I went into the field of Speech Language Pathology to help people. It started out that I was definitely going to work with children and more than likely work in a school system. I had ZERO interest in working with adults while I was still in graduate school.
It was a wonder that I actually completed an adult-based internship. I was in a Level 1 Trauma hospital working in the rehab unit. I actually enjoyed it. I was a little grossed out at the time with some of the dysphagia techniques, but eventually grew to love it.
No matter what the setting, I went into this field to help others. Whether it be children learn to correctly articulate sounds or use this wonderful language that we speak or adults learn to swallow or to find words again. I wanted to fix everybody!
During my years of work, I have found that I just can’t fix everybody. It’s not just my fault. It’s not that I don’t know what I’m doing or that I don’t keep up with the research for the best clinical practice.
Sometimes I have to understand and accept that the patient doesn’t want to be fixed. I’ve actually had patients that were completely satisfied with nectar thick liquids. Just because that is not something that I want, doesn’t mean that it’s not ok for that person.
There are times that the patient is just tired and they don’t want to deal with the therapy. They don’t want to complete home exercises, they don’t want to see you once a week for therapy.
Patients have been known to not follow recommendations. There are times that they know that they have no intention of following the SLP recommendations and that they will eat and drink whatever they want. They just don’t want you to know that.
You will meet patients that have no motivation. They are just as happy sitting on the couch and watching Jerry Springer. They don’t want to work.
This is the time that I have to step back and acknowledge the patient’s rights. They have the choice to refuse services, recommendations and home exercise programs. I will use my evaluation time to educate the patient on oral care, educate them on dysphagia and then recognize their rights and their wishes.
I have had to understand, as I continue to grow as an SLP that patients don’t always want my help and that’s ok. I need to devote my time to patients that DO want my help and let the patients that don’t, exercise their right to choose and make decisions in their own health care.