1 00:00:12,275 --> 00:00:14,514 Welcome to the Swall Your Pride podcast. I'm 2 00:00:14,514 --> 00:00:16,835 your host, Theresa Richard. I'm a board certified 3 00:00:16,835 --> 00:00:18,934 specialist in swallowing and swallowing disorders, 4 00:00:19,314 --> 00:00:21,554 a mobile thieves business owner, and founder of 5 00:00:21,554 --> 00:00:22,934 the MedSLP Collective. 6 00:00:23,394 --> 00:00:25,474 This podcast is all about delivering the latest 7 00:00:25,474 --> 00:00:28,199 evidence based practice to medical SLPs everywhere. 8 00:00:28,579 --> 00:00:30,980 Whether you're a new clinician seeking tangible tools 9 00:00:30,980 --> 00:00:33,059 for treatment or a seasoned vet stuck in 10 00:00:33,059 --> 00:00:34,979 a rut, my goal is to help ditch 11 00:00:34,979 --> 00:00:36,659 the old school ways of the past that 12 00:00:36,659 --> 00:00:38,899 no longer serve you or your patients, to 13 00:00:38,899 --> 00:00:41,299 reinvigorate your passion for our field, to broaden 14 00:00:41,299 --> 00:00:43,365 your knowledge about our scope of practice, and 15 00:00:43,365 --> 00:00:45,125 to inspire you to practice at the top 16 00:00:45,125 --> 00:00:47,284 of your license. So if you're listening, I 17 00:00:47,284 --> 00:00:49,604 encourage you to swallow your pride, be open 18 00:00:49,604 --> 00:00:51,685 and willing to learn because let's face it, 19 00:00:51,685 --> 00:00:54,325 your patients deserve that kind of care. With 20 00:00:54,325 --> 00:00:56,104 that, let's dive right in. 21 00:00:56,645 --> 00:00:57,465 Just a quick 22 00:00:58,710 --> 00:01:00,479 disclaimer that all statements and opinions expressed in 23 00:01:00,479 --> 00:01:02,309 this episode do not reflect on the organizations 24 00:01:02,309 --> 00:01:04,790 associated with the speakers and are their own 25 00:01:04,790 --> 00:01:05,689 opinions solely. 26 00:01:06,149 --> 00:01:07,290 Hello, my friends. 27 00:01:07,670 --> 00:01:09,590 It is me, Teresa Richard. I am back 28 00:01:09,590 --> 00:01:12,694 with another solo episode today. So hope you 29 00:01:12,694 --> 00:01:14,135 don't mind that I'm hogging the mic all 30 00:01:14,135 --> 00:01:15,114 to myself today. 31 00:01:15,655 --> 00:01:16,855 But wanted to get a few of these 32 00:01:16,855 --> 00:01:19,015 solo episodes out before we have some amazing 33 00:01:19,015 --> 00:01:20,775 guests coming up in the next few weeks 34 00:01:20,775 --> 00:01:23,674 that I'm really excited about. But I recently, 35 00:01:24,135 --> 00:01:26,540 took a trip to Hawaii. I was asked 36 00:01:26,540 --> 00:01:28,939 to come out and do fees training for 37 00:01:28,939 --> 00:01:31,979 a hospital group out there, and there are 38 00:01:31,979 --> 00:01:34,299 so many insights, so many lessons that I 39 00:01:34,299 --> 00:01:34,799 learned 40 00:01:35,180 --> 00:01:37,500 from a professional level, from a personal level, 41 00:01:37,500 --> 00:01:39,019 and it was just it was such a 42 00:01:39,019 --> 00:01:41,935 rich learning experience that I have a lot 43 00:01:41,935 --> 00:01:43,295 that I wanna come back and share with 44 00:01:43,295 --> 00:01:45,454 you. So I'll share a little bit of 45 00:01:45,454 --> 00:01:47,854 the logistics first because, you know, that's the 46 00:01:47,854 --> 00:01:50,174 important stuff, and then I'll share some of 47 00:01:50,174 --> 00:01:52,510 the insights that still you know, it's been 48 00:01:52,510 --> 00:01:53,709 a few months since I did this trip 49 00:01:53,709 --> 00:01:54,930 that I think about 50 00:01:55,310 --> 00:01:56,750 so, so, so often. And I think about 51 00:01:56,750 --> 00:01:58,829 this a lot with patients that I work 52 00:01:58,829 --> 00:02:00,129 with, with situations 53 00:02:00,430 --> 00:02:01,969 that I have with my son. 54 00:02:02,510 --> 00:02:03,010 And 55 00:02:03,390 --> 00:02:05,325 yeah. So I'm I'm excited to dive into 56 00:02:05,325 --> 00:02:07,724 this stuff. Let me rewind. I again, as 57 00:02:07,724 --> 00:02:09,164 I said, I was asked to come out 58 00:02:09,164 --> 00:02:11,805 and do fees training for a hospital system 59 00:02:11,805 --> 00:02:13,564 in Hawaii. And the way that they had 60 00:02:13,564 --> 00:02:15,004 set this up was, gosh, I think it 61 00:02:15,004 --> 00:02:17,084 took them I'm I'm not even joking when 62 00:02:17,084 --> 00:02:18,705 I say probably two to three years. 63 00:02:19,139 --> 00:02:21,379 And and if I'm off on that Hawaii 64 00:02:21,379 --> 00:02:23,379 system, I apologize. But that was what I 65 00:02:23,379 --> 00:02:25,219 was informed, was that it took about two 66 00:02:25,219 --> 00:02:26,680 to three years for them to 67 00:02:27,139 --> 00:02:29,219 start to get the the budgeting and start 68 00:02:29,219 --> 00:02:31,060 to get all of the pieces in place 69 00:02:31,060 --> 00:02:32,840 for this training to take place. 70 00:02:33,354 --> 00:02:36,155 And I just wanna first commend, there was, 71 00:02:36,794 --> 00:02:38,715 a few different hospitals that were involved in 72 00:02:38,715 --> 00:02:40,574 this, but there was two main hospitals, 73 00:02:41,034 --> 00:02:43,455 and both of their directors of rehab 74 00:02:43,754 --> 00:02:44,254 were 75 00:02:44,555 --> 00:02:45,055 incredible 76 00:02:45,435 --> 00:02:45,935 champions 77 00:02:46,314 --> 00:02:48,870 for bringing fees in. And neither of them 78 00:02:48,870 --> 00:02:49,610 were SLPs. 79 00:02:49,909 --> 00:02:52,069 But I wanna give the SLPs so much 80 00:02:52,069 --> 00:02:53,290 props for 81 00:02:53,669 --> 00:02:56,310 continuing to advocate for why they needed fees 82 00:02:56,310 --> 00:02:59,030 in these hospitals in Hawaii. So all that 83 00:02:59,030 --> 00:03:00,469 to say, thank you so much to these 84 00:03:00,469 --> 00:03:01,930 two DORs who 85 00:03:02,385 --> 00:03:04,485 were just incredible advocates, 86 00:03:05,185 --> 00:03:07,985 and they helped make this training they they 87 00:03:07,985 --> 00:03:10,305 were what made this training successful. All that 88 00:03:10,305 --> 00:03:12,324 to say, they were the middle women 89 00:03:12,705 --> 00:03:15,264 between all the SLPs and all of the 90 00:03:15,264 --> 00:03:15,764 administrators. 91 00:03:16,349 --> 00:03:18,270 And going to all these budget meetings and 92 00:03:18,270 --> 00:03:19,889 going to all these compliance meetings 93 00:03:20,349 --> 00:03:22,590 and figuring out, you know, how and and 94 00:03:22,590 --> 00:03:24,830 talking with SPD, and they were the ones 95 00:03:24,830 --> 00:03:26,669 that really put all of these pieces in 96 00:03:26,669 --> 00:03:27,169 place. 97 00:03:27,629 --> 00:03:29,550 And so I think if you're thinking about 98 00:03:29,550 --> 00:03:32,185 getting fees training or or getting fees brought 99 00:03:32,185 --> 00:03:33,245 into your hospital, 100 00:03:33,544 --> 00:03:35,544 there's so many steps. There's so many things 101 00:03:35,544 --> 00:03:36,764 that have to take place 102 00:03:37,064 --> 00:03:39,485 when you do that. So getting a champion 103 00:03:39,544 --> 00:03:41,784 in your hospital, whether it's your DOR or 104 00:03:41,784 --> 00:03:44,580 whether it's infection control or whether it's someone 105 00:03:44,580 --> 00:03:46,659 in IT who can, you know, help get 106 00:03:46,659 --> 00:03:48,900 the the software uploaded because that was another 107 00:03:48,900 --> 00:03:50,900 big thing that had to happen too. There's 108 00:03:50,900 --> 00:03:52,180 a lot of pieces that have to go 109 00:03:52,180 --> 00:03:53,620 into it. So the more I think you 110 00:03:53,620 --> 00:03:55,300 know about that in the future, the less 111 00:03:55,300 --> 00:03:56,040 curve balls 112 00:03:56,564 --> 00:03:58,724 there will be when it's go time. And 113 00:03:58,724 --> 00:04:01,064 I think that's something that this hospital did 114 00:04:01,525 --> 00:04:03,604 such a great job of. When I got 115 00:04:03,604 --> 00:04:06,485 on-site, SPD was totally familiar. You know, they 116 00:04:06,485 --> 00:04:08,004 they knew this was coming. Right? You know, 117 00:04:08,004 --> 00:04:09,525 they didn't know exactly what it was gonna 118 00:04:09,525 --> 00:04:11,259 look like, but they knew this was coming. 