Q&A with Gail Finsand, MS, CCC-SLP, a Speech-Language Pathologist at Madonna Rehabilitation Hospital in Lincoln, Nebraska
Gail Finsand is an SLP with a primary clinical focus on Mild Traumatic Brain Injury (MTBI). She earned her BA in Communication Disorders from the University of South Dakota in 1982 and received her MS in Communication Disorders from the University of Wisconsin-Madison in 1984. Gail is licensed in the state of Nebraska and certified by the American Speech and Hearing Association. More recently, she became a certified VitalStim provider, which is neuromuscular electrical stimulation for the treatment of dysphagia, in 2008, and was certified by the Academy of Certified Brain Injury Specialists in 2009.
Q: Who or what motivated you to become a speech-language pathologist?
A: I have always had an interest in communication, viewing it as a vital component to interpersonal relationships and connections. Communication is essential to every aspect of our lives, yet it can be taken for granted.
The summer after my sophomore year in college, my father was in a motor vehicle accident in which he sustained a severe traumatic brain injury. I learned so much during his recovery process. He had no physical challenges after his injury, but was like a different man due to his cognitive-communication impairments. I returned to school in the fall knowing that I wanted to become a speech-language pathologist and hoped I would be able to work with this specific population.
Q: Is Madonna Rehab Hospital a large or small facility? What is the major focus of Madonna?
A: With 319 beds, Madonna Rehabilitation Hospital is one of the largest freestanding rehabilitation hospitals in the country. The hospital offers a comprehensive continuum of care: a long term acute care hospital, acute inpatient rehabilitation, transitional care, rehabilitation day, outpatient care, a specialized pediatric rehabilitation hospital, and a health and wellness center. The hospital’s long term care division includes an assisted living facility for young adults and a specialized unit for patients who are ventilator-dependent.
Madonna includes a state-of-the-art research institute, which conducts studies and collaborative projects to develop the future of medical rehabilitation. As one of the nation’s foremost rehabilitation facilities for children and adults, Madonna offers many highly specialized programs and services for those who have suffered a disabling injury or illness.
Q: What’s it like working at Madonna?
A: Madonna is a place where patients, families, staff, and visitors feel inspired. Our motto is “Now You Can,” which sends a message of hope and healing.
I work with an amazing team of professionals who are always at the ready to support me in any way I need. I see myself as a life long learner and I have many resources available to me right here at Madonna.
I also feel fortunate to be part of an organization that recognizes the importance of research in the field of rehabilitation. Because we have the Madonna Research Institute, I am able to access and participate in research.
Q: When and how did you start at Madonna?
A: I started working at Madonna in April 1994. I had recently moved from another state and was looking for a challenging and fulfilling work environment that would also allow some flexibility regarding my family. I quickly learned of Madonna’s reputation within the community and surrounding areas.
Q: Typically, what are your day-to-day responsibilities?
A: I evaluate and provide treatment for adult outpatients with speech, language, voice, cognitive-communication, and swallowing impairments. I am responsible for documentation of services. I participate in speech department meetings, rehab department meetings, and a brain injury program development team. I also supervise graduate program students, who typically participate in 12-week externships. I very much enjoy the collaboration with other professionals that’s a part of my work day.
Q: What types of patients/diagnoses do you encounter most frequently?
A: The majority of my caseload is comprised of patients with cognitive-communication impairments resulting from MTBI. It is common for me to also have patients who have sustained more severe traumatic brain injuries, strokes, or who have progressive neurological diseases such as Parkinson’s disease and Multiple Sclerosis.
Q: Can you share a motivational story about your experiences?
A: One story that is particularly memorable is my experience with a woman who suffered a severe stroke during childbirth. Her baby was born strong and healthy, but she had significant aphasia affecting all aspects of language. This woman had two preschool children as well. Prior to her stroke, one of her most treasured times of day was reading to her kids. Reading was one of many areas we addressed in her therapy. I will never forget the day she enthusiastically told me that she was able read a book aloud to her children. Although it seems like a simple accomplishment, it held more meaning for her than she was able to describe.
