Episode 7 l Season 1: On being SLPs during a Global Pandemic

Highlights from this episode:

In the highlights section we will be choosing one word, one idea, one feeling that we are taking away from each conversation.

Visibility

Efficiency

Questioning

Transcript

hi everyone welcome back um today we'll be discussing being an SLP during a global pandemic that's a heavy one today Liza definitely something that sounds like everyone on this podcast will have gone through everyone listening at least yeah definitely so we'll be discussing where we were what we were doing professionally and personally um how the pandemic affected our practice and what we learned about ourselves so can't wait you ready I'm ready where were you when you found out the big news? INGRID: i think i was early to the party because personally my husband had traveled to a hot spot even before we knew what hot spots were so he had been to one of the cities in one of the airports where the first cases were reported so i was home with my sick husband trying to google everything i could about covid before we even called it covid and so it's February 2020 and then we don't know still if he had covid or not because there were no covid tests and then shortly after he was sick my two daughters were sick oh my goodness so i was stuck at home February 2020 with my whole entire family sick and i still don't know if it was covid but anecdotally we feel like it's a really strong possibility just because of where he had been how long he had been there um the timeline fit so that's where i was that's crazy ingrid i had no idea yes and professionally we had a plan um the whole district was pretty proactive we had planned for a extended spring break and for packets so we had packets

ready and then the students took their technology devices home with them for spring break in case we couldn't come back so that's where we were in march where we're like oh it's going to be a long spring break it's going to be fine but you know here are packets and take your computers and chargers home and plan for it to be extended if we need to so that's where we were i was at target whenever the first case in my county was announced okay and it was kind of like oop and that was probably the last time we went to target for a long time all of us together so mm-hmm well you're not gonna be traumatized by target because you were there today before the podcast no i love target this is not an ad but no

i love a picture if you guys go to my instagram i have a picture of the girls at target that last time when we felt it was safe no masks or anything and they're hugging the dog the spot we found the spot dog in one of the changing areas and they wanted to take a picture with it and that's the last time we had a normal day wow how about you desi where were you DESI: oh i to be honest i don't have a clear memory of um i don't have a clear memory of when exactly we went into lockdown or i remember the first time it impacted me that you know something big was coming uh i was actually in boston uh with my husband and my son um my husband was at a conference with tons of people um and it was understood that like you know we're supposed to all wash our hands you know um sanitize our hands not shake hands not you know but none of the actual uh measures had been put into place obviously this was march early march uh 2020. and so it was just hitting us watching the news in the lobby surrounded by people nobody masked or anything nobody distancing that this was just coming our way head-on um watching the news of like cases in seattle um and um and so we drove home um you know the next day uh back to maine and it just kind of hit me in the car i'm like i don't know that we're gonna go anywhere for a long time or leave the state for a long time um so then quickly after that things started changing like within those two weeks or so um one of my clearest memories is when my husband's university said okay we're going into spring break and i mean it was like literally the day before spring break they said never mind you're not coming back just clean out the dorms go get your stuff you're gonna go remote for the rest of the school year i mean which was such a crazy thing like everyone was still like responding to that they're like what does that mean what does that look like i mean they just said go home and stay there um and then for me professionally i was working in home health um at the time and it was just the weirdest thing you know like we were supposed to be like these health professionals who had answers and understood this disease and we were going into meetings still like all of us 20 30 people in a room not mass not distancing and we were just talking about like okay well what is this what does this look like you know what what is it doing to the lungs what is it doing to the heart like you know what what are some preventative measures and so again like it i just i remember this like slow lurch toward figuring out oh well we can't meet together ever again or well you have to go home you have we have to just meet on you know i think they were using skype um we have to just um build up our ppe so i that the next thing i really remember was being home um all of us all three of us and i would just sit in hour long meetings every day at noon waiting to get information because they were just trying so desperately to like gather ppe i mean nurses visits were still taking place but all of the therapists were just waiting waiting for you know and it wasn't really clear like they didn't have like a full plan but i think that was the case for a lot of these like home health based you know agencies just trying to figure out how do we keep our people safe how do we not you know circulate this respiratory illness among all of our patients who live in all these separate homes um it's a weird time super bizarre so weird this is coming from like a fully private practice type of work right or were you working in the schools so actually this was completely medical right um you mentioned this and stuff so i was like oh i wasn't yeah yeah yeah it was actually an adult-based um position so i worked mostly with adults some children every once in a while who were homebound but um no my my my patients were i'd say 70 and up for the most part and yeah so a rehab team yeah exactly like especially knowing what was coming you knew that it was coming for people who were immunocompromised had health conditions i mean and that that was everybody on my caseload

