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​An SLP’s Clinical Experience During COVID 19

Posted by Sara Bouchard M.A., CCC-SLP on

Evolving Identity as an SLP in a SNF

I’m a Frontline Worker and my appearance is ever-evolving. My ID badge sports a new tag that reads “Essential Worker 2020” and explains why I’m needed. I don clear goggles that fog up during therapy sessions and blur the computer screen when typing patient notes and entering orders. My best friend is a head band with buttons (given to me by a nurse whose mom made them for ALL of her daughter’s fellow colleagues) to hold the loops of my N95 mask providing my ears with much needed relief. I no longer wear make up to conserve the life of my N95 mask, increasing its candidacy for being cleaned should it need recycled. I spend mornings convincing myself that gray roots and a rosacea-like rash around the perimeter of my mouth and on the bridge of my nose courtesy my PPE should be celebrated. The tips of my fingers are frayed and feel like sandpaper from increasing daily office and treatment cleaning techniques. I’d have this no other way, as I know my patients need me more than ever right now.

A New Way of Practicing

After reading the above description, I’m sure I am quite the sight for my patients, especially when meeting them for the first time. Add a yellow gown to my look if you’re a patient in quarantine and on droplet precautions. I reassure patients that I have a smile under my mask and try to modulate my voice to reflect an empathetic tone more than ever before in my 20 years of practicing. Communication conveyed by facial expressions is now missing and I’m trying to compensate through head nods, gestures and a friendly voice. My therapy is evolving, as I now use videos and apps (see my list of resources at the end of this blog) since patients cannot see my mouth. A significant portion of my therapy relies on the patient’s ability to see my lips and tongue to aid in motor planning for speech production and target placement for exercises to improve swallow function. Some of my colleagues make videos of themselves performing exercise at home then show them to patients during their sessions at work.

I prioritize who really needs a VFSS, as I can no longer send patients to the hospital for diagnostics and rely solely on our mobile units. Patients who have any degree of hearing loss report I sound muffled and complain about difficulty hearing me through my mask, as they can no longer read my lips. I use assistive listening devices to decrease this barrier and minimize background distractions when possible. Caregiver training has a new look, as I now e-mail or mail educational materials and conduct teaching over the phone, including FaceTime, in lieu of in person. I’m counseling more than ever before, as patients are navigating their rehabilitation stay without visitors at their side and need increased support to cope with the life changing event that brought them to our health care facility.

Appreciating Community Support

Communication finds a way. Daily I observe caregivers outside, as if they are part of the landscape now, blowing kisses, waving, speaking over the phone, and holding signs containing messages of support and encouragement through what has now been dubbed as "window visits". Patients once timid of technology are embracing their cell phone or iPad to use Skype and Face Time to catch a glimpse of their loved ones. Patients and healthcare workers alike (including myself) have received cards and pictures from the surrounding community, truly uplifting our spirits. On my commute to and from work, I see billboards reading "Gratitude Beyond Measure, Thank You Nursing Home Workers". Signs have been posted outside my healthcare center reading "Heroes Work Here". These positive messages provide needed fuel for delivering speech pathology services so patients can safely swallow and effectively communicate, to return home and reunite with their loved ones. Ultimately, we are more resilient than we ever thought we could be, to increase everyone’s safety during this time. To all of our healthcare workers, thank you for being there for our patients. To our communities and caregivers, thank you for finding creative and safe ways to communicate your support! 

Stay safe and strong, Sara

List of Resources To Help SLPs Navigate COVID19

Lingraphica Small Talk Oral Motor Exercises: This application contains high contrast videos for oral motor exercises, click here for the link.

Tactus Apraxia Therapy Application Featuring VAST Video: This application provides an amazing visual hierarchy for motor planning, click here for the link.  

Pocket Pro Care: Contains a extensive assortment of videos for voice, speech and swallowing exercises, click here for the link.

Anti-Fog Spray for Glasses: Helps reduce googles from fogging so you can see your patients and your computer screen, click here for the link.  

Headband with Buttons: Etsy has so many choice when it comes to headbands or other holders for the loops of your surgical and N95 masks, click here for the link.

ASHA COVID19 Updates: Stay up-to-date on all things COVID 19 related to public health and clinical practice, click here for the link.  

Mary Kay Satin Hands: For reducing the sandpaper appearance of your fingers, click here for the link.  

Tips for Healthcare Workers During COVID 19: Are you taking care of yourself? Do you need to talk to someone about coping with taking care of patients during these times? Click here to view a comprehensive resource from CDC.

Functional Treatment Materials: is offering SLPs 60% off their entire order for the month of May in honor of Better Hearing and Speech Month (sale excludes the MIT-E spoon). Use code: WELOVESLPS to save 60%, click here.

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