119 00:04:11,259 --> 00:04:13,599 They were prepared for it. Same with IT. 120 00:04:13,979 --> 00:04:15,500 We had a few different scopes, a few 121 00:04:15,500 --> 00:04:18,459 different software systems. They were prepared. They were 122 00:04:18,459 --> 00:04:20,939 on-site. They were able to help. So it 123 00:04:20,939 --> 00:04:23,339 was I just I can't say enough good 124 00:04:23,339 --> 00:04:25,935 things about how smoothly this training went, 125 00:04:26,415 --> 00:04:28,435 and that is all because of the preparation 126 00:04:28,814 --> 00:04:31,935 that the DORs put into this. That is 127 00:04:31,935 --> 00:04:34,735 all attributed to what the SLPs did to 128 00:04:34,735 --> 00:04:36,975 prepare them for everything. So that being said, 129 00:04:36,975 --> 00:04:38,790 the way that it worked was I flew 130 00:04:38,790 --> 00:04:40,810 out gosh. I flew out on a Thursday, 131 00:04:40,870 --> 00:04:42,870 so I had Friday to recover from jet 132 00:04:42,870 --> 00:04:44,629 lag. Thank goodness. And then I taught the 133 00:04:44,629 --> 00:04:47,689 two day basic course over Saturday and Sunday. 134 00:04:48,069 --> 00:04:50,709 So I I'm I can't remember how many 135 00:04:50,709 --> 00:04:52,230 of the USLPs were in the room with 136 00:04:52,230 --> 00:04:52,629 me. Gosh. 137 00:04:53,675 --> 00:04:55,115 But I I but we were all sitting 138 00:04:55,115 --> 00:04:56,394 at a conference table. I wanna say maybe 139 00:04:56,394 --> 00:04:57,995 there was six six or seven. We sat 140 00:04:57,995 --> 00:04:59,675 at a conference table, and I delivered the 141 00:04:59,675 --> 00:05:01,915 entire two day basic course over the span 142 00:05:01,915 --> 00:05:03,355 of the two days, the Saturday and the 143 00:05:03,355 --> 00:05:06,175 Sunday. And what was nice about having twofold. 144 00:05:06,394 --> 00:05:08,160 What What was nice about having a small 145 00:05:08,160 --> 00:05:10,420 intimate group from the same hospital 146 00:05:10,960 --> 00:05:12,259 is that we could troubleshoot 147 00:05:12,639 --> 00:05:14,100 their hospital issues 148 00:05:14,480 --> 00:05:16,759 as they were learning things about fees. So 149 00:05:16,759 --> 00:05:18,160 a lot of times, like, I've taught a 150 00:05:18,160 --> 00:05:19,920 few of these I've taught a lot of 151 00:05:19,920 --> 00:05:23,024 these fees courses before, and sometimes you just 152 00:05:23,024 --> 00:05:25,425 have to teach broadly. You know, sometimes you 153 00:05:25,425 --> 00:05:27,345 have SLPs that are in private practice or 154 00:05:27,345 --> 00:05:29,504 SLPs that do outpatient fees or SLPs that 155 00:05:29,504 --> 00:05:30,805 work in sniffs or outpatients 156 00:05:31,185 --> 00:05:33,264 or SLPs that work in hospitals. And the, 157 00:05:33,264 --> 00:05:35,985 you know, regulation's different, the billing's different, the 158 00:05:35,985 --> 00:05:38,639 cleaning's different, the report writing's different. So in 159 00:05:38,639 --> 00:05:41,040 in those trainings, just the teacher has to 160 00:05:41,040 --> 00:05:44,560 teach generally broadly. Right? What was awesome, awesome, 161 00:05:44,560 --> 00:05:47,840 awesome about having this tailored hospital system was 162 00:05:47,840 --> 00:05:49,360 it was just so streamlined. So I was 163 00:05:49,360 --> 00:05:50,985 able to just if there was some stuff 164 00:05:50,985 --> 00:05:52,185 that didn't apply, I would just tell them 165 00:05:52,185 --> 00:05:53,785 this doesn't apply. If there was something that 166 00:05:53,785 --> 00:05:57,225 was very pertinent to the ICU, specifically, this 167 00:05:57,225 --> 00:05:58,105 hospital had, 168 00:05:58,665 --> 00:06:00,504 had a very intensive burn unit. So we 169 00:06:00,504 --> 00:06:02,105 spent a lot of time talking about that. 170 00:06:02,105 --> 00:06:03,785 So it was I really, really like that 171 00:06:03,785 --> 00:06:05,560 we were able to just get to the 172 00:06:05,560 --> 00:06:07,560 details, and we got into a lot of 173 00:06:07,560 --> 00:06:09,240 details. So that being said, on the second 174 00:06:09,240 --> 00:06:10,759 day, which is Sunday, which if you take 175 00:06:10,759 --> 00:06:13,240 a basic fees course, usually, you know, Saturday 176 00:06:13,240 --> 00:06:15,079 is all day instruction, and then usually maybe, 177 00:06:15,079 --> 00:06:16,919 like, Sunday morning is more instruction, and then 178 00:06:16,919 --> 00:06:19,500 Sunday afternoon should be getting tons of passes. 179 00:06:19,835 --> 00:06:22,875 And this is where I'm very, very, very 180 00:06:22,875 --> 00:06:25,035 opinionated. And I will go on record and 181 00:06:25,035 --> 00:06:26,955 say all of this stuff because I I 182 00:06:26,955 --> 00:06:29,514 feel so, so, so strongly about this. I 183 00:06:29,514 --> 00:06:30,895 made all of the SLPs 184 00:06:31,355 --> 00:06:34,600 do their first passes on pool noodles, and 185 00:06:34,600 --> 00:06:37,160 that's for a few reasons. Number one, I 186 00:06:37,160 --> 00:06:39,580 cannot tell you the amount of SLPs 187 00:06:39,959 --> 00:06:42,839 and or fees courses that I have gone 188 00:06:42,839 --> 00:06:45,399 to where the first time an SLP picks 189 00:06:45,399 --> 00:06:47,544 up a scope, they stick it in someone's 190 00:06:47,604 --> 00:06:50,004 nose. They don't know what they're doing. They 191 00:06:50,004 --> 00:06:51,685 don't have a handle on the scope. They 192 00:06:51,685 --> 00:06:53,685 know nothing about the body mechanics. They know 193 00:06:53,685 --> 00:06:56,084 nothing about what the scope does. They know 194 00:06:56,084 --> 00:06:58,004 nothing about any of this stuff. They ram 195 00:06:58,004 --> 00:07:00,004 it in their colleague's nose. The colleague is 196 00:07:00,004 --> 00:07:02,379 in pain. And now the SLP says, crap. 197 00:07:02,379 --> 00:07:03,740 This is painful. I don't wanna do this 198 00:07:03,740 --> 00:07:06,540 procedure anymore. And I've seen this happen so 199 00:07:06,540 --> 00:07:08,220 many times, and this is why I am 200 00:07:08,220 --> 00:07:10,379 so passionate about this. So those of you 201 00:07:10,379 --> 00:07:13,579 that are fees, teachers, fees, educators, I implore 202 00:07:13,579 --> 00:07:16,035 you. I beg of you. Like, do not 203 00:07:16,035 --> 00:07:18,435 make your patients blindly pick up a scope 204 00:07:18,435 --> 00:07:20,035 on their first time with a scope in 205 00:07:20,035 --> 00:07:22,514 their hand and go go jab a colleague. 206 00:07:22,514 --> 00:07:25,555 Like, that's just it's it perpetuates. I I 207 00:07:25,555 --> 00:07:27,355 I firmly believe because I've also heard this 208 00:07:27,355 --> 00:07:30,675 as well. I've had SLPs in other basic 209 00:07:30,675 --> 00:07:32,729 fees courses that have come back to take 210 00:07:32,729 --> 00:07:34,729 fees again maybe two, three two, three years 211 00:07:34,729 --> 00:07:35,229 later 212 00:07:35,610 --> 00:07:37,209 because the first one they were in, they 213 00:07:37,209 --> 00:07:38,729 said they felt so bad that they hurt 214 00:07:38,729 --> 00:07:39,389 the SLP 215 00:07:39,689 --> 00:07:41,289 that they just didn't wanna do it. And 216 00:07:41,289 --> 00:07:43,365 now their hospital's making them do it again. 