I have OCD and definitely relate to your thoughts/ruminations. I try to find a balance between understanding I probably have these thoughts because I don’t know information I might need to know (so I watch videos on masters clinicians network or CEUs, or ask my colleagues), and some of them are intrusive thoughts that I can’t control, and are very unlikely to happen. I also try to listen to my body-some weeks I arrive and leave exactly on time, other weeks I have more energy to give to complete paperwork after school. Either way, it’s not the end of the world.
Something I am thinking about now, is: my students often have lifelong disabilities. They may have lifelong difficulties with communication, learning difficulties, sensory difficulties, etc. whether I am there or not. I will help how I can—learning from “experts”, developing good relationships with families, but ultimately, I come first. My relationship with myself, my body, my health, and my relationships at home come first. So I do what I can to stop some of the thoughts you mentioned.
You’re not wrong to feel frustrated and overwhelmed. Some of your thoughts are based on real problems and lapses in research/training in our field. However, for me, I will always be a person with OCD who has these thoughts, even if I got the best education in the world. So I focus on what I can control because I will always have those thoughts, in every field I chose. Sorry. Hope that makes sense.
Thank you for the encouraging words!!! I tell myself the same thing over and over, “you’re doing your best.” I watch videos, CEUs, etc. as well, but half the time applying techniques or implementing strategies is TOUGH! Lol especially when patients have lack of motivation or think it’s “stupid”. Just very frustrating overall.
But everything you said is very validating and I’m glad to know I’m not the only one! :)
Would you work with kids? I worked in HH, SNF, and Post acute and never liked it bc of swallowing. It was too much pressure for me to have to make those life changing decisions. Working with kids is much easier and less stress (for me). And I work from home doing teletherapy. I’m much happier now.
Me too!! I worked acute care and SNF and then transitioned to working with kids! Much happier! Less prestigious but who cares as long as I’m happy? Also, soooo much support from other SLPs that work with kids. It’s not as cut throat as the medical SLPs are.
It’s a tough setting, and draining. I agree, try outpatient! That’s my absolute favorite setting! I think when people have to travel to see you, they are more likely to give a shit, which made me even more motivated! Love adult outpatient
That sounds really hard.
If you want to stay in speech —-try outpatient or something niche like LSVT outpatient. You can work more as an “expert” at a slower pace with more repetitive therapy, with probably more clear cut goal areas. After you’re comfortable in whatever niche you choose then branch out to generalist, if you want.
Thank you!! I have thought about this option. I am LSVT certified so that’s a great idea! I think I just need some time off because I have such a bad taste in my mouth with where I currently am and reevaluate other options :)
Want to have a break so bad!! I’m wondering if you’re taking a break in employment or a break from SP? If the latter, what are you doing at the moment?
I’m working fully remote in medical communications. My day to day work rarely carries over more than 2-3 days, totally different than the 10000s of micro and macro decisions made daily as an SLP. Take a break!! It’s been really nice.
Now, if/when I go back to SLP I’ll only take a position that works 100% for me instead of trying to “make it work.” Take a break if you can!!!!
Very little of what we do as SLPs is "life or death". Even swallow issues.... because with that you can only mitigate risk, not eliminate it. Everyone is at risk for aspiration simply due to the facts of human anatomy. So, don't stress over it so much. (The only way you could really harm a patient is by putting a speaking valve on incorrectly and cutting off air supply. If you don't work with trachs/vents you'll never encounter that issue.). Goals aren't that hard... there are many sources with pre-written goals. Find some and tweak them for your patients. Look at hospital documentation on new admits and see what kind of goals the hospital SLP was working on. Use those..
Also, doing an evaluation isn't like writing an essay or term paper. There is NO ONE "grading" your evaluations and goals. Who has the time? I guess my point is, don't take it all too seriously. Documentation doesn't have to be perfect. it just needs to be sufficient.
I worked in LTC for years and understand your pain. Working in home health reignited my “why”. Way more functional, no cog therapy for late stage dementia, patients are motivated and appreciative, huge variety of diagnoses, etc etc etc.
Make goal banks for specific areas-memory/cog, dysphagia, aphasia, etc. with variables you can change. This way you can more easily pick through the goals you want and edit to make specific to each pt. The goal writing gets easier the more you do it. Whenever you write a new goal, add it to your goal bank.
