23. How Speech Pathologist Nikki Wells Helps Stroke Survivors Reclaim Their Voice

What would life look like if you couldn’t speak? No way to order your morning coffee, tell someone you love them, or ask for help. For people recovering from strokes or neurological conditions, this loss of communication can be one of the most isolating parts of their journey and it’s where speech pathologist Nikki Wells steps in with purpose and compassion.

Nikki shares how her unexpected start in a teenage sign language class sparked a lifelong commitment to adult rehabilitation. Unlike many who gravitate toward paediatrics, she’s drawn to supporting people through some of life’s most vulnerable moments. She explains how aphasia doesn’t affect intelligence, comparing it to being dropped in a country where you don’t speak the language and why moments of reconnection, like saying a grandchild’s name or sipping tea again, are so powerful.

We also explore how telehealth and technology are reshaping access to care, especially for rural patients, and why speech therapy is so much more than just words. This episode is for anyone who values empathy, resilience, and the power of human connection in healthcare.

More about Nikki's Organisations of Choice, Logan Hospital Fund
The Logan Hospital Fund supports the Logan community through funding patient support initiatives, staff education and equipment at the Logan Hospital. Donations support patients and their families and help create a happier and healthier community, where patients, their family, friends, and neighbours experience improved health outcomes.

It Takes Heart is hosted by cmr’s Samantha Miklos and Kate Coomber and recorded at cmr’s head office in Brisbane.

We Care; Music by Waveney Yasso

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Transcript

Life Without Speech

Sam Miklos 0:00

So imagine waking up one day unable to speak. You can't order a coffee, you can't tell your loved ones that you love them, you can't ask for help All of the things that we take for granted. And that is the reality for many people who have suffered a stroke or had some kind of an injury or serious illness. So today our guest, nikki Wells, is a speech pathologist, and for her, she helps people to find their voice again. That is not just a job, it's her life's work so this was one of the patients and he'd had a stroke so he had had a stroke.

Nikki Wells 0:31

Um so when I met you for the first time, I'd fallen down at the bottom of a deep hole. You guided me to the right direction. You've done a hell of a good job. Um, now I can see the light oh, it always makes me tear up. Um, now I can see the light oh, it always makes me tear up so good. Now I can see the light at the end of the tunnel.

Kate Coomber 0:49

So before we jump in, though, if you really want to hear more stories from real people and having impact, then make sure that you follow and subscribe, because that really helps the show. It really helps us reach more people and keep sharing these stories.

Sam Miklos 1:11

So today we are joined by speech pathologist Nikki Wells. Nikki works with patients who have had life-changing events and helps them to rebuild not just their speech but their confidence, their identity and, ultimately, their future. Welcome, nikki to it Takes Heart. Thank you for having me Now. Nikki, you are our first ever podcast fan. You are also Kate's friend, so I know Kate's a bit nervous about today. When your friends see you at work, it feels really weird Really nice, we'll just excuse her if she's a bit weird.

Nikki Wells 1:42

I feel like I'm fangirling today.

Sam Miklos 1:45

And you've listened to one of the podcasts and then referred one of your friends at work who we've now got locuming around the country for us. So it's so nice to finally meet you, and I've heard a lot about you and you probably don't know a lot about Nikki from a work perspective.

Kate Coomber 1:58

You know we're mum friends, Our boys are best friends and we've known each other for years. But I'm so excited because I genuinely don't know a lot of these things about you and I can't wait to actually just find out. You're a speech pathologist. I know that much. I know you're very passionate about your work, but maybe talk to us about what's a speechy what do you do? What do you actually?

Nikki Wells 2:20

do a great question. So being a speechie like it's such a wide field. So I've got my best friends from uni. One of them works with kids that stammer, and then I have another friend that works in head and neck cancer. So it's a huge field. So I work predominantly in adult rehab. So I work with people who've had strokes. I work a lot with progressive neurological conditions as well, so people that have Parkinson's disease. So I see people at a time in their life where they've had something really catastrophic happen and being able to help them through that is amazing, yeah how did you?