217 00:07:43,524 --> 00:07:45,044 And that's not what this is about, you 218 00:07:45,044 --> 00:07:47,944 guys. Fees is an incredible, incredible, incredible tool 219 00:07:48,724 --> 00:07:51,764 that can help so many patients. There are 220 00:07:51,764 --> 00:07:53,044 so many things we can do with this 221 00:07:53,044 --> 00:07:55,785 tool. There's so many patients in rural hospitals, 222 00:07:55,925 --> 00:07:58,404 in in low accessible places that we can 223 00:07:58,404 --> 00:08:00,610 help swallow and gain back quality of life 224 00:08:00,610 --> 00:08:02,129 with this tool. And that is why I 225 00:08:02,129 --> 00:08:04,290 am so incredibly passionate about this, and I'm 226 00:08:04,290 --> 00:08:06,449 so incredibly passionate about fees, but also making 227 00:08:06,449 --> 00:08:08,710 sure that we're teaching and supporting our SLPs 228 00:08:09,490 --> 00:08:12,230 best so that they feel truly feel comfortable 229 00:08:12,610 --> 00:08:13,430 doing fees. 230 00:08:13,735 --> 00:08:15,495 And that is by making sure that their 231 00:08:15,495 --> 00:08:17,175 patients are comfortable as well. And we're gonna 232 00:08:17,175 --> 00:08:18,775 talk a lot about that later on in 233 00:08:18,775 --> 00:08:21,095 the episode. I've got lots of research articles 234 00:08:21,095 --> 00:08:22,615 that I'm gonna cite as well, and this 235 00:08:22,615 --> 00:08:24,295 is actually a presentation I'm doing at ASHA 236 00:08:24,375 --> 00:08:25,355 the ASHA convention, 237 00:08:25,735 --> 00:08:27,520 coming up this year, and it's also part 238 00:08:27,520 --> 00:08:28,419 of my dissertation. 239 00:08:28,959 --> 00:08:30,319 And I'm hoping to finish up in the 240 00:08:30,319 --> 00:08:32,080 next few months as well. So there's a 241 00:08:32,080 --> 00:08:33,679 lot a lot lot to this, and it 242 00:08:33,679 --> 00:08:35,839 comes from just years and years of experience 243 00:08:35,839 --> 00:08:37,299 and years and years of passion 244 00:08:37,679 --> 00:08:39,919 trying to make sure that SLPs SLPs feel 245 00:08:39,919 --> 00:08:41,985 comfortable and supported in doing this. So that 246 00:08:41,985 --> 00:08:44,225 being said, let me rewind. So I had 247 00:08:44,225 --> 00:08:46,565 them do their first passes on pool noodles, 248 00:08:46,625 --> 00:08:48,384 and it was so you know, it's eye 249 00:08:48,384 --> 00:08:50,065 opening. They and I tell them, you guys, 250 00:08:50,065 --> 00:08:51,904 like, I know you think I'm nuts. Like, 251 00:08:51,904 --> 00:08:54,160 I know this seems very silly, but I 252 00:08:54,160 --> 00:08:56,720 assure you this this it will help. And 253 00:08:56,720 --> 00:08:58,559 and, actually, we didn't have pool noodles the 254 00:08:58,559 --> 00:09:00,799 one day. So I literally just folded like, 255 00:09:00,799 --> 00:09:03,040 rolled up a manila folder so that it 256 00:09:03,040 --> 00:09:05,360 just had, like, a an opening a small 257 00:09:05,360 --> 00:09:07,120 opening, and that's all we did. We just 258 00:09:07,120 --> 00:09:10,345 practice passing the scope, practice manipulating the throttle, 259 00:09:10,644 --> 00:09:12,504 practice moving your wrist 260 00:09:12,884 --> 00:09:15,845 up forward, left, right, noticing what that does 261 00:09:15,845 --> 00:09:17,924 on the camera. Then we added some fun 262 00:09:17,924 --> 00:09:19,764 things inside the pool noodle and inside the 263 00:09:19,764 --> 00:09:21,409 middle of folder. Like, you know, I found 264 00:09:21,409 --> 00:09:23,570 some buttons and some gems. I just whatever 265 00:09:23,570 --> 00:09:25,649 you guys can find around this conference center 266 00:09:25,649 --> 00:09:27,409 or and they found some stuff in some 267 00:09:27,409 --> 00:09:29,329 other office in the hospital, and we glued 268 00:09:29,329 --> 00:09:31,009 them onto these middle of folders on the 269 00:09:31,009 --> 00:09:33,829 inside. So, basically, they could practice navigating 270 00:09:34,129 --> 00:09:37,165 around these objects that we placed inside this 271 00:09:37,165 --> 00:09:39,404 folder. And that's how you what you have 272 00:09:39,404 --> 00:09:40,845 to do when you're putting a scope in 273 00:09:40,845 --> 00:09:42,924 a patient's nose. You have to manipulate around 274 00:09:42,924 --> 00:09:45,965 the turbinates, and sometimes patients have swelling and 275 00:09:45,965 --> 00:09:48,529 there's gunk in there, and sometimes there's expressences 276 00:09:48,669 --> 00:09:50,350 and polyps, and it's it can be a 277 00:09:50,350 --> 00:09:51,949 mess in there. And you have to learn. 278 00:09:51,949 --> 00:09:53,970 You have to feel confident with the scope, 279 00:09:54,190 --> 00:09:56,209 and you have to be comfortable and confident 280 00:09:56,269 --> 00:09:58,829 navigating that patient's nose. If you're not comfortable 281 00:09:58,829 --> 00:10:01,784 and confident, if you're hurting them, if if 282 00:10:01,865 --> 00:10:04,105 you don't seem like you're comfortable and confident, 283 00:10:04,105 --> 00:10:06,024 it's going to be apparent to the patient, 284 00:10:06,024 --> 00:10:07,304 and they are not going to want to 285 00:10:07,304 --> 00:10:07,804 participate. 286 00:10:08,184 --> 00:10:09,384 And then you are going to say the 287 00:10:09,384 --> 00:10:11,625 patient didn't participate, and you didn't get good 288 00:10:11,625 --> 00:10:13,065 results. And now you're going to say these 289 00:10:13,065 --> 00:10:14,264 fees did not work, and it was a 290 00:10:14,264 --> 00:10:15,725 fail. And this is the 291 00:10:16,139 --> 00:10:17,920 exact thing that I am on a mission 292 00:10:18,139 --> 00:10:20,779 to prevent from happening. So that being said, 293 00:10:20,779 --> 00:10:22,139 we spent a lot of time, like I 294 00:10:22,139 --> 00:10:24,940 said, you know, scoping pool noodles and and 295 00:10:24,940 --> 00:10:27,259 manila folders. And I just said, we will 296 00:10:27,259 --> 00:10:29,340 not practice on each other, you guys, until 297 00:10:29,340 --> 00:10:31,274 you feel so comfortable with this scope. And 298 00:10:31,274 --> 00:10:32,675 I and I honestly don't even remember how 299 00:10:32,675 --> 00:10:34,675 long it took, but it was it was 300 00:10:34,675 --> 00:10:36,754 a learning curve. And it's something that I'm 301 00:10:36,754 --> 00:10:38,595 really passionate about, and and I know that 302 00:10:38,595 --> 00:10:40,115 there's a lot of instructors that do scope 303 00:10:40,115 --> 00:10:42,514 with the pool noodle first, but give build 304 00:10:42,514 --> 00:10:44,675 your SLPs confidence. Like, don't throw them to 305 00:10:44,675 --> 00:10:46,274 the wolves and have them go jab their 306 00:10:46,274 --> 00:10:47,610 friend in the nose the first time. Like, 307 00:10:47,610 --> 00:10:49,289 that's not fun for anybody. Like I said, 308 00:10:49,289 --> 00:10:50,410 we did that till they were good and 309 00:10:50,410 --> 00:10:53,370 comfortable, then they practiced on each other. That's, 310 00:10:53,370 --> 00:10:54,889 like I said, that's the first thing that 311 00:10:54,889 --> 00:10:57,210 I'm very passionate about is making sure that 312 00:10:57,210 --> 00:10:59,690 they feel confident manipulating the scope. The other 313 00:10:59,690 --> 00:11:01,450 thing that I'm very passionate about is the 314 00:11:01,450 --> 00:11:04,014 language that we use when we introduce the 315 00:11:04,014 --> 00:11:05,455 scope to our patient. Like I said, I'm 316 00:11:05,455 --> 00:11:07,295 gonna talk about a few research studies in 317 00:11:07,295 --> 00:11:09,134 a little bit. But let let's just talk 318 00:11:09,134 --> 00:11:10,894 about common sense. Right? If if you approach 319 00:11:10,894 --> 00:11:13,134 a patient and you say, I'm going to 320 00:11:13,134 --> 00:11:15,134 stick the scope in your nose. It's going 321 00:11:15,134 --> 00:11:17,680 to be painful. It's going to hurt. I'm 322 00:11:17,680 --> 00:11:19,360 not really sure what I'm doing. I'm just 323 00:11:19,360 --> 00:11:20,480 gonna try to get it in the right 324 00:11:20,480 --> 00:11:21,840 spot, and then I'm gonna give you some 325 00:11:21,840 --> 00:11:23,519 food and drink. How do you think that's 326 00:11:23,519 --> 00:11:24,960 going to go? How do you think that's 327 00:11:24,960 --> 00:11:26,639 going to go? Right? And and I get 328 00:11:26,639 --> 00:11:29,040 that I over exaggerated there. Right? But I 329 00:11:29,040 --> 00:11:31,680 have heard SLPs go up to patients before 330 00:11:31,680 --> 00:11:33,375 and say, I'm gonna put this scope in 331 00:11:33,375 --> 00:11:35,134 your nose. It's gonna hurt. It's gonna be 332 00:11:35,134 --> 00:11:37,615 painful. I'm sorry. I'm doing my best. And 333 00:11:37,615 --> 00:11:38,894 when you say that, what do you how 334 00:11:38,894 --> 00:11:40,574 do you think the patient's gonna feel? Right? 