Thursday, September 16, 2010

Advice for new SLPs: Kristin's version

One of you commented that you would like a post with advice for newbies.  Allow me to share my thoughts on the matter.

One of Bob's and my professors at USU seems to be a master in every area of Speech-Language Pathology.  She's a nationally-awarded authority on AAC (Augmentative and Alternative Communication, newbies!)  She taught our class on neuro-anatomy, cognition, and aphasia beautifully.  Also taught our childhood language class with expert detail and insight.  On the side she taught an awesome hands-on assistive technology class where we built adaptive furniture and devices ourselves, etc., etc.  She even became department head!  (Dr. F. if you're reading this, don't get a big head now.) 

I always think back to the time we were all nervously asking her ("The queen bee of speech-language pathology") just how competent we would feel when we got out into the field.  She said that for the first five years you feel like a fraud.  Coming from our SLP idol, this was comforting.  If she felt like a fraud for the first 5 years, we might just be okay!  So remember Dr. F when you've got that new patient or client with a rare neurological syndrome and you think, "Just a minute; I need to go hop on Google for a few minutes before I know how to proceed...."

I guess I haven't really given actual advice yet- just words of comfort.  Let me begin (again) by saying that confidence will be one of the most important things you can bring to your first job.  You don't want to start out by being apologetic, letting people know you are new and unsure, or sitting in the back of the team meeting and nodding quietly (you should always nod LOUDLY).  You are already more expert in your field than anyone else in the room, even though all you have to offer in the beginning is what you learned in class.  You know more than you think you do, and you need to make your presence known at your new job.  I say fake it 'till you make it. 

It took me a long time as an SLP to see the bigger picture in some ways.  To stop just surviving, and focusing on what I call, "doing speech therapy for the sake of doing speech therapy."  Do you know what I mean?  I didn't think about the other pieces of the puzzle, such as OT and PT goals, discharge problems, keeping up with the patient's medical changes, and knowing who would be the main care-takers, etc.  I think I just thought, "I'll do the best speech therapy I can for as long as they are here, and when they leave, I hope they have speech [insurance] benefits and keep doing it!"  My goal was to get through my documentation as fast as possible and get out of there (I worked looong hours as a CFY).  Now I can see how limited my approach was, and I have become a lot more holistic.  I think it's important to be aware of more than just what task you will bring to the patient today.  What you can do to keep other team members "happy" (I'm mostly speaking about MD's here.  More on this in a future post), what safety issues this particular patient needs to work on based on what the OT is seeing. Is the family trained?  What else can be expected/determined based on their specific diagnosis (e.g., they have terminal brain cancer- why are you working on cognition?), etc.  These are just a couple of examples of course.  Even as I write this I wonder if it will even be helpful, because at first, it may be all a new SLP can do just to get decent therapy done and get their charting done. 

Don't be afraid to ask questions.  Especially when you are a CFY.  Take advantage of the excuse you have, being new and all.  Call an old professor, ask a colleague, ask Bob and me :) (not that we have all the answers, it just makes us feel good that you asked), ask your grad school comrades, call and ask the company that makes the product (e.g., "Hi Passy-Muir.  Can you tell me if my trached patient should wear a speaking valve when he's eating?).  [Oh, and yes- wear when eating!] 

Read up!  I know, I know, it's so hard to find the time to read professional journals and articles.  Maybe you could just keep one in the bathroom.  Maybe you could start a journal club.  Maybe just read 1 page a day and high-light it.  I do a lot of reading and it has made a HUGE difference in my clinical skills and knowledge base.  My favorite and # 1 recommendation: (Bob, you will totally laugh at this) text books. 

Well, I could really go on and on.  I really like getting blog readers' requests because it helps me blog to your interests.  Let me know if this didn't answer your question and I'd be thrilled to do a "noob advice" post # 2!  I just hope I don't get a "TL:DR" here.

And you SLPs out there- what is your advice??

Upcoming posts: 
A sweet giveaway!
Bob's perspective on this same topic...



  1. Great Post, Kristin- I think your points can apply to many settings. I did my CFY in a medical setting and though the supervision was great (can't imagine getting that kind of guidance in a school setting), so many of the stresses you mention above burned me right out of there when I finished. It was a CFY, Bye Bye. I don't regret leaving as I am definitely more cut out for the schools, but your point about "big picture" is something I didn't get til a few years later and might have made me stay!

  2. This was a great post and I really enjoyed reading it! I wish it had been available when I first graduated.

    Just letting you two know that I gave you an award on my blog.

    I am also feeling inspired to write a more "professional" post :)

  3. Great post Kristin. Now we need to get Bob to do a school based Newbie post! I think you hit the nail on the head when you mentioned appearing confident, be the expert, but don't be afraid to ask questions. Great post.

  4. Kristin

    This is the first time I have "visited" your new blog. Way to go! I like it--even though it is understandably still a bit esoteric for me. I'm not even a "newbie", just a neophyte/outside observer.

    My situation in that regard reminds me of the story told of a common man who decided to sit in on a long lecture by a noted scientist on nuclear physics. After the session he remarked: I still don't know much about nuclear physics, but now my confusion on the subject is on a much higher level." :)

    BTW, did I provide inspiration to the blogspot's name with my suggestions a few months back?


  5. This is great advice, I will definitely reread when I actually move past textbooks and into real practice.

  6. Hi Kristin,

    I just recently made the decision to transition to a medical setting! I've been trying to brush up on skills and have read through your posts (Great stuff by the way!). I was wondering... You had mentioned that you use a lot of textbooks as reference. Are there any particular texts which you find yourself using more than others? I have some from my grad program, but i'm open to adding to my collection if it'll help me out.