Lisa Murray has more than 10 years experience working with children and adults in a variety of settings and is currently starting her 5th year in home health. She has a strong passion for evidence-based assessment and treatment, having earned three ASHA Awards for Professional Participation in Continuing Education. Lisa launched EatSpeakThink.com in June 2018 to help other clinicians be more successful working in home health, as well as to provide strategies and resources to people living with problems with swallowing, communication, or cognition. She makes time for indoor rock climbing.
Note: You should consult with your doctor or speech pathologist for recommendations on treatment. The views and opinions expressed in this article are those of Lisa Murray and do not necessarily reflect the official policy or position of SpeechPathologyMastersPrograms.com
How did you become interested in working in home health and being a medical SLP?
Before grad school, I was certain I’d work with children in the school setting. I didn’t have any interest in working with adults, and I was especially nervous about taking the dysphagia course. But once I took the course, I was hooked! By the time I graduated, I couldn’t decide whether to work with adults or children, so I completed my clinical fellowship in a private practice working with both.
After a year or so, I moved from Maryland to Connecticut. I wasn’t able to find a private practice that served both children and adults, so I worked almost a year and a half in public schools while working per diem in a skilled nursing facility. To be honest, while I love working with kids, I didn’t feel I was very effective in the school setting so I moved fully into medical speech pathology.
After four years in a medical facility, I moved into home health because I really wanted to work with people in their own homes. I also wanted to freedom to spend as much time as I wanted with my patients.
What are the challenges and benefits to working in this setting?
My biggest challenges were learning how to manage my time and to write goals to achieve my patient’s desired outcomes instead of addressing impairments. In addition, home health requires much more documentation that I’ve had to do in any other setting, and things change all the time.
But the benefits are amazing! First, I have a lot of flexibility. I have a set number of visits I have to make each week to meet productivity. Other than initial evaluations, I can make those visits anytime Sunday through Saturday. I can see more patients on one day, and fewer on another. I can schedule my own doctor’s appointments during days I work without taking paid time off. I can run errands in between patient visits. If we’re going to get a snowstorm on Monday, I can move those patients to Sunday instead. I can even go home for lunch or walk along the shoreline on some days.
Second, I love driving between patients (as long as it’s under half an hour) because then I get to listen to podcasts, books on tape, or continuing education courses. My car is my university!
Third, I feel more effective than I ever did in the medical facility or the outpatient setting. I just find that working with people in their own environment is so meaningful. Therapy can be very effective when we’re working with people in their own environment, with their family around, and with their own food, calendars, mail, etc.
What qualities does an SLP need to succeed in this setting?
A successful home health SLP has to be able to work well without a lot of structure and oversight. They have to be able to adapt to frequent changes in their schedule, as well as to frequent changes to policy and procedure. And they have to be a dedicated lifelong learner because the caseload is so varied.
What inspired you to start your blog, Eat, Speak & Think?
I’ve watched other SLPs burn out in home health, and I nearly burned out myself a year or so ago. I’ve worked hard to figure out how to do this job in a meaningful but healthy way. I love working in home health, and I’d like to help other SLPs learn to be more successful in this setting. I still have room to improve, and one of the best ways to learn is to teach others!
In addition to inspiring other SLPs, I’m also writing for people living with chronic conditions or aging in place. I’d like to help them make the most of the knowledge and technology that exist but are underused. Too many people are living with problems that could potentially be fixed. I’m hoping to offer practical information, as well as to educate them about what SLPs can do to help.
What do you hope readers get out of your posts?
Working in home health has a steep learning curve. I’d love to help others to have an easier time adjusting than I did. I hope clinicians also appreciate learning about resources for their patients.
For the general public, I hope to educate people about practical solutions and tips to improve daily life as well as to empower them to advocate for themselves and loved ones.
What is your advice to future SLP graduate students?
I’m not going to lie. Grad school and the first few years are going to be tough, but rewarding. Changing people’s lives is not easy, but it can be fun and it can make the long hours worth it. For me, it began getting easier and I began feeling confident after about five years. I’m ten years in, and I’m loving it.
If you’re not already a pro at setting goals for yourself, time-management, and organization, consider spending some time learning these skills. They’ll make grad school and the first years of your practice so much easier, and you’ll use them for the rest of your life.