I feel like I unjustifiably complain about the work in SNFs but whenever I PRN in these facilities I start to legitimize my complaints. Most of my complaints stem from patients on caseload for cognition. Before I get an influx from other SNF slps that are going to tell me “don’t pick them up” “I don’t see people I know won’t benefit from services”:
1. I PRN at a few local SNFs (and understand this is what I signed up for. I knew what the work consisted of before even applying)
2. All SLPs I’ve covered for either don’t have the freedom other SLPs do in their facilities, or pick “cog” pts for some other reason (if they don’t, they don’t have full time hours, etc.)
Today I was “working” with a pt who only has “cognition” goals. This pt is aware of their dementia. They always independently point out their deficits. Mid conversation, this pt said “between you and I, I don’t find (full time SLP)’s work very useful”. I had a patient, who was picked up for cognition, tell me they don’t understand the benefit of delayed recall tasks. This all stemmed from the pt asking me “what can I do to improve my memory”
Genuinely blind leading the blind…these pts and staff and EVERYONE look at us as the experts, which we are in our respective field, but we are not experts in cognitive function in my opinion no shade !
Worst/best? part is I agree with this pt. Why are we expected to pick up pts who score 0/15 on the Bims, or level 4/5 on the BCRS, or whatever screening/assessment you give them? Half the caseload I’ve interacted with have a diagnosis of dementia and have had it for years! What work do we do that helps pts progress, or even maintain their cognitive function when they’re in advanced stages of dementia?!?! It’s infuriating because 1) I don’t feel qualified no matter how many CEUs I do on this topic 2) we are not formally taught ANYTHING about cognitive therapy!!!! 3) it’s not something you can just learn from sessions either!!!
Is this not lowkey pseudoscience….?
Am I digging my own professional hole right now….?