It has been a while since I have worked as an SLP in a hospital or a school setting. However, I am aware of the many changes that have occurred in both settings over the years as a result of legislation such as IDEA, demographics (more CLD populations), and technology. As a university professor, I often hear my students say that even though they prefer working with young students or with adolescents, they will seek a hospital job. They believe that there are more opportunities to serve clients on a more individual basis and less paperwork compared to working in the public schools.
I am not certain that working in a hospital is necessarily the solution to having less paperwork and fewer clients or, for that matter, experience less stress. Whether you work in a school, a hospital, a rehabilitation center, or even in a private practice, you will be equally busy and consumed by the demands of the job. The work schedule of an SLP does not follow the typical “9 to 5” pattern in either setting. Dedicated clinicians work as much whether they deliver services in the public schools or a hospital. When I worked in a hospital many years ago, I had pressure from my supervisor to be productive. This meant scheduling as many clients as possible during the day to maximize billable hours. To show that I was trying my best, I scheduled as many clients as I could fit and hoped that I would have some cancellations so that I could write some reports during those times. If I could not finish the reports because everyone showed up, I had to take them home. When I worked in the public schools, I did not want to seek extensions, so I tried to assess all students on time and often ended with an inflated caseload.
To prove that the demands made upon the SLP are equally great regardless of setting, I have drafted a table that includes several factors to consider such as caseloads, paperwork, collaboration etc. and how they are addressed in the two settings. As you read on, you will find that there are variations between settings in regards to a particular factor but, in some, a lot is required of SLPs whether they work in a hospital or a public school setting. For example, the public schools demand a great deal of paperwork but, in exchange, the SLP has many more breaks throughout the year including having the summer off. The caseload in a hospital may be less, but the clients’ needs are often more challenging and unpredictable from day to day. Both settings require collaboration with other professionals including families. The SLP working in the public schools may have more control in setting a final work schedule compared to the SLP working in a hospital or rehabilitation center. The challenge of working with clients for whom English is their second language is on the rise in both settings and it is necessary to coordinate times to collaborate with an interpreter/translator. Therefore, in my opinion, there is no “better” or “worse” setting.
In the end, SLPs need to decide the type of clients that they enjoy working with the most. Ultimately, the setting where they work will be secondary to their job satisfaction.
|Caseload||May be very high at times.||Variable.|
|Schedule||More control from the SLP but depends on school schedule. Yet, ends up being more predictable by following the hours of the school.||Quite npredictable. Full week and weekends may be necessary.|
|Client’s needs||More predictable||Quite unpredictable.|
|CLD clients||On the rise. Collaboration with an interpreter / translator is necessary.||On the rise. Collaboration with an interpreter / translator is necessary.|
|Collaboration with other professionals||Very necessary because goals need to be aligned with curriculum.||Necessary to enable client to attain functional skills to regain maximal performance.|
|Intervention||Individual- but mostly groups.||Mostly individual- but some groups as well.|
|Place of Intervention||“Pull in” and “pull out” models.||One on one, but sometimes in conjunction with other therapies.|
|Paperwork||Quite substantial||More contained.|
|Pace of work||Sustained||Sustained|
|Vacations||Several breaks and summer||Some breaks and generally only two weeks.|
Coming up in the QUÉ TAL issue of May 2007
Multilingual and Multicultural Resources Readily Available Online