Become a Speech Pathologist in a Hospital Work Setting

Speech-language pathologists (SLP) working in acute-care hospitals perform critical roles in both daily care and long-term recovery of patients. On any given day, an SLP might help a person with a traumatic brain injury learn to speak again; give a stroke patient exercises to help with swallowing; perform a video fluoroscopic swallow study (VFSS) to see whether a patient is managing the texture of food; recommend surgery to help a pediatric patient; work to develop alternative communication methods with a patient who can’t talk; collaborate with doctors and nurses, and educate patients, their families, and/or caregivers about conditions and therapies. It’s a busy, demanding position, well-suited for people who are passionate about helping others.

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NYU Campus

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Earn Your Master’s in Communicative Sciences and Disorders Online at NYU Steinhardt

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  • Now accepting applications

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Earn your Master of Science in Communication Sciences and Disorders Online from Baylor University

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Qualifications for Speech Pathologists Working in Hospitals

There are many places an SLP can work—schools (including preschools, elementary, secondary, and colleges and universities), government agencies and public health departments, residential or non-residential health-care facilities, in private practice, as consultants to corporations, and in hospitals, both acute-care and rehabilitation. Each of those work settings and subsequent speech pathologist careers determine the SLPs’ priorities and focus. In hospitals, SLPs tend to do more medical assessment, diagnosing, and educating than in other settings; they may see a wider variety of patients, and they often won’t know at the beginning of the day what the rest of their day may hold. And they tend to be working with patients and families who may be scared or in pain, which means they have to be extra compassionate as well as professional.

Hospital speech therapists must complete a bachelor’s degree (typically in communication sciences and disorders, but it can be in a related field), earn a master’s in speech pathology or doctoral degree in speech-language pathology from a school accredited by the Council on Academic Accreditation in Audiology and Speech-Language Pathology (CAA), perform 36 weeks of supervised clinical experience and a year-long postgraduate fellowship, pass a national licensing exam, and fulfill state requirements where he or she lives; this results in certification by the American Speech-Language-Hearing Association (ASHA) Council for Clinical Certification. SLPs must also complete a certain number of hours of continuing education before renewing their CCC-SLP certification every three years.

What Does a Speech Pathologist in a Hospital Setting Do?

The certification requirements are the same for SLPs in any situation, but those who work in hospitals must also understand medical terminology and procedures and collaborate with doctors, nurses and other members of a patient’s care team. As for a day in the life of a hospital speech pathologist, they may be working with patients who are in more critical situations than do other SLPs, since hospitals are managing the sickest and most emergent cases, which means that their diagnostic skills must be wide-ranging and quick. A hospital’s SLPs are a consulting resource for medical personnel treating patients who have had strokes, experienced traumatic injuries or head injuries, or who have swallowing or respiratory issues; as such, the SLPs must be able to assess needs and recommend treatments on an immediate basis.

Unlike many SLPs—for instance, those who work in school settings—medical SLPs may work with patients of any age, from infants to seniors and everyone in between.

5 Skills Hospital Speech Pathologists Use Every Day

While there are many skills that a speech pathologist may possess, the BLS suggests that the below qualities are important when working in this field:

1. Communication skills

It may seem obvious, but communication skills are critical for an SLP; working with patients is just the beginning. You’ll constantly communicate with doctors, nurses and other medical professionals, which means you’ll be discussing complex medical conditions and procedures. You’ll also be dealing with patients and their families, so you must be able to speak clearly and in plain language about exactly what’s going on and the path forward.

2. Listening skills

When you’re relying on your patients—who may be in discomfort or unable to speak well—and their families to explain symptoms and problems, you must be able to take in what they’re saying in detail to decide next steps. Active listening is important, especially in situations where your patient is having difficulty communicating.

3. Critical-thinking skills

You’ve listened to the patient; you’ve decided what you need to do to assess the problem. You’ve run tests or other diagnostics. Now, you have to be able to find the most probable causes and solutions for your patient, which may require thinking outside the lines, finding alternative methods or changing the treatment plan when needed. Thinking on your feet is vital in a hospital situation, as an emergent or critically ill patient may not be able to communicate well and yet needs help quickly.

