professional

Taking Chances

For a couple of years now, I've been talking about wanting to develop continuing education workshops. I have loose sketches of ideas in various places, but little in the way of something cohesive. Early this year, I saw a call for proposals for the ASHA Connect conference. I attended this conference for the first time last year under its former moniker, the ASHA Healthcare and Business Institute, and found it be one of my favorite conferences I've attended to date. It's more intimate and less overwhelming than the large convention (which I also love, to be sure), and there's time to really get to know fellow attendees.

Having never submitted a proposal before, I was excited to learn the process and give it a try. I was also very nervous. In the past, I've found that quite often I'm great at visualizing things, but less great at making those things then happen. As a result, having a deadline for submission, as well as a template to help provide an outline, proved to be very helpful. Instead of just letting ideas buzz around my head as I often do, I had something that helped me make sense of the many ideas which have been bouncing around for so long.

I designed my proposal to be a two-hour presentation. One of my current goals is to develop and present day-long workshops, but having to think about a smaller scope was a helpful way to get more focused. I also wanted to be flexible, so when I submitted everything, I offered to have my proposal considered for other formats (in this case, a poster presentation). I did this for two reasons: (1) I thought additional perspectives would be beneficial, and (2) I wanted to have the opportunity to present, and have appreciated how posters offer immediate interaction and discussion.

In late February, I learned that my proposal had not been selected for a presentation. While no feedback is provided regarding what kinds of improvements can be made, I reviewed my proposal and found a few things I felt could improve it. I reworked it and submitted it for the ASHA Convention in November, so am excited to see where it goes.

Then, about two weeks ago, I got word that my proposal was selected as a poster for the ASHA Connect conference in July. I am looking forward to presenting my ideas at one of my favorite conferences, and even more than that, I am eager to see how it resonates with my colleagues there. I couldn't be more honored and excited to take this next step.

My poster will be about making the most of working with interpreters in clinical settings. I'm excited to be discussing two things so dear to me, and which are an everyday part of my work. If you're heading to the conference this summer, come say hello! I have a lot of work to do in the interim, but can't wait to get started.

◆ 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.

★ On Improving the ASHA CE Registry

Last night I wrote a tweet regarding the ASHA Continuing Education Registry that seemed to resonate a lot with other folks across Twitter. ASHA had linked to an Instagram photo that encouraged members to join the CE Registry, and I replied that while I liked it, I felt it should already be included in the cost of annual dues (rather than the additional $25/year it currently costs each member).

I have paid the annual fee for the continuing education registry ever since earning my CCCs. I find it convenient and helpful, as it puts all my continuing education in one place. I could easily do so myself with a simple table or spreadsheet on my computer, but having it as part of my ASHA profile is helpful because when ASHA wants to verify my CEUs, it’s a snap to do so because they’re already in their own system. I don’t have to pull out my file, or scans, or any other information to verify that I earned my CEUs. Also, when my state organization wants to audit my CEUs, it’s simple to log in to ASHA, print out my transcript, and send it along.

I’m lucky enough to be in a position where I have been able to afford the annual $25 fee for the past few years. I have no idea if that will always be the case, and for many folks, the additional fee on top of the annual membership fee is just not feasible for them. This is especially true when additional costs for continuing education itself, as well as state licensure, are considered.

In my concurrent career as a certified sign language interpreter, the certifying body has a means to track CEUs as part of the annual cost of membership. It’s easy to see why: having all members be able to track CEUs as part of the online dashboard is helpful for us to keep track of continuing education. On the flip side, it’s also easier for the organization itself to keep track of our its members CEUs. It saves them time and resources and simplifies the bookkeeping on their end. It’s a win-win, so it’s worth it to incorporate it into the cost of membership.

A bonus to including CE registry cost into annual membership would be that more members may consider joining a Special Interest Group rather than trying to decide between the two (SIG membership is $35 per year, but you get my drift; costs for SIGs could benefit from a pricing structure change, too, but that’s another discussion for another day). Fundamentally, I think all members would benefit from having access to the CE registry as a part of the basic cost of membership, and ASHA and the professions at large would benefit from increased SIG membership and the resources and professional discussion that can be gained from them.

