[Dysphagia] Options as dsphagia specialists

[gjackson at rochester.rr.com (gerriann jackson)]

Donna,
Your correction does make a difference to the tone of the email.  The skin care issue is another thing.  I am part of the skin care management team at my hospital since malutrition and dehydration play important roles in healing. Out of that participation came a wonderful oral care policy that is now part of the pathway for anyone with dysphagia or who may be NPO for any other reason and now that the docs are familiar with the protocol, they ask for it when they don't like the looks of their patients' oral cavities!!  We are important to the overall well-being of the patients in our facilities.  In the case of a patient with skin breakdown, if the SLP in question documented her participation, i.e. swallow abilities, recs for AHN when necessary, she should not have a problem.

As for the CFY, she needs supervision, yes?  So it would up to the person who was supervising her as to how frequent and hands on that supervision needs to be.  I cannot imagine too many clinical supervisors who would want to risk their licenses by leaving a clinical fellow without sufficient supervision in a risky situation.  It is the supervisor who's license is at risk.

Gerriann 

-----Original Message-----
From: donna w [mailto:lovdatsoap at gmail.com]
Sent: Saturday, August 25, 2007 4:22 PM
To: gerriann jackson
Subject: Re: [Dysphagia] Options as dsphagia specialists


I sent a correction and an apology  to the post since I am an awful
typist I left off the phrase
responsible  for the prevention of deterioration

 The care plans in SNFs now have us as perceiveded responsible for the
prevention of many systems including  skin/wound ( dehydration)
   A FL SLP mentioned that some SLP had gotten caught up in a wound
skin lawsuit and they thought she should be listed as one of those who
should have been more active in its prevention  -crazy

  It is just that our list is for swallowing and it has a lOT of
complex presentations that  need more than one head  at times to
puzzle it all out
 I just think that many contract positions are solo and a CFY can get
over their head with complex swallowing pts in any setting and need
the benfiet of more experienced staff to bounce thoughts off of ( as
do we all) and help in the many grey areas in swallowing
I know many fine SLPs in SNFs and they have a hard job with complex
pts with multiple diagnoses that change rapidly  I just think a CFY
has lots of time before they go off by themself in a facility  and
many employers are not going to look out for their best interests( as
evidenced by that job offer ) There are too many good places to earn a
living to put up with that type of an offer
For some reason it has not posted my correction
Donna