[Dysphagia] slp coverage

[dysphagialist at yahoo.ca (fay nascimento)]

I just want to throw out some food for thought on the SLP coverage issue...
 
I'd like to leave Christmas/holiday coverage specifically, and expand it generally to all periods of SLP absence. To me the question of coverage and service provision needs to be broadened a bit - it's about how and when we provide service, rather than just covering on holidays. It's also about expectation of service provision. 
 
While many hospitals and medical centres have more than one SLP, there are facilities where there is only one physical body there, perhaps not filling a 1.0 FTE. There are also facilities that don't even have an SLP at all. For those, when a weekend falls or the SLP goes home, they are not required to have someone there to "cover" for them, as we see with MDs. There's no backup person to call if an SLP is sick one day, on vacation, or at a conference, and not coming in. We are not required to be "on call", carry pagers at home, or come in when a new referral comes through. I have even heard under some styles of management, that even if there are three SLPs, when they each work for different programs (e.g., medical, surgical, etc), there is no cross-coverage permitted. 

I don't want to talk myself out of a job, but I don't see us as being in the critical place with respect to patient care. If we were, I suspect we'd be getting much higher pay and benefits that match those of crticial decision makers. We'd also be getting a lot more respect from our medical colleagues (in some facilities).
 
Many facilities don't expect SLPs to provide 24/7 coverage, and sometimes we are the ones bringing this expectation to our service. 
 
I feel we offer suggestions and recommendations to the physicians in charge of patient's care. The MRP then takes those recommendations and comes up with a plan for their patient. I see myself as adding to the plan of care, but not "making" decisions for direction of care. 
 
This issue has come up for me many times at my facility, it seems to be around stat holidays. Again, I think broadening it out to understand the expectation of service provision is the best place to start. There are many reasons SLPs may or may not be available. 
 
Please keep the thread going. As I said, this is a really hot topic where I am, and I am curious to hear how other centres are dealing with it. 
 
Thanks!
Fay




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