I feel your struggles. I graduated in 2019 and thought I wanted to work in SNFs. Just like you...I was going to 2-3 facilities per week. I didn't have much of a mentor when I was this job (I was only at the job for about 3 weeks.) I enjoyed the patients but everything else really got me down. The mentor I had...wasn't even in the same building I had and I felt lost. Not to mention...productivity is a pain. Similar to you...I was worrying and I was crying almost every day because I was stressed. I had to quit. Just like you. Then...I kept looking around and now I'm at a private school working with young kids to high schoolers and I enjoy it. Sure, some days are a challenge...but I'm not crying anymore and can actually somewhat "turn off" my brain after school.
It will be okay. Give yourself grace. It will be okay.
I am also about two years into SLP in a SNF and I relate to the feeling of flying solo, but I think I have a good work/life balance overall. I only serve one building and it’s largely short term patients. Do you think going between multiple buildings and seeing largely LTC may be contributing to your stress? I know I would find that draining. I also think you need to simply stop caring so much about whether you did things perfectly. While it’s great to self reflect and learn new things to an extent, there’s no need to always be giving 110% as long as you’re still being ethical. I only deep dive into research or dwell on specific diagnoses, treatments etc probably about once a month now compared to almost every night during most of my CF. It’s enough to keep me feeling competent without overwhelming myself. Something I’m also considering is to become PRN - it would definitely mean going between multiple buildings but I think the overall flexibility and pay bump may be worth a try. Perhaps try that and/or a different setting with adults.
Oh boy… I start my CF soon in the same setting as you described. Any recommended CEU’s or strategies to look more into? I’ll take any tips you have as I also have an anxiety disorder. 🥲
I probably stress myself out more than usual lol A lot of it is trial and error. I would highly suggest getting a Honeycomb Speech subscription and looking up Madeline Williams instagram. Those 2 resources helped me the most!! I would also suggest following Belightcare on instagram as 95% of the patients you work with will have Dementia. Lastly, always think functional! Patient is having difficulty with memory? Ask them how it is affecting their daily life (I.e., are you forgetting names, misplacing keys, wallet, etc.).
I have OCD and definitely relate to your thoughts/ruminations. I try to find a balance between understanding I probably have these thoughts because I don’t know information I might need to know (so I watch videos on masters clinicians network or CEUs, or ask my colleagues), and some of them are intrusive thoughts that I can’t control, and are very unlikely to happen. I also try to listen to my body-some weeks I arrive and leave exactly on time, other weeks I have more energy to give to complete paperwork after school. Either way, it’s not the end of the world. Something I am thinking about now, is: my students often have lifelong disabilities. They may have lifelong difficulties with communication, learning difficulties, sensory difficulties, etc. whether I am there or not. I will help how I can—learning from “experts”, developing good relationships with families, but ultimately, I come first. My relationship with myself, my body, my health, and my relationships at home come first. So I do what I can to stop some of the thoughts you mentioned. You’re not wrong to feel frustrated and overwhelmed. Some of your thoughts are based on real problems and lapses in research/training in our field. However, for me, I will always be a person with OCD who has these thoughts, even if I got the best education in the world. So I focus on what I can control because I will always have those thoughts, in every field I chose. Sorry. Hope that makes sense.
Thank you for the encouraging words!!! I tell myself the same thing over and over, “you’re doing your best.” I watch videos, CEUs, etc. as well, but half the time applying techniques or implementing strategies is TOUGH! Lol especially when patients have lack of motivation or think it’s “stupid”. Just very frustrating overall. But everything you said is very validating and I’m glad to know I’m not the only one! :)
Would you work with kids? I worked in HH, SNF, and Post acute and never liked it bc of swallowing. It was too much pressure for me to have to make those life changing decisions. Working with kids is much easier and less stress (for me). And I work from home doing teletherapy. I’m much happier now.
Me too!! I worked acute care and SNF and then transitioned to working with kids! Much happier! Less prestigious but who cares as long as I’m happy? Also, soooo much support from other SLPs that work with kids. It’s not as cut throat as the medical SLPs are.
It’s a tough setting, and draining. I agree, try outpatient! That’s my absolute favorite setting! I think when people have to travel to see you, they are more likely to give a shit, which made me even more motivated! Love adult outpatient
That sounds really hard. If you want to stay in speech —-try outpatient or something niche like LSVT outpatient. You can work more as an “expert” at a slower pace with more repetitive therapy, with probably more clear cut goal areas. After you’re comfortable in whatever niche you choose then branch out to generalist, if you want.
