[Dysphagia] I am fed up

[lobsterpam at aol.com (lobsterpam at aol.com)]

 My apologies to people who have tired of this topic. Clicking on by is always an option. 
 
 <<
 Let me give an analogy: you are a surgery resident, and have the choice of two surgeons to chose from to do a rotation they both have the same set of qualifications, same record of successful surgeries: surgeon A makes you feel comfortable and open to ask questions, even if they have been asked before..she will point out areas that you need to improve, doesn't hold back in terms of criticism, and never lets patient care get compromised. Surgeon A , equally well trained, tends to make you feel a little silly if there are things you ask that seem repetitive, or she's already answered them , or she can't understand why anyone would even be concerned about that. I pick surgeon A, but she's not available, I will go to surgeon B, too but I am probably going to feel less comfortable asking questions, will probably still become a well trained surgeon but enjoy the residency a lot less.
 <<
 
  Of course. But I suspect that your discomfort would only be temporary, if you were REALLY concerned about LEARNING things and doing good patient care, and less concerned about how happy, safe and comfortable you felt at the end of the day. You'd also get used to the style and develop a thicker skin. AND, you'd learn to make your points to Surgeon B in a manner that she would process. A larger point is, I think, that no one would take Surgeon B to task for knowing things that the surgical resident did not know, and for expressing dissatisfaction at that lack of knowledge. I also doubt that people would suggest that Surgeon B had something against surgical residents because she had a personality that was different from Surgeon A. And I would suspect that in time, you would learn to appreciate Surgeon B, and might, by the end of the rotation, be glad you had the experience that you did... perhaps even saying that you learned a lot more than you might have with Surgeon A because your confidence grew as you overcame difficult situations that Surgeon A would more likely have protected you from. You wouldn't fear confrontation anymore, because you'd have dealt with it in a learning environment. Of course, there are no guarantees, and this is a hypothetical. But straying from our comfort zone is the only way to EXPAND our comfort zone.
 
 <<
 Maybe because my perspective on this field of study (swallowing disorders) comes 

from the perspective of a profession that trains us in learning style and 

communication, I think its relevant to this list serve to talk about how we 

train future clinicians, and help them become life long learners.

<<

 No argument at all. But we can't always choose the personalities with whom we will interact. No one is under any obligation to be as nice to us as we think they should be. Best learn how to interact with them, since our ideal about "how" a person should present themselves is only an ideal - perhaps how WE might wish to be perceived. Anyone who has had to work for a couple YEARS at convincing a recalcitrant radiologist about the importance of an esophageal pan knows exactly the dynamic to which I refer. 
 
 Pam Smith, Ph.D.
 Bloomsburg University
 Bloomsburg, PA
 
 
 
 -----Original Message-----
 From: mbuckie at dmc.org
 To: hillivie423 at adelphia.net; lobsterpam at aol.com
 Cc: dysphagia at b9.com
 Sent: Fri, 9 Mar 2007 9:26 PM
 Subject: RE: [Dysphagia] I am fed up
 
  Pam-
I completely agree that we most always be examing why we are doing things, 
examining outcomes and practices, etc. 
 
Irene, among MANY others (Barbara Sonies, Joe Murray, Suzanne Evans Morris, 
Catriona Steele,and a bunch of other low profile people who posted to me off 
list, has contributed greatly to my knowledge base as a clinician. )Many of the 
other clinicians I have learned from aren't on the list, or don't post as often. 

I do know that I have thanked Irene when she has answered specific questions I 
have directed towards her, and I have spent money purchasing some of her 
products because I do value her knowledge base. 
 
I also have learned to use medline myself!
 
 
 
Having worked in the acute medical care setting for most of my career, I have 
developed a thick skin. I have been barked at by surgeons, nursing assistants, 
radiologists, nurses, patients and patients families. I get that. I have been 
caught in certain situations where my knowledege base has fallen short, but 
similarily, I have been in the situation where I have had a segment of knowledge 
that a prominent ENT, or a neurosurgery resident did not. 
 
