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[Dysphagia] Irene's response to Suzanne
I believe the comments from both sides were strong and from two different perspectives. Irene appears to have a vast amount of knowledge in the area of dysphagia and it is great that she is willing to share that with the list serve. Barbara also stated she has many years of experience as well, I am certain she has alot to share with this listserve as well. I believe that "sharing" knowledge is the key purpose of this listserve. When a member or members feel that this information is being passed on in a condescending or derogatory manner, it is certainly appropriate to address that. We are all here to share our knowledge and to help each other.
We are all in this area of speech language pathology for what I believe to be very specific and special reasons. Because we love the involvement with our patients and we want to do what is in their best interest. I suppose that maybe we all need to have thicker skin regarding comments made on this listserve, but I am not sure that is what brought us into this field in the first place, and quite honestly, I don't want to grow a thicker skin.
Let us please remember, that we are colleagues, looking to each other for knowledge and support.
Cheryl Goettsche, MS, CCC-SLP
Barbara Morrison <bjm@francomm.com> wrote: Dear Listserve members,
My intention was not to "quarrel" with Irene or to waste
anyone's time on this listserve. I appreciate all of the information
that I gain from this listserve. I just do not always appreciate the
tone in which the information is delivered. So, maybe I was
harsh in expressing my dislike of generalizations made about
my profession. Perhaps, I took it too personally since I am not
one of the SLPs "in general". I do not overreact to aspiration.
I do stay on top of the latest information. I treat each patient
on an individual basis. My swallowing assessments look at
the cause, risk of aspiration, and help to determine the
safest means of nutrition for the patient.
I have mentioned in a previous posting that I have ten years of
acute care experience, but that I am relatively new to this listserve.
I guess the argumentative nature of this listserve is something
that one must acquire a taste for.
Barbara
----- Original Message -----
From: "Suzanne Morris"
To:
Sent: Tuesday, November 29, 2005 11:44 PM
Subject: Re: [Dysphagia] Irene's response to Suzanne
>
> Barbara,
>
> I rarely get involved in responding to this type of comment but I
> found your reactions extremely strong and inappropriate. Irene's
> comments were directed toward questions that I had asked. I found
> her answers extremely helpful and thought-provoking. Her comments
> were addressed not toward all SLPs, but very specifically toward
> those who make decisions that either don't make sense or could result
> in serious risks for patients. Irene's observations that patients
> very frequently are given an NPO recommendation for even slight
> amounts of aspiration is very on-target. Her point was that it is
> often these same therapists who want to give food mixed with barium
> during the swallowing exam. Her point that the known risk (or
> innocuousness) of aspirating barium is very different from the
> potential risk of barium mixed with food. This is a critical issue
> for many patients. The risk is particularly true if food is left
> sitting out before the examination. Unfortunately, professional
> education and training programs often do a great job of training
> common sense out of therapists!
>
> The function of this type of a listserv is to invite us to think and
> to challenge our beliefs and knowledge-base that may be outdated. We
> do not grow as professionals unless we look carefully at what we are
> doing and at the research knowledge that supports or doesn't support
> it. I don't see that this view fits at all with your suggestion
> that if "you don't have anything nice and constructive to say, keep
> it to yourself. We do not need people on this listserv who are going
> to belittle what SLPs do." If that, indeed, were the focus of this
> group I would resign from the list immediately! I don't always
> agree with Irene or with others on the list. I probably wouldn't be
> thinking and challenging my own growth as a therapist if I agreed
> with everybody.
>
> Suzanne
>
> __________________________________
> Suzanne Evans Morris, Ph.D.
> Speech-Language Pathologist
> New Visions
> 1124 Roberts Mountain Rd.
> Faber, VA 22938
> (434) 361-2285 ext. 5
> www.new-vis.com
>
>
> On Nov 29, 2005, at 6:02 PM, Barbara Morrison wrote:
>
> >
> >> Irene,
> >>
> >> Please do NOT make generalizations about Speech Pathologists.
