The world of speech pathology was honestly a mystery to me before my best friend started working on her Master’s. Fast forward a few years and she just finished her clinical fellowship year, completing her CCCs in the process. I love her take on entering the field with confidence, even if you feel a bit unsure. Fake it ‘till you make it, right? Her advice is applicable to any field, so if you’re lacking confidence, just know that there are tons of people who feel the same, so get out there and be confident.
I walked into my first day of my Clinical Fellowship at an SNF (Skilled Nursing Facility) in rural South Carolina feeling confident and ready to make a difference in the lives of my patients. For reference, after you graduate with your Master’s in Speech-Language Pathology, it is expected by the board that you complete a 9-month supervised Clinical Fellowship (CF) before you are able to obtain your official certification of clinical competence (CCC). The purpose of these 9 months is to gain confidence while having a mentor SLP within reach. They provide a minimum of 36 hours of supervision throughout the 9 month period, as well as provide guidance if you need it.
Just having finished a year and a half of clinical rotations at different medical facilities across the east coast, I was accustomed to the first day consisting of walking the floor with my supervising Speech-Language Pathologist (SLP) and observing her give treatment and learning the ins-and-outs of the documentation system. When I entered the therapy gym, I was expecting a day full of orientation and onboarding. Instead, I was introduced to my CF mentor, handed my log-on information for the documentation system, and given a schedule of patients that I was to see that day. Jumping in feet first on day one truly set the tone of my CF experience.
The transition from student to CF-SLP has not been easy, especially during a global pandemic. Although it hasn’t been the smoothest 9 month beginning of my new career, I’ve learned a host of different lessons along the way. First, you need to act confident even when you feel unsure. A lot of people don’t know this, but SLPs evaluate, diagnose, and treat swallowing disorders, otherwise known as dysphagia. Through evaluating a patient’s swallowing function, we make skilled recommendations on what diet texture they are safest to consume in order to prevent aspiration (a fancy word for food or liquid “going down the wrong pipe). Throughout the course of my CF, I have had to make independent decisions regarding which textures and viscosities are safe for patients to consume based on my clinical judgment. When making these diet recommendations, I have to be unwaveringly confident in my decision both inwardly and outwardly, because I often need to justify my decisions to the patient, family members, and other members of the medical team. Every time I go into one of these conversations, even if I am feeling nervous, I urge myself to trust in my gut and know my schooling has more than adequately prepared me to make the right decisions for my patients.
Another important lesson I have learned during my CF is that you need to admit when you don’t know something. This may sound counter-intuitive to my last point made, but you need to have enough confidence to admit when you definitely don’t know something. There have been a few cases that I have been presented with that have stopped me in my tracks, not completely knowing the correct next course of treatment to take. In these situations I have swallowed my pride and sought guidance from my supervisor, admitting that although I have a rough idea of how to treat the patient, that I am not feeling entirely confident in my knowledge to construct an adequate treatment plan. I started my CF thinking I needed to act like I knew everything to earn my keep, but the truth is, even SLPs who have been practicing for multiple years still have cases that cause them to pause and seek guidance from their colleagues or drive them to delve deeper into the research to best provide services for their patient. We never stop learning and never should stop learning, because when we do this, we stop growing as clinicians. Even after a long week, I try to set aside time to do independent research or take continuing education courses on disorder areas to ensure I am providing the most comprehensive care for my patients.
Finally, you need to be flexible. My CF experience has certainly not gone as planned. Providing services for hard of hearing patients who rely heavily on lip-reading, attempting to provide visual cues for patients struggling to form words, and being expected to step foot into a COVID isolation unit each day are just a few of the obstacles that have required me to be flexible this year. I have had to think of new ways to address patients’ goals and shape my treatment sessions in ways that help these patients get the same benefit from speech therapy sessions that they would if I were not wearing full personal protective equipment. Although the pandemic has been less than ideal, it has forced me to get rid of an “I can’t do that because…” attitude and forced me to adopt an approach of “how can I adjust what I’m doing to make this work?”. My first year on the job definitely would have been easier without COVID, but I am entering my first year as a CCC-SLP armed with important lessons learned that will help me be the best clinician I can be in years to come.
YoPro Know's Takeaways:
– When you are entering your field; act with confidence even if you feel a bit unsure
– It is okay to admit that you do not know how to do something
– It is important to be flexible and adapt to changes that arise in your workplace