Let me give an analogy: you are a surgery resident, and have the choice of  two 
surgeons to chose from to do a rotation
they both have the same set of qualifications, same record of successful 
surgeries:
surgeon a makes you feel comfortable and open to ask questions, even if they 
have been asked before..she will point out areas that you need to improve, 
doesn't hold back in terms of criticism, and never lets patient care get 
compromised
surgeon b , equally well trained, tends to make you feel a little silly if there 
are things you ask that seem repetitive, or she's already answered them , or she 
can't understand why anyone would even be concerned about that. I pick surgeon 
A, but she's not available, I will go to surgeon B, too but I am probably going 
to feel less comfortable asking questions, will probably still become a well 
trained surgeon but enjoy the residency a lot less.
 
Maybe because my perspective on this field of study (swallowing disorders) comes 
from the perspective of a profession that trains us in learning style and 
communication, I think its relevant to this list serve to talk about how we 
train future clinicians, and help them become life long learners.
 
Marcia
 
 
 
 
 
 
 
 

    -----Original Message----- 
    From: dysphagia-bounces at b9.com on behalf of hillivie423 at adelphia.net 
    Sent: Thu 3/8/2007 8:19 AM 
    To: lobsterpam at aol.com 
    Cc: dysphagia at b9.com 
    Subject: Re: [Dysphagia] I am fed up
    
    

