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If 2020 was a gift, I would wrap it in the ugliest, most depressing design of wrapping paper. No bow, no frills, and as a matter of fact, no tape either. Just stuck together with some chewed up gum at the corners where the folds of paper meet – not to mention, no less than three big tears, like when you accidentally tug too hard and the result is irreparable, but you act like you can hide it under tape or patch it with another piece of paper. Yeah. 2020 was THAT gift that if you saw it before it came, you would have looked the other direction. It’s been one for the books, and mostly not in a good way.

Although that gift is rough around the edges like Santa’s last minute effort to deliver his drunken elves work down a chimney with the fireplace still burning the midnight oil… sometimes what comes of it is a bigger lesson and a bigger blessing than the ones with all the frills.

If it weren’t for 2020… If it weren’t for COVID… things would look very different.

Tattletales had a name before 2020 began, but it didn’t have anything but a few paragraphs strung together. Now it is a book, the beginnings of a community and service organization, and a growing resource center.

Breaking the fourth wall, well I had credentials at the start of this year, but I was actively running from my job. Any and everything outside of those lobby doors looked like fuzz and frill and fun…

Work was work, and life was life. I was determined to live them as separately as possible.

Yet, today, I find myself toppling task over task, most of which have a similar foundation in my work. But I’m loving it. I’m finally proud to be a speech-language pathologist. It’s a funny thing, but the more I lived life away from my job, the better I was able to give to myself from a work perspective. I deduced that the only way to make it come full circle was to learn what my needs were, and have the work follow. 

Heck yeah, there’s a long way to go. If there’s anything 2020 has taught me, it’s that good things take time. Inevitably. Uncomfortably. 

So I welcome 2021 with open arms and a few items on my bucket wish list. Most of all, I wish to see curious but hesitant post-grads learn how to love this field – to help build a recipe for success. We bring so much to the table, in such a unique way. I want that to be noticeable, to be a source of pride, and to ultimately elevate everything we touch.

Cheers to the undergrad and graduate students, clinical fellows, licensed clinicians, researchers, directors, private practitioners, and leaders that make the SLP world go ’round.

You are somebody’s hero.

Recently, I have come upon a bunch of new opportunities and ideas that have moved me left or right, onto some new path tangential to the one before it. To say the least, I’ve accepted so many new things, that my already full plate is weighing me down and I can’t stomach it all. It all looks, smells, and give the right appetite can taste amazing. But I’m learning slowly but surely that I can’t say yes to everything.

I’ve gone above and beyond in my confidence, which I denounced in my recent post on interviewing. I’ve also made promises I couldn’t keep…. send me to the guillotine. I don’t even follow my own advice 😩.

I’m going to be honest with you all, at all times. What good does it do me or you to be any less? At the very least maybe you can laugh at my pain. At best, you can make fewer of the amount of mistakes I have or tweak my successes into your own great feats.

We talked about how 2020 has been all the big, long, uncomfortable things. Well, to give myself the relief I thought I needed, I searched high and low for new opportunities. Some, I forgot all about until they came knocking at my door. I’m a pleaser, of course I invited them in for hot chocolate and cookies 🥴

To stay long or to stay for just a little while, I have said “yes” as a jerk reaction to just about everything.

“Yes, I will take that job”

“Yes, I can move”

“Yes, I can learn how to do that”

“Yes, I can meet that deadline”

“Yes, I am ready to take this to the next level”

“Yes, I can commit to that in a short-time frame with no experience”

“Yes, I can work weekends”

Let’s stop right there. I do NOT, have NEVER considered working weekends. If you read Tattletales of a Speech Language Pathologist, you know I was in shambles when PDPM, the new system for reimbursement in the skilled nursing facility, had me working every other Saturday.

Why am I being so untrue with myself and (potential) employers, you wonder? 

It’s nothing more than the FOMO that plagued my social life for many years, and has now picked up its things and moved over the professional side of the neighborhood. FOMO has led me to believe that after 2 years of practice, I need all the right answers right now. I’m accepting things that I hope will advance me intellectually, put me in an enviable position, and set me on a path towards greatness. Maybe I don’t need to take a jet pack up every step at once, but I need to know where I can place things on a calendar. How long will it take?