Kate Coomber 3:09

how did you become one? Because I mean, I probably hadn't heard of speech really until I had children, and then everyone was talking about speech pathologists, but we have kids and, all of a sudden, all these allied health professionals that we need literally did? How did you learn about it all? How did you choose to become one so?

Nikki Wells 3:28

McDonald's is the reason that I'm a speech pathologist.

Sam Miklos 3:31

McDonald's, I mean obviously Fast food, obviously. Okay, take us on the journey.

Nikki Wells 3:38

So I was really lucky that I was about 14 when I discovered what I wanted to do, which isn't the same for everybody, but I did a sign language course at school. And why was this? Because you've got a little accent. Yes, I'm Welsh, right, so this was in Wales. So I did a sign language course at school. I was terrible at sign language, but the teacher that taught us talked about communication difficulties, and he used the example of McDonald's and how it's so hard to order in McDonald's if you can't speak. There's no menu that you can point to. You are really relying on verbal communication to be able to say what you want, and, as a 14 year old, my mind was just blown at the thought of not being able to order in McDonald's, which is quite embarrassing.

Nikki Wells 4:36

I was an adult at that time it really resonated with me and that sort of started me then on the journey of looking into professions where you could help people that had communication impairment, and so that's what led me to speech pathology.

Sam Miklos 4:53

Was adults always the preference, because there are so many specialist areas, like you just said, that even just like head and neck cancer. You were 14. Was it always going to be adults?

Nikki Wells 5:03

It was always going to be adults for me.

Nikki Wells 5:07

So I again, I was very lucky I've been so lucky throughout my career actually I was very lucky that I got the opportunity to do some observation work in my local hospital and I got to go and work actually in head and neck cancer as a 17 year old and got to sit in on some of the sessions and be able to see the work that the speech pathologists were doing and that really solidified it for me of this is what I want to do. I want to be sitting in this chair helping these people. So, yes, I was never paediatrics, was never going to be my thing, and when I started my degree they did a hands up who wants to work in adults and who wants to work in paediatrics, and I think there were two of us that wanted to work in adults at the start.

Sam Miklos 6:00

Same in occupational therapy. Everyone wants kids. Yeah, it just. It's what you're saying earlier about being a midwife everyone thinks it's just working with kids and it's just sweet and beautiful and yeah and then by the end it was probably more 50, 50 one of my greatest achievements in my work is when I switch a student from wanting to work in paediatrics over to adults.

Nikki Wells 6:24

So I always ask them when they start do you want to work in adults or paediatrics? And if they say paediatrics, my challenge for the placement is to try and convince them that adults is where they want to be.

Kate Coomber 6:36

And what are the reasons, like how, if you're standing, there with graduates and. I know you do a lot of work with the people coming through. Why?

Sam Miklos 6:44

Why do they need to be in adults? How do you sell?

Nikki Wells 6:48

it to them, so you don't have to make games, that's true.

Sam Miklos 6:52

I do. Peds is an OT and it's a lot of games you don't have to sit on tiny chairs.

Kate Coomber 6:58

Much better be on your knees.

Nikki Wells 7:00

So I think the big thing and actually my both of my sons have had a lot of speech therapy, so I've kind of been able to see it from the other side as well and I think with the difference with adults is that they are there because they want to be there, they want to improve and a lot of what I do is very goal orientated, so working with them to achieve their goals. With children, it's not their goals, so everything is around convincing them to do it, and disguising things, whereas with adults it's like right.

Nikki Wells 7:42

Well, this is what we want to work on.

Kate Coomber 7:44

Let's get on and do it if we do this, we can, this will happen yeah, yeah and have you been in the private and the public system?

Sam Miklos 7:53

is there a difference between the work or, you know, between those two settings?

Introduction to Speech Pathology

Nikki Wells 7:58

yes, I think the biggest. So I do. I work across both. So I work for Queensland Health and I work in private practice as well and I actually love doing both of those roles and I find that being able to work in the public system so the patients are very similar and they're often at different stages in their journey. So in the hospital setting that I work in, it's often in the first few days, weeks, months of them having a stroke, whereas in the private work they've kind of gone through that process and they're now back in the community. It's kind of the next stage.

