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Focus on Geriatric and Adult Services

Advantages of PRN Therapists

Published July 19, 2012 8:18 AM by Jennifer Kay-Williams

On July 4, 2012, Valerie Lill devoted her blog post on Speech in the Schools to the ever-present need for Speech-Language Pathologists to cover positions in public school systems. I started to think about the sort of shortages we have in long-term care settings: even when positions are filled by permanent or contract staff, SLPs and rehab managers are often scrambling to find coverage for SLPs that are going on vacation or need a day off here and there. Typically, when I take a weekday off due to an appointment, or when I want to use a vacation day on a Monday or Friday in order to enjoy a long weekend, I make up for it by working a Saturday or Sunday.

While this ability to be somewhat flexible in scheduling is a definite perk, it does not solve the ultimate problem: it is often nearly impossible to find a consistent substitute for coverage. There is frequently only one speech therapist working full-time in a building, and even if the size of the building calls for more than one, the second therapist may not be able to cover the combined caseload alone. Sometimes another SLP who works for the same company may be able to lend a hand, but that can be tricky if facilities are spread out or caseload sizes increase drastically.

So, wouldn't rehab companies and nursing facilities want to have a pool of PRN therapists to cover in such circumstances for employees who need to take time off ? Of course! But that pool cannot exist without professional staff. Working PRN at a SNF can also be a great chance for SLPs in other settings, such as public schools and pediatric programs, to maintain their clinical skills with dysphagic and aphasic patients, and persons with dementia. SLPs who are currently exploring related career opportunities that do not require direct patient contact, and therapists who do not want to commit to full-time work due to family obligations or other situations, may want to consider such "casual" arrangements. Some reasons I hear SLPs in educational and other settings give for hesitating to try this are:

  • Not wanting to feel obligated to work at times when they have a busy schedule at a full-time job.
  • Worry that it has been "too long" since they last used necessary clinical skills.
  • Concern over "fitting in" or functioning in a medical setting that involves doctors, nurses, therapists from several disciplines, families, dieticians and so on.
  • The need to learn new documentation protocols, billing systems, and software.
  • Lack of a wide variety of books and materials that address the needs of adult and geriatric patients.

Think for minute about the experiences you already have. As a professional, you have earned an advanced degree. You have taken graduate level courses, worked in university clinics and hospitals, and gained important on-the-job experience. You are able to problem-solve, adapt, and work creatively in a team. So, how can you translate your current skills into an opportunity to gain professional experience (and earn a little extra income)? Stay tuned, because I want to delve into that next week!

5 comments

Previously, I have discussed options for those of you who want to gain some experience in geriatrics

August 22, 2012 9:05 AM

Big downfall of being PRN now in Rehab is the Productivity levels- my last 2 rehab companies had PRNs at at least 90% productivity.

L B July 26, 2012 3:22 PM

Another reason for not exploring part time service in another facility is because of employers' contracts. My employer has a clause that says that all employment outside of their facility has to be approved by them. I for one was denied due to "conflict of interest" and only was allowed to work outside of the agency when I said that I would contact a lawyer. Employers should work together in order to help with the shortage of therapists across all settings.

Mela Shannon, e - Speech Therapist, MIU4 July 26, 2012 10:02 AM
Stoneboro PA

Good article.  I'm looking forward to the continuation.  I live 5 blocks from a LTC facility and I've thought it would be convenient to do some hours there, but I know the paper work is a bear.  I last worked at a LTC 12 yrs. ago for a few months, but left because all I did was 'try' to hand write reports.  I needed more training with procedures, but I was disenchanted by all that paper work. (And I have previous hospital and LTC experience, so I wasn't coming in as a newbie to that setting.)  I hope things have changed in that regard.

Long- and short-term nursing facilities seem to only advertise for salaried, permanent staff.  If they want temps they need to advertise for that, too.  :)

J.S. July 26, 2012 8:53 AM

Jennifer thank you for this! I am in the process of exploring this option and am excited and terrified!  I look forward to reading your next post.

Alex Streeter July 25, 2012 11:41 PM

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