Q: Are there other areas of interest for you as a speech-language therapist, either clinically or educationally, that you plan to pursue?
A: I am interested in the use of technologies applied as external communication devices to support memory and other cognitive-communication skills. Some of this has been implemented through our Augmentative and Alternative Communication program. I would like to learn from those colleagues in order to become more familiar with the various devices and applications that are available and user friendly.
Q: What are the greatest challenges you face as an SLP?
A: Because I have been in the field for some time now, I have witnessed changes in the landscape of provision of care and its challenges. At this time, I am most concerned about obtaining and providing services for my patients within the ever-changing healthcare climate. I have patients that are uninsured or underinsured, and therefore, have no or very limited speech therapy benefits. This is discouraging when he or she has strong potential for progress, yet does not have the resources to receive the amount of therapy they need.
Q: What do you like most about your position at Madonna?
A: The best part of my job is, hands down, my patients. These individuals have had their abilities compromised in some way. They are generally grieving and adjusting to some degree, yet they often come to therapy with a ready to work attitude. My patients are the strongest, bravest people I know and I feel blessed to be a part of their recovery process. The same goes for their families.
Q: What do you dislike most?
A: Unfortunately, there are patients who do not make the progress desired, due to the severity of their impairment. This has no relationship to therapeutic interventions or the patient’s hard work, but rather, a difficult reality. I am thankful for every bit of progress my patients make and support them in any way I can, but there comes a time when services are no longer warranted. This is the most difficult part of my job.
Q: Are you currently involved with any research projects?
A: I just completed a research project with a former Madonna colleague who is now practicing in Oklahoma. We recently learned that our poster presentation was accepted at the 2010 American Speech and Hearing Association National Convention in Philadelphia. We conducted research on patient characteristics associated with improved swallow function using VitalStim and are looking forward to sharing the information with our peers.
Q: Do you feel that the role of speech-language pathologists has changed over recent years? If so, how?
A: Yes, I think our role continues to grow as therapists, researchers, educators, mentors, and advocates. Our field has become more evidence-based, allowing for improved standards of care. It seems there are more opportunities for us in terms of treatment settings, populations, and specializations. We must continue to provide the same quality of care, but with fewer resources.
Q: What do you feel is of the greatest concern to SLPs today?
A: Growing the number of speech-language pathologists. We need to foster education within our communities as to the nature of what speech-language therapists do. This field has so many different opportunities, but there is a misconception about speech therapy. I frequently encounter people who are very surprised that speech pathologists work with swallowing impairments, help people learn problem solving strategies, or train communication on an electronic device.
Q: What is the most rewarding part of working at Madonna?
A: Being a part of a patient’s journey to reach their goals. It involves a great deal of hard work and patience on his or her behalf. When progress is achieved as a result of his or her efforts, I can’t help but be thankful and rewarded that I was able to participate in that.
Q: What is the most important thing you’ve learned over the course of your career?
A: That the patient is the most important member of the rehabilitation team. If I provide the right combination of patient education, therapeutic expertise, and support, my patients trust me. They understand from the beginning that I am totally invested in their progress. If we don’t take the time from the very start to include them in every aspect of their treatment program, something is lost.
Q: What advice do you have for others thinking of entering the field?
A: I would advise them to shadow a number of speech-language pathologists in a variety of settings. They should spend time in the schools, hospitals, rehab centers, outpatient clinics, extended care facilities, pediatric units, etc., to get a strong picture of what the field entails. I would advise them to meet with potential instructors as well as researchers. Having these experiences may help lead them in a direction best suited for them.
Q: How has working in rehabilitation allowed you to grow professionally?
A: There is always new information in this field. Even after 25 years as a speech-language pathologist, I continue to learn and it is very exciting. I have grown professionally because of all that I am exposed to. There is a wealth of information and my professional colleagues and peers are always willing to share their knowledge to support my professional growth and development.
Q: If you could sum up your job in one word, what would it be and why?
A: Rewarding. The rewards of this work come from so many aspects of patient care. I feel rewarded by the challenges as well as the successes.
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