4. Being detail-oriented

When a patient can’t speak or swallow correctly, every hint you get—from the patient or the family members present—is valuable. You must be able to piece together possibilities and probabilities from these details, match them up with your knowledge, and decide how to proceed. Being able to ask the right question, hear the nuances in an answer, and pick out the details that matter is a valuable skill. In addition, a medical SLP will be responsible for charting patients—just as doctors and nurses do—and must know and understand a patient’s condition, any medications that patient is on, and all the possible diagnoses, tests, and treatments for that condition. In some cases, an SLP is also contributing to the body of knowledge that an insurance company will use to make coverage decisions, which requires detailed documentation.

5. Patience and compassion

Once an emergent situation has been stabilized, an SLP focuses on helping patients regain the ability to speak, recall language and swallow. This can be slow going—stroke or traumatic-brain-injury patients may make progress incrementally, for example—and patients can get frustrated with their inability to progress more quickly. Understanding this, being able to empathize, and knowing how to help manage others’ emotions when needed is vital.

Why Become a Hospital SLP?

The reasons to consider becoming a hospital speech pathologist are strong:

  • You can make an important contribution to people during some of the toughest times in their lives 
  • You’ll have an interesting career that is not the same day-to-day
  • You’ll be a part of a team of medical professionals working together to accomplish good outcomes for patients
  • The employment prospects and salary potential are good; $85,420 was the median wage earned by a speech pathologist in a hospital setting in 2019, according to the Bureau of Labor Statistics (BLS), which projects there will be 27% more SLP jobs by 2028—much faster job growth than average. 

When you’re considering which direction to go in any career, it’s a great idea to talk to someone already in the job. You can ask questions and learn about the job differently than by research alone. Pursuing a career as a hospital SLP is no different. 

Brenda Arend is a speech-language pathologist with 30 years of experience who works in acute care at Providence St. Peter Hospital in Olympia, Washington. In a post titled “A Day in the Life of an Acute Care SLP,” she writes about her caseload in a single day, which included:

  • Assessing a man whose saliva went into his lungs (aspirated) during a heart attack to determine whether he was ready for oral feeding
  • Evaluating whether a woman with a blood clot on her brain had any oral control or swallowing difficulty
  • Postponing evaluation for a man who overdosed on street drugs until he was more alert
  • Performing a VFSS to watch how food moved through the mouth and throat of a cancer patient with a tracheostomy tube 
  • Assessing how a patient with dementia was managing food texture
  • Evaluating a patient and recommending a gastroenterologist assessment
  • Visiting and evaluating the progress of two patients who had strokes
  • Helping manage palliative care for a man with end-stage chronic obstructive pulmonary disease (COPD), who couldn’t eat food by mouth, including allowing him the treat of a few spoonfuls of ice cream.

At the end of the day, Arend wrote: “Time to go home to my family. It was a day of great variety in patients and disorders. Each patient had complex medical issues that had to be considered in my work with them, which is what I think makes work in the acute setting a challenge, but also keeps it very interesting.” 

Is a Speech Therapy Career in a Hospital Right for You?

If you like the challenge of an ever-changing landscape in your workplace, if you can easily manage moving from one care situation to the next, being a medical SLP may be the right fit for you. SLPs help people, but those in acute care are working with patients in confusing, scary or painful circumstances, which can give the job more immediacy. 

If you were to become an SLP in a school setting, you routinely would work with one student at a time in an ongoing situation; you would set goals, collaborate with teachers, and follow students’ long-term progress. You probably would see some of the same students each week. In a hospital setting, you might see 30 or more patients a week, each of whom presents with different symptoms, circumstances and needs, each of whom needs help quickly, and most likely none of whom you’ll keep up with on a long-term basis. The two SLP positions share resources, education, and professionalism, but are very different as far as day-to-day responsibilities.

Information last updated September 2020

Sponsored Online Speech Pathology Programs

Sponsored Program

Earn your Online Master’s in Speech Pathology from Emerson College

  • Complete degree in as few as 20 months
  • No GRE Required for all 2021 Cohorts
  • 5-term and 9-term study options
  • Now accepting applications

NYU Campus

Sponsored Program

Earn Your Master’s in Communicative Sciences and Disorders Online at NYU Steinhardt

  • Live, online classes of no more than 15 students
  • Prepare for SLP licensure from anywhere in the country using a state-of-the-art online platform
  • Now accepting applications

Sponsored Program

Earn your Master of Science in Communication Sciences and Disorders Online from Baylor University

  • Complete degree in as few as 20 months
  • Full-time and part-time options available
  • Same standards as the on-campus program, which has 50+ years educating SLPs
  • Now accepting applications