By the end of January hopefully SLP graduate student interns have settled into their spring semester internships and some of the fear of the unknown has dissipated. Now it is time to focus on making the most of your internship. Here are 10 things I did or wish I did during my internships.
1. Remember you are there to learn the job of an SLP. It is within the scope to be asked to do some things that are not direct treatment like make copies, file reports in charts, etc. It is not okay for you to be the errand runner (e.g. being the default person to make Starbucks runs, picking up lunch, etc.). Look at what the other SLPs are doing. You should be learning their job. Unfortunately there are situations when your internship supervisor and the team you are working with may try to take advantage of you and your time.
2. But do not just learn from SLPs. When treating adults I think of SLPs as rehab professionals that specialize in swallowing, speech, and cognitive-communication. Whether you are in a hospital, LTAC, SNF, or outpatient, try to observe OTs and PTs to learn how they help patients. This will help you learn how to work as a team and make appropriate referrals down the road. If you are interning in a school, try to do the same thing but observe the RTI specialist, special education teachers, and other teachers. We are all working collaboratively, so it is a good idea to learn what other professionals bring to the table to help our clients.
3. Since you are an SLP graduate student intern, expect strong supervision. As a graduate student clinician you are not ready to treat patients independently, at least not yet. Even if you treated patients in the graduate school clinic prior to the internship, you will be in a different setting with a different population. It is okay to need supervision. If you are not getting the supervision that you need, speak to your graduate school clinic supervisor or another mentor to help you problem solve to obtain adequate supervision. Doing an internship is not an opportunity for your onsite supervisor to catch up on email, documentation, or projects.
4. But do not lean on your supervisor to lead you all the way and make plans. You are going to have to refer back to textbooks, class notes, and journal articles to help you make treatment plans. All SLPs do this to some degree. As a student clinician you will need to do it even more. Your supervisor should be supervising you but not creating your treatment plans. If you have a challenging client discuss the case with your supervisor; however, lead with a proposed solution. e.g. “I am thinking about… for Mrs. M. What do you think?”
5. Treatment materials are good, but they are not everything. You will end up with a sore back if you cart around heaps of materials for your patients/students. Rather than picking unique materials or stimuli for each patient on your caseload, trying picking a few things and using them all day to target patient’s goals. The goals and objectives have to be individualized, but the materials do not. How many different goals could you address with a Guess Who game with your students or with your adults in a SNF? What can you do with this week’s sales flier or today’s menu selections at the hospital? I really like Results for Adults: Cognition. They have great examples of how you can use one topic (e.g. making breakfast) with many different levels of memory, attention, problem solving, and communication. It is worth checking out the sample lesson for sure to get inspired. Tactus Therapy Solutions’ Conversation TherAppy helps you target many different things using a single picture stimuli. They offer a lite version where you can view 3 of the pictures with questions.
6. Set a budget for material purchases. It is really exciting to be treating patients instead of listening to lectures and reading textbooks all the time (of course you will still have to look at the textbooks to help you with patients!). Do not let that excitement get away from you and your budget. Talk to your supervisor and other colleagues about their materials and the facility’s materials. Now is the time to play with and test other clinician’s materials to see what works best for your particular therapy style. The best thanks you can provide is to return materials exactly how you found them. Remember some of us SLPs have totally type A personalities. If you want to do more, at the end of the semester gift your supervisor or team with a game that you think would be a great addition to their collection.
7. Take a dedicated lunch break. Rather than doing documentation or eating your lunch during a meeting, take a dedicated lunch break. As SLPs in the healthcare setting this can be difficult as we are often seeing patients at lunch, but make an effort. Maybe even go outside for some sunshine. A moment of downtime during the middle of the day will be good for you (and for your patients when you are able to focus better).
8. Talk your patients about their goals. Sometimes the goals we see for patients are not the goals that patients and their families value most. Really get to know your patients and their families, so you can set meaningful functional goals for them. Also important is to write goals that you understand. Many of the computer systems we use for documentation have goal writing software. I have yet to meet goal writing software that was helpful. Think about the behavior you want to see as a result of treatment, and then write your goal to describe that behavior.
9. Explain the objectives of a treatment activity. Try to explain goals and treatment task objectives to patients and families in ways that they can understand. Not only is this good for your patients, but it is good for you to practice making sure that every task is clearly goal oriented. This helps your patients see the value in the services you are offering and helps them see how they are making improvements.
10. Say please and thank you and mean it. It is such a simple thing, but it means so much. When I use the call button to call a CNA to help a patient to the bathroom, I always tell them thank you. I offer to help in anyway that I can. I generally do not do solo transfers, because I have not been trained adequately. However, I am comfortable being the 2nd person in a 2-person transfer. I can fetch wheelchairs, foot pedals, briefs/Depends, etc. When I stand in the hall to give patients privacy I will also check on other patients when their call lights go off (when a CNA is working with my patient briefly). Answering call lights in these brief instances is a great opportunity to screen if people can recall why they pushed the call light and clearly communicate their wants and needs. When the CNA is finished, thank them again and report any messages regarding call lights that you answered.
I hope these suggestions are helpful. I would love to hear from SLP graduate student interns and supervisors about what tips and tricks you have learned through internship opportunities.
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