|Author: Julia Elliott|
|Embracing Change at the Start of a Career
|A recent college graduate, Lisa Gavin, MS, CCC-SLP, came to Medical City in Dallas, Texas with the knowledge of the newest and freshest innovations in speech-language therapy. Although all of her college courses provided her with a beneficial education, Gavin says that it was her internships that really reinforced what she'd already learned. Lucky enough to do her CFY at Medical City, it was a happy day for Gavin when she was offered a job at the facility.
Gavin admits the transition from student to employee was an interesting one and says that, at this point, all of the studying and learning has begun to fall into place. As a student and during her internship, she was in a protected place complete with the safety net of her supervisors, but stepping into the role of an SLP for the first time was a different experience.
Gavin, however, was no stranger to change. In college, she began as a psychology major before she switched to special education. Her involvement with special education gave her extra assurance that she was on the right track. "I had always enjoyed working with children that had special needs," explains Gavin, whose mother is a reading specialist and part of the reason she gravitated towards education. "That was my first love. I loved assessing the children, but I didn't really enjoy the student teaching part as much as I thought I would."
Two months before graduation, Gavin experienced second thoughts after speaking with a student that was studying to become a SLP. After learning about the field, Gavin decided that speech-language pathology was an area that she wanted to pursue after she graduated. "I realized that not only could I work with children, but I was able to focus in a more targeted area, as well," she recalls.
It was during graduate school that Gavin learned about a completely new world while working with adults. Until then, she had focused on children and figured that she would work in a school system for the rest of her career. However, after completing one practicum working with children and then three or four with adults, her future took another turn. "I did my last practicum in a county hospital working with adults, and I have to say it was one of my favorite clinical experiences. This is when I decided I wanted to work in an acute care hospital specifically with adults. I think my preference for working with adults is because of the deficits that we target in adults, and I like the assessments and therapy," reasons Gavin, referring to the patients she sees that have TBI, dysphagia, stroke, aphasia, cognitive deficits, dysarthria, voice and memory problems.
After graduating from the University of Texas at Dallas in December of 2004, Gavin immediately went to work at Medical City in January of 2005. Without much of a break between school and work, she jumped in, ready to assume her new role.
"It was pretty much what I expected when I began working, and I did see a lot of room for growth at this hospital," says Gavin. "From my experience working at a county facility in an urban setting to a private, paid setting made me realize they were two different worlds as far as paperwork and population, but I adjusted quickly as I learned how things worked."
As she assumed her role at the prestigious Medical City Hospital, Gavin appreciated the fact that the facility is on the leading edge of medicine. Recently, Medical City was awarded the 2006 Texas Award for Performance Excellence, the state's highest honor for quality and organizational performance presented each year by the Quality Texas Foundation. On December 8, 2003, Medical City achieved the American Nurses Association's Magnet Recognition, the most prestigious designation of excellence in nursing services. According to Texas Monthly magazine, Medical City ranked number 15 out of the 50 Best Companies to Work for in Texas and has a reputation for treating staff as the special professionals they are. All of this positive publicity spelled success to Gavin as she jumped in with both feet.
Gavin currently treats patients on the acute care floors and helps with the inpatient and outpatient overflow. She and the other SLPs also provide treatment wherever there is a need. "We will help each other out, depending on the patient load." Because she treats mostly acute care patients, Gavin works in many areas of the hospital, but for a shorter amount of time. "The patients I usually treat fall into two very broad categories—half cognitive and half dysphagia patients. I see significant improvement in almost all of them with treatment. Sometimes I am called in on a consult that may not be the most appropriate for therapy, but the doctor just wants an evaluation to ascertain options. Take, for example, an Alzheimer's patient. The patient may not be a candidate for swallowing therapy, but the doctor can find out if there is other help, such as implementing a modified diet or inserting a feeding tube. Patients appropriate for therapy—and willing to undergo therapy—experience a high success rate, as far as the dysphagia patients. With the cognitive patients on the acute care floors, I see improvement on a day-to-day basis."
Gavin is happy about the high and often swift success and improvement rate that occurs as a result of the efforts of SLPs and the other members of the patient care team. Working together makes life easier for both patients and professionals, and although she has learned the latest methodology, Gavin finds that she is still learning every day. "Communicating with the families was touched on in school, but it really isn't learned until you actually experience it," she explains. "Communicating about deficits, how much improvement to expect or not expect to see, talking about recommendations about eating or not ever eating on their own—this is all hard at first. You get better at it as you do it more."
Although communicating with families is not the easiest task to accomplish, Gavin is trying to learn the best methods. Usually, she finds that for the most part, the educated patient and/or their families make this task a bit easier. There are a number of factors to consider when explaining the patient's problem, treatment and expected outcome, and it is something that comes with experience. "Another area that is difficult to learn in school is the assessment of a patient," says Gavin. "You learn it and think you are intelligent in this area, but you have to see over one hundred, two hundred or three hundred patients with aphasia before you truly know what it is, how it manifests itself and how certain types respond to treatment."
Having always enjoyed the assessment of patients from when she worked with children, it became even more interesting when Gavin began treating adults. Her previous experience and expertise was very useful as she fine-tuned her assessment skills to meet the older patients' needs, and she still enjoys that part of SLP.
One challenge Gavin faces as a speech-language pathologist is the occasional doctor not willing to accept speech therapy as a viable treatment. Gavin believes that these few professionals just have not experienced the wonders of her field. "There are still some that are hesitant, but not very many at our facility," admits Gavin. "We have had a lot of volume with a lot of doctors, due to them becoming educated about SLP, and now there are a lot of doctors that have come to rely on our recommendations for diet, status and prognosis. I feel that our patient load is increasing due to doctor education. I think this is happening because we are meeting with them and talking with them on a daily basis and now they know that we know what we are talking about regarding their patients. This daily exposure allows them to see us as well-educated professionals that they rely on for alliance. For the most part, the doctors at our facility that are on the ‘cusp' regarding our recommendations would readily prescribe SLP if they were more educated about what we do, and we would get less inappropriate cases and more appropriate cases where our services could make a difference."
Agreeing that this acceptance is an ongoing struggle, Gavin has seen a lot more doctors turning to speech therapy in the almost two years that she has worked at Medical City. She hopes that it will continue, so that she and other medical professionals can work together to serve the varying needs of their patients.
In pursuit of providing the best care for her patients, Gavin works hard to continue her education in any way she can. She recently became certified in Deep Pharyngeal Neuromuscular Stimulation (DPNS). Becoming certified in this area has allowed Gavin to help numerous patients regain function, which has been her goal since she decided to pursue a career in speech-language pathology. Additionally, Gavin plans to expand her knowledge of dysphagia treatments by obtaining her certification in Vital Stim.
Along with her continued education efforts, Gavin hopes that universities continue to update their curriculums to stay abreast of all current speech-language pathology issues. "Though I have only been a speech therapist for two years," she notes, "I feel that speech therapists continue to take on more responsibilities in the management of dysphagia. I feel that more education for students would be beneficial on the slight differences and similarities of these differential diagnoses."
Lisa Gavin, MS, CCC-SLP, is a speech therapist at Medical City in Dallas, Texas. She earned her BS in Special Education from Texas A & M in 2002 and her MS in communications from University of Texas at Dallas in 2004. Gavin is also a member of ASHA and certified in Deep Pharyngeal Neuromuscular Stimulation.
Julia Elliott is a freelance writer from New York. She is on the editorial staff of NEWS-Line for Speech-Language Pathologists.