The field of speech-language pathology offers a vast number of opportunities, but SLPs heading into the workforce may not know which path to take. In the medical SLP world alone, there are many environments to choose from. If you’re considering working with an adult population, one of those settings is skilled nursing. 

Skilled-nursing facilities (SNFs) — often referred to as nursing homes — give SLPs the opportunity to work with elderly patients, some of whom are long-term residents and others who will eventually move to a lower level of care, such as assisted living. These patients cover a range of diagnoses, and their care will require SLPs to collaborate with other professionals, from doctors to physical therapists. As you might expect, it can be a challenging setting to work in.

For Jessica Schell, the most recent guest on The Missing Link for SLPs podcast, it has also been an incredibly rewarding environment. If it’s one you’re considering looking into, these are five things you should know going in. 

Be Ready for Productivity Requirements

Productivity requirements aren’t exclusive to SNF settings, but clinical fellows and new speech pathologists should be prepared to ask about them while interviewing for SNF positions. The percentage of productivity you’re expected to meet will vary depending on your facility, but some settings will account for more tasks than others. You’ll want to find out what a facility’s productivity requirements are for this reason. This will make it much easier to manage time should you decide to take a position. 

As a newer SLP, it can also be useful to ask prospective employers when they’ll expect you to meet such productivity requirements. Someone adjusting to the field — and a new setting — will undoubtedly need time to learn the ins and outs of SNFs before hitting the company’s productivity goals. You’ll want to make sure the facility you’re joining is prepared to give you that room to learn.

Know Your Population

SLPs working in SNFs can expect to see a variety of etiologies and diagnoses, but the majority of the clients they’re working with will be elderly. Whether you’re hoping to build a career in this setting or simply looking to get your foot in the door, it’s important to have some desire to work with adult populations.

You May Be the Only SLP

Many SNFs don’t have the caseload to support more than one speech pathologist, so those entering this setting should be prepared for that reality. This can prove a challenge for newer SLPs and clinical fellows who need more supervision than a seasoned clinician would. 

Ask about supervision during the interview process, and confirm that an off-site clinical supervisor will be available to answer questions as needed. You’re going to need some guidance and support entering this field, so you’ll want to make sure you’re receiving those things, even if it’s not from someone in the building. 

It Takes People Skills

Working as an SLP requires people skills no matter what setting you’re in, but building rapport with elderly clients and their families can often take that one step further. Those with patience and the ability to handle difficult situations with grace are more likely to succeed in a SNF. 

Communication is also critical to this setting, as you’ll be collaborating with other professionals on client care. If you have prior experience working in team-centric environments, you’re in good shape to take on skilled nursing. 

You’ll Need to Advocate

The ability to advocate is another important piece of working in a SNF, but that’s a skill many SLPs need to build as they grow in their field. Working with elderly patients will require that you advocate for them at times, especially if their treatment demands something that’s beyond the scope of an SLP.

Of course, new SLPs will also need to learn how to advocate for themselves, especially in settings where they’re likely to be the only clinician in the room. This takes time and practice, but it’s something you should be able to work through with a clinical supervisor or mentor.

Want to learn more about Jessica and her journey to becoming an SLP? Listen to her and Mattie chat on The Missing Link for SLPs Podcast.

Did you know Mattie provides coaching to SLPs? Learn more here.

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