Nick Sobieraj is our speech and language therapist at our Nottingham Brain Injury Rehabilitation Centre. Nick trained and worked as an actor before making the career move to speech and language therapy. He gives us an insight into his role and his passion for speech and language therapy.
Nottingham Brain Injury Rehabilitation Centre offers rehabilitation, care and support to people with a brain injury or other neurological condition.
Can you tell us a bit about your career background and experience?
“I originally wanted to be an actor. I trained and worked as an actor, but it was difficult to get work, so I decided I wanted a fresh start in a new career.
“I thought about counselling and psychology but eventually I found speech and language therapy. When I was researching online, I really liked the sound of it, and it sounded so interesting. I decided to apply for a speech and language degree at De Montfort University in Leicester. After my degree, I went to work in children’s services in Leicester, but I realised even though I was happy working with children, I wanted to work with adults as well. This led me to my role at Nottingham and I have now been here for seven years.”
What stood out for you about speech and language therapy when you were looking for a new career direction?
“It was unique to me because I’d never heard of it before, but I loved the idea of doing something different and working with people on communication. There’s also a lot of different areas you can work in which really appealed to me.”
Can you tell us some of the ways in which you work with the patients at Nottingham?
“We have three units at Nottingham: Fernwood, Millwood and Hazelwood.
“Fernwood deals with high-dependency rehabilitation so a lot of patients have a tracheostomy. A lot of the work here is around assessment as they are in prolonged disorders of consciousness, so we try to find a reliable mode of ‘yes’ and ‘no’ communication. That might include a thumbs up, thumbs down, a slight movement of the hand, finger, or leg. It’s about seeing if the patients can follow simple auditory commands and if they can, we can look at developing this further.
“For patients with a tracheostomy, there is often limited vocalisation because there is no air flow over the vocal cords so we would look at if they can use low-tech communication to make requests and make their needs known. It is also important for their overall understanding too. Low-tech communication devices can include an alphabet board, picture card, and written words. And this is all before any verbal communication.
“Depending on a patient’s ability, we might involve high-tech communication, for example the Electronic Assistive Technology (EAT) which is an NHS service. If we feel a patient could benefit from this then we can implement it.
“We also work with the Environmental Controls Team who provide functional controls for patients such as controls for the tv, a fan, or a light switch.
“Another area of speech and language therapy is working with people who have aphasia.
“We work on therapy techniques with the patients to help them to become more expressive. We find ways to support them so they can find the words as there are a lot of patients who struggle with finding the words they require. We do this through various different activities with them. The goal is to help them to communicate with their family, their friends, and the staff at Nottingham.
“Dysphagia is another condition we work with. Some patients with dysphagia can’t communicate as well as they could before so we work with them on speech exercises to support them with having clearer speech.
“Eating and drinking is another big part of my role as speech and language therapist. Some people at Nottingham will be on normal fluids and diet, but others need assessments, so for example, there will be a process to get someone from nil by mouth where they can’t eat or drink via their mouth, to eventually eating and drinking again.
“My role also involves liaising and working closely with the patients’ families, as well as with the multi-disciplinary team here at Nottingham.”
What do you enjoy most about being a speech and language therapist?
“I like working with the patients, building relationships with them, and seeing the progress they make. I’ve seen patients come in who are minimally conscious where there’s no communication at all because their brain is repairing, and then with therapy input I see them progress.
“For example, there is a lady who came in minimally conscious, but she is now communicating with her family, her friends, and the staff. She can now also eat and drink which is fantastic.
“It’s so sad when we have patients who can’t eat and drink but when they progress it’s incredible to see they have reached their goal of eating a McDonald’s or a pizza. Food and drink are such huge pleasures, it’s a massive part of being human.
“I love that we’re able to support the patients throughout their journey and to see them communicating again or eating and drinking again is brilliant. I love it.”