Kate Coomber 8:46

Yeah, yeah, but the so the types of patients, so the types of conditions you're seeing are the same, but they're often at different stages in the journey yeah, do you ever get patients that you've seen sort of directly after that then might seek you out to continue Like, is there any sort of you know that continuation of care?

Nikki Wells 9:07

No, so they would. So it's completely, yeah, completely separate.

Sam Miklos 9:13

So you must have had such an incredible impact on so many patients' lives. Is there one that stands out to you?

Nikki Wells 9:22

So I've had so many, there have been so many patients over the years that have really touched touched me and, I think, for me, those patients that work so hard to achieve their goals, and I'm in a really fortunate position and I work in a position where I'm able to see people for a long time, so I have yeah, how long would you have a patient with you that you'd be working in the hospital?

Nikki Wells 9:53

So I have had a patient that I saw for a year and that's so wonderful to be to have that opportunity to work with those people and often language and speech recovery is not a quick fix it is something that takes a long time and being able to build up that rapport and work on small goals and build up to bigger things yeah.

Kate Coomber 10:20

So what kind of like if you had a patient first day and then a year later like what's the what's the growth in that progress in that instance, for example?

Nikki Wells 10:29

So it really varies from person to person, and that is often a really hard thing for stroke in particular is that everybody wants One size doesn't fit all yeah.

Nikki Wells 10:42

Everybody asks the question when will I be better? And unfortunately we can't answer that question because it's different for everybody. There's so many factors, so the size of your stroke, where the stroke was, your age, there's so many things that impact on it. So, but we can go from people in the early days. I had one patient that he went from not being able to say anything, could not get a single sound out, and he got to the point that he was able to have a conversation and he joined conversation groups and he was looking into volunteering at the hospital. So we can make huge gains with people, but that isn't the experience for everybody, unfortunately.

Sam Miklos 11:38

They must be so grateful for the work that you do.

Nikki Wells 11:42

Yes, sometimes.

Kate Coomber 11:46

There must be a lot of work with the families as well. At times is there Like if you're saying that communication is challenging. If existent, do you have to then build those bonds and get the buy-in and the trust from the families?

Nikki Wells 11:59

Definitely, I guess, if there's a lot of work to do in between sessions and things Definitely, and that education for the families is a huge part of what we do. One area that I work in is aphasia rehab. So aphasia is when your language is affected from a stroke and when I talk to families, the hardest thing is when you're saying to them your husband can no longer understand. Point to the table, for example. That's a really hard thing for a family member to hear Because your instant thought goes to well, they're a really intelligent man, like they're a lecturer at university. What are you? What are you saying? He can't now understand. Point to the table.

Nikki Wells 12:50

So I will often use an analogy of. It's a bit like aphasia is like being dropped in Japan if you don't speak Japanese. So you are still the same person, you still think the same way, you still have the same opinions about things, you've still got the same intelligence, but you can't understand what people are saying to you and you can't communicate what you want to communicate. And I find that that helps more than just the. He can't understand this and he can't understand that as a way of families understanding that it's not about intelligence and we recognize that their relative is still that same intelligent person. Their language has just been affected by the stroke that's not, I gotta say.

Sam Miklos 13:48

I was an exchange student at 15 in japan and I was in a mcdonald's and couldn't order food so when you were saying that and then bringing it back to like your full circle, I was like I remember being like we couldn't order food anywhere because we were so young and we didn't speak a great deal of Japanese. And then, yes, we were in McDonald's and we were just like how do we get food here?

Kate Coomber 14:10

Full circle moment. There you go, Thinking about that now, if you think about if you walk into McDonald's now there are touchscreens and various things where maybe so many gains have been made since. So if you think about technology in your field, how has that impacted your line of?

Nikki Wells 14:26

work. Oh, it's been massive. Actually, I am the latest. I mean I know that we're 25 and we're still learning when I was in Japan 10 years ago.

Kate Coomber 14:37

This is what I mean, you know. I'm sure those screens were there, Sam.