yeah because we forget that the pandemic was so long ago like it started so long ago because now i know you're in a fully different place working with fully different clients so i didn't oh wow yeah and that's it kind of fed into that right like i i started the pandemic in home health and i'm no longer in it so that's kind of the beauty of this episode to share how that happened that i transitioned away um but how about you LIZA: well i'm i mean we were talking about the introverted extroverted i feel like i'm a secret introvert but i have many extracurricular activities that involve social groups and like i'm on a step team i'm in the gospel choir like it was a huge shift personally speaking i mean everything just shut down from one day to the next i mean i went from rehearsing with 60 people in a room to being on zoom all of a sudden so that that was different i mean zoom wasn't even a word in my vocabulary i was gonna say i did not know what zoom was before the pandemic yeah it's like a full word now are you i'm gonna zoom you i zoomed him yesterday like it's like the most quickly acquired verb ever yeah now it's forever in our vocabularies but a little like you desi i can't remember the exact like spot i was in when we got the news because i felt like it was like a gradual understanding of what was happening i have some private clients that were like i'm not sure if we're gonna come next week we're not feeling good with what's going on they kind of alluded to to like this disease that's spreading from different countries and i that was the first i'd heard of it one of my clients mother's mentioned to me that she didn't want her son going anywhere they're not sure if they're coming back and i mean i had like a full caseload even before the pandemic so i was like you don't want to come that's okay i have someone else who wants to take the spot so i didn't even think about it as shutting down everything that was the first i heard of it then there was a pregnant girl at the office who was like they just declared a global pandemic or she like made a statement like that and i was like who declared that and she's like oh the wh like who the who that's funny yeah so it was so that was the second thing but even when she had said that i was still in schools that day and i went and um i was at a school where the janitor was freaking out and was like why are we still here and children are coughing all over the place and he was like really really panicking and i was just thinking i mean very wrongfully what is he doing he's causing so much panic he needs to be quiet you know but he was right a week later i think it was yeah it was march break and then and then the whole extension he was so right all of us just stayed home um i came from a family that like panics very often so i'm used to not taking panic very seriously like i just i think people overreact a lot and i'm never sure but this became more and more real as the days went on and like we couldn't even go to the office to pick up some stuff because they didn't know what kind of ppe you needed to have and just stay home do your thing so so yeah so professionally i was just in a state of confusion really i don't think i was you know fearful at the time because i don't take panic seriously um and personally it was very tough to shut down everything we had just done our montreal stepper show at the end of february and we had tickets to other people's shows people came to support us we were ready to support them in their in their shows and all their shows got cancelled so yeah it was interesting

now how did the how did the pandemic affect our practices?

desi i know you have a story because you kind of alluded to it DESI: yeah um so i guess what's fascinating um about my experience in home health was um well eventually my agency did build up their stockpile of ppe and then once they did that they're like great you guys are going back on the road um so that was maybe about a week and a half in two weeks um it wasn't if again it felt like we were home for a long time but i don't think i realistically was home for that long um so again it just it kept evolving like all the time and that was what was hard to keep up with um we had meetings all the time we had pandemic meetings i mean it's hard to do home health on the road especially when you're expected to like stop by the side of the road and attend a meeting um and so you know ppe was constantly changing um at first it was just okay well wear uh you know the mask and you're gonna wear the one mask for as many visits as you can um and then you're gonna put in a paper bag in between visits um and then eventually it evolved to okay well now we have enough ppe that you can wear one mask per day um and but you're still gonna keep that one mask uh same thing throw it out at the end of the day um and then eventually um when the general recommendation was for everyone to mask including our patients um they started to make a plan to like give us half mask respirators especially for patients who would refuse to mask um well in theory they weren't supposed to refuse to mask but you know you always had a few who did um or people who couldn't mask um so we eventually had half-mask