335 00:11:40,574 --> 00:11:42,735 You instantly elevate their anxiety. They're not excited 336 00:11:42,735 --> 00:11:44,174 to be there in the first place. Their 337 00:11:44,174 --> 00:11:46,059 anxiety is already high. They're getting a scope 338 00:11:46,059 --> 00:11:47,500 getting put in their nose probably puts their 339 00:11:47,500 --> 00:11:49,659 anxiety even higher. And now you're telling them 340 00:11:49,659 --> 00:11:51,579 how painful and how comfortable it's gonna be. 341 00:11:51,579 --> 00:11:53,259 You're lucky if they sit for the study. 342 00:11:53,259 --> 00:11:55,179 Right? So let's think about how we approach 343 00:11:55,179 --> 00:11:57,279 our patients in this way. And 344 00:11:57,954 --> 00:11:59,475 this is why I want you to get 345 00:11:59,475 --> 00:12:02,375 so comfortable and confident in manipulating the scope 346 00:12:02,514 --> 00:12:04,834 so that you can feel confident when you 347 00:12:04,834 --> 00:12:06,754 tell the patient, hey. I'm gonna stick this 348 00:12:06,754 --> 00:12:08,514 scope in your nose. Okay? You'll you might 349 00:12:08,514 --> 00:12:10,195 feel a little pinch. It might be a 350 00:12:10,195 --> 00:12:11,720 tiny bit of discomfort. 351 00:12:12,179 --> 00:12:14,100 But once I get it passed once I 352 00:12:14,100 --> 00:12:16,259 get it in the pharynx, you should be 353 00:12:16,259 --> 00:12:19,459 fine. You'll feel something there, but shouldn't shouldn't 354 00:12:19,459 --> 00:12:22,019 be uncomfortable. Okay? How do you think that 355 00:12:22,019 --> 00:12:24,919 sounds? Right? That sounds like I'm an SLP 356 00:12:25,220 --> 00:12:28,024 that feels confident with this camera in my 357 00:12:28,024 --> 00:12:30,764 hand that I can safely navigate your turbinates 358 00:12:30,825 --> 00:12:32,745 and get this camera in position where it 359 00:12:32,745 --> 00:12:35,404 needs to go in your ferrets. Right? Okay? 360 00:12:36,184 --> 00:12:36,684 So 361 00:12:37,464 --> 00:12:39,384 the these are things that I've just learned 362 00:12:39,384 --> 00:12:41,404 from years and years and years of experience. 363 00:12:41,669 --> 00:12:42,950 And I'm I'm gonna pick on one of 364 00:12:42,950 --> 00:12:45,110 the SLPs at this training and I I 365 00:12:45,110 --> 00:12:46,870 love her dearly and I'm so proud of 366 00:12:46,950 --> 00:12:49,269 she's doing fees like a champ now. But 367 00:12:49,269 --> 00:12:50,649 it was so funny because 368 00:12:50,950 --> 00:12:53,669 when she first started doing them, so like 369 00:12:53,669 --> 00:12:56,105 I said that that second day, that base 370 00:12:56,184 --> 00:12:57,325 basic course day, 371 00:12:57,785 --> 00:12:59,705 they finally started passing on each other. The 372 00:12:59,705 --> 00:13:02,264 next day, they started passing on other employees 373 00:13:02,264 --> 00:13:04,105 in the hospital, and she would go up 374 00:13:04,105 --> 00:13:05,865 to them and say, okay. I'm gonna stick 375 00:13:05,865 --> 00:13:07,165 this camera in your nose. 376 00:13:07,470 --> 00:13:09,470 It's gonna hurt. It's gonna, you know, it's 377 00:13:09,470 --> 00:13:10,990 gonna hurt when I go, you know, you 378 00:13:10,990 --> 00:13:13,309 might cry. And I was like, hey, no. 379 00:13:13,309 --> 00:13:14,990 Like, that is not how we need to 380 00:13:14,990 --> 00:13:17,709 prepare our patients. Right? You don't know for 381 00:13:17,709 --> 00:13:19,470 every patient that it's gonna hurt. And most 382 00:13:19,470 --> 00:13:21,554 patients, it doesn't hurt. You so this is 383 00:13:21,554 --> 00:13:23,574 also an an important thing. I'm not sugarcoating 384 00:13:23,634 --> 00:13:25,314 it, but think about the patients that you 385 00:13:25,314 --> 00:13:28,534 are scoping. Okay? If it is a normal 386 00:13:28,754 --> 00:13:32,355 human, normal person, normal person, you or I, 387 00:13:32,355 --> 00:13:34,274 we are sensitive and we will feel it. 388 00:13:34,274 --> 00:13:35,820 Right? Think of our patients. 389 00:13:36,200 --> 00:13:37,980 If they're older, they're desensitized, 390 00:13:38,600 --> 00:13:40,220 they're already in the ICU. 391 00:13:40,839 --> 00:13:42,600 A lot of times, they are so much 392 00:13:42,600 --> 00:13:43,419 more desensitized 393 00:13:43,799 --> 00:13:45,879 that it does not bother them. So get 394 00:13:45,879 --> 00:13:47,559 to know your patient population too that you're 395 00:13:47,559 --> 00:13:49,000 gonna be passing on. I will not say 396 00:13:49,000 --> 00:13:51,565 that for for some patients, especially I know, 397 00:13:51,884 --> 00:13:53,565 a lot of us LPs that do, like, 398 00:13:53,565 --> 00:13:56,125 fees and outpatient for ENTs. You know, sometimes 399 00:13:56,125 --> 00:13:58,284 they may use numbing agents, but sometimes they 400 00:13:58,284 --> 00:14:00,284 may not. And so for the some of 401 00:14:00,284 --> 00:14:01,725 those patients, it might be a little bit 402 00:14:01,725 --> 00:14:03,725 more uncomfortable, but it's all in how you 403 00:14:03,725 --> 00:14:04,225 frame 404 00:14:04,549 --> 00:14:05,750 what you are going to do to the 405 00:14:05,750 --> 00:14:08,789 patient and and educate them from a power 406 00:14:08,789 --> 00:14:12,149 stance, from a confident position, not from a, 407 00:14:12,149 --> 00:14:14,169 I don't know, like, it might hurt, like, 408 00:14:14,230 --> 00:14:16,149 sorry. I'm gonna try to be really gentle, 409 00:14:16,149 --> 00:14:18,875 but it might really hurt. That that that 410 00:14:18,875 --> 00:14:22,235 uncertainty is not comforting. Right? So that was 411 00:14:22,235 --> 00:14:25,115 something that I was very, very passionate about 412 00:14:25,115 --> 00:14:27,434 making sure that they felt confident in their 413 00:14:27,434 --> 00:14:29,674 language going up and talking to patients. So 414 00:14:29,674 --> 00:14:31,509 we practice that with each other. And we 415 00:14:31,509 --> 00:14:33,029 practice, you know, when you're setting up the 416 00:14:33,029 --> 00:14:34,470 equipment, you know, what do you say to 417 00:14:34,470 --> 00:14:36,470 the patient? And what do you say to, 418 00:14:36,470 --> 00:14:38,309 you know, the a nurse or a CNA 419 00:14:38,309 --> 00:14:40,070 or a family member that's in there? And 420 00:14:40,070 --> 00:14:41,750 they wanna know that you're confident and you 421 00:14:41,750 --> 00:14:43,509 know what you're doing. And I really firmly 422 00:14:43,509 --> 00:14:45,634 believe that the only way to get confident 423 00:14:45,634 --> 00:14:48,434 is by practicing in a safe environment. And 424 00:14:48,434 --> 00:14:50,674 so, you know, I even told them, you 425 00:14:50,674 --> 00:14:52,915 know, after the whole experience was done, just 426 00:14:52,915 --> 00:14:54,835 keep keep keep passing the scope on your 427 00:14:54,835 --> 00:14:57,315 Manila folders or your pool noodles. Just get 428 00:14:57,315 --> 00:14:59,554 so comfortable that you could scope anything, to 429 00:14:59,554 --> 00:15:00,215 be honest. 430 00:15:00,529 --> 00:15:02,129 And I can confidently say that I feel 431 00:15:02,129 --> 00:15:03,730 like I can pass on on anything. I've 432 00:15:03,730 --> 00:15:06,149 done thousands and thousands and thousands of fees. 433 00:15:06,769 --> 00:15:09,169 I've there's three patients in my entire career 434 00:15:09,169 --> 00:15:10,370 that I have not been able to pass 435 00:15:10,370 --> 00:15:10,870 on. 436 00:15:11,330 --> 00:15:13,750 And I say that confidently. I feel very 437 00:15:13,809 --> 00:15:15,325 good that I can pass on anyone, and 438 00:15:15,325 --> 00:15:16,764 that just comes with lots and lots and 439 00:15:16,764 --> 00:15:17,585 lots of experience. 