This type of thinking is actively ruining me. I’m saying this because I think we all will run into a point at which we don’t know which way seems the most direct, or maybe you’re standing at a fork after which all paths seem to be littered with jewels of great fortune. Maybe they all are, but if you choose one, the others are inevitably removed from your sight.

The idea that you and I should choose “reasonably”, is unfair. Perhaps what’s most reasonable in my case is making more money. Perhaps what’s reasonable in your case is having great job security or being able to travel. We have to be willing to sacrifice. A wise man once said “What are you willing to go without?”

I was challenged this past week to make a list of the things that are most important to me, where a job or career move is concerned. Making this list may be less the challenge for me because I am driven to believe in the impossible, chase every dream, and trust that I have the power to make it come true.

The greater challenge, which is really the unspoken one, is crossing out one, two, or even all of those things. Maybe it seems like working backwards, but it isn’t. 

In reality, how many “most important” things are there really? When it comes to a job, even less. There are things that may give us value in the workplace itself or in our total prospect towards a successful career. In this, we may accomplish a lot, but it is not without the sacrifice of something that we consider to be “most important”

I yielded a little bit of myself in a way in my book, and I spoke about my relationship with my family. “Workaholic” is one word that can bring rise to a lot of negative feelings when I consider the effect that its had on my life. I know that the allowance for personal or “family time” is on every professional’s list of important things. It’s also the sacrifice of many who realize a need for additional money or to stride towards a higher position on the totem pole.

There are things that are never worth the sacrifice, but that will be a subjective and personal decision. I think that when the time comes, we all have an internal shift towards what feels most correct, and I want to say more often than not we are right about it. 

I say all this to say that coping with “I accept” syndrome has looked almost like digging a shovel into a hollow grave. There is nothing productive about it, it isn’t safe nor satisfying, and it wastes potential energy – at the end, there is barely enough to show for all of the hard work.

This time I vow to follow my advice, finally. Setting myself up for success is creating a vision and working effectively towards it. It’s saying “no” more often, even to myself. It’s establishing “What’s the one thing you can do, such that by doing it, everything else will be easier or unnecessary?

-Gary Keller

Ideally, you’d spent some weeks training. Maybe, instead, a stork just came and dropped you head first into a several-hundred-bed box of no windows, squeaky doors, paper charts, and slow elevators. Don’t panic! 

After applying for the graduate entrance, CFY, and for every job after this step, you can expect an interview and matriculating process to ensue. You may wonder what to expect and what tactics to use. If you haven’t yet mastered the interview, I help out with that in my book: Tattletales of a Speech Language Pathologist. Essentially, I just have to say… bring YOU. You already have everything you need to hold this sucker down, you just need a little flair and a lot of confidence. 

Confidence doesn’t equate to acting like a hot shot or that you know everything you in fact, do not. I’ve been unafraid to say “I don’t know” at interviews. Most times, I stated that under a certain circumstance, I can expect to do blank blank blank; however, I understand that there may be other ways to handle such a situation. A hot shot doesn’t leave room open for guidance and is likely not that teachable; there’s no worse trait for an employee. Rather than deal their cards at the risk of what the heck you could turn out to be – hey, maybe you are a great therapist – it’s safer to take someone who knows nothing, and who they can mold.

Tangentially, take care to making promises that you can’t keep up with. Whether it’s something that requires a skill, or something that requires too much of your time, any unmet promises reflect poorly on you and may even jeopardize your position or your license. For instance, in response to “Would you be comfortable working a 60 hour week every week for 52 weeks of the year?” you should not say yes because you want the job. Say no and explain that although your work is very meaningful to you, you also value balance so that you can bring your very best self to work every day. You may be willing to negotiate scheduling and paid time off to satisfy a need that the company has, but it would not be possible or reasonable to make that commitment. The fear of having a company choose another candidate is STRONG, I feel it every time. It’s professional FOMO. I actually have this weird way of immediately saying “I accept…” and experiencing a weird chill of regret right after. The truth is that it’s extremely helpful to have the time to consider how a new position may uproot other plans or commitments you may have. Even if I had thought about it before, having the job offer in hand changes things. At times, I’ve followed up with …”unofficially” and stuttered my way through whatever excuse I could use to delay the process. I might have said I would like to ask a few more questions or see the facility. Don’t be like Suleika. Take the time to be sure.

Lately, it’s been the case that most interview processes start off with the interviewer answering many questions I hadn’t even thought to ask yet. I could tell they loved my resume because they seemed to be trying to impress me in return by telling me all the wonderful reasons I should work with them. Alternatively, I also had an interview that started off with the interviewer warning me about how hard a position might be to obtain or keep, as the nature of the work was very stressful.

One shouldn’t expect that the interview will be hard or worthy of an anxious breakdown just prior. It’s not an exam. Still, to impress an interviewer, there are some things one should prepare to be questioned about and ready to respond to.

Sometimes, but not often enough, I was asked why I was the right person for the job. To best answer this question, it’s important to know the ideals of the workplace and about the activities that are most beneficial for the population you’ll be servicing. It is a personality question, as well as knowledge-based one. There is no specific right answer, but one surefire way to let an interviewer know that you are wrong for it is to use some generalized list of traits about yourself or to not have any idea of what your clients will need from you.

I was never asked what my feelings were towards my then current position, why I was ready to leave it, or how I was sure this position would be any different. I might have had an answer ready for these sometimes, but even then, I imagined that the interviewer would have seen right through me or devalued whatever answer I gave. It was a personal issue of self-confidence and anxiety, really. Do yourself one better than I did and shoo those feelings. Your interviewer knows that there is a reason you are looking for a better opportunity. If asked, perhaps honesty is the best policy, but what if your reason for leaving is your fault or makes you look bad? My Tattletales advice could be to restructure and retell the story in your own favor, but there is a positive outcome of retelling your mistakes and what you’ve learned. The interviewer will see a person who is not only teachable, but seeks understanding and resolution when mistakes are made… and we all know they will be!

While I received at least one dysphagia therapy or evaluation question during the interview, I was never asked actual speech modality therapy questions. I was certainly never given anything such as outlining a therapeutic plan on the spot, and to date I can recall being given one single case study question. I mean, I really thought the PRAXIS was going to come back to haunt me each time, and it didn’t. That’s not a reason not to stay prepared. A little research may go a long way in your interview, and even if you still aren’t sure of the answer, you have more to share than the person who didn’t even think to get a quick blurb from Google.

I was asked other questions I wasn’t ready for, but somehow killed with great responses that surprised even me. They were questions that made me reflect on why I decided to serve a certain population in the first place, and I recalled what my biggest challenges were in a certain setting or with an individual client. They were questions that, when I answered, I reassured myself I was making the right move. Interviewers liked me because they saw I brought myself and my passion to the interview, aside from just a little bit of knowledge.

After all, the interview is a two-way street. Interviewers know what they are looking for. It could be just a body to put in a position, and you’ll know that when they ask checkbox questions and do not use the time to get to know you or have a conversation. Alternatively, they could be looking for someone to set a new course of things around a system that is developing, and this really allows you to bring your experience, ideas, and charm. Your personality leads this interview.

For someone early on in the field, it is most important to keep in mind what you are looking to achieve, rather than to bank on what you feel you’ve already achieved. The truth is, there are plenty more experienced professionals applying who are well qualified, who may still not necessarily be a better candidate than you, for any variety of reasons.

Give yourself the benefit of the doubt, and grasp opportunity barehanded by the horns. You deserve all those that come charging at you blindly, and will learn to balance them with those that you seek out and diligently pursue. Come with YOU first, and everything else will follow.

Remember that your silent goal is to reduce patient AND caregiver burden, therefore it’s important to consider who cares for this patient and what they are capable of.

One thing nobody tells you about in grad school is how heavily money drives service provision. You know that in order to survive, businesses need to make money, of course – but does it have to be a big red boxing glove uppercut in your chin big deal? Well, different settings have different ways of managing billing situations and your money isn’t necessarily always tied up in that confusion, but most recently for me it has. Coming from the SNF (skilled nursing facility) setting, where my hours may not have always been guaranteed, my time was always compensated without question or confusion. If I clocked in and clocked out, I received my hourly pay rate whether or not my billing and notes were all done properly. While that is never an excuse to slack on either billing or notes (don’t go and get fired!), it seemed fair. Taking my talents over to EI was not this way… at all. There was no clock machine, and I sure as hell wasn’t paid for the in-betweens including travel, phone conversations with other providers, advocate letters for families, nor the occasional drag to leave a child’s home when the parent has tons of questions that they don’t ask until after you’ve already completed your 30 mins. I decided that because each session paid an erroneously high amount for 30 mins of play time, all of those things were essentially priced in. Well, in the month of September, I was smacked in the face to learn that no it was not effectively priced in, and furthermore I might not get paid at all after I failed to fill out billing documents to the satisfaction of the agency’s billing coordinator who works with Medicaid for reimbursement. She returned THIRTEEN session notes marked with red circles and Xs and scribbles, bringing me back to the memory of 5th grade English class book reports. The agency clinical director put me through a mandatory retraining and advised me to return all documents ASAP to reduce delay of my payment. What else could I do? I worked tirelessly to redo the notes, but they were still imperfect. In the next billing cycle, I had 8 more notes returned, continuing on in the silly cycle. I legitimately missed session appointments just to ensure I got it all together. I drove to houses at odd hours, just to collect parent signatures the second time around. Still, two months after making EI my full time job, I had not received a PENNY for my services provided. If this sounds like an introductory episode to how to get away with murder, it’s definitely because I was sharpening the knife and polishing my steel toed boots. To be continued…

Maybe we don’t differ so much in our industry as we think we do, if we can’t consider ourselves to be agents for a greater cause than keeping the wheels turning in our facilities.

As a follow up for my recent post on pants-less Early Intervention.. I mean the Telehealth to In-Person Transition, I wanted to write a short how-to for choosing your work wardrobe. 

On a long day, I realize there are not only temperature changes outside, but also inside the homes. Some people love heat 😅 and while I do too, some kids will have you running up and down hallways and lifting their too-heavy-for-age-2 bodies above your head several times in a 30 minute period. Let’s not get into jumping, spinning, and stomping like an elephant – it gets to be a bit much. It’s recommended to wear removable layers in the event that the heat (or cold) are a bit beyond your threshold. 

I have kids that grab and hold on tight, which could be because they’re angry or they’re just very excited to see me. Care for wearing long sleeves (can be breathable fabric), buns over ponytails or loose hair, and absolutely NO V necks! I know I mentioned layers but it should really be a consideration to wear an undershirt as a precautionary measure if ever you are sitting on the floor, bending, or lifting up high that the entire family doesn’t necessarily have to enjoy your midriff. Ladies, aways wear a bra, and I don’t have to tell you why. 

Pants, whether shorts (near the knees please) or long pants should pass the buttcrack test. Don’t be that guy. If you live in a warm place, you may be tempted to wear loafers or flip flops/sandals often which is no problem. If you do so, have a handy dandy pocket with extra socks. Don’t ever put it past a family that they may not want you to wear shoes in their house. I know my house is outside shoes free, and because I walk around my house barefoot, I have tried this in other homes and when I tell you I was so regretful sometimes, when I realized the dirt or other particles that cane in contact with my skin!? 

I don’t wear jewelry, but for those of you who do… well, DON’T 🤷🏽‍♀️. There isn’t a single safe piece of jewelry that I can think of that should beyond a reasonable doubt enter the home of a 0-3 year old client. If you must, make sure it passes the poke and pull test (i.e. that it will not scratch, cut, or bind anything on the child’s body if they try to grab you). 

Surprisingly, I find that long nails (for my long tips queens) is not a no-no for EI Therapy. Let’s be real, while the mundane look works for EI kids for a reason, you have a life outside of those homes and nails cannot be repetitively put on or taken off like jewelry can. With care to the kinds of activities you’ll be doing, long nails should generally hold up well during the session and do not typically pose any unnecessary danger to the child (just try not to poke an eye out). A fun positive – long nails make noise on solid surfaces and is a great attention grabber during session time. Use it to your advantage. 

I wish I had advice for glasses, but I don’t ever wear them, except for those silly ones with the big nose and furry eyebrows I use to get some extra eye contact during activities. They always get ripped off, so perhaps if you don’t need the glasses, don’t bother with them just for fashion.

Your mask will be also be ripped off at some unexpected time, without a doubt, if you work with children. Carry more than one, in the event it falls on the floor, gets coughed or sneezed on, or the child runs with it and you can’t catch them, you at least have gave a backup.

Thanks for coming to my Ted Talk. Have a great day.