A patient comes into the ER, complaining of numbness, dizziness, and trouble swallowing. Doctors suspect the patient has suffered from a stroke, so they order blood work, a cat scan of the patients head, and they admit the patient for observation. During the patients hospital stay the doctor will consult a Speech Language Pathologist.
The Speech Pathologist is consulted to assess the patient’s safety of eating and drinking, in regard to the suspected diagnosis of a stroke. Maria Ioquinto, a nurse from Kennedy Hospital, describes the procedures that will take place upon the patient’s arrival. Ioquinto explains that the nursing staff will communicate the tests that will be performed during the patients stay, one of which will be the Speech Pathologists consult. The Speech Pathologist will go to the patient’s bedside and record a history of how the patient has been eating, swallowing, and if they are having trouble with the consistency of what they have been eating. The Speech Pathologist will bring in a variation of thickeners and add them to foods such as water or apple sauce. They will then watch the patient’s swallowing process through a device called a “video swallow.” Coughing is a sign the patient is having trouble swallowing. The consistency that works best for them is designed to their diet. The Speech Pathologist will design a safe and appropriate plan on helping the patient eat the texture of the food that is suitable for them. Along with the rest of the healthcare team, evaluating swallowing and speech will give a great deal of information into formulating a diagnosis and a safe treatment plan.
A Speech-Language Pathologist is the professional who engages in clinical services, prevention, education, administration, and research in the areas of communication and swallowing (Scope 1). To become a Speech Language Pathologist one must undergo extensive training and meet several qualifications. A masters degree is required to practice Speech Pathology, although other recognized post-baccalaureate degrees may also be obtained. It is a requirement for Speech Pathologists to be certified by the American Speech-Language Hearing Association (ASHA) and possess the Certificate in Clinical Competence in Speech-Language Pathology (CCC-SLP) (Scope 4). Along with a degree and multiple certifications, a Speech-Language Pathologist must complete a supervised postgraduate professional experience and pass a national examination (Scope 4). Speech Pathologists hold other required credentials such as a state licensure or a teaching certification for those who work in schools. Speech Pathologists have the opportunity to provide services in a wide variety of settings. These settings include: public and private schools, hospitals, clinics, neonatal intensive care units, mental health facilities, and individuals homes (Scope 9). Within these settings, Speech Pathologists provide a range of clinical services. Expert clinical services include but are not limited to prevention and pre-referral, screening, consultation, diagnosis, treatment, collaboration, documentation, and referral (Scope 6). Speech Pathologists determine services based on applying the best available research evidence using their expert clinical judgment, and by considering their patients preferences and values (Scope 5). Speech Pathologists address communication and swallowing in the following areas: speech sound production, resonance, voice, fluency, language, cognition, and feeding and swallowing (Scope 5). Overall, Speech-Language Pathologists improve the quality of life of the patients who are in need of their services.
Speech-Language Pathologists engage in an array of communication practices that they will exercise from undergraduate school to on-the-job training. Oral and written communication are crucial skills for Speech-Language Pathologists to get the best treatment for their patients. Examples of oral and written communication are teamwork and written documentation. When used together they can benefit not only the patient, but also the healthcare professionals themselves.
One of the most critical aspects of communication for Speech Pathologists include teamwork, specifically the ability to work on inter-professional teams. An inter-professional team involves individuals from two or more disciplines who collaborate to improve patient care (Morrison, Lincoln, Reed). “Internationally the use of inter-professional health teams has been cited as best practice for treatment of clients and provides improved working conditions for health providers” (M,L,R). This is seen as the best practice because when a team is able to communicate effectively, misinterpretation is avoided. The ability to practice with a team of professionals from other disciplines is seen as a generic skill to be learned before graduation (M,L,R). Desiree Francisco, a Speech Pathologist from Kennedy Hospital, says that gaining knowledge outside of the college classroom is a great opportunity to get experience working on teams. While talking about her experience working in an outpatient facility as a student Francisco admits, “Working as an aide gave me a sneak peek into the therapy world in terms of how therapists work together and with patients.” Explaining the same point of view, Lauren Venzeniani, a Speech Pathologist also from Kennedy Hospital explains the importance of communication between disciplines in the hospital setting. Venzeniani provides the example, “Occupational therapy will often comment on a patient’s cognition, which allows Speech Therapy to get a more thorough idea of planning evaluation and treatment more appropriately.” Because of the documented information that Speech Pathologists provide, other health professionals such as doctors and nurses can deliver the best care for their patients. Lauren emphasis teamwork by saying, “Nurses and doctors are able to read the Speech Pathologists reports and design a plan of care and discharge recommendations accordingly.” It is evident that Speech Pathologists rely heavily on teamwork to aid in the communication between patients and doctors from other disciplines.
