In Limbo

kathleensymeI haven’t written a post in a little while. However, I felt suitably inspired by a visit to the new Kathleen Syme Community Centre on Faraday St in Carlton. The following things have happened since my last post:

  • I passed both my Fluency Placement and my Adult Acute Hospital Placement.
  • I went interstate for a small holiday
  • I finished off a major assignment which I will be presenting on Tuesday
  • I sorted out a few volunteering experiences for the next three months.

I won’t commence my next placement until September. Hopefully, I will be placed with a paediatric community health service.

Adult Placement

By the end of this placement, I was feeling slightly constrained by the boundaries of being a student. The placement is “Entry Level”, meaning that I should be able to walk into a graduate job in a similar field at the conclusion of the placement. By the end of the placement, I felt ready to start dealing with a caseload by myself without supervision, and to take charge of situations in my position as a “Speech Pathologist” rather than a “Speech Pathology Student”.

Things I learned on this placement:

  • Acute work requires you as a clinician to efficiently summarise a patient’s presentation without much assessment or contact. Worrying about the path of cranial nerves, specific sites of lesions, or the exact agrammaticism a patient presents with is rarely helpful.
  • Instead the acute environment requires you to plan. Plan. Plan. Where is the patient going? Where should they go? What do they need to maximise their future function and quality of life?
  • Acute hospitals require clinicians to deal with rapid change. A patient who appears well on Monday can pass away by Wednesday; or the patient who appears to be in terminal decline can recover enough to only need a few weeks of rehab.

Most importantly perhaps, I saw how patients’ outcomes were driven by social determinants. The patient who lives in close proximity to shops, public transport and other services with their spouse is likely to remain independent longer than the patient who lives alone in a car-dependent neighbourhood with children interstate. Often, this meant the difference between being placed in aged-care or going home.

Stuttering Placement

It was difficult to finish this placement. Stuttering is a chronic condition, requiring constant monitoring and intervention from the patient. If a patient lacks sufficient attentional, organisational or monitoring skills, they are unlikely to succeed without constant support. However, the limits of the placement force us to set our clients free, hoping that we have equipped them to remain fluent without assistance.

I really saw the value of continuing formal supports like Speak Easy, speech buddies (people they can ring to practice their speech with), or review days. However, I couldn’t help but think some of the clients would relapse.

New Directions

Over the break, I will be volunteering with the Aphasia Lab at La Trobe University (website forthcoming, although they are on Twitter @aphasiaLTU). Specifically I will be offering office support for the PhD students and the lab leader, Associate Prof Miranda Rose. Some of the tasks will be more challenging than others (coding data, updating technology, literature searching, proofing, etc.)!

I will also be working with a community not-for-profit in an oral language development program for at-risk preschoolers in Melbourne’s West. I will deliver a formal oral-language development program with four-year-olds in early childhood centres, with the aim of preparing them for the language demands of primary school.

Finally, I will be assisting in the Classroom Promotion of Oral Language project run out of the Royal Children Hospital’s Education Institute. I will be assessing students who have participated in the program using standardised instruments for research use.

And I hope to fit in a few Speak Easy visits in between. Hopefully it should be enough to stop me going spare with boredom!

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