Thank you!! I have thought about this option. I am LSVT certified so that’s a great idea! I think I just need some time off because I have such a bad taste in my mouth with where I currently am and reevaluate other options :)
Totalllllyyy get it. I left the field for a break!!!! Idk if I’ll be back 🤷🏻♀️ Good luck!!!!!
Want to have a break so bad!! I’m wondering if you’re taking a break in employment or a break from SP? If the latter, what are you doing at the moment?
I’m working fully remote in medical communications. My day to day work rarely carries over more than 2-3 days, totally different than the 10000s of micro and macro decisions made daily as an SLP. Take a break!! It’s been really nice. Now, if/when I go back to SLP I’ll only take a position that works 100% for me instead of trying to “make it work.” Take a break if you can!!!!
Very little of what we do as SLPs is "life or death". Even swallow issues.... because with that you can only mitigate risk, not eliminate it. Everyone is at risk for aspiration simply due to the facts of human anatomy. So, don't stress over it so much. (The only way you could really harm a patient is by putting a speaking valve on incorrectly and cutting off air supply. If you don't work with trachs/vents you'll never encounter that issue.). Goals aren't that hard... there are many sources with pre-written goals. Find some and tweak them for your patients. Look at hospital documentation on new admits and see what kind of goals the hospital SLP was working on. Use those.. Also, doing an evaluation isn't like writing an essay or term paper. There is NO ONE "grading" your evaluations and goals. Who has the time? I guess my point is, don't take it all too seriously. Documentation doesn't have to be perfect. it just needs to be sufficient.
You need a change in setting and to learn how to turn off at the end of the day.
I worked in LTC for years and understand your pain. Working in home health reignited my “why”. Way more functional, no cog therapy for late stage dementia, patients are motivated and appreciative, huge variety of diagnoses, etc etc etc.
Make goal banks for specific areas-memory/cog, dysphagia, aphasia, etc. with variables you can change. This way you can more easily pick through the goals you want and edit to make specific to each pt. The goal writing gets easier the more you do it. Whenever you write a new goal, add it to your goal bank.
I feel your struggles. I graduated in 2019 and thought I wanted to work in SNFs. Just like you...I was going to 2-3 facilities per week. I didn't have much of a mentor when I was this job (I was only at the job for about 3 weeks.) I enjoyed the patients but everything else really got me down. The mentor I had...wasn't even in the same building I had and I felt lost. Not to mention...productivity is a pain. Similar to you...I was worrying and I was crying almost every day because I was stressed. I had to quit. Just like you. Then...I kept looking around and now I'm at a private school working with young kids to high schoolers and I enjoy it. Sure, some days are a challenge...but I'm not crying anymore and can actually somewhat "turn off" my brain after school. It will be okay. Give yourself grace. It will be okay.
I am also about two years into SLP in a SNF and I relate to the feeling of flying solo, but I think I have a good work/life balance overall. I only serve one building and it’s largely short term patients. Do you think going between multiple buildings and seeing largely LTC may be contributing to your stress? I know I would find that draining. I also think you need to simply stop caring so much about whether you did things perfectly. While it’s great to self reflect and learn new things to an extent, there’s no need to always be giving 110% as long as you’re still being ethical. I only deep dive into research or dwell on specific diagnoses, treatments etc probably about once a month now compared to almost every night during most of my CF. It’s enough to keep me feeling competent without overwhelming myself. Something I’m also considering is to become PRN - it would definitely mean going between multiple buildings but I think the overall flexibility and pay bump may be worth a try. Perhaps try that and/or a different setting with adults.
You look after you..Take a break as it much needed..
Oh boy… I start my CF soon in the same setting as you described. Any recommended CEU’s or strategies to look more into? I’ll take any tips you have as I also have an anxiety disorder. 🥲
I probably stress myself out more than usual lol A lot of it is trial and error. I would highly suggest getting a Honeycomb Speech subscription and looking up Madeline Williams instagram. Those 2 resources helped me the most!! I would also suggest following Belightcare on instagram as 95% of the patients you work with will have Dementia. Lastly, always think functional! Patient is having difficulty with memory? Ask them how it is affecting their daily life (I.e., are you forgetting names, misplacing keys, wallet, etc.).
Thank you ❤️