respirators which if you've ever seen those they look like gas masks because they have three filters one on the front and then two on the sides so doing speech therapy in a half-mask respirator i mean i felt i i sounded like i was trapped in a closet like this um nobody could hear me um especially my my elderly patients with hearing loss so um it was just yeah it was like an evolving challenge you know some people did do um some zoom visits with me which was really nice um i i had never thought about or conceptualized how to do speech therapy through zoom um especially with adults like i felt like with kids you know you can pull some games out or you know get them like to watch a video with you or something but with adults i was like wait a minute how do i reconfigure this because usually i'm in their home and we're using stuff that they have um so it was one of those things where yeah we had to pivot and think quickly um and thankfully the agency i worked for did a really nice job of allowing the people who were home to figure out how to manage that pivot how to like consult with asha how to figure out the best way to roll out something like this and how to do documentation for it um so in that sense like i think i think the hardest thing about home health was just the fact that it was constantly changing i mean there came a point too where they're like hey um you know we have um PAPR um so positive airway pressure respirators so those are the ones that had the um it's like a kind of like a helmet for your head kind of and i i apologize to all my medical slps out there who know what i'm talking about and i'm just bumbling through the vocabulary on this um but essentially you have the respirator on your back um and then the air is filtered through um the the head piece that you're wearing so it completely covers your head um and it allows you to not wear a mask um or at least it did at that time and then eventually you were like no you're gonna have to wear a pepper and your mask i mean it was just always changing yeah it was just every week was something new so you couldn't miss out on meetings or anything and i was part-time so i always felt like i was like checking in with people like wait what's what's the policy what are we doing or the number of emails was like insane um which i feel like must have happened to everybody but um yeah it made me realize like eventually how overwhelmed i was because in a in a sort of preventative measure a lot of the hospitals in the area um weren't necessarily taking on as many patients or they would be quicker to discharge people home so the people that i would see in their homes were more acute than they ever would have been normally so my visits would carry on sometimes like 45 minutes an hour i mean i've had some visits that were ridiculously long um and and so i found myself in the position of taking blood pressures and reporting blood pressures to doctors and they were too high you know a call to the doctor extends your visit too so anyway um you know it just it just felt like my life was my professional life was kind of escalating into like this very medical you know frail population um and it just it made it harder to go to work every day um so i really empathize with slps who are in hospitals who just day after day have been just working through this entire pandemic i don't know how they do it so shout out to them but but that that was my evolution um professionally in home health um yeah one of the reasons why i'm not there anymore but oh my gosh i wonder if you would still be there if it weren't for the pandemic maybe um i mean i i think i think that a lot of people um have that same experience right of where would i be if i didn't if this big event hadn't happened and um i don't know would you guys be in the same place i don't know i guess we should really go back and see i didn't go anywhere i stayed the same place you guys we're the ones who changed a little bit but i didn't go anywhere but i'm so glad that you went first desi because now i feel like i should not complain

i don't think you were do think that changes happened right like even if you stayed at the same job ingrid yeah i mean can you tell us about what what flipped what was your your big transition within your practice with the pandemic well i think they quickly realized that the packets were not going to cut it even though our schools are amazing they were literally dropping packets with the meals with the school buses so the school buses would go to their designated bus stops with meals and with work for the children but we have a pretty hefty system we use schoology already so everybody was covered like second and up i feel like they know how to get their assignments and get on conferences and stuff for other normally normal things and then we were lucky because we have teletherapists in our district already so they really they were like invaluable to us whenever we had to make that shift because they already knew all the platforms the zoom the resources like the we had so many meetings

so many meetings about how do you zoom how to project how to share your screen how to give the children remote control and you know all those fun little things and um i was one of the few cynics because there were a lot of people who were like oh no the PED

is going to be like you're forgiven for the year for the minutes and i was like i don't think so i'm pretty sure we're on the hook for all the minutes that are on that iep um and so i was one of the first who was like hey if we can see our kids through zoom like can we just start can we not wait for the platform to be perfect and for everybody to have the program and the landline i'm like can we just do it through the platform we already have because i don't feel comfortable i don't feel like the PED is gonna come back and say you're good for the year and sure enough

