You're An SL- What?: Life as a SNF SLP

Hey hey, SLP friends! I'm excited to get back to the "You're an SL- What?" Series with one of my SLP best friends! Caroline was my neighbor and study buddy in grad school. I wouldn't have made it through without her! She's incredibly skilled at what she does and is always a great resource for me when I need a sounding board! Check out her experience!

Hi, my name is Caroline Baumunk. I graduated with my bachelors and masters from OU Health Sciences Center in Oklahoma. I have been working as a SLP for 4 years - one year in a pediatric private practice, and three years in SNF facilities. 

I first learned about speech pathology when I was a senior in high school. I would go to family functions and my cousin and cousin-in-law (who are both SLPs) would constantly talk about how much they loved their jobs and what they do. I was immediately interested because I was unsure of what I wanted to major in and they made it sound so great! I was interested in the health field and wanted a job where I could help people, but did not want to go the nurse or MD route. The more I looked into what a SLP actually “does” I was drawn to it even more. I loved the idea of how many various settings there were, thinking if I got tired of one I could try another. I also loved the amount of positive impact you could make on a person by doing speech therapy with them (in any setting), which is what I wanted most in a job. I shadowed both of my cousins multiple times and decided going into college to start on the path toward become a SLP. 

Graduation Day

I currently work at a CCRC, or Continuing Care Retirement Community. This type of community includes independent living, assisted living, skilled nursing (SNF,) long term care, and a locked memory care unit. I work primarily with patients in the skilled nursing who are there for rehab, long term care patients and memory care patients. I do have some outpatient appointments in Assisted Living Facilities (ALF) and Independent Living Facilities (ILF) though. This is different from other settings because we have such a wide range of patients to be seen. I have patients from 40 years old to over 100 years old on my caseload at any given time. Being this type of facility, a lot of the patients we get in the SNF come from our ILF and ALF, a lot of which come after having falls at home. Cognition is one of the primary things I address, especially memory, sequencing, safety, and finding ways to improve the patient’s safety and independence with completing their activities of daily living (ADLs) - think bathing, dressing, grooming, cooking, cleaning, leisure activities, etc. I also have a heavy dysphagia caseload. We have a significant amount of patients with dementia and Alzheimer’s diagnoses, which often require diet modifications due to the progression of the disease. Our facility has recently become “behavior health” certified because of the amount of Alzheimer’s and dementia patients we have. It has been challenging but fun learning how to work with this population, as I did not have a lot of experience prior to this. 

One of the greatest challenges I have had thus far is building up the speech department. The company I work for acquired this MASSIVE facility back in July (when I started) and the previous company had not done a great job with therapy. There were only 3 (!!!) people on the SLP caseload when I got there. This was quite a shock, as there are around 170 LTC beds and 50 memory care unit beds. To piggyback on the facility not previously having a strong therapy presence, I had the job of educating everyone (nurses, CNAs, dietary, etc) on what I actually DO and trying to implement new, more efficient ways of doing things. This initially was not well received because it wasn’t “how things have always been done”. I have made a lot of progress in educating people, doing multiple in-services at “all staff” meetings on the role of the SLP, diet modifications and prevention of aspiration/choking. Some days it still feels like an uphill battle, but it inspires me to look at much improvement we’ve made in the past 8 months, and think of where we will be in another 8 months. 

The greatest reward for me working in this facility is seeing progress not only with the patients but with the staff as well. When a I see staff members correctly following diet recommendations and following through with education I’ve provided, it makes me feel like i’m doing something right. Seeing a patient make progress and do things they didn’t think they could do anymore because they think they’re “too old”, seeing a patient be able to return back home independently, upgrading a diet for someone who has been eating puree and thickened liquids - those are the things that keep me coming back each day. My favorite experience being a SLP is just hearing patients and families say “thank you” and noticing how I was able to help them and their family members. I feel like speech therapy is often a thankless job, and I it feels nice when people notice how much you care, and the work you put in to help them. 

The one thing that I teach people almost every day about our field, is that we don’t JUST work on speech and talking. We also do thinking and swallowing :)

Celebrating passing our comps together!

Thank you SO much, Caroline, for taking the time to be a part of this series! I am so proud to call you a friend and to share this field with you! 

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