440 00:15:18,125 --> 00:15:19,565 So that being said, so we did the 441 00:15:19,565 --> 00:15:22,205 two day basic course. And then the next 442 00:15:22,205 --> 00:15:24,044 day, we passed the whole day. They just 443 00:15:24,044 --> 00:15:25,245 passed the scope on, 444 00:15:25,725 --> 00:15:27,670 on other employees of the hospital. And, again, 445 00:15:27,670 --> 00:15:29,990 I can't stress enough, that these DORs were 446 00:15:29,990 --> 00:15:33,110 just such rock stars because they had people 447 00:15:33,110 --> 00:15:35,029 lined up the entire day. They had every 448 00:15:35,029 --> 00:15:37,269 fifteen minutes, they had a new employee. So 449 00:15:37,269 --> 00:15:38,870 it was they had all the PTs come 450 00:15:38,870 --> 00:15:40,070 through, all the OTs come through. We had 451 00:15:40,070 --> 00:15:41,350 a bunch of nurses come through, and there 452 00:15:41,350 --> 00:15:42,995 was a lot of doctors too, which I 453 00:15:42,995 --> 00:15:45,154 loved. So a lot of the hospitalists, a 454 00:15:45,154 --> 00:15:47,075 lot of the intensivists came in so they 455 00:15:47,075 --> 00:15:48,835 could see and get an understanding of fees 456 00:15:48,835 --> 00:15:51,235 too. So, again, I commend those those DORs 457 00:15:51,235 --> 00:15:53,075 for really getting them all in there so 458 00:15:53,075 --> 00:15:55,250 they could feel it, experience it. A lot 459 00:15:55,250 --> 00:15:57,329 of them just had really, you know, awesome 460 00:15:57,329 --> 00:15:59,889 questions to ask about it. And they it 461 00:15:59,889 --> 00:16:03,409 it really turned them immediately into champions for 462 00:16:03,409 --> 00:16:06,129 fees. And, you know, while while the SLPs 463 00:16:06,129 --> 00:16:07,409 were passing on them, they're like, oh, you 464 00:16:07,409 --> 00:16:08,924 know what? How soon can you guys do 465 00:16:08,924 --> 00:16:10,524 this? I'm I'm just thought of a patient 466 00:16:10,524 --> 00:16:12,845 on, you know, in 03/2004 that could use 467 00:16:12,845 --> 00:16:14,044 the fees today. And I'm like, well, we'll 468 00:16:14,044 --> 00:16:15,404 put them on our list for tomorrow when 469 00:16:15,404 --> 00:16:17,804 we start scoping patients. So in that aspect, 470 00:16:17,804 --> 00:16:19,565 it was so, so, so great to be 471 00:16:19,565 --> 00:16:22,044 able to have this real time training in 472 00:16:22,044 --> 00:16:22,705 the hospital 473 00:16:23,149 --> 00:16:25,309 with the patients now getting all the staff 474 00:16:25,309 --> 00:16:27,470 on board. It was awesome. So the next 475 00:16:27,470 --> 00:16:29,889 day, I believe all my days were blurted. 476 00:16:30,110 --> 00:16:32,269 I should have kept a better, a better 477 00:16:32,269 --> 00:16:34,669 diary of of what days what what what. 478 00:16:34,669 --> 00:16:37,004 So once they got comfortable passing on, you 479 00:16:37,004 --> 00:16:39,404 know, everybody got all of their passes in 480 00:16:39,404 --> 00:16:40,705 with normal subjects. 481 00:16:41,165 --> 00:16:43,245 So they all got their 25 passes in 482 00:16:43,245 --> 00:16:45,804 with normal subjects. I know each state has 483 00:16:45,965 --> 00:16:48,080 some some states. Some states do not. But 484 00:16:48,080 --> 00:16:50,480 some states do have requirements about what's needed 485 00:16:50,480 --> 00:16:53,040 as far as passes for normal patients and 486 00:16:53,120 --> 00:16:54,340 or normals and abnormals. 487 00:16:54,879 --> 00:16:56,160 So just make sure that you guys look 488 00:16:56,160 --> 00:16:57,759 that up if you're interested in going through 489 00:16:57,759 --> 00:17:00,000 fees training, see what your state requires. So 490 00:17:00,000 --> 00:17:01,304 we went with the 25 491 00:17:01,705 --> 00:17:03,725 for the SLPs here. And 492 00:17:04,025 --> 00:17:06,825 after that, then, you know, they were good, 493 00:17:06,825 --> 00:17:08,285 I say, in quotes, 494 00:17:08,744 --> 00:17:11,144 to go start passing on patients. I was 495 00:17:11,144 --> 00:17:11,964 very, very, 496 00:17:12,265 --> 00:17:14,105 very hands on. I will say that. And 497 00:17:14,105 --> 00:17:15,704 I I did tell them, hey. Probably this 498 00:17:15,704 --> 00:17:17,389 first day that you guys are passing on 499 00:17:17,389 --> 00:17:19,230 patients, I am going to be hand over 500 00:17:19,230 --> 00:17:20,589 hand with you because I will not let 501 00:17:20,589 --> 00:17:22,509 you hurt a patient. Because as I said, 502 00:17:22,509 --> 00:17:24,929 what what happens if you hurt the patient? 503 00:17:24,990 --> 00:17:26,829 You don't feel good about what you're doing, 504 00:17:26,829 --> 00:17:28,750 and you don't wanna continue to do this. 505 00:17:28,750 --> 00:17:30,750 Okay? And I started to see that with 506 00:17:30,750 --> 00:17:32,765 one of the SLPs, she was getting frustrated. 507 00:17:32,904 --> 00:17:33,805 She was not 508 00:17:34,105 --> 00:17:37,384 she just her her SLP interpretation brain was 509 00:17:37,384 --> 00:17:39,305 incredible, but as far as the mechanic, she 510 00:17:39,305 --> 00:17:41,865 was really having trouble with it. So we 511 00:17:42,265 --> 00:17:43,785 I went back and just gave her, you 512 00:17:43,785 --> 00:17:45,839 know, so many and actually, she was a, 513 00:17:46,079 --> 00:17:47,519 she was a surfer. And I was like, 514 00:17:47,519 --> 00:17:48,960 you know, what's so funny is you ride 515 00:17:48,960 --> 00:17:50,880 these, like, 40 foot waves, but you're you're 516 00:17:50,880 --> 00:17:52,319 scared to stick the scope in the nose 517 00:17:52,319 --> 00:17:53,759 and she would do great. She just would 518 00:17:53,759 --> 00:17:55,839 hesitate. So she'd get it in the turbine 519 00:17:55,839 --> 00:17:57,359 and I would say ride the wave, ride 520 00:17:57,359 --> 00:17:59,279 the wave, keep going. Like, she had great 521 00:17:59,279 --> 00:18:02,085 positioning. She was just nervous herself. We made 522 00:18:02,085 --> 00:18:04,565 it fun. And and I think that's what's 523 00:18:04,565 --> 00:18:06,565 important. Like, they're you know, SLPs are not 524 00:18:06,565 --> 00:18:08,244 gonna wanna do this unless they feel good 525 00:18:08,244 --> 00:18:10,565 about it themselves, and they really truly see 526 00:18:10,565 --> 00:18:12,345 the direct impact that it has on patients. 527 00:18:12,404 --> 00:18:14,085 So, the the like I said, that that 528 00:18:14,085 --> 00:18:15,924 first day we started passing on patients, I 529 00:18:15,924 --> 00:18:17,869 was very hand over hand. Hand. I basically 530 00:18:18,329 --> 00:18:20,170 you know, I helped them get everything set 531 00:18:20,170 --> 00:18:21,769 up. I I didn't throw them to the 532 00:18:21,769 --> 00:18:23,210 wolves. And I know in a lot of 533 00:18:23,210 --> 00:18:25,690 settings, I've been asked to maybe supervise some 534 00:18:25,690 --> 00:18:27,289 fees, passes, and things like that. And I've 535 00:18:27,289 --> 00:18:29,309 just seen these poor SLPs 536 00:18:29,615 --> 00:18:32,095 just thrown in these situations without really good 537 00:18:32,095 --> 00:18:33,154 guidance and supervision. 538 00:18:33,775 --> 00:18:35,134 And this is just one thing that I 539 00:18:35,134 --> 00:18:36,494 just don't want us to mess up you 540 00:18:36,494 --> 00:18:38,654 guys. Like, this is such a powerful tool, 541 00:18:38,654 --> 00:18:41,215 but it's also it needs a level of 542 00:18:41,215 --> 00:18:42,894 hand holding that I think a lot of 543 00:18:42,894 --> 00:18:43,890 other things don't. 544 00:18:44,690 --> 00:18:47,089 This is an actual endoscope that we're sticking 545 00:18:47,089 --> 00:18:48,789 inside people's botanies. Right? 546 00:18:49,170 --> 00:18:51,009 This isn't, you know, that I I'm I'm 547 00:18:51,009 --> 00:18:52,450 not trying to downplay anything else that we 548 00:18:52,450 --> 00:18:54,070 do in our field, but this just really 549 00:18:54,369 --> 00:18:56,710 it it warrants some good supportive mentorship. 550 00:18:57,009 --> 00:18:59,045 And so like I said, we passed passed 551 00:18:59,045 --> 00:19:01,365 the scope on on the patients that day, 552 00:19:01,365 --> 00:19:03,205 and then the next day we started you 553 00:19:03,205 --> 00:19:04,964 know, I I let them be a little 554 00:19:04,964 --> 00:19:05,625 more independent. 555 00:19:06,484 --> 00:19:08,505 So at that point, we were actually identifying 556 00:19:08,565 --> 00:19:10,404 patients on the floor. With that first day, 557 00:19:10,404 --> 00:19:12,450 they had had some patients already lined up. 558 00:19:12,609 --> 00:19:14,450 And then the the next next day, we 559 00:19:14,450 --> 00:19:15,649 made sure that, you know, we talked to 560 00:19:15,649 --> 00:19:18,210 different unit supervisors, things like that, and we 561 00:19:18,210 --> 00:19:20,289 identified some more patients. So one thing I 562 00:19:20,289 --> 00:19:22,609 I do wanna share is we had gone 563 00:19:22,609 --> 00:19:24,529 into the burn unit. There was one patient 564 00:19:24,529 --> 00:19:25,990 in the burn unit, and 565 00:19:26,365 --> 00:19:28,125 I will probably remember this patient for the 566 00:19:28,125 --> 00:19:29,724 rest of my life. I'm mind I'm trying 567 00:19:29,724 --> 00:19:30,845 to be mindful of it, but I don't 568 00:19:30,845 --> 00:19:32,544 wanna share too many details. But, 569 00:19:32,924 --> 00:19:35,644 very, very young gentleman had burns on most 570 00:19:35,644 --> 00:19:36,544 of his body, 571 00:19:37,085 --> 00:19:39,039 if not all of his body. 572 00:19:39,579 --> 00:19:41,579 He was basically in, like, a full body 573 00:19:41,579 --> 00:19:43,099 cast, and I could see his eyes and 574 00:19:43,099 --> 00:19:45,099 I could see his mouth. And by the 575 00:19:45,099 --> 00:19:47,359 grace of God, he was able to verbalize 576 00:19:47,579 --> 00:19:50,059 and communicate. And also by the grace of 577 00:19:50,059 --> 00:19:52,884 God, these SLPs had a great relationship with 578 00:19:52,884 --> 00:19:55,045 him and his wife. And, you know, she 579 00:19:55,045 --> 00:19:57,285 said, I just feel like since he can 580 00:19:57,285 --> 00:20:00,244 talk and since, you know, he's he's wanting 581 00:20:00,244 --> 00:20:02,805 ice chips, he's wanting to eat, we should 582 00:20:02,805 --> 00:20:04,404 probably do a feast and see if he 583 00:20:04,404 --> 00:20:06,490 can. And this is one of those patients 584 00:20:06,490 --> 00:20:08,089 that probably if you walked in off the 585 00:20:08,089 --> 00:20:09,369 street and you looked to him, you would 586 00:20:09,369 --> 00:20:11,609 say there is absolutely no way on this 587 00:20:11,609 --> 00:20:13,769 earth that this patient can swallow. And this 588 00:20:13,769 --> 00:20:15,450 is why I love FEES. This is why 589 00:20:15,450 --> 00:20:17,695 I love FEES so much. And so I 590 00:20:17,695 --> 00:20:18,674 commend this SLP 591 00:20:18,975 --> 00:20:20,914 so much for advocating for this patient, 592 00:20:21,375 --> 00:20:23,375 because it made this patient's life. It made 593 00:20:23,375 --> 00:20:25,775 the patient's wife's life. It and and I'll 594 00:20:25,775 --> 00:20:27,535 share more about what the burn director burn 595 00:20:27,535 --> 00:20:30,015 unit director said as well. So, again, we 596 00:20:30,015 --> 00:20:33,410 do the fees. This patient's swallow was perfect. 597 00:20:33,789 --> 00:20:36,990 For someone that was just completely, completely covered 598 00:20:36,990 --> 00:20:40,029 in burns and full body cast, the patient's 599 00:20:40,029 --> 00:20:42,750 swallow was perfect. And so we were joking, 600 00:20:42,750 --> 00:20:44,750 you know, the the patient said, well, can 601 00:20:44,750 --> 00:20:46,190 I order a cheeseburger? And I was like, 602 00:20:46,190 --> 00:20:47,570 let's get the man a cheeseburger. 603 00:20:47,884 --> 00:20:49,485 You know? And and the patient's crying, the 604 00:20:49,485 --> 00:20:52,305 wife's crying. We're almost all in tears too. 605 00:20:52,605 --> 00:20:55,565 And it's just a testament to what this 606 00:20:55,565 --> 00:20:57,965 tool can do because I believe this patient 607 00:20:57,965 --> 00:20:59,884 had been in there for about I'm I'm 608 00:20:59,884 --> 00:21:01,404 sorry if I'm wrong, you guys, about four 609 00:21:01,404 --> 00:21:02,865 to five months already. 610 00:21:03,339 --> 00:21:05,839 Right? Has gone through this horrific, 611 00:21:06,299 --> 00:21:09,259 horrific ordeal. And what is what is his 612 00:21:09,259 --> 00:21:11,419 quality of life while he's improving? And and 613 00:21:11,419 --> 00:21:13,659 his wife was just the most amazing, incredible, 614 00:21:13,659 --> 00:21:15,980 supportive woman, had not left his side. And 615 00:21:15,980 --> 00:21:17,259 so when we said he could eat a 616 00:21:17,259 --> 00:21:20,275 cheeseburger, it was just incredible. You know? And 617 00:21:20,275 --> 00:21:22,695 so the burn unit director comes in, and, 618 00:21:23,475 --> 00:21:25,315 thankfully, he was he was a a very, 619 00:21:25,315 --> 00:21:27,075 very, very kind man. And he's like, what 620 00:21:27,075 --> 00:21:28,275 are you doing to my patients? And I 621 00:21:28,275 --> 00:21:29,715 said, well, this is fees. You know, we 622 00:21:29,795 --> 00:21:31,394 they've been trying to get it for years 623 00:21:31,394 --> 00:21:32,914 and, you know, we got this tool and, 624 00:21:32,914 --> 00:21:35,059 you know, I'm Teresa. I said, I'm board 625 00:21:35,059 --> 00:21:36,740 certified swallowing. I've been doing these for years 626 00:21:36,740 --> 00:21:38,099 and years and years and years, and I 627 00:21:38,099 --> 00:21:39,779 shared more about it and what we did. 628 00:21:39,779 --> 00:21:41,059 And he's like, you gotta be kidding me. 629 00:21:41,059 --> 00:21:42,420 And he's like, he can eat. And I 630 00:21:42,420 --> 00:21:43,619 said, yeah. He can eat. And he said, 631 00:21:43,619 --> 00:21:46,180 I don't think you understand how much better 632 00:21:46,180 --> 00:21:48,734 and faster my patients can get now that 633 00:21:48,734 --> 00:21:51,134 they can get actual nutrition by mouth? And 634 00:21:51,134 --> 00:21:53,055 he said, do you understand the nutrition that's 635 00:21:53,055 --> 00:21:53,555 involved 636 00:21:54,335 --> 00:21:56,095 with healing burns? And I said, oh, I 637 00:21:56,095 --> 00:21:58,174 do. And that's why I'm here. And that's 638 00:21:58,174 --> 00:22:00,095 why I'm very passionate about this tool. And 639 00:22:00,095 --> 00:22:02,575 it was such a powerful learning moment for 640 00:22:02,575 --> 00:22:03,875 everybody in the room, 641 00:22:04,599 --> 00:22:06,200 and for this conversation that I had with 642 00:22:06,200 --> 00:22:08,140 the burn unit director. And and I'm grateful, 643 00:22:08,519 --> 00:22:10,859 that he was so open minded about everything. 644 00:22:11,319 --> 00:22:12,440 And it was just like I said, it 645 00:22:12,440 --> 00:22:14,539 was just such a overall overwhelmingly 646 00:22:15,640 --> 00:22:16,140 incredible 647 00:22:16,525 --> 00:22:19,164 experience. And we ended up the next day, 648 00:22:19,164 --> 00:22:20,924 passed on even more patients. We spent a 649 00:22:20,924 --> 00:22:23,005 lot more time those last two days on 650 00:22:23,005 --> 00:22:25,005 a lot of report writing. And that's something 651 00:22:25,005 --> 00:22:26,444 that, you know, of course, you have to 652 00:22:26,444 --> 00:22:28,730 get better at, but I wanted to spend 653 00:22:28,730 --> 00:22:30,330 the bulk of my time while I was 654 00:22:30,330 --> 00:22:33,289 there really, really, really making sure that we're 655 00:22:33,289 --> 00:22:36,269 driving home, how to feel comfortable with patients, 656 00:22:36,570 --> 00:22:38,410 how to feel comfortable with the scope in 657 00:22:38,410 --> 00:22:40,490 your hands so that you feel comfortable and 658 00:22:40,490 --> 00:22:40,990 confident, 659 00:22:41,305 --> 00:22:43,144 and how to feel comfortable and confident when 660 00:22:43,144 --> 00:22:45,565 you stick that scope in that patient's nose. 661 00:22:45,865 --> 00:22:47,705 And so I felt like that was where 662 00:22:47,705 --> 00:22:49,484 all of my time was 663 00:22:49,785 --> 00:22:51,625 was worth spending. Like I said, of course, 664 00:22:51,625 --> 00:22:53,305 we spent some a lot of time on 665 00:22:53,305 --> 00:22:55,545 on report writing. I gave them tons of 666 00:22:55,545 --> 00:22:57,730 resources for reports. I said I'm more than 667 00:22:57,730 --> 00:22:59,490 happy to do calls and Zooms with you 668 00:22:59,490 --> 00:23:01,650 guys and and review reports and and continue 669 00:23:01,650 --> 00:23:03,329 on with that. But that's sort of one 670 00:23:03,329 --> 00:23:04,230 of my gripes 671 00:23:04,609 --> 00:23:06,390 with with some fees, 672 00:23:06,769 --> 00:23:08,849 training is that I just think we spend 673 00:23:08,849 --> 00:23:11,409 way too much time on report writing and 674 00:23:11,409 --> 00:23:12,224 just don't 675 00:23:12,544 --> 00:23:14,704 let SLPs feel comfortable with it. And and 676 00:23:14,704 --> 00:23:17,184 I've experienced some SLPs that, you know, they're 677 00:23:17,184 --> 00:23:18,464 like, I can write the best fuse report 678 00:23:18,464 --> 00:23:19,664 in the world, but I just still don't 679 00:23:19,664 --> 00:23:21,345 feel comfortable sticking a scope in a patient's 680 00:23:21,345 --> 00:23:23,265 nose. And and that defeats the purpose. Right? 