Because verbal communication is not always accessible, written documentation is also a key factor in receiving information and achieving the best treatment for patients. Venzeniani talks about the daily occurrence of publishing her reports when she says, “Speech Therapy, as well as other health care professions, requires extensive documentation on a daily basis.” Types of writing that Speech Pathologists perform daily include: treatment notes, weekly progress notes, evaluations, and discharge summaries (Venzeniani). These notes can be read by doctors from all disciplines and can help in the comprehensive care of patients. In hospitals, patients can see a multitude of Speech Pathologists, which means that written documentation is imperative. Venzeniani explains,
If I am treating a patient another SLP (Speech-Language Pathologist) evaluated or treated the day before, I am able to look at the patient’s electronic record and read the other SLP’s evaluation/treatment note. This will give me information on the patient’s performance/abilities, recommended diet level and goals that are to be addressed in treatment.
Without reading the written documentation, Speech Pathologists, as well as other health professionals, would not be aware of their patient’s level of function and goals that they must address during their treatment sessions (Venzeniani). Along with recording and reading electronic records, writing a clinical report is a major component of a Speech Pathologists written work. The written report has been seen as the leading form of communication following the evaluation (Middleton). The clinical report communicates specific findings about a patient, acts as a guide for referral, and serves as documentation for research (Middleton). Because the clinical report contains relevant information, it addresses the patient’s progress to the patient (or parent) who must receive the information. All of this information assists in consistent and comprehensive care for the patient.
Overall, Speech-Language Pathologists rely on teamwork and written documents to optimize communication between patients and other healthcare professionals. To be a Speech Pathologist, one must possess strong communication and teamwork skills. For someone going into this field, observing a Speech Pathologist can be highly beneficial because it will reveal how they interact with their patients and with other therapists, as well as help get an inside look on a variety of interesting settings. Venzeniani admits, “Speech Therapy for me in the hospital can be frustrating and disheartening at times, but it is also incredibly rewarding and self-satisfying.” Working in healthcare is not easy, but it does have its rewards. Venzeniani’s piece of advice for anyone who is considering pursuing Speech-Language Pathology is: “You should know that by going into this field you will truly be making a difference and have an impact on someone’s life.” I am eager to pursue my future in Speech Pathology, in hopes of making a difference and having an impact on someone’s life.
American Speech-Language Hearing Association. American Speech-Language Hearing Association. n.d. Web. 20 Jan. 2015.
Ioquinto, Maria. Personal Interview. 12 Nov. 2015.
Middleton, Grace. Report Writing for Speech-Language Pathologists. Tuscon, 1992. Print.
Morrison, Susan C, Michelle A Lincoln, and Vicki A Reed. “How Experienced Speech-Language
Pathologists Learn To Work On Teams.” International Journal Of Speech-Language Pathology
13.4 (2011): 369-377 9p. CINAHL Complete. Web. 24 Oct. 2015.
“My Swallow Study.” 21 Aug. 2010. YouTube. Web. 20 Nov. 2015.
Scope of Practice in Speech-Language Pathology [Scope of Practice]. America Speech-Language- Hearing Association. ASHA. (2007). pdf.
Venzeniani, Lauren and Desiree Francisco. Personal interview. 26 October. 2015.