I love what I do!!

I've been getting a lot of questions about what I'm doing every day at the hospital. It's a pretty detailed explanation, but I find it fascinating and that means everyone finds it fascinating, right? Of course!

I am 'working' (fo' FREE) four days a week in the acute care department and one day a week in the pediatric inpatient department at Wake Forest University Baptist Medical Center. I follow my supervisor (an ASHA-certified speech language pathologist) around all day and participate when it's permissible.

In the adult acute care setting, we see any patient that has been admitted to the hospital that may also have cognitive, communicative, and/or swallowing concerns. We receive "consults" (orders from doctors) to complete evaluations on patients. The majority of these consults for swallowing evaluations. The next process is called a clinical swallow evaluation ("bedside" for short). We just have the patient take a few bites of food and sips of drink to determine if the patient can at least take in and manipulate food in attempt to swallow. If they can, we do a fiberoptic endoscopic evaluation of swallowing (FEES). This involves my supervisor putting a tube with a camera on the end of it up the patient's nose and down into their throat. From here we can actually watch green dye-tinted food and drink travel from the back of the patient's tongue down into (hopefully) the esophagus. We spend 10 to 20 minutes or so watching the patient's vocal cords and making sure the food and drink goes where it supposed to and not into the windpipe. If you go to this website http://www.med.nyu.edu/voicecenter/resources/video.html and click "abnormal FEES study" you can see an example of what I look at every day.

If for some reason, the patient will not tolerate a FEES or we need more information, we can do a modified barium swallow study. This involves taking an x-ray of the patient while they eat and drink stuff with barium on/in it. http://www.youtube.com/watch?v=hf2kRD85zvc This is an entertaining version of what the MBSS looks like.

Once we have all our diagnostic information, we make recommendations about what a patient can and can't eat or drink, as well as make recommendations about therapy exercises. We are also consulted to do Passy Muir valve evaluations for patients with tracheostomys. A PMV is something a patient can use to produce voice with the trach. It's a really neat gadget. The company's website has fantastic videos. http://www.passy-muir.com/

We also work with patients who have had laryngectomees to learn how to use an electrolarynx. There is also a level of counseling we provide for these patients pre- and post-operatively.

We also see patients who have had brain injuries of many varieties for language and communication deficits. We have some short standardized testing we can do, but mostly our evals for these patients are short and informal, due to their medical state. Even these informal evals give us a lot of information about possible intervention for the patient related to language and cognition.

Whew...there's more. I'm doing all that four days a week. Once a week, and soon, two or three times a week, I'm with the pediatric inpatient SLP. Half of those days involved MBS studies with children of all ages, including preemies! The rest of those days, we do feeding therapy and oral motor exercises with the babies in the NICU and IMC.

I absolutely love this placement. I am learning so much and every bit of it fascinates me. It's challenging and interesting. Every day is different. I'm so grateful for this experience.

I have decided to start applying for this type of position. If you know of any hospitals that might have openings and especially if you know anyone I can talk to in the Speech and Hearing Departments, I would greatly appreciate the contacts! My resume is ready to be sent out!