hospital

This is not my for-keeps internship (real internships are in the spring; I have my school placement but am still interviewing for my other placement), but I have an offsite placement at this hospital for a few months this semester. I spend one morning per week here going around with the SLPs.

I just finished my second week, so I am still doing a lot of observing. So far, it has been a really great experience. I am with the SLPs who work on the acute floors (as opposed to rehab), so the patients we see have just had their injuries/damage/surgery or have just had a new development in their speech/language or swallowing. Yes, swallowing. This offsite is actually specifically for swallowing, though I have seen about half-and-half swallowing and language/speech evals. My first week I saw a heartbreaking stroke case but obviously can't share the details. This last week was all about swallowing. I even saw someone in the ICU, got to gown and glove up, and help move the patient...I felt so Grey's Anatomy, haha. We also had two video fluoroscopic swallow studies (VFSS), and I was pleased with how much I actually do remember from my dysphagia class.

If anyone is curious what a VFSS is, it is a video x-ray of swallowing. We present the patient with different textures of liquids and solids that have barium in or on them so that they can be visualized by x-ray. Our job is to observe how the patient handles the different textures in her mouth, pharynx, and larynx and to determine what is safe for the patient. Typical textures are thin, honey-thick, nectar-thick, puree, and cracker/cookie, and then we will often do a barium tablet as well to determine the safest way for a patient to take meds. The most important thing to look for is if anything is going down the trachea instead of the esophagus, but there is A LOT more to look for than that, and it all happens crazy fast.