Student's Say: Across Professional Lines A graduate student discovers that what other rehab professionals teach cannot be found in coursework. Student's Say
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Student's Say  |   April 01, 2014
Student's Say: Across Professional Lines
Author Notes
  • Lauren Tandy, MS, SLP-CF, recently completed Idaho State University’s online graduate speech-language pathology program, and is considering clinical fellowship placements. She lives in Post Falls, Idaho, with her husband and two sons. ■tandlaur@isu.edu
    Lauren Tandy, MS, SLP-CF, recently completed Idaho State University’s online graduate speech-language pathology program, and is considering clinical fellowship placements. She lives in Post Falls, Idaho, with her husband and two sons. ■tandlaur@isu.edu×
Article Information
Special Populations / Older Adults & Aging / School-Based Settings / Healthcare Settings / Student's Say
Student's Say   |   April 01, 2014
Student's Say: Across Professional Lines
The ASHA Leader, April 2014, Vol. 19, 34-35. doi:10.1044/leader.SSAY.19042014.34
The ASHA Leader, April 2014, Vol. 19, 34-35. doi:10.1044/leader.SSAY.19042014.34
I used to have only a vague sense of what rehabilitation specialists do, based loosely on physical therapy and otolaryngological treatment my sisters received for a torn ACL and a broken nose. (I also knew an occupational therapist whose specialty was “hands,” and I was totally confused. How could someone focus a career solely on the mechanics of hands?)
Fast-forward to now. I am a few weeks away from completing my speech-language pathology externship at a children’s hospital in Spokane, Wash. As a graduate student in Idaho State University’s three-year online program, I had practicum placements in a variety of settings: the university clinic; preschool, kindergarten and elementary schools; a skilled nursing facility; outpatient and inpatient rehabilitation; and acute rehabilitation for adults and children in two different hospitals.
I am thankful for the breadth and depth of these experiences—but most of all for the knowledge I have gained from professionals in other disciplines. From nurses to dieticians to occupational therapists to physical therapists to physicians, I made connections that proved vital to my own practice and decision-making.
School setting
At the school in which I was placed, I worked directly with teachers, reading specialists, school psychiatrists, counselors, special education specialists, principals and school nurses to best serve the students who needed speech-language services. The school held weekly response-to-intervention meetings to brainstorm ways to help students who were falling behind. I learned how important it was for my supervising SLP to be a part of this process, because she could provide tips to teachers of students with hearing impairments or language delay. She could also see if previous “speech” students were falling behind and needed to be reassessed.
I also met regularly with the special educator, her aides and the school psychiatrists to coordinate individual education programs and consult on what services would best fit each child’s needs. I learned about the roles of each discipline and how one could scaffold to support the other in helping each child succeed.
Skilled nursing facility
During my placement at the SNF, I worked in an office of SLPs, occupational therapists and physical therapists. The SLPs conducted co-treatments with the OTs and PTs often to maximize clients’ rehabilitation and their ability to perform activities of daily living. For example, when the PT was working on the steps to remove a prosthetic leg, we discussed strategies to remember those steps. Every goal was practical and functional for the patient. We worked together in the gym, the dining hall and patients’ rooms.
Participating in the patients’ discharge meetings was also beneficial. As the nursing director, social worker, rehabilitation director and two of the patient’s therapists met with family and/or caregivers to discuss abilities and needs at home, they painted a clear picture of each profession’s role in helping patients return home and to independent life.
Outpatient rehabilitation
The first thing my supervisor told me on my first day of an outpatient rehab placement was to get to know the other therapists—not just the other SLPs, but also the OTs and PTs—and she graded me on how often I consulted with them about patients. At the end of my placement, I realized that I learned almost as much from other professionals as I did from the SLPs I worked with.
In an outpatient setting, patients often have successive appointments with an OT, PT and SLP—so establishing a good relationship with other disciplines was critical. We would let each other know how the patient was doing each day, what had happened since the last appointment, as well as what we might need to add to our notes (such as reports from family or changes in health status).
For new patient evaluations, we would share “CliffsNotes” from the first evaluation to identify the best assessment method. For example, if a child was fidgety, the SLP could consult the colleague’s report to learn about the child’s temperament and general abilities, and determine what may be the best evaluation method (standardized test, language sample from play, parent or sibling interaction, or other measures).
Inpatient rehabilitation and acute care
In an inpatient rehab center and a children’s hospital, I found that interdisciplinary teamwork in inpatient and acute care settings can be even more pervasive. In addition to OTs, PTs and other SLPs, professionals with different specialties (adults and pediatrics), from different departments, and from different levels of care (acute versus transitional or rehabilitative) work collaboratively. Add into the mix nurses, doctors, specialists, nurse practitioners, dieticians, respiratory therapists, social workers and psychologists.
With all these professional colleagues, it can be difficult to remember names—but it’s important to try. If you don’t cultivate a relationship with them and they don’t know what you do, they have no reason to request your services. Try to determine and follow their communication preferences to maintain positive relationships.
It’s important to remember who is in charge of what, how to find out who has the information you need, and to whom you should report certain information. For example, lines are blurred among the roles of OTs, PTs and SLPs for feeding in pediatrics, and those roles may vary depending on the setting. SLPs should refer to ASHA’s website for roles, responsibilities and scope of practice information, and follow the facility’s guidelines.
I’ve quickly discovered that interdisciplinary teamwork is not only important to better patient outcomes—it also enriches your own life. To make the most of your interdisciplinary experiences:
  • Be kind and courteous to everyone with whom you work.

  • Respect others’ professions and roles in the care of your patient or client.

  • Earn others’ professional respect through your actions and patient care, demonstrating how the treatment you provide is valuable to the patient or client’s outcome.

  • Learn from the professionals working around you.

I have learned so much more in practice from other professionals than I could hope to learn in a classroom. If, like I did, you have the opportunity to work with other disciplines, cultivate those relationships—you and your patients and clients will all benefit.
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April 2014
Volume 19, Issue 4