A Spotlight on SLT

We asked Lucilla Ogley Advanced Neonatal Nurse Practitioner about her experience of increased SLT provision on her unit.

1.  What benefits have your seen from having increased SLT provision on your unit?

From a clinical perspective I would say that an increased provision provides a more complete service for the babies and their families.  Increased provision allows for babies with either new concerns or ongoing feeding plans to be reviewed in a timely manner allowing for progress to be reassessed more regularly.

2.  What would say to a matron or clinical lead considering increasing their SLT provision on their neonatal unit?

Increased provision can only be a positive move to support staff in assessing babies with potential or known feeding difficulties. Increased SLT means less delays in introducing and reassessing the effectiveness of a feeding plan. Increased availability would ensure plans are being adhered to.

Nicoll Bell, Clinical Neonatal SLT Lead at St George’s Hospital

1.How long have you been in post

I started my post in October 2023 so I have been here now for 5 months.

2.What have been your priorities as the new clinical lead?

My long term goal for the unit is to establish a robust, clinically excellent and compassionate service to provide input not only for babies with specific feeding difficulties, but to provide feeding and communication support to every single baby and family who comes onto our unit. Every baby who stays on the neonatal unit could benefit from the expertise of SLT input – from pre feeding skill development, to bonding with caregivers and teaching caregivers about interaction and communication with their preterm or medically fragile baby. I also want to involve SLT on our unit in national projects that improve and push forward neonatal SLT as a profession and produce research around feeding and communication in neonatal care that can be used as an evidence base to help babies and their families across the world.

This goal is rather large, but I feel can be achieved in small steps with a lot of determination and smiles.

My number 1 priority has been to smile, meet all the wonderful staff who keep the neonatal unit going (the nurses, doctors, admin staff, cleaners, community nurses, ward clerks, infant feeding team, ward managers, education leads, other AHPs) and to quietly observe what happens in the unit. Get to know the daily workings, who does what role and get a feel of the environment.  This ‘relational’ foundations are vital for any new service.

My second priority has been educating other professionals about my role and how it can change the lives of these infants and their families. If people know of and understand your value and feel you are approachable, they will automatically help you to achieve your goals.

It is also important to prioritize joining various meetings, ward rounds and projects. This might feel uncomfortable because it takes you away from clinical work for a short time but it is vital in building relationships and trust and integrating into the unit. If you know what your units’ priorities are, what projects are happening and who has an interest in which areas, you can use all this information to make change that is felt on a deeper level through pathways and guidelines that improve patient care, QI projects that bring positive change and you might even make some wonderful friends too.

3. Any wins/successes in the last 5-6 months?

We have been embraced wholeheartedly on the unit from the very beginning so I feel very lucky to work on such a progressive unit.  Our opinion is not only consistently asked for but also appreciated and taken into consideration. Project ideas that we have brought up have been welcomed and supported. We have just got organized enough to get our photos on the board at the front of the unit. We have really good engagement from the consultants for our weekly developmental ward round where we look all the babies on the unit, the support they need developmentally from an AHP perspective and how we can implement this. A personal victory is that I have made enough friends to feel comfortable asking to make a big change; changing the teats of the unit. I have been given full support to do this which is excellent for patient care.

4. Do you have any exciting projects/plans for projects?

I was lucky enough to start my role around the same time as other AHP leads and have since had more AHP colleagues join. We are now a full team and are all trying together to establish our services, integrate onto the unit and raise the profile of AHPs in neonatal care. A realization that we all had early on was that coming into a service that is new, there is not much awareness of what we do and how we can impact babies and their families. 

Education was key in this aspect and we were welcomed to join both nurses and Dr’s training. It was easy to quickly establish the infants who acutely needed our input and be able to communicate this with the team. But we wanted more! We wanted to make sure that every single baby who came onto the unit had the opportunity to access AHP input. This is important as it moves towards a universal approach to care, with the thinking that every baby would benefit from our help, which is indeed true. The ‘How to’ of achieving this with stretched resources is hard. We have decided to tackle it by suggesting and leading on the set up of a padlet for the unit. Existing information that is given to parents when admitted will be added onto this platform. But importantly for us as allied health professionals, there will be tabs for each of our professions, introducing ourselves and our role and then providing generic input that ALL parents can do to improve their babies outcomes without necessarily having to have a referral for AHP input. We want to empower parents to be able to become the lead in their babies care and development as it would be if they were at home. 

SLT will provide advice on how to read infant cues and respond to these, how to interact and communicate with them face to face, read to them and reproduce a language rich environment for the infants throughout their hospital stay. St Georges as a unit is already phenomenal at encouraging frequent skin to skin, oral cares with EBM and our infant feeding team launched a ‘Colostrum counts’ project that aims to get all Mums expressing within 2 hours of birth and all infants received EBM within 6 hours. So within this context SLT hope to add to this and use the padlet to offer all parents information on feeding development, pre feeding skills and how to nurture them and we know that building these foundations well can have such a positive impact on the transition to oral feeding for a lot of our infants.

5. What advice would you give to anyone starting out in neonatal SLT?

Embrace the passion. Neonatal care is an all encompassing calling and such a rare privilege to be able to work with babies at their most fragile point and have an impact on families at an important and potentially challenging time in their lives.

Dive straight in – get involved in national networks and special interest groups, link in with authors of your favourite research papers (I have never reached out to anyone and not been met with grace, support and friendship), offer to do that project, write that paper, review that guideline. In doing so you are changing lives and that will bring joy for you and so many others.

Change takes time; stick with it and it will happen.

We asked Lucilla Ogley Advanced Neonatal Nurse Practitioner about her experience of increased SLT provision on her unit. 

1.  What benefits have your seen from having increased SLT provision on your unit? 

From a clinical perspective I would say that an increased provision provides a more complete service for the babies and their families.  Increased provision allows for babies with either new concerns or ongoing feeding plans to be reviewed in a timely manner allowing for progress to be reassessed more regularly.

2.  What would say to a matron or clinical lead considering increasing their SLT provision on their neonatal unit? 

Increased provision can only be a positive move to support staff in assessing babies with potential or known feeding difficulties. Increased SLT means less delays in introducing and reassessing the effectiveness of a feeding plan. Increased availability would ensure plans are being adhered to.

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