A day in the life of a Speech Therapist
Kristina Brocklesby is a Speech and Language Therapist at Blackheath Brain Injury Rehabilitation Centre in London. Earlier this year, she was awarded a Huntercombe Hero Award for demonstrating professionalism, resilience and compassion when working with her patients. We caught up with Kristina to find out more about her role and the person behind it.
What does a typical day at work look like?
We assess, carry out therapy with, and support patients with their communication and swallowing difficulties and support the wider team to provide care to our patients. On admission each patient is allocated a Named Therapist. This is the therapist who will lead on assessing, planning, implementing and co-ordinating an individual patient’s therapy during their stay.
Each speech and language therapist manages their clinical and administrative time differently. We could see up to seven patients a day back-to-back, or we could see fewer patients and also carry out all the ‘extras’ which surround this, for example, setting up communication aids, providing equipment or independent therapy programmes, writing reports, completing assessment scoring, liaising with both internal and external professionals and carrying out tasks associated with our named therapist role.
Communication impairments can present in many ways and communication therapy is a broad topic. One example of intervention could be focusing on supporting an individual to produce everyday, useful words, such as “hello”, “thank you”, “cup of tea” etc to communicate their needs on the ward and with their relatives. We may do this through facilitating them to use speech, writing, gesture or communication aids – any form of communication which works for them. This is called using total communication.
If the therapy sessions are focusing on speech itself, we support the patient to say these functional words as clearly or as easily as possible. This could involve using different techniques to find the word in the lexicon or ‘mental dictionary’ as it were, formulating the word in their head, co-ordinating the muscles in their mouth and throat, and producing clear, strong sounds.
For example, we may use word-drills to support the consistent production of clear sounds. If we are working with someone with dysarthria (the umbrella term for difficulties with slurred speech), we may assess which sounds someone has difficulty producing or in which types of words and then use drills to increase muscle strength and to improve the clarity of those sounds. Word drills may include the difficult sounds in words at the beginning, middle and end and we may start with one word at a time, and then practice at sentence level to increase difficulty. If someone has a milder difficulty, we may advise strategies, such as slowing down the rate of speech or taking a breath before speaking. If someone’s difficulty is more severe, we may need to assess for the use of communication aids.
When not actively seeing patients, the Multi-Disciplinary Team (MDT) are working hard on administrative tasks and completing all of the required tasks for the Named Therapy roles. Administrative tasks may include working with each other to complete therapy reports, contacting families to increase our understanding of their relatives’ difficulties and answering any questions, attending goal review and case review meetings, and discharge planning. MDT working includes understanding each disciplines’ roles, working to achieve similar goals with patients, listening to each other and tailoring care to our patients’ needs, wants and wishes.
Other administrative tasks include attending handover, updating menus to ensure that the rest of the teams are aware of any changes made to swallowing recommendations and completing assessment forms to name a few.
What do like best about working at Huntercombe Blackheath
What I like best about working at Blackheath is joint working between therapy, medical and nursing disciplines and the caseload we work with and support here. The Speech and Language Therapy Team are very supportive of each other and we are also very appreciative of our wider team and would not be able to do our part without every other team.
The other thing I really like is that you have longer episodes of therapy with patients, so that you have more chance to see them reach their therapy goals.
How did you find out about the role?
I was here on placement from my university in 2014. I really enjoyed the placement, and when I finished, I knew that I wanted to work here! I was initially intrigued by the fact that we have Level 1 and 2a units here, which are the more specialised levels of neurorehabilitation, and that the team uses MDT assessments to measure a patient’s independence, which is what we aim for in therapy. From previous roles, I knew that I really wanted to work with neurologically impaired patients in the inpatient setting and I knew that there would be plenty of learning opportunities.
Did you get any special training?
I have a degree in Linguistics and a Master’s degree in Speech and Language Sciences. I have experience of working in lots of different neurorehabilitation settings and with different adult client groups.
What, if anything, do you find challenging in your role?
The Named Therapy role can be really stressful at times, but working in a supportive environment and being able to access resources, such as other specialist professionals, makes it easier to problem solve.
What would your number one tip for new starters be?
My top tips for new starters would be: to learn everyone’s names, take your time to settle in and remember to have “Joy in work”!
Author: Paul Chesnaye, Practice Development Nurse, Blackheath Brain Injury Rehabilitation Centre