681 00:23:23,265 --> 00:23:25,710 So, this is why I'm just very, very 682 00:23:25,710 --> 00:23:27,630 passionate about this topic. So one of one 683 00:23:27,630 --> 00:23:29,710 of the things I really wanna impress upon 684 00:23:29,710 --> 00:23:31,069 with this is that if you guys are 685 00:23:31,069 --> 00:23:34,369 a hospital system looking to bring fees in, 686 00:23:34,509 --> 00:23:36,750 if you can bring a fees trainer to 687 00:23:36,750 --> 00:23:39,695 you, it is it's a world of difference 688 00:23:39,695 --> 00:23:42,815 because the training can be tailored directly to 689 00:23:42,815 --> 00:23:44,674 your facility. You don't have to learn 690 00:23:45,055 --> 00:23:46,095 general things. 691 00:23:46,414 --> 00:23:47,934 You don't have to take what I tell 692 00:23:47,934 --> 00:23:49,934 you or what what a fees and structure 693 00:23:49,934 --> 00:23:51,375 tells you and try to take it back 694 00:23:51,375 --> 00:23:53,250 and interpret it in language that, you know, 695 00:23:53,250 --> 00:23:55,830 maybe SPD will understand in your facility. 696 00:23:56,529 --> 00:23:58,210 And there's a bunch of different companies out 697 00:23:58,210 --> 00:24:00,289 there that do this. If anybody wants to 698 00:24:00,289 --> 00:24:01,730 reach out to me privately, I can you 699 00:24:01,730 --> 00:24:03,109 know, I'm happy to share 700 00:24:03,410 --> 00:24:06,289 companies that I contract with to do fees 701 00:24:06,289 --> 00:24:06,789 training. 702 00:24:07,544 --> 00:24:09,865 I'm I'm very happy to share share some 703 00:24:09,865 --> 00:24:11,544 names, but that's just one thing that I 704 00:24:11,544 --> 00:24:12,044 want 705 00:24:12,505 --> 00:24:14,184 to share is that if you as a 706 00:24:14,184 --> 00:24:16,825 hospital system are wanting to go to training, 707 00:24:16,825 --> 00:24:18,424 it's so much better if you can bring 708 00:24:18,424 --> 00:24:20,365 someone to you and actually train 709 00:24:20,799 --> 00:24:23,039 in your hospital with the equipment that you 710 00:24:23,039 --> 00:24:23,539 purchased, 711 00:24:24,240 --> 00:24:27,039 with your SPD department, with your IT department, 712 00:24:27,039 --> 00:24:28,180 and on your patients, 713 00:24:28,799 --> 00:24:31,440 and and let the trainers just help you 714 00:24:31,440 --> 00:24:33,460 get comfortable in your home environment. 715 00:24:33,865 --> 00:24:35,224 And so I just think this was such 716 00:24:35,224 --> 00:24:36,044 a fantastic 717 00:24:36,424 --> 00:24:39,544 learning opportunity. It was such a rich learning 718 00:24:39,544 --> 00:24:41,784 opportunity for me. I I'm so grateful I 719 00:24:41,784 --> 00:24:42,684 got to do this. 720 00:24:42,984 --> 00:24:45,304 It's like I don't honestly, my, like, dream 721 00:24:45,304 --> 00:24:45,804 job 722 00:24:46,210 --> 00:24:48,369 is just, like, in in day hospitals and 723 00:24:48,369 --> 00:24:50,150 do fees training all day long. 724 00:24:50,450 --> 00:24:52,850 I was, like, beyond exhausted. I got home 725 00:24:52,850 --> 00:24:55,090 and, like, could not even formulate words to 726 00:24:55,090 --> 00:24:57,640 order, like, food or dinner at, like, 07:00 727 00:24:57,640 --> 00:24:59,825 at night, but it's you know, I I 728 00:24:59,825 --> 00:25:01,585 love doing this. I'm so passionate about doing 729 00:25:01,585 --> 00:25:04,244 this, and I'm super, super grateful to the 730 00:25:04,384 --> 00:25:06,965 Hawaii system that brought me out and and 731 00:25:07,184 --> 00:25:09,345 allowed me to do things my way because 732 00:25:09,345 --> 00:25:10,785 they're a little bit different than the way 733 00:25:10,785 --> 00:25:13,150 that other SLPs and and and training programs 734 00:25:13,150 --> 00:25:15,150 do things. So, that being said, like I 735 00:25:15,150 --> 00:25:17,230 I said, I wanted to talk about why 736 00:25:17,230 --> 00:25:18,210 it's so important 737 00:25:18,750 --> 00:25:19,890 to be confident 738 00:25:20,190 --> 00:25:22,509 and in and comfortable in holding the scope, 739 00:25:22,509 --> 00:25:24,029 but then also the way that you approach 740 00:25:24,029 --> 00:25:26,588 the And I I alluded to this a 741 00:25:26,588 --> 00:25:27,194 little bit 742 00:25:27,494 --> 00:25:28,934 earlier in the in the conversation. This is 743 00:25:28,934 --> 00:25:30,055 what I'm gonna be talking about at the 744 00:25:30,055 --> 00:25:31,595 ASHA convention in November, 745 00:25:32,214 --> 00:25:34,634 is how do we communicate effectively 746 00:25:34,934 --> 00:25:37,515 with our patients to be informative and 747 00:25:38,200 --> 00:25:40,700 reduce anxiety, not induce anxiety, 748 00:25:41,160 --> 00:25:42,059 reduce anxiety. 749 00:25:42,360 --> 00:25:44,039 And there's a few studies that I want 750 00:25:44,039 --> 00:25:44,779 to share. 751 00:25:45,559 --> 00:25:47,900 And there was a study in the Digestion 752 00:25:48,039 --> 00:25:49,420 Journal in 2016 753 00:25:49,960 --> 00:25:50,779 that introduced 754 00:25:51,080 --> 00:25:53,500 structured informational leaflets. And 755 00:25:53,855 --> 00:25:55,695 what's that? Like a brochure? It takes even 756 00:25:55,695 --> 00:25:57,375 though we don't even really use brochures. We 757 00:25:57,375 --> 00:25:57,875 use, 758 00:25:58,255 --> 00:26:00,355 you know, iPads and things like that. But 759 00:26:00,494 --> 00:26:03,855 also along with staff communication training. So the 760 00:26:03,855 --> 00:26:05,855 staff actually went through training on how to 761 00:26:05,855 --> 00:26:08,440 communicate these procedures to their patients, and the 762 00:26:08,440 --> 00:26:09,500 patient's anxiety 763 00:26:09,960 --> 00:26:13,480 dropped, their understanding of the procedure improved and 764 00:26:13,480 --> 00:26:17,720 their overall patient satisfaction ratings skyrocketed to ninety 765 00:26:17,720 --> 00:26:18,460 five percent. 766 00:26:18,840 --> 00:26:22,275 They even reported less discomfort during the scope 767 00:26:22,275 --> 00:26:24,434 itself. So what I take away from this, 768 00:26:24,434 --> 00:26:26,034 right, is we talk about, you know, there's 769 00:26:26,034 --> 00:26:28,275 some SLPs that you'll see on the Facebook 770 00:26:28,275 --> 00:26:29,794 groups. Like, they're like, I just don't like 771 00:26:29,794 --> 00:26:31,634 fees because I just can never see anything 772 00:26:31,634 --> 00:26:33,734 or, like, my patients hate it. 773 00:26:34,039 --> 00:26:36,519 And they just have these negative views of 774 00:26:36,519 --> 00:26:38,119 fees. And a lot of times, once I 775 00:26:38,119 --> 00:26:39,799 start talking to them, it's because they had 776 00:26:39,799 --> 00:26:42,519 a very poor experience with their training, and 777 00:26:42,519 --> 00:26:44,599 they weren't properly mentored. And I know that 778 00:26:44,599 --> 00:26:46,839 happens. Right? I I I get get get 779 00:26:46,839 --> 00:26:48,835 that that happens. But there's something there's things 780 00:26:48,835 --> 00:26:50,595 we can do about it. Right? And so 781 00:26:50,595 --> 00:26:52,194 that's why I think this is such a 782 00:26:52,194 --> 00:26:54,054 bigger, more important topic 783 00:26:54,355 --> 00:26:56,115 because we want to be able to get 784 00:26:56,115 --> 00:26:56,615 fees 785 00:26:57,075 --> 00:26:59,234 into some of these more rural areas. We 786 00:26:59,554 --> 00:27:01,554 fees has so much portability and so much 787 00:27:01,554 --> 00:27:03,095 capability and so much accessibility. 788 00:27:03,740 --> 00:27:06,859 Let's maximize that. And that starts with being 789 00:27:06,859 --> 00:27:08,619 able to say that, you know, if I'm 790 00:27:08,619 --> 00:27:10,059 gonna drive you know, I used to do 791 00:27:10,059 --> 00:27:12,299 mobile fees all the time. I would drive 792 00:27:12,299 --> 00:27:14,299 to a facility four hours away to scope 793 00:27:14,299 --> 00:27:16,220 one patient. But I would do that because 794 00:27:16,220 --> 00:27:18,744 I was about 99.9% 795 00:27:18,744 --> 00:27:20,424 confident that I could pass the scope on 796 00:27:20,424 --> 00:27:22,025 that patient. I know there's a lot of 797 00:27:22,025 --> 00:27:23,465 SLPs that'll say, oh, you know, I don't 798 00:27:23,465 --> 00:27:25,305 think this patient's a good candidate. And it 799 00:27:25,305 --> 00:27:27,225 might be because they don't feel like they 800 00:27:27,225 --> 00:27:28,904 can pass the scope on that patient. There's 801 00:27:29,065 --> 00:27:30,505 I will tell you there's not a patient 802 00:27:30,505 --> 00:27:33,019 I don't. I'm intimidated to scope. I will 803 00:27:33,019 --> 00:27:34,480 share with you this burn patient. 804 00:27:35,099 --> 00:27:35,599 I 805 00:27:36,380 --> 00:27:39,339 wasn't sure, but I was 1000% 806 00:27:39,339 --> 00:27:40,700 willing to attempt it. 807 00:27:41,019 --> 00:27:42,700 And I can probably tell you there's a 808 00:27:42,700 --> 00:27:43,980 lot, a lot, a lot of people that 809 00:27:43,980 --> 00:27:45,674 would have just said, you've gotta be out 810 00:27:45,674 --> 00:27:47,554 of your mind to think you can pass 811 00:27:47,554 --> 00:27:48,615 the scope on this patient 812 00:27:48,994 --> 00:27:51,174 and that this patient will actually pass. 813 00:27:51,474 --> 00:27:53,075 So there's just there's a lot to be 814 00:27:53,075 --> 00:27:54,994 said about giving our patients the benefit of 815 00:27:54,994 --> 00:27:57,315 the doubt, not projecting our own fears, not 816 00:27:57,315 --> 00:27:59,640 projecting our own weaknesses, but how can we 817 00:27:59,640 --> 00:28:01,960 get better at our craft? How can we 818 00:28:01,960 --> 00:28:03,720 get better at using this tool? How can 819 00:28:03,720 --> 00:28:05,099 we get better at communicating 820 00:28:05,640 --> 00:28:08,119 more effectively with our patients, which will in 821 00:28:08,119 --> 00:28:09,980 turn reduce their anxiety, 822 00:28:10,279 --> 00:28:11,180 help the 823 00:28:11,535 --> 00:28:12,994 procedure go more smoothly. 824 00:28:13,375 --> 00:28:15,315 Therefore, we get better results. 825 00:28:15,695 --> 00:28:18,015 Therefore, the patient can eat, which is the 826 00:28:18,015 --> 00:28:20,575 end goal. Right? So it's a huge, huge, 827 00:28:20,575 --> 00:28:22,035 huge overarching issue, 828 00:28:22,734 --> 00:28:24,255 with a lot of pieces that I think 829 00:28:24,255 --> 00:28:26,029 need to fall in line better. And then 830 00:28:26,029 --> 00:28:27,710 another study that I would like to quote 831 00:28:27,710 --> 00:28:30,750 was in Digestive Diseases and Sciences in 2025. 832 00:28:31,069 --> 00:28:33,069 And it says you know, and and just 833 00:28:33,069 --> 00:28:35,409 think about it. Right? Like, endoscopy, video stroboscopy, 834 00:28:35,470 --> 00:28:37,869 it means scopes are in sensitive areas like 835 00:28:37,869 --> 00:28:40,265 the nose, like the scope. Patients feel anxious. 836 00:28:40,404 --> 00:28:42,325 This study that that was found in Digestive 837 00:28:42,325 --> 00:28:44,325 Diseases and Sciences found that more than half 838 00:28:44,325 --> 00:28:47,785 of patients, fifty two percent, reported significant anxiety 839 00:28:47,924 --> 00:28:48,424 before 840 00:28:48,884 --> 00:28:50,184 non sedated endoscopy. 841 00:28:50,725 --> 00:28:53,765 And interestingly, just knowing about the procedure didn't 842 00:28:53,765 --> 00:28:56,099 lower their anxiety. It's not information 843 00:28:56,480 --> 00:28:59,839 alone that matters. It's how that information is 844 00:28:59,839 --> 00:29:02,079 delivered. So that's why it's so, so, so 845 00:29:02,079 --> 00:29:03,539 important for us to 846 00:29:04,000 --> 00:29:06,640 deliver this information, but deliver it in a 847 00:29:06,640 --> 00:29:09,359 confident way that is not projecting our fears 848 00:29:09,359 --> 00:29:10,339 and our discomforts 849 00:29:11,365 --> 00:29:12,724 on our patients. Anyways, just a little sneak 850 00:29:12,724 --> 00:29:15,204 peek of what's coming up for my, my 851 00:29:15,204 --> 00:29:16,724 ASHA talk this year and some things that 852 00:29:16,724 --> 00:29:18,644 I'm gonna be including in my dissertation. But 853 00:29:18,644 --> 00:29:21,045 hope this episode was helpful for you, those 854 00:29:21,045 --> 00:29:22,964 of you that might be looking to get 855 00:29:22,964 --> 00:29:25,019 fees trained in the future, some things to 856 00:29:25,019 --> 00:29:26,859 consider. If you're looking to get your whole 857 00:29:26,859 --> 00:29:28,940 hospital system trained or if you yourself are 858 00:29:28,940 --> 00:29:29,920 a fees mentor, 859 00:29:30,460 --> 00:29:32,220 and you found some value in this, please 860 00:29:32,220 --> 00:29:33,740 do let me know, and please do share 861 00:29:33,740 --> 00:29:34,240 because 862 00:29:34,619 --> 00:29:36,779 I I I love that we have people 863 00:29:36,779 --> 00:29:39,884 out there doing the lord's work, teaching fees. 864 00:29:40,265 --> 00:29:41,945 Don't wanna knock anybody doing that, but I 865 00:29:41,945 --> 00:29:43,705 just think those of us that are fees 866 00:29:43,705 --> 00:29:46,105 trainers can do a better job of helping 867 00:29:46,105 --> 00:29:48,184 to make our SLPs feel more comfortable and 868 00:29:48,184 --> 00:29:50,424 confident and supported. So that is my ask 869 00:29:50,424 --> 00:29:51,545 to you. That is what I'm putting out 870 00:29:51,545 --> 00:29:52,365 into the universe. 871 00:29:52,825 --> 00:29:54,589 I would just love for every SLP in 872 00:29:54,589 --> 00:29:56,990 the world to be totally comfortable and confident 873 00:29:56,990 --> 00:29:59,230 performing fees. That would just be my absolute 874 00:29:59,230 --> 00:30:01,470 wish. So, that is my quest. That is 875 00:30:01,470 --> 00:30:03,389 my passion. That is the hill die. That 876 00:30:03,389 --> 00:30:05,869 is the hill I will die on. So 877 00:30:05,869 --> 00:30:07,409 thank you everybody for listening. 878 00:30:08,365 --> 00:30:10,924 And that's a wrap for this episode. As 879 00:30:10,924 --> 00:30:12,944 always, thank you so much for listening. 880 00:30:13,325 --> 00:30:14,845 If you'd like to download the show notes 881 00:30:14,845 --> 00:30:18,784 from this episode, please visit swaddlerpridepodcast.com. 882 00:30:19,005 --> 00:30:20,525 There you can also sign up for our 883 00:30:20,525 --> 00:30:22,444 email list so that you'll never miss another 884 00:30:22,444 --> 00:30:22,944 episode. 885 00:30:23,450 --> 00:30:25,210 If you do like what you hear, then 886 00:30:25,210 --> 00:30:27,789 please subscribe and leave a review on iTunes 887 00:30:28,329 --> 00:30:30,089 or share it on social media with your 888 00:30:30,089 --> 00:30:32,250 friends and colleagues because that is what keeps 889 00:30:32,250 --> 00:30:33,630 these episodes coming. 890 00:30:34,170 --> 00:30:35,865 If you'd like to be a guest, share 891 00:30:35,865 --> 00:30:38,585 feedback, or request a topic to be discussed 892 00:30:38,585 --> 00:30:42,984 on the show, please email podcast@TeresaRichard.com. 893 00:30:42,984 --> 00:30:45,065 Thank you so much for listening, and we'll 894 00:30:45,065 --> 00:30:46,285 catch you next week.