we were on the hook for all of those minutes and i was so thankful to not have kind of just taken it as a break um i know a lot of surrounding school districts had to extend their school year because of that because of the missed services and we were not one of them we tried everything and we i was pretty much seeing my whole caseload by week two um because all the kids were into it and then calling the parents they all knew how to do zoom you know after all of us being stuck at home for a couple of weeks so we just got going but at that time my caseload was a lot more manageable that was one huge change with budgeting and worries about all of that i used to have a full-time slp in my in my setting and now it's just part time just like shortages so that was a huge change for me but i also had to learn really quickly because i had a cf depending on me that cement it was her last section right so we had been together since may and it was march and she literally had that section left so i had to be on my toes for her i had to make sure she was getting her hours that we were doing everything that asha was recommending because she was an amazing cf and i wasn't gonna let the pandemic derail her career even if for a few weeks you know so it was a huge learning experience if we were at home at first it was fine because my husband was here um but as things so we did a red yellow green stop light thing in our state so whenever we were in the green or yellow then my husband had to go into work if we were ever in the red then he was like the first to be sent home but when we were in the yellow or green it was so hard like my daughter was three my littlest and my oldest was seven so it was chaos it was chaos half the time i'm like doing a therapy session and muting myself to yell at somebody it was ugh i feel like i aged five years a um luckily they kept us virtual so even when the kids would return because we had a lot of like back and forth um our school our schools opened in layers like the neediest children and then you know they would come in like smaller groups and the people who like really needed to be at school and then the people who could stay home would stay home it was kind of like a it was really a volunteer kind of system like if you can stay home can you please stay home so that the children whose parents have to work outside the home can come to school so it was kind of like that i felt it was a strong community i think decision to go that way so we stayed open all of that year without a lot of cases i think we did good but it was hard for me to be home and then i went back in 2021 and i still have some virtual things to contend with but i don't know nothing feels normal anymore and i worry that it won't feel normal for a long time because of all the masks and quarantines i know we haven't talked about that yet but we were just in quarantine my daughter has missed probably 23 days of school this year being in quarantine and we are only in november does she have an online um yes so we have that little okay yeah we have that back up but um yeah we just all got through covid and it was my youngest who got covid at her preschool which she hadn't been to in a year so we took her out when she was two and a half and then she just got to go back and she got covid a few months into it i mean when they're so little and then she brought it

home to all of us so we just got done being quarantined um and missing a ton of everything but like i said nothing feels normal still even though we're very lucky and desi i feel like you said for the medical slps and medical providers because it's bananas i don't even know how they do it DESI: i don't know and i was gonna say just for our listeners um we were all three of us were actually just all sick um poor ingrid was the one who got the positive covie test but i know uh liza sorry liza had um her family get sick and then my family was sick so we just all cycled through that um so this episode felt really appropriate um to speak to that um i mean and i just i you brought back some ptsd for me ingrid i was thinking about sorry uh like one morning uh i was on a meeting and my husband was on a meeting and my son was just not having any of it because he was yeah about um 12 months old at that point and so i was making breakfast my son was screaming his head off my husband was having his meeting as well and it was just utter chaos i mean things that i just would never want to revisit ever again INGRID: i had to potty train my daughter because there were no diapers

