No matter which path you choose in Speech Language Pathology, a job as an SLP can be a very rewarding experience. Many choose to work in the school system. Many SLPs find that it is rewarding working with children on areas such as articulation and the many facets of language.
Another career path can be as a medical SLP. Many times, SLPs choose to work in a Skilled Nursing Facility (SNF), hospital, home health or an outpatient clinic.
As a medical SLP you may work with a variety of patients, of all ages from infancy to elderly patients in a variety of settings. Patients often require a continuum of care that may begin in the hospital setting and end in the home.
Patients may experience a variety of symptoms or complications of a disease process requiring the skill of a Speech Language Pathologist. The SLP is often called in to evaluate and treat patients following CVA (stroke), exacerbation of COPD (Chronic Obstructive Pulmonary Disorder)
The SLP in the hospital is often evaluating patients following a significant event including a stroke, Traumatic Brain Injury (TBI), pneumonia or even when COPD is exacerbated and worsens to the point of requiring hospitalization.
Due to payment from insurance and demands of the setting, the hospital or acute care SLP will often evaluate the patient for swallowing, cognition and/or speech/language skills. The patient may only be in the acute care hospital for 3 days.
The evaluation often begins at bedside, evaluating the patient for possible dysphagia and completing a Modified Barium Swallow Study (MBSS) which is also called a Videofluorographic Swallow Study (VFSS) or a Flexible Endoscopic Evaluation of Swallowing (FEES) to visualize the swallow and determine what anatomy and physiology may be impaired causing difficulty with swallowing.
Language skills may also be evaluated to determine the baseline at the beginning of the event causing hospitalization. The person may be assessed for type and severity of aphasia, dysarthria, apraxia or even cognitive impairment.
Patients are often discharged from the hospital requiring further care and rehabilitation. A patient may be discharged to the Skilled Nursing Facility (SNF) or even an inpatient rehabilitation facility where they will receive intensive therapy, often 3 hours a day, 5-7 days a week. Rehabilitation to home is often the focus in the SNF or inpatient setting.
The SLP will often work on word finding strategies for patients with expressive aphasia, comprehension for patients with receptive aphasia (both may be a focus of therapy when the patient has global aphasia). The SLP may teach the patient dysarthria strategies to improve intelligibility or may work on strengthening the swallow to increase safety of the swallow to resume oral eating if the patient is not allowed to eat by mouth or the upgrade a patient’s diet (diet levels may be altered, food may be pureed or foods may be restricted or liquids may be thickened).
When a patient reaches a level of care that no longer requires 24 hour supervision they may be discharged to home with home health care if they are deemed to be homebound and unable to leave the home or to outpatient services, where they leave home to go in for therapy 3-5 days a week. A patient may even be discharged from the acute care hospital to home health care or even to outpatient therapy services.
Home health care or outpatient services will often pick up where the inpatient or SNF services left off. Care at this level may continue with rehabilitation of the swallowing system, word finding strategies for aphasia or even strategies to assist the patient with cognitive deficits such as setting up a calendar system or a system of cues to remind the patient to complete a variety of tasks.
Most times, students will complete an internship in both the school setting (student teaching) and in some type of medical setting to get a feel for a variety of settings to choose their career path.
One of the most wonderful things about being a Speech Language Pathologist is the wide variety of job opportunities available.