> >> You are participating in a listserve which is geared towards SLPs.
> >> You refer to SLPs in the below comments as "these same people" and
> >> "what are they thinking". This is disrespectful and offensive.
> >> Irene, are
> >> you a Speech Pathologist? Have you worked in acute care? Have you
> >> had to make decisions regarding a patient's PO intake??? We do NOT
> >> take
> >> these decisions lightly. AND the whole idea of swallowing evaluations
> >> (whether it be bedside or a video) is to
> >> test various food and liquid consistencies to see what a patient CAN
> >> tolerate.
> >> Of course there IS a risk of aspiration, that is why the patient was
> >> referred to us
> >> in the first place. AND we know that an evaluation situation is
> >> just a
> >> moment
> >> in time and it does not resemble real life. However, we need the
> >>
> > evaluation
> >
> >> information to make decisions about the patient's PO intake and risk
> >> of aspiration.
> >> I hope that you understand where I am coming from and I am sure
> >> that I
> >> am not the only SLP who feels this way about your comments. In the
> >> future,
> >> if you don't have anything nice and constructive to say, keep it to
> >> yourself. We
> >> do not need people on this listserve who are going to belittle
> >> what SLPs
> >>
> > do.
> >
> >>
> >> ----- Original Message -----
> >> From: "Irene Campbell-Taylor"
> >> To:
> >> Sent: Thursday, November 24, 2005 2:17 PM
> >> Subject: [Dysphagia] Response to Suzanne
> >>
> >>
> >>
> >>
> >>> You also say, "I have to wonder why food is being used in a
> >>> situation
> >>>
> > in
> >
> >> which one might well expect aspiration to occur." Is this because
> >> of a
> >> potential risk to someone whose immune system is compromised or
> >> who has
> >>
> > poor
> >
> >> health of the lungs (i.e. BPD in children)? Would you see any
> >> risk to
> >>
> > the
> >
> >> food + barium mixture if the individual's health was good and there
> >>
> > weren't
> >
> >> specific lung or immune system problems?
> >>
> >>
> >>
> >>> *** My point here is that SLPs in general have a inappropriate
> >>>
> > response
> >
> >> to the issue of aspiration and I see so many scores of
> >> recommendations
> >>
> > that
> >
> >> patients be NPO because of a hint of a risk of aspiration that it
> >> drives
> >>
> > me
> >
> >> insane. If these same people - as they largely are- give food in a
> >>
> > situation
> >
> >> in which it may be aspirated - what are they thinking? Also, I
> >> have seen
> >> food sitting around the x-ray department for hours before being used
> >> gathering every noxious germ that only hospitals can provide.
> >> Infection
> >> control officers would go mad. Barium alone is innocuous to the
> >> lungs.
> >>
> > Food
> >
> >> that is, even under the best of circumstances, filled with
> >> bacteria, is
> >>
> > not.
> >
> >> Also, the "bits" in mashed or ground foods can block the alveoli,
> >>
> > especially
> >
> >> in small childen and potentially cause great harm. I wonder how
> >> many of
> >>
> > the
> >
> >> pneumonias that occur following the VFSS were caused by the VFSS.
> >>
> >>> Irene.
> >>>
> >>>
> >>>
> >>>
> >>>
> >>>
> >>>
> >>> Dr I Campbell-Taylor
> >>> Clinical Neuroscientist
> >>> Exclusive Distributor:
> >>> www.interactivetherapy.com
> >>> _______________________________________________
> >>> Dysphagia mailing list
> >>> Dysphagia@b9.com
> >>> http://lists.b9.com/mailman/listinfo/dysphagia
> >>>
> >>>
> >>>
> >>
> >>
> >
> >
> > _______________________________________________
> > Dysphagia mailing list
> > Dysphagia@b9.com
> > http://lists.b9.com/mailman/listinfo/dysphagia
> >
>
>
> _______________________________________________
> Dysphagia mailing list
> Dysphagia@b9.com
> http://lists.b9.com/mailman/listinfo/dysphagia
>
>
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