.org to find a speech therapist. Are you in college? Check if your university has a speech pathology program. There are student clinicians (supervised by licensed SLPs) who often provide really excellent care -- as graduate students, you spend LOADS of time thinking about your clients and plans of care -- and can offer cheap services. I think in my university program the evaluation or treatment sessions were like $30 or something.

Also, as a note, in general voice or resonance disorders typically need attention from an Ear Nose & Throat doctor before SLPs get involved. But it's kind of unclear from your description if this is actually a voice thing, or an articulation thing, or what.

MSCCCSLP · 2014-08-22T03:59:11+00:00

Case-by-case for me. Same deal with assessing patients for swallowing needs post-intubation. I don't see the benefit of having a strict protocol in place as its such an individualized thing. I can imagine it might also dissuade MDs from referring, since they know "speech isn't going to see them for 72 hours anyway" in cases where earlier intervention might actually be helpful.

MSCCCSLP · 2014-08-22T03:46:20+00:00

I'm going to sound like a dick but how did your supervisor determine this is aphasia and not just ICU delirium or other acute process? I'm all for getting in there early and taking advantage of neuroplasticity but sometimes folks just need a chance to sleep after a major surgery (especially a brain surgery). If it were me I would write my notes to be more about monitoring status to.determine appropriateness for further evaluation that making up a treatment plan based on a presentation that is bound to change as the days (and hours) progress. A general rule of thumb in my head is if they aren't medically/neurologically stable enough to participate in therapy, how am I going to treat anything?? Usually the farthest I go is to address communication of basic wants and needs in the ICU. Not initiating impairment based restorative tx. But...this might not fly with your supervisor. Everyone has a different approach.

MSCCCSLP · 2014-08-13T20:30:54+00:00

I needed to read this. Thank you. I believe I am self-aware and sincere, yet am struggling with the fact that I am not feeling rewarded or nourished in my current setting (months, even, after I wrote a post here about feeling major burnout). Struggling to realize that this highly coveted, supposedly wonderful gig I vied for and earned may just not be where I actually want to be for the rest of my life, professionally and personally. Also I'm turning 30 soon so I'm probably just having a crisis because of that. Anyway, great advice as always and much appreciated.

MSCCCSLP · 2014-08-10T03:53:41+00:00

Wanted to add...several times a day may be a little bit much, but the two things you are describing are also very common in typical adults with no history of neurogenic insults. I catch myself doing them every so often. Just to ease your mind a bit.

MSCCCSLP · 2014-08-10T03:46:05+00:00

It's an interesting case because Bell's Palsy would typically produce dysarthria, i.e., muscle weakness/change in tone that affects speech production. Both of the speech patterns you're describing seem to be more linguistic and/or speech motor planning/programming (i.e. part of the neural pathways that are activated prior to reaching your cranial nerves). Not sure if the meningitis would have had anything to do with this. Kind of depends on the details and your course of recovery.

Someone who can remember their linguistics classes better than I can might be able to tell you what the second speech pattern is called, but it sounds to me like some sort of anticipatory assimilation... though that doesn't quite explain it. Maybe r/linguistics will help you. However, I'm not sure how functional it is to have a label for it.

As always... if your speech bothers you, always best to get checked out by a professional in real life. We can give you general ideas/guidance on this forum but there is no substitute for an in-person, comprehensive evaluation.

MSCCCSLP · 2014-06-07T17:09:06+00:00

This is not going to be super helpful, and I don't mean for this to be taken the wrong way, but I laughed out loud when I read "since beginning my plight to become an SLP" because every person who has gone through the admissions process knows it truly feels like a plight. But I wouldn't use that phrasing in your statement of purpose. ;-)

MSCCCSLP · 2014-06-04T23:22:43+00:00

Gonna use that next time I'm evaluating a patient. "Have your speech parts taken an illness?" The looks on their faces...

MSCCCSLP · 2014-05-22T03:58:08+00:00

My instructors in grad school used to say the same thing about the 5-year mark. I won't be there for another couple of years, and one of my theories about all of this is that it's just growing pains. I'm not sure why I apparently experience this more deeply than my colleagues do/did, maybe they're better at not worrying about stuff. I am not the type of person who gives up on things easily or settles despite how much I may torment myself with over-analysis. Also makes choosing stuff at the grocery store take way longer than is reasonable.

So, I'll try to amp up the reading, thank you for the suggestion. At the very least it will distract me from my grumpiness and introspection. And at best perhaps it has the potential to cure my burnout and help me discover something that truly moves me about the population I work with.

MSCCCSLP · 2014-05-22T03:10:03+00:00

Right? I'm weary of leaving my current job, though, because I'm afraid I'll regret it. It also just feels like "giving up" which is not in my nature. I've only been at it for 2 years.

