You're an SL- What?: SLP Life in the NICU

I’m beyond excited to kick off the “You’re an SL- What?!” Series! This series will start with settings that involve our youngest patients and progress to settings that serve our older patients with a few non-traditional roles here and there. To start us off, Megan Kilpatrick from the NICU setting is going to share why exactly an infant could need an SLP!

Megan is a Speech-Language Pathologist in the Neonatal Intensive Care Unit at a hospital in Texas.

"I initially had wanted to go into teaching, but quickly learned after an internship that managing 25 kiddos all at once was not for me. I took the Intro to Communication Disorders class my freshman year of college and was hooked.  

I received my BS from TCU and my MS from Marquette University with a certificate in their BIES program (Bilingual-Bicultural English/Spanish). 

I am in my ninth year of practicing now. I started out working in two SNF’s, then moved into contract work and acute rehabs, and eventually started the job at a community acute hospital, where I am now. I have been there for four years. 

Just over a year ago, our hospital began to incorporate therapy into our NICU because they were trying to get state designation as a level III facility. We had essentially no therapy presence in the past in the NICU, so it has been a huge transition for both nurses and therapists. 

The NICU is considered an advanced area of practice, and it really takes a lot of supervision, mentorship, guidance, and continuing education to develop skills in there. Probably the most helpful resource I have found along my journey has been the Ignite program through NANT (a year-long mentoring program for NICU therapists). 

We receive speech orders on nearly all the babies admitted to the unit. We have an eleven bed unit, so it’s not usually very many at one time. Most of the babies I see are admitted to the unit for prematurity and/or RDS (respiratory distress syndrome). Most of my goals for them pertain to parents demonstrating competence with supportive feeding techniques and feeding positioning, development of pre-feeding skills, demonstrating stability during PO feeding, and ultimately reaching full oral feeds safely. 

When I evaluate a baby, I am looking at their overall development, how they show signs of stress, how they are calmed, and their oral motor function and status. If they are ready for PO (by mouth) feeding, I assess them with bottle-feeding and/or breastfeeding. Then as they grow, I continue to follow them to make sure they are developing their feeding skills appropriately, providing intervention as indicated, and educating parents. I work closely with Physical Therapy and Occupational Therapy as well. 

I think what sums up my job the best is when I tell parents my 3 goals for speech therapy: to make sure baby is eating safely, make sure he enjoys eating, and to make sure they enjoy feeding him. 

The hardest part of working in the NICU has been trying to start a culture change in our unit from volume-driven (amount of formula/milk intake) to cue-based/infant-driven feeding. There has been a lot of resistance from staff as it is not how they have always done things and change is just difficult. This challenge is just part of being in a NICU. Many units struggle with resistance on the topic. I pursue as much continuing education as I can find and keep up on research about best practices so that I can answer all the “why” questions. 

My favorite part of my job is when a parent is able to feed their baby on their own, safely and confidently. Feeding is a huge bonding experience, and it is rewarding to see parents enjoying it."

Megan is a rockstar! And I'm so thankful for her sharing a little SLP gospel about this specialized setting!! Next we will dive into the Early Intervention setting with my mentor and gal pal, Molly Ooten!

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