LIZA: me too not because there were no diapers it was my choice but there was no toilet paper around that's for sure INGRID: i mean we were kind of pushing it i mean she's so she turned she was two and a half and we were kind of like there with it you know but when there were no diapers and then the the toilet paper came and then the wipes went too i was like okay like this is it i am not doing the cloth diaper thing like you you need to be done we have diapers for you to wear one per day at night and that's it DESI: wow figure it out kid LIZA: figured it out so much so much that you said ingrid resonated with me but i wanna mention that like i'm amazed at the kind of mentor that you are because you still had your student in mind knowing fully well that she had to give you grace i mean you couldn't possibly have all the hours that you were able to provide for her before the pandemic but you were still like no we're gonna get you what you need so that's beautiful because a lot of supervisors here in montreal just dropped their oh my gosh they're students because they're like we don't know what we're doing and we don't know what we're teaching and a lot of people were like against online you know telepractice that kind of thing they didn't think it would work and i used to be in that camp before the pandemic like i wasn't interested at all and even learning how to work online i was like in person's always best you know the kids get their high fives the hugs the toys but i really changed my tune when this pandemic hit and the just the sheer guilt i felt with every passing day of being paid and not working with children i i just couldn't have it so like you i was like i need to figure out the zoom thing and i just need to know how to work with some kids and one thing that you said at the very beginning about these packets just not working i mean so many online tools were put in place so many links were given to parents so many things that you know me and my team and the psychologists and the ed consultants like uh the special ed consultants they all came together and made these like amazing uh powerpoints and things but like desi said their emails were just saturated like their inboxes i'm sorry which is full full full so they couldn't keep up with all the links we were sending and then we tried to put it all in one place but then that page was so overwhelming for them because it was like 75 links and often you need to know what um difficulties your child is having to know which link to go to and you need a professional for that and we were not really available at the time and it was it was very messy at first so my very kind boss was like just take this time to catch up on your paperwork and your reports and you know you have a young child at home just make sure she's safe and don't stress so much and i was like okay so i i spent more time with mila that i had ever spent i mean she was always in daycare and i was at work and it was beautiful like i i got to i got to potty train her like i got to hear the evolution of her language like in real time so that was that was a really beautiful thing that i felt that i had um but i feel because the original question is how it affected our practice and i felt it sharpened my skills as an slp because once i was okay with zoom and these parents opened up their screens and i saw what home life really looked like i saw how useless my packages were can you read a story for 20 minutes to your child when you have a three-year-old running behind you and a newborn and like the tv is on yeah right the tv is on you know there are dishes in the sink life is happening yeah my house is the same yeah and and just like just seeing what parents go through on a day-to-day basis help me provide appropriate recommendations that were doable and natural and parents got to see me at work because right and and then parents took on the onus of repeating the strategy in real time and getting the feedback that they needed and i was like i have never done this before at the school board it felt like i was able to bring my private practice skills to the school board i had parents involved i i was able to see families and like you know sometimes we would have a super great session and like the dad would walk by on his cell phone and have like a full conference call and just like you know and his voice was like cutting out my voice and like and we just waited like literally no hurry nobody's going anywhere and it was it was wonderful and i like not the pandemic itself but the practice and learning how to just be a better clinician to the families that were servicing yeah i think it really positively affected my practice once i got over the fear of telepractice DESI: i think that's what's really um nice about the telepractice piece like you were saying just how much more you can individualize it um because i felt the same way um in a lot of regards like it was like all right well we can't just sit here and like like not we can't sit here and waste time in the sense that like you have other things to attend to so let's focus on what it is that you need how it is that we can practice it and then how you can take it and use it later um because we need to capitalize on this time because you do have to get back to dishes and you do have to get back to your other kid i i felt like it was in that like just how you said it like figuring out a way to make it personalized and LIZA: parents you realize that doing dishes sorry ingrid well you know well parents don't realize that doing dishes or cooking with your child and all of that can be could definitely be a speech therapy goal they were so used to like cue cards and booklets and you know reading books word for word and like all these old school type of tips uh but there was something else i want to say about um instagram and facebook actually and what that did for me in my practice but ingrid i think you want to say INGRID: i was just gonna say that i'm glad you brought all that up because i think the major thing that changed in my practice that i wouldn't have mentioned unless you had shared yours is that parents finally know what i do LIZA: yes! INGRID: they finally see me do it they've seen me how i you know take one whatever sound their kid is working on even something simple as artic and they're like i see how you're cueing and why and i understand or you know i saw how you played that game with them and i saw that you weren't just playing like you know because the kids go back and tell their parents very simplistic you know oh we worked on this in speech or we played this in speech and they don't know why but when they see you in action and they're like i see what you're doing why you're doing it and then so getting those emails are like what got me through like i saw the other day what you did can you send me that book so i can do it? LIZA: yes and i know exactly now that i saw you do it the cutest thing was so i had to have all of my sessions right at mila's nap time i couldn't have it before or after because she was just running around but sometimes she would wake up early from nap and she'd come on screen and i just became human to to these people like we are living the pandemic together we are in the same boat it was always like i was this professional that they never saw until a results meeting you know and i came in with like this report and and it was such a different feel like being being there both of us quote unquote stuck at home you know and i liked it i really liked it but um ingrid you mentioned that you already had like telepractice specialists in your district we didn't have that um at my school board not that i know of anyway everyone was like are we doing you know people didn't even like to facetime i know i was the only one facetiming my friends before the panda making they're like why do you want to stop why wouldn't you want to but yes so wait why am i mentioning that oh because i had to search online to find other slps who knew what they were doing and were willing to share and i met a whole community on instagram a whole community and that's where i met all of you actually and then clubhouse actually that's where i met ingrid and then clubhouse desi but all of that happened because of the pandemic like everything i am now as a professional i can directly relate back to the pandemic right it's crazy DESI: and actually i wanted to mention that too and i can't believe i forgot i left that out but i'm so glad you mentioned that because that's exactly where i started making more connections with people and one of the reasons that i left home health was because of the fact that now i could you know i knew that there was just so much more opportunity to like work online or um you know i really went down this road of thinking about starting my own practice because i realized that i was taking risks and i was working um in these situations where i really didn't necessarily want to be and there were so many more opportunities that i could just reach out and do without risking my health or without having to go into people's homes um and so part of that you know part of putting that plan into motion was connecting with people and i went on facebook and i started asking questions in groups um i built up uh an instagram um page and i i wasn't planning on i i literally like started it i put up a picture and i was like okay i'm here this is just so i can follow people um who are slps and not have it like crowd my personal one um and then from there um i realized like hey well i should post i really want to engage with this community um and i say this now when i haven't posted anything in months but you get other things going on i do have other things going on but i i still love the community i still get messages like even people just commenting on stories that i've shared and it's just so enriching like you were saying i've learned so much and i think it's made me a better person um just being able to see what other people are doing up you know upgrade my practice learn about things that are you know up and coming um it's kept me way fresher than i think i've ever would have been on my own so INGRID: you almost kind of went on to our last question so what did you guys learn about yourselves as an slp and as a person through this?

