◆ Looking back and moving forward.

2015 started out as a year of uncertainty for me: I was leaving my job of over three years to venture out into the unknown. I was stressed out, exhausted, and not sure how to proceed. I had tied much of my professional identity to being an acute care SLP, and the thought of changing was incredibly daunting. Would I be able to jump into the world of rehab and know what to do? Would I like it? Would I be able to make ends meet?

In the midst of this large professional shift, my family was having its own challenges. My mom was in the middle of chemo and radiation treatment for cancer, and making sure I was present for my parents was very important to me.

This blue bear served as a frequent reference point for me when trying to navigate the Denver convention center at #ASHA15.

This blue bear served as a frequent reference point for me when trying to navigate the Denver convention center at #ASHA15.

When I first wrote about this change I had no idea what all these changes would look like. As these things so often seem to go, nothing goes according to plan. Because the credentialing process for insurance takes a very long time, and because I was the very first SLP at the private practice, I had to find other work while waiting to be approved to provide services in that setting.

To sustain myself in the meantime, I picked up a PRN position in home health. This was (and is) a fascinating and challenging position, and was a wonderful way to rebuild my therapy skills. I also picked up freelance interpreting work. I was a sign language interpreter before becoming an SLP, and have long kept up a small handful of hours on the side. Picking up more hours was a helpful change of pace, and afforded me a nice variety to my work.

With all that said, here's some things I've learned in 2015 that I believe will make 2016 an even more exciting year.

The Denver convention center was an easy walk from the hotels and the sunny weather made for a very pleasant convention experience. 

The Denver convention center was an easy walk from the hotels and the sunny weather made for a very pleasant convention experience. 

Trust those instincts.

From figuring out how to proceed in therapy, to knowing what kind of work to accept, pay attention to that little voice especially if it expresses nervousness. In the process of my hiring for both the home health and the outpatient positions, I noticed a fair amount of disorganization that left me nervous, so I accepted only PRN positions to afford me more flexibility in that environment. As a result, I've been able to be flexible with my hours and make sure that my caseload is manageable.

Learn new things.

It's no secret that I enjoy conferences. They are in part a social experience for me, since it's a chance to see colleagues from around the country (and world). Meeting new colleagues is equally important. The interaction with my fellow SLPs and audiologists allows as much opportunity to learn as the workshops themselves.

This year, I stepped out of my comfort zone and attended some sessions in areas which I don't currently treat. For example, I attended a session about transgender voice therapy, and it turned out to be one of my favorite sessions of the entire convention. When thinking about why this was, I realized that it was because I got to think about therapy in a different way for a change. Also, one of the topics emphasized in the talk was principles of motor learning, which is a hot topic in the areas of dysphagia and motor speech. Hearing it discussed in new ways, by SLPs who talk about their work differently than I do, was a fantastic way to really start to get a better grasp of the concept and understand why it is so vital to therapy. On top of that, it helped me learn about an area I have interest in, but not experience or training. It may help open new doors in the future, and in the meantime has already helped make me a better clinician.

The main entryway in the Denver convention center. 

The main entryway in the Denver convention center. 

Do the right thing.

Ethical challenges come in all shapes and sizes. It may be a company that accepts more patients than they have staff to accommodate. It may be an employer with unethical billing practices. It may be pressure to see more patients than you are able to handle.

In the past year, all of these situations have presented themselves to me, in varying degrees of seriousness. It proved to be to my advantage to accept work only on a PRN basis, as it has afforded me more control over my time and my work. I do not accept new patients unless I know I can commit to providing their treatment consistently. Having become all too familiar with burnout, I recognize and honor my limits, and always remind myself that if I don't take care of myself, I'll be a less present, and therefore less effective, clinician for my patients.

I love windows that move up tall buildings, and appreciated all the light they brought to the convention.

I love windows that move up tall buildings, and appreciated all the light they brought to the convention.

Move forward.

For me, 2015 was a chance to reboot. Though I wasn't looking for it at first, change found me and reminded me I needed it. Challenges presented themselves and I found strength I didn't know I had. I re-invented myself in ways I hadn't imagined I could, and in the process of learning about myself, I found myself growing both personally and professionally. My patients were a big part of that growth, and have helped me to identify new goals for myself.I never used to set goals for myself. In my last job, we had an annual performance review, and I always had a hard time thinking about what I wanted to accomplish in the next year. "I just want to do my work and do well at it," I used to say. This year, I find myself having tangible goals I want to accomplish. Among these, I want to more readily identify ways to target and help my patients meet their goals. I want to start a business and learn to establish contract relationships so I can be more flexible and mobile with my services. In this vein, I want to write about what I learn, both so that I can hold myself accountable with my goals, have a way to look back on what I've learned, and also that others may learn from my experience (both the good and the bad).

Cheers to 2016. Let's make this year an awesome one.