5 Top Tips to Thrive as an SLP in the Skilled Nursing Setting

Speech-language pathologists (SLPs) often work at skilled nursing facilities (SNFs), providing short-term rehab care and ongoing treatment for long-term care residents. Some of the SLP treatments most frequently seen in the SNF setting include care for dysphagia, cognitive-linguistic functioning, and speech-language deficits.

As a traveling speech-language pathologist, I’ve worked in more than 40 SNFs. Here, I offer my top tips to thrive as an SLP in a SNF.

1. Be Flexible

In the fast-paced medical field, things don’t always happen how or when you want them to. You need to be flexible when it comes to changing your plans and your schedule based on the needs of the people in your care.

For instance, one day you might need to reschedule a treatment time at the last minute. On another, you might need to change the plan for a treatment session to focus on cognitive instead of language goals.

Understanding this dynamic and being flexible with treatments and your schedule will help you better help those within your care.

2. Be a Team Player

SNFs are comprised of a large staff in a variety of different roles. From the dietary team to the building administrator, everyone plays an important part in keeping the facility running smoothly. Get to know not only the rehab team, but the many other teams that work in the SNF as well. Take the time to introduce yourself to the dietary department, housekeeping, and nursing staff.

Working as a team can improve overall outcomes for the people living in the facility. Plus, lending a helping hand to your coworkers will not go unnoticed, and if you need help in the future, you will be more likely to receive it.

3. Take Advantage of Continuing Education

When you work in a SNF, you provide care to a large and diverse group of people. One day you might work with a patient who has memory loss, and the next you might assist someone who has had a stroke or head and neck cancer. Keep your skills current by subscribing to educational resources like MedBridge.

It’s easy to fall into the rut of thinking you don’t have time for your continuing education, especially after a busy day. But many MedBridge courses are short, often only one to two hours, making them easy to fit in your schedule. Plus, the range of topics is so diverse that you can usually find a course to help you address a new set of needs or a particularly challenging circumstance.

Not a subscriber yet? Take a look through MedBridge’s courses on evaluation and treatment related to dysphagia, cognitive communication, and speech-language deficits. I enjoyed the courses on dysphagia evaluation and treatment, and I’ve been able to transfer the skills I learned online to my treatment sessions.

4. Create Resident-Centered Plans of Care

When you are completing an evaluation and developing a plan of care, let the residents’ goals guide your treatment. During your evaluation, make sure to find out what their goals are and continue to check in during treatment sessions. Selecting a highly motivating goal will improve participation and attention in treatment—particularly when you are working with someone who has dementia or memory loss.

As you complete tasks in treatment, let the resident know how this treatment is impacting their overall plan of care and progress toward their goals. It’s also helpful to tailor short-term goals to match the resident’s long-term goals. For instance, if the person you are treating has a long-term goal to eat steak, you can create a short-term goal of eating a moist, minced solid, like ground beef.

5. Use Your Materials to Address Multiple Goals

One of the challenges of working in a SNF is that you might not have a dedicated speech office on site or access to (or the budget for) a variety of materials. For this reason, SLPs in this setting often find themselves conducting treatment sessions in residents’ rooms or on tables in a therapy gym.

This can be addressed by gathering a (literal) handful of materials that can be easily carried with you throughout the day. These same materials can work for multiple residents and multiple goals. Workbooks, an iPad, picture cards, and decks of playing cards are all useful items that can be used to work toward a variety of goals. It’s helpful to look at your materials in advance and determine ways in which you can use the same materials to address multiple goals. Personally, I keep an aphasia workbook, deck of cards, and an iPad in my SLP toolkit when I work in the SNF setting.

Now that you know these tips, I urge you to put them into practice at your SNF. Be flexible with your schedule and take the time to introduce yourself to somebody new on the team—or take some MedBridge courses to further your clinical expertise!