LIZA: well i learned that i was doing too much too many times uh writing reports with details that really didn't matter putting in paragraphs because they seemed professional but parents would just skim right over them or not understand them so for sure i learned about doing too much and doing not necessarily the bare minimum but efficiently working with only the things

DESI: we've got a visitor for our pandemic podcast INGRID: she's whispering at me why is this taking so long?

LIZA: oh you're almost done my friend

DESI: well i'm gonna just piggyback off of you liza because i feel the same way like i i i questioned a lot of things you know and i think that having a new community having other opportunities just you know with teletherapy changing with my own priorities shifting um i really started questioning like well what why why do i do this and why does this matter or you know why is it expected that i should do x job and see x many clients and work myself till you know x number of hours each day um i i couldn't do it anymore especially you know having a family um and we live away from our families like our parents and stuff so it was just too much um and so i'm grateful for the covid 19 pandemic for showing me that it was too much and that there were more efficient ways of managing my time just like you said LIZA: mm-hmm what about you ingrid? and your little one can answer too INGRID: yeah amelia's here i'm gonna get a little philosophical about what i learned about myself about an slp because you know that my personal learnings are like i just don't give a crap about as much as i used to but about being an slp the pandemic taught me that i need to step it up that my visibility my voice i learned the phrase take up space yes i didn't know that i needed to take up space for my community until the pandemic and Instagram i didn't know that me being visible to future slps who are Mexican-american was important and so that has been my biggest lesson through the pandemic and through this like influx of being in social media connected through social media because we're all stuck at home and not doing all our normal things but yeah that was a major realization for me you're not stuck at home AMELIA: i'm going to Gigi & Papa's INGRID: yes you're going to gigi and papa um but that has been my major you guys i didn't know that anybody wanted to hear from me i was just here in my little happy corner small town making change here of course because it's within me but i didn't know that i needed to make that visible and make myself available and for mentorship which i love so LIZA: you did an incredible job you did an incredible job representation wise visibility wise i'm going to coin your word for you as visibility INGRID: yes! that's my last word LIZA: that's your last word and mine is going to be efficiency oh what about you desi DESI: i think questioning I'm going to stick to that one questioning so we have to question everything questioning efficiency and visibility yes what will our next episode be about Desi uh so actually this is a perfect transition right here because next episode we'll be talking about how social media brought us together so i'm glad we didn't go further into the details into the weeds but i think it's gonna be a great um episode to follow up on this one

thank you for listening and supporting the bold slp collective you can find a closed captioned version of this podcast on our YouTube channel we will also have show notes on our website if you enjoyed this episode we'd really appreciate it if you do all the podcast things follow subscribe download and review and don't forget we love hearing from you so connect with us on Instagram at the bold slp collective stay bold and humble see you next time