★ And now for something completely different.

It’s been over one year since I last wrote here. In that time, I have experienced joy, sadness, exhiliration, exhaustion, and more, some in greater amounts than others. As seems to be common among medical SLPs, I have ended up on the wrong side of burnout. I’ve been working in acute care for going on five years, and it’s finally worn me out.

In this process, I’ve begun exploring new areas and trying new things. After years of talking about it, I’ve finally worked up the courage and the confidence to start developing my own niche. I’ve long wanted to work with adults with hearing loss, in many areas of their communication and swallowing needs, but I wanted first to have the experience working in my native language before doing so in my second language.

In order to pursue this new goal, I have left the hospital I’ve called home for the past three years and am in the process of getting set up at an outpatient clinic. The outpatient world is vastly different from inpatient, and though the paperwork and billing are daunting, I am very excited to be making this change. It’s taken a long time to get here, and I aim to do it right.

The hardest part of such a big change is figuring out where to start. Starting fresh is both exciting and terrifying; it’s amazing how comfortable you can get in one situation, and how hard it is, while in it, to imagine being anywhere else. As I think about how challenging this change is for me, I am reminded of many of my patients, who had no say in the sudden and dramatic changes which confronted them. Their resilience and determination inspire me. I have many ideas, and have slowly been collecting my thoughts, organizing them, and discussing them with colleagues.

Writing has long been something that brings enjoyment, and this website has always been a nice side project to work on. For the past year, I have been too exhausted to put any effort into side projects, and I have even found little energy for continuing education, which I value greatly. The questions have been there, but the energy to pursue them has not. Coming to this realization was helpful in accepting that the time for change is now.

So much is uncertain right now, though in time I know I will gain renewed confidence and vigor. For now, I will be working diligently to meet new goals which have me excited about the work I do. I will find new questions to ask, new things I want to learn, new challenges to overcome.

The unfamiliarity of my new world has left me with a drive I thought was lost. And yet, I still impatiently wait for things to be familiar once again.

★ Extra Xtra: Why some "entertaining" videos may do more harm than good.

Perhaps it's the result of being bi-professional, but I have developed a pet peeve regarding the use of a tool called xtranormal to portray what our professional lives are like. Every so often I receive an email, or read a facebook post or tweet, with a link to a video about "how true" some video is about life as an educational interpreter, community interpreter, educational speech pathologist, medical speech pathologist, etc. After seeing them enough times, I recognized a pattern:

  1. Introduce two parties in an "Us vs. Them" situation.
  2. Create dialogue regarding a specific problem or question common to a duty or knowledge.
  3. Portray the "Us" profession positively while simultaneously denigrating the "Them" profession.
  4. Carry on for 1-2 minutes in this fashion.

I have seen videos that portrayed teachers as unable to figure out that a deaf student is asking to use the restroom. I've seen others that suggest nurses are inflexible and know nothing about swallowing disorders, or outright refuse to let SLPs do their jobs. Pick your issue: use of thickened liquids, instrumental assessments, language or cognitive disorders, stuttering. Chances are there is a video of it out there, festering with frustration and negativity.

Are these videos cathartic? Perhaps. I am not suggesting our professional lives are a picnic. I really have had people ask me if my deaf client reads Braille, or is he able to drive. Not too long ago, I had to get a patient a new trach because his nurse washed the inner cannula with tap water. These things happen.

What all these videos have in common, though, is that they foster stereotypes. Often, the maker describes it as "based on an actual event", only instead of offering up a title that clearly defines it as a solitary incident, it is branded as defining ALL TEACHERS/EAs/NURSES EVER.

What is fundamentally wrong, though, is that we are not in competition with any of these people. We are meant to work as a team, and teams only get stronger when we don't work against one another. It isn't about proving you know more about something than the people you have to work with. It's about sharing your knowledge thoughtfully and being open about explaining what your goals are and what you have to offer.

By all means, please vent your frustrations when you have them. They are legitimate, and I will be right there to hear you out. But please be courteous and respectful. And please, when you come across these videos, challenge the negativity they foster, and know that we--as individuals and a community of professionals--are better than that.