    Well said, Pam!
    ---- lobsterpam at aol.com wrote:
    >   This isn't directed at the 'introductory course' topic specifically, but 
is a more global comment simply offered for consideration. My thoughts on the 
introductory course is that if someone needs the training, go get it. But 
recognize the larger less personal point that dysphagia education in our 
profession in general needs work. Those of us in universities know that and are 
we working hard to improve it. The ASHA Knowledge and Skills documents speak for 
themselves, and Division 13 has many excellent resources available for members.
    > 
    >  That said, I think it's very unhealthy for professionals - or members of 
a professional discussion lists - to stop questioning the practices of the 
profession. NO profession improves unless it is constantly examining itself. The 
whole concept of evidence based practice requires continual objective evaluation 
of the evidence supposedly supporting what we do. If list serve participants 
only wish to support each other with "atta boy!" comments, no one grows as a 
professional. Would we rather have an attorney ask some of the questions that 
are asked here? How do you feel when a smart and savvy family member questions 
what you are doing? Or when a physician won't order your services? In the 
litigious society in which we find ourselves, it's best we get used to people 
asking us the "why" questions about our field, and be prepared to state 
objectively and from an evidence base - not defensively - why we are doing what 
we are doing.
    > 
    >  The management of patients with dysphagia is a multidisciplinary field, 
and any SLP who believes he or she can do it himself/herself has a lot of 
reading to do and additional academic degrees to obtain. A discussion list that 
welcomes the contributions of other professionals only helps us to appreciate 
what these other professionals know. If we are intimidated by that, nothing is 
gained by telling these people to get out of our sandbox. Have the people who 
find themselves angry ever located and read the information Irene has posted? A 
number of years ago I argued openly on this list with Irene, and her tone was 
directed right at me, and of course I didn't appreciate it. Then I finally read 
the literature that was posted (Irene was the first one who I had ever heard of 
mentioning the contribution of reflux or oral secretions to pneumonia, and I'd 
been practicing for close to 10 years at that point.)
    > 
    >  Individuals have their own manner of conveying their thoughts; some 
people just don't sugarcoat things. The written word doesn't provide the 
complete pragmatic. That's a limitation of email communication and it needs to 
be accepted if one is going to use this medium. Sure, people could be nicer, but 
I remember a colleague who could be nicer, too. It's a shame if people choose 
not to interact because of personality differences. Wasn't it Eleanor Roosevelt 
who said no one can make you feel inferior without your consent? Anyway, 
eventually I realized that my angst wasn't really about Irene. It was easy to 
blame this person who was faceless and only showed up in my email inbox with 
abstracts that showed she had a lot of information at her fingertips that I 
didn't have, and who wrote things in a way that made me realize that I was 
missing some very basic information that I SHOULD know. There are and were 
choices here - to get angry and defensive, or to suck it up and learn thi!
     ng!
    >  s. My issues were that I knew practically nothing about lab values, 
dietary requirements, respiratory physiology or infectious diseases, and yet 
here I was working with patients with these very problems. My issues were coming 
to terms with the fact that some of the interventions I had been doing for years 
had the potential to do as much harm as the underlying problem I was trying to 
help.
    > 
    >  Whenever students ask me about why practices are so inconsistent, and why 
they must continue to read research and understand evidence when they are 
finished with school, I tell them that not so many hundred years ago, doctors 
used to bleed people to cure them of disease, and that's what killed George 
Washington. Someone questioned the practice, and someone had to be the first to 
suggest that maybe bloodletting wasn't the best way to go.
    > 
    >  Working in health care requires a knowledge base, an inquisitive open 
mind, access to information, and a thick skin.
    > 
    >  Pam Smith, Ph.D.
    >  Bloomsburg University
    >  Bloomsburg, PA
    > 
    >    
    >  -----Original Message-----
    >  From: cohoe at uci.net
    >  To: vickycox at yahoo.ca; dysphagia at b9.com
    >  Sent: Wed, 7 Mar 2007 11:52 PM
    >  Subject: Re: [Dysphagia] I am fed up
    > 
    >   I vote for a kindler, gentler listserve as well.  Can we stop wit the
    > questioning of others and simply be supportive?  If we fear posting for 
the
    > ridicule of one member we allow her to win.  Let's ask those beginner
    > questions and let's advertise those courses.  This listserve is for SLP's;
    > let's take it back.
    >
    > -----Original Message-----
    > From: dysphagia-bounces at b9.com [mailto:dysphagia-bounces at b9.com] On Behalf
    > Of Vicky Cox
    > Sent: Wednesday, March 07, 2007 7:42 PM
    > To: dysphagia at b9.com
    > Subject: [Dysphagia] I am fed up
    >
    > Hello all,
    >
    >   I am an SLP and proud to say that I am attending "beginner" workshops 
even
    > though I have been practising for a long time. I suppose I never think I 
am
    > a perfect SLP, and guess what, I may even learn something from the new
    > grads, who as someone put it, should already know everything form their
    > masters program.
    >
    >   I posted a question a few years back when I was a new grad, and a
    > particular person posted a reply and made me look like a total idiot (the
    > same person who normally does this). I feel saddened to say that I have 
been
    > afraid of posting since then. But reading all of these replies, I am glad
    > that others can see how toxic this list serve can be.
    >
    >   Its a shame really, because there are some really great SLPs who post 
here
    > (all in fact), and I am sorry I had such a bad experience in the past.
    >
    >   Thanks,
    >   Vicky
    >
    >
    > ---------------------------------
    > Make free worldwide PC-to-PC calls. Try the new Yahoo! Canada Messenger 
with
    > Voice _______________________________________________
    > Dysphagia mail list: Normal and disordered swallowing information
    > Dysphagia at b9.com Manage subscription:
    > http://lists.b9.com/mailman/listinfo/dysphagia
    > Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
    >
    >
    >
    >
    > _______________________________________________
    > Dysphagia mail list: Normal and disordered swallowing information
    > Dysphagia at b9.com
    > Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
    > Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
    >   
    > ________________________________________________________________________
    > AOL now offers free email to everyone.  Find out more about what's free 
from AOL at AOL.com.
    > _______________________________________________
    > Dysphagia mail list: Normal and disordered swallowing information
    > Dysphagia at b9.com
    > Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
    > Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
    
    _______________________________________________
    Dysphagia mail list: Normal and disordered swallowing information
    Dysphagia at b9.com
    Manage subscription: http://lists.b9.com/mailman/listinfo/dysphagia
    Visit the new Dysphagia Web Forum: http://dysphagia.com/forum
    

   
________________________________________________________________________
AOL now offers free email to everyone.  Find out more about what's free from AOL at AOL.com.