Not MY job anymore?

(Blogger's note: the title of this post owes a debt to an interviewee of the psychologist Sherry Turkle, who was quoted in Turkle's 2015 book, RECLAIMING CONVERSATION, as saying "nothing is mine anymore".)

When we train to be an SLP, it feels like we walk alone. It is post-baccalaureate education, after all. We crack open all those books and web pages alone; we learn to be an expert and a colleague alone (really!); and we find our voices as guides for the persons we serve, alone. It is hard,  but as Tom Hanks told Geena Davis in "A League of Their Own", - it's supposed to be hard. And then, one day, you've made it and the big world of your professional career opens to you.

 Paradoxically, there is a lot to be said when you are a new SLP professional, for being part of a group. You most likely had just left a peer group you inhabited when in graduate school, and your group's cohesion and energy may have comprised a major percentage of the "posterior push" you got to earn your degree. Where you as a clinician are 1:1 with a person served in the therapy setting, it can be the group ethic and the group energy during training, that can propel you to success in the first work setting.

Memories of class dinner parties with bananas foster; staffing summer camp and ineptly interpreting in sign for some of the kids; all night dance parties before boarding the charter bus for ASHA Convention, and the incantation invoked at the start of our Craniofacial Disorders class, "pass out the Valium and let's get started" [note: this was the 1970's]; these times with your fellow CSD students make the solitary trek to the first job bearable.

 The organization you join in taking your first job has hired you to be part of a team, whether the team be educational or healthcare-based. One skill set that is essential to your Clinical Fellowship success includes building team identity, team communication and team empowerment. There is no "I" in team, the aphorism goes, yet there is a "U" (you) that has to function successfully to undergird a team. Your clinical legerdemain becomes, in the organization, only one component of a maker of outcomes.

I often tell adults I serve, who had been admitted to an acute or post-acute medically-based program, "Nothing I do will keep you here". What may be described in the SLP treatment plan as "Patient will generate x 10 simple active declarative sentences to describe a  color photograph", might instead be folded into the team treatment plan that reads: "Patient will return home with home health services". Does that dilute the effectiveness of SLP services?

The organization is dependent upon you to help make these high quality outcomes both cost-effective, and sensitive to the needs of the person served. The organization may or may not give you the  support you need to help your person served achieve that outcome: that is the reality of working in today's healthcare market. The flavors you impart to this clinical ratatouille may not be "the star of the dish", as hosts of cooking competition TV put it. How easily can a new professional maintain a balance between the needs she* has for professional growth as an SLP, and the team needs that help feed the organization? How can your clinical efforts be properly recognized as contributing to the final outcome of the person served?

This is not a question blithely asked. When a new SLP joins an organization, she is given a challenge to turn the clinical skills she has required with significant effort, into a largely automatic work process for each new encounter with persons served.  In addition to helping persons under her care improve their function, she is helping her organization to provide an efficient product that helps keep the lights on and your paycheck coming.   What can often follow as your teamwork experiences grow in number and complexity, are pressures to control, limit and de emphasize the role of SLP in the team setting, to emphasize the facelessness of the team.  

There's really some simple solutions for you, the new clinician on how to make yourself noticed; how to be marketable, and the sterling team member while upholding the rightful role of SLP in managing a team outcome.

1. Respect your education and training. Never stop learning when you enter the job setting, to meld your knowledge and skill sets with the learning demands of the job.
2. Use your understanding of the therapeutic alliance to establish great rapport with your persons served, and keep feeding the alliance during your therapeutic encounter. Reinforce that you are focused on the person's goals, and that you are training her to 'be your own therapist'.
3. Teach, teach, teach. Teach the person served; her circles of support and the staff assigned to the person's encounter; teach them about normal human function in the areas addressed by the treatment plan, and how diagnosed impairments of function have changed.
4. Communicate your work, both orally and in writing, with conciseness and depth.
5. Maintain the highest professional standards within your work group. You will be seen as more than "a face in the crowd".

*for editorial convenience, the pronoun "she" is used to refer to all speech-language pathologists.