Sam Miklos 14:40

Yeah, yeah, yeah, you can see the picture you ago. This is what I mean. I'm sure those screens were there, but yeah, with AI instruction of telehealth, it would have gone in leaps and bounds.

Nikki Wells 14:51

Yes, absolutely. I am the least tech savvy person you will ever meet in your life. I don't know how to do anything on computers. Excel scares me, so it has been a very steep learning curve for me and I'm still very much learning.

Kate Coomber 15:06

Do you find the grads coming through? Oh yeah, have that in spades.

Sam Miklos 15:10

Yeah, because that would be quite daunting mentoring grads because obviously, as an occupational therapist coming through, I remember looking to all my mentors and whoever had the placements for you and they knew everything. There was nothing that we were bringing or knew that was different, Whereas now, with tech and so many changes so quickly yeah you'd be like they'd be almost up to speed in some way, or ahead in other ways.

Nikki Wells 15:36

Yeah, I actually love that. I love learning from all the people that I work with and and it's great, like when we get new, new grads that come through like you can learn so much from them because they are really on top of what the latest evidence is as well, and what they're being taught at uni and how we can apply it into a clinical setting and, yes, certainly the technology they can teach us a lot.

Kate Coomber 16:09

Can you give us some examples of how that's improved?

Sam Miklos 16:12

Or changed treatment or how you interact.

Adult Rehab and Patient Journeys

Nikki Wells 16:15

So a couple of things. So, in terms of the technology, we now have so many apps that people can do therapy on, which has really transformed how we do therapy, so we're able to use the apps in sessions. So it's a lot less paper-based resources that we used to use.

Sam Miklos 16:41

I was going to say photocopying everything. The allied health photocopy would always be like, especially down in paediatrics.

Nikki Wells 16:46

go, go, go yeah so we've definitely been able to move away from that a bit more now, which is really good, and it's also great that we can lend iPads out to patients so that they can use those apps at home or on the ward if they're still on the ward. So that's been really fantastic to be able to have these more resources. In terms of telehealth, I think telehealth has been a game changer in speech. How so.

Kate Coomber 17:18

Because the concept of speaking telehealth Is telehealth on a screen like a Teams video call or is it? Telehealth on the phone. Sorry, am I so? It's a little phone signal. Again, I'm 25.

Nikki Wells 17:31

So it's predominantly video. We don't use Teams, but a platform very similar to Teams, a platform very similar to Teams.

Kate Coomber 17:46

So we really we had a big uptake in telehealth during.

Nikki Wells 17:48

COVID as everyone else in health had, and during that time I must say I hated it when it was first brought in, but I think because we had this such a steep uptake of it, but we had.

Nikki Wells 18:02

So I run communication groups in my work and I was running a communication group at that time and we were able to transfer that onto telehealth and it meant that for those four people that were in that group that were otherwise isolated because they weren't able to communicate very well, that was an opportunity twice a week that they had social contact and they were able to communicate in a safe environment about what is going on.

Nikki Wells 18:40

We don't understand what's happening, and so we were able to use those groups then to provide some education about COVID because for them, if they've got difficulties with understanding, being able to understand all that information they were getting from the news was really confusing. So it allowed us to provide some education for them to have a bit of social contact during a time when they wouldn't have got that otherwise and they were able to still continue to have their therapy, whereas they wouldn't have been able to because they were a vulnerable population not able to come into the hospital. Telehealth has also been great in terms of my private work, I see a patient who is in a different state.

Sam Miklos 19:29

I was thinking about that with like rural and remote communities like for them to have that access as well.

Nikki Wells 19:34

And so he lives in a small community where he doesn't want to access speech pathology in his community. Why?

Kate Coomber 19:44

is that? Is that a?

Nikki Wells 19:44

stigma thing, I think maybe a bit of that and a bit of. I don't want people to know my business.

Kate Coomber 19:52

That's hard in a small town, isn't it? We've found that a lot with getting their own help.

Nikki Wells 19:57

Absolutely, and so telehealth has meant that he is able to access the services that he needs in a way that feels comfortable to him.

Sam Miklos 20:08

Do you think that the introduction of all of this tech has actually meant that you're able to treat patients faster, or are you getting better outcