Jayme Menier, CCC-SLP, Angela Baker, CCC- SLP and Brittany Godin, CCC-SLP, three SLPs at MedStar Georgetown University Hospital in Washington, D.C, recently shared their experiences as frontline healthcare workers during the pandemic.
Throughout, Jayme, Angela, and Brittany had to think outside the box, aided by the professional education and training they received earning their CCCs. Jayme leads the hospital’s SLP department, while Angela and Brittany have been working there for four years.
What brought you to the field and made you want to become an SLP?
Jayme: My father was a healthcare administrator and I volunteered throughout high school at his facilities. I found myself in the rehabilitation department where I latched onto the speech pathologist. I found it amazing how the speech pathologist was able to restore communication to people who had their voice box removed or suffered a traumatic brain injury.
Brittany: I was first exposed to the field as a child because I stuttered. In college, I studied linguistics; when I was looking into graduate programs, I noticed that speech pathology was a field that some people with English degrees pursue. I thought it was a great intersection of my personal history and education. I did two rotations in graduate school at Baltimore hospitals and realized that the medical side of speech pathology, specifically working with adults, was my passion.
Angela: I majored in linguistics during my undergraduate education and became interested in how language is impacted by neurological disorders while working at the Center for Aphasia Research and Rehabilitation at Georgetown University. I also had a couple of family members who had neurodegenerative disorders and saw how their communication and swallowing abilities were impacted. I was always interested in working with adults, and I had the opportunity in graduate school to do aphasia research and work at the University of Maryland’s Aphasia Research Center, where my interest in adults branched into an interest in medical speech pathology.
How has the pandemic impacted your day-to-day professional lives?
Jayme: For a few months we weren’t allowed to have patients coming in for therapy. Our hospital system was able to establish telehealth services, which allowed us the ability to stay connected with our outpatient population. It continues to be a popular option. The ability to connect with people without masks allows us to use some of the SLP techniques often needed to facilitate communication. Luckily, through ASHA’s advocacy, we were able to eliminate insurance restrictions that once inhibited us from connecting via telepractice.
Angela: We’ve also had to be creative with our care on the inpatient side. Patients are not able to have family members and friends at the bedside throughout the day, so we’re not able to do family education in the same way. Instead, we pull in an iPad to video chat from the hospital unit or call family members on speakerphone. Also, because we wear masks, this impacts our ability to provide visual cues with our mouth, so we use various technologies to give cues to patients, such as recording ourselves or using different applications on the iPad.
What is recovery from ventilation like?
Brittany: You don’t just turn off the ventilator and things are back to normal. These are patients who have been laying in a bed with a machine breathing for them, and they have to be rehabilitated because their muscles are deconditioned— including the muscles they use to speak, breathe, and swallow. If a patient is on the ventilator for an extended period of time, they sometimes will have a tracheostomy placed. That removes the breathing tube from the mouth, and the ventilator is attached to the tracheostomy. The patient can have difficulty communicating and swallowing, so there can be a long road of rehabilitation. We’re starting to hear more stories of patients who are saying this wasn’t just “I’m out of the hospital and better”— it’s taking months.
How have your CCCs helped you provide care?
Angela: Having a clinical practicum in an adult inpatient setting was critical to my getting involved in medical speech pathology and gave me an introduction to critically ill patients. I’ve also drawn from the continuing education requirement of the CCCs, such as ASHA’s TBI online conference. As a team, we are constantly exploring ways to best treat our patients by growing our practice and understanding different levels of evidence in articles and journals we’re researching.
Brittany: As part of the CCCs continuing education, I completed the ASHA Leadership Development Program in 2019. Colleagues from my group are in hospitals across the country. This was particularly helpful throughout the first wave of COVID-19 because different geographic areas were experiencing waves at different times. I remember a conversation I had with a colleague when we were reporting low COVID-19 patient numbers here, but her 2500-bed acute care hospital in Houston was slammed. Having that conversation and checking in with the protocols and practices being rapidly developed was eye-opening. It was helpful to have those connections, and I wouldn’t have had that if it hadn’t been for my experience with the Leadership Development Program.
Angela: The CCCs also provided us with a great professional community and network. We often participate in the special interest groups and tap into the message threads to contact people around the globe to hear from experts in the field. As Brittany said, this was particularly helpful during the COVID-19 pandemic to hear how different medical experts around the country and world were handling the virus.
What lasting impact will the pandemic have on your profession?
Brittany: In the future, who knows how many in-person continuing education courses will be safe to hold in person. How do you have “continuing education” on a virtual platform when training clinical skills? There are certain skills that need to be trained in-person. Innovative people will have to come up with ways to train all medical personnel, not just speech pathologists.
Jayme: COVID-19 has shined a light on what speech pathology is in a medical setting. In my opinion, prior to the pandemic, few people recognized how SLP services were related to respiratory illness and the impact that has on communication and swallowing. I’m also hopeful that we will be able to maintain connection with our patient population via telepractice.