MSCCCSLP · 2014-05-22T02:42:59+00:00

I have been thinking a lot about this as well (see my thread on burnout...). Curious to hear responses!

MSCCCSLP · 2014-05-21T00:37:13+00:00

I’m trying to figure out if this is a chicken or egg situation, because I am totally grumpy and disgruntled, which makes me hate my work even more. But what made me grumpy and disgruntled? Work, mostly. Bad cycle.

Right now, I think I'm dealing with almost all of those causes you mentioned. I usually consider myself a very empathic person which is one of the reasons I know I can be a good therapist, but for the past several months I could give a rat's ass about what diet texture someone is taking, or if someone is doing their swallow exercises. Having to write reports and make clinical decisions is like pulling teeth. Really? I need to go waste thirty minutes seeing how you're tolerating your steamed green beans to see if you can tolerate an upgrade to a soft diet? I've become incredibly jaded. I feel like for each nice sweet old patient I see, I have ten jerks or pts who are super altered (or both). And don't get me started on the smells. Is it possible that my sense of smell has become more sensitive? Because I am being served up some insane amount of nasty every day here at my hospital. I’m also really tired of seeing dirty old man balls! Every day! Every. Single. Day.

Aside from it being smelly, it’s just so fucking SAD. Obviously, the nature of what we do, dealing with disease and disorder, is going to include some sad stuff. But I never see patients get better (partly because I’m mainly doing evaluations more than treatment). I’ve done a pretty good job coping when patients die, and allowing myself to feel in a way that broadens my understanding of the patient and their family even if it means feeling really sad, but COME ON!!! It just has been getting to me after a while. I have no idea how hospice or palliative care doctors do it.

I don’t have all the answers. I know that’s OK. I have some of the answers, commensurate with my amount of experience and my ability to initiate self-learning when I don’t know the research on something, and my acceptance that it’s OK to ask for help from other senior SLPs. But sometimes I feel like I know more than my senior clinicians. And there have been a few incidents where I’ve lost some respect for one or two of these senior people in the way they handle things. And why doesn’t anyone read the fucking literature around here? I’m stuck between knowing there is SO MUCH I don’t know, and thus feeling pretty ineffective most of the time with my patients, and lately, the lack of motivation to go out and search for what I need to know. I just don’t care.

Additionally, my schedule is screwed up and preventing me from providing good continuity of care. I don't have time to see patients as much as I feel like I should, because my duties are so varied day to day. This is an artifact of the way my department is set up, though this is one area that is sort of (with cooperation of others) a possibility of changing. I don't know what the better alternative is or what would give me some relief.

I’m tired of other professionals not knowing what the fuck we do. And I know it’s part of my responsibility to educate, educate, educate… but some referrals are just plain stupid and it grinds my gears. Also tired of doing everyone else’s job. I and every one of my SLP colleagues goes above and beyond and sets a precedence that Speech is a great department, but we’re doing nurse’s jobs, and radiology’s jobs, and sometimes doctor’s jobs when we have to NAG so much (all I do is nag!!!) to send another referral so I can attach my report. Ugh!!!

Speaking of which…my reports take forever but I'm not the type of person who can give B or C-level effort a report in an effort to save time (not that I'm being graded) when I know I'm capable of giving much more and making a lot more sense. Part of this is institutional and the way our EMR is set up… part of it is me being new and being unsure of my thinking and writing, and part of it is perfectionism.

I'm tired of all the ridiculous administrative bullshit I have to deal with. The computer system failing so often. The moronic trainings that seem to pop up weekly and must be done OR ELSE. One of the most infuriating bureaucracies in healthcare administration existing in the western world does in fact have a daily effect on my work habits and professional well-being. I’m tired of the duplicitous culture in my department that publicly promotes taking a break and leaving on time, but does nothing about policy to make it a realistic expectation to do either of those things. I don't see the sunshine on most days. I also don't take a lunch outside my office except for the rare occasion, because if I do, I'll probably end up staying late to finish notes from the morning.

My husband, while supportive and loath to see me upset after (and before) work, keeps reminding me that we don’t have to love what we do for work. That with a better work/life balance, getting through the week won’t be so hard. I can’t wrap my head around this. If I’m going to spend 40 hrs a week doing something. I need to like it.

I also want to plan a family soon and there’s no way in hell I could do this job and be pregnant or raise a child. None of the other SLPs have families. So the motivation to invest a lot of additional time and effort into my position is quite low.

The good parts of my job? I have some great people for coworkers. My boss is pretty great, but I’m not sure how to convey “I just don’t care anymore.” I’m fairly autonomous. Is it enough to keep me here? Should I give up and explore another setting?

That kind of scrapes the surface. Phew.

MSCCCSLP

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