Regret ever training as a Speech and Language Therapist

[oneanddonemaybe]

I am a SLT and have been working for 9 years. I haven't liked my job for most of this time. Its too long to get in to aaaall the reasons why i don't like my job, if anyone has specific questions I am happy to help. If you go on reddit there are so many people like me but most of them seem to be American. Would love to speak to UK SLT's who feel the same as me.
i don't see myself retraining because it took a lot of effort to graduate. Had a lot of personal stuff going on at the time and also an absolute nightmare final year placement which I had to 're-sit'. I know i am good at my job. But its costing me my mental health and my personal time outside of work. I am also a mum of a 3 year old.
I don't want a paycut and there is no job i could slide into with no further education, which would give me the same salary as I am on now (top of band 6 payscale).

I think i like working in a health related career, but out of all the Allied health professions i could have chosen, i think SLT was the worst decision. I wish i did audiology or radiography. At the same payscale as me, i know for sure there is less admin and less pressure in one of those careers.
I am going to be doing dysphagia training next month, which means about 7 months of studying, coursework and a final exam, but i am willing to put in the work. I have wanted to do dysphagia training for the last 5 years or so but the only way you can do it is if your workplace will allow you the time and give you a supervisor for those 7 months, this is even if you are willing to pay the 1k it costs to do the training, which i was. thankfully my work is paying for this. I really hope i feel a lot happier with a dysphagia caseload. i really think i will. Time will tell!

Would love to hear from any UK SLT's or even students who are regretting their decision. Just so I don't feel like the only one out there!

You don’t really say why you don’t like it?

Just that other jobs appear to be easier. So I’m not sure what you mean sorry.

I’m an SLT and work across 7 days and not nine to five.

I don’t work in the NHS OP. I think I would struggle if I did as it would clash too much with my values - would be hard for me to work in the way I enjoy and like.

The role is so varied maybe look to move service/area?

I had this experience working as a PT, hit a wall at 7 years pq, and then left after a few more years. Now I have been out for a year, I think it was just the relentlessness of patient's and for me the lack of a cohesive MDT which is essential for allied health.

SLT you will have skills in comms/education type of fields so looking for a role in these sectors as a leap to another career might be an option for you. And you can go into Admin while you work out your next steps as well.

As a layperson, I mainly have experience with family members coming to the end of their life and the salt team (rather than with children)
I think speech and language as a term is so narrow, when so much more than that is included in the role.
It must be a terrible job at times, I have seen a completely different side of it to a lot of people. And though I’m sure that it’s fulfilling to help rehabilitate someone, when it is the other end and you are giving someone a poor prognosis, it must be tremendously difficult.

Agree with others though- lots of room round here for private practitioners for children. There’s many parents who are willing to pay given the nhs waitlists.

It's definitely not all about this

That just isn't true. My DS needed it after being partially deaf for a few years and I had to fight to get seen. He needed help with 3 different sound groups. But after waiting another 2 years and no therapy being offered I had to kick up a fuss and all they did was hand packs over to the school for them to run it.

Luckily the TA who ran it was very experienced and absolutely amazing. A side product of this was that other children with mild issues were put into that group so that my DS didn't stand out so they got help as well.

Hi OP,

Another UK SaLT here. I love seeing clients and doing actual therapy, but that is now such a tiny part of the job. I'm so burnt out all of the time and caseloads are so big we get to actually effect such a small amount of change.

I've been in practice 15 years and I'm desperate to leave, but am kind of trapped by the security of the NHS pay cheque as we are struggling financially.

If the role was funded well and there were enough of us to be able to see patients regularly enough it would be a dream job, but at the moment it feels like a nightmare 😞

My DD is currently in her 2nd year of SALT and absolutely loving it.
Don't get me wrong, it looks like a tough course, but as others have said, there are soo many areas you can work in. The career prospects look very diverse in comparison to other allied health professions.

What is it you don't like about your current role?

My experience:
Caseload is huge and unmanageable.
Rarely out of the door on time due to size of caseload.
Having to make clinical decisions based on bedside assessment only due to lack of accessibility of instrumental assessment.
Associated risks of dysphagia and fear of missing aspiration due to lack of instrumental.
Worries about over prescription of thickener and associated risks.
Minimal support given by managers.
Impossible to effect change with lack of staffing resources.
Dealing daily with relatives (rightly) concerned you are not spending enough time with their relative working on communication.
Perception of job by public means it is difficult to complain. Everyone understands nursing perspective, no one understands SLT perspective.
Exhausting and unfulfilling job.

I’m much happier now I’ve left SLT.

I do like my job but I'm an adult therapist. I move when I'm miserable as well. Right now I'm in a terrific job with a nice team, working in people's homes or wfh, 90% communication, admin is there but it's well under control in this team.

I do like dysphagia work, particularly when I basically took on board the evidence and pretty much stopped using thickener. But it's a lot easier to like dysphagia work where you have some access to instrumentals, however minimal.

I'd say move. You could probably get a B6 role in an adult team, especially once you're dysphagia trained, if you're prepared to be out of your comfort zone for a bit - I always think paeds work is much harder.

Another teacher considering retraining here so interesting to hear your perspectives! Is it busy/stressful while on duty but then you can switch off when shift ends as I'm assuming you are unable to finish work at home? Just wondering how much work bleeds into home life as I'm looking to find a role where I can leave work at work and enjoy my evenings and weekends again!

My experience of SLTs as the parent of a service user is that the NHS ones tend to be very young (and therefore I assume fairly newly qualified) and spend all their time doing assessments and not therapy. I said something sympathetic along those lines to one once, she had come to assess DS and I made some comment about him having made progress, and she was trying to get him to show her and looked like she was enjoying it. I said it must be hard for her, not getting to do much of that side of her job and she said it wasn’t what she’d trained to do. She looked so unhappy, bless her. We then went private and the SLT we saw seemed really to love her job, made a massive difference to DS and saw him for years, so they had total continuity.

So it seems to me that if you actually want to deliver therapy, private is the way forward. The same could be said for a number of AHP jobs - physio for instance. An NHS physio will get maybe ten minutes and may not ever actually see the patient, just have to try and assess them by phone, certainly around here. Private ones can take their time.

I hope you find another job you enjoy. My son had SLT through the NHS (5-7 yrs) - it was truly dreadful - a series of speech therapists (people not staying in the job and some not replaced). Really boring exercises, no resources - just not engaging at all.

It's possible to get direct SLT into an EHCP, but only if there is supporting evidence showing why it is needed, and frequently that means going to a tribunal and having evidence from a specialist SLT in a school or independently instructed. That is where private work can be more rewarding, because you get to work with people directly and can make a difference.

I'm a SLT (20+ years of practice)and I'm a parent of a child who needed SLT and had some rubbish ones!

I left the NHS 4 years ago, with a heavy heart.

Now I work for a social enterprise and have the freedom to actually do the job I trained for and I love. It's amazing. Best job ever and a brilliant work/life balance.

The things that were hard in my previous role were:
Limited resources.
Constraints on what I could offer families.
Long waiting times (this has got much worse since covid).
Never enough hours in the day and finishing later and later.
Incompetent processes around EHCP assessments.

It's still a fantastic job but like all public sector roles, people are increasingly burnt out.

That’s why I was asking what it was about. The question is right there at the end of the paragraph.

I think you’ve linked the wrong post? Mine didn’t contain anything that you refer to.

I've never worked outside my hours as an SLT! I work in adults and work in the hospital and when I leave, I leave the job behind. There's no pressure to stay later or 'finish the job' where I am.

As someone who leads the service in dysphagia, this makes my heart sink. Your managers and leads need to put the work in to get better services and policy for thickener / instrumental services etc. It's hard but not impossible at all.

I made the switch from primary supply work to SALT and don't regret it.

OP - I think you might be best off looking for a different area of SLT as a starting point - swapping paeds/adult or vice versa. I don't think I could ever do paeds now (despite it being my initial plan) as I hate the assess - give exercises - back to wait for your next block of care model that's going on and the horrendous caseload numbers.

In contrast I work community ID, limited caseload (they're often blooming complex people but you get to know them properly), very much autonomous over my diary and how I book people in as long as they get seen and no one is breathing down my neck saying I need to do X sessions and then get them gone off the caseload. I get to do the problem solving bits that really appeal to me and I've got a fantastic team of colleagues around me. The Trust drives me mad at times but I think that's par for the course.

I know I couldn't cope with working in acute - I've shadowed there (I've been a right bugger shadowing around everywhere I can get my nose into to be fair - and it's encouraged for us - my big boss is keen to keep people in the service where they fit best and are happiest), and I'll be honest, dysphagia is haunting my fucking nightmares at present (I'm nearly finished my competencies on it and that competency document is driving me insane) and it's really pissed me off that they put another colleague through the Manchester course who promptly buggered off and left, but there's no money for me to do it and I'm the one with every intention of sticking around! We also tend to be quite conservative with the thickener - so much so that I cleared out the office cupboard recently and binned a load of trial samples dated about 2018 which says how much we actually use the stuff!

Incidentally to add into the reading discussion - my daughter couldn't say a hell of a lot of speech sounds (was barely intelligible when she started school)... which is what sparked my interest in the career in the first place... and she clicked reading really easily and well - she could read sounds she couldn't consistently articulate (she has verbal dyspraxia so there are days when things are more coordinated than others).

I have found that most SLTs for my autistic DS to not be that great, which was a surprise. One or two were very good and those were ones who were clear about the restrictions they were under (NHS funding), and took me seriously as a parent and actually listened to my child’s needs.

I found many not to really have a clue though and often quite patronising. Is it a lack of experience or specialism? Most I met were very ‘set’ in one way of thinking and barraged DS with questions. At least two caused him to have severe meltdowns in the office eg by spending 45 minutes asking me questions then going straight in and asking DS to do things he didn’t want to do, and by that point after 45 minutes was stressed out (why couldn’t I just fill in a form and chat over the phone?), and then looked to me very cross that DS was kicking off.

I wouldn't consider it if you don't want the role to bleed into your home life. In order to just meet the demands of my massive caseload I put a lot of extra hours in during my non work time. Just as much if not more than my teacher friends. I work three days and currently carry a caseload if 200.

I also spend a huge amount of time liaising with child protection and in safeguarding meetings. Or as a PP said doing assessment, and writing reports so an assistant can go out and do the actual therapy.

There are huge disparities across the country. I work in a pretty well funded area and our SLTs on 3 days in Early Years would carry a caseload of around 50. They would have to do a few other bits with their time e.g. run drop in sessions but mostly using it to see children. We also don't write reports now apart from EHCP. We will send emails with targets and how to achieve them, but not full reports. Of course it's easier to do that when you can see them for more therapy.

The waiting list increase is the biggest challenge for us. Particularly because it is not just this 'bulge' that were not seen in COVID, but also all the children now presenting as delayed due to impacts of lockdowns etc. Also families are struggling more with other things e.g. reduced funding in schools meaning there is no money for TAs, cuts to other supportive services.

I love my job. I work a bit after hours but not hugely (maybe 2 hours per week on 3 days per week). But I can see the pressures others are under in a stretched service. It's hard enough to meet demands in our relatively well funded service.

Wow - colleagues I graduated with have caseloads of 150+ in paeds around here. Mine's generally about 20-ish but it depends on what referrals have come in because we seem to get batches of straightforward assess, put some supports in place and then review to discharge; followed by a run of really really complex people where things are drawn out and you end up with MDT after MDT and can have them on caseload for months and months (one reason I love my client group because you can get to know them so well), or a run of dysphagia referrals which is where we're at at the moment.

The issue we have with staffing is we have the posts - but we can't get the applicants to get them filled because it's an area you really have to have the drive to want to work in (I think sometimes you either "get" a particular client group or you don't) - add in the fact it's community with some very rural patches (it can take me a couple of hours to get from one side of my area to the other) and it means you need to be a car driver, and band 5s straight out of uni often don't have cars these days so look for clinic based roles. We've had one post out to recruitment for most of this year and we just cannot get a good applicant (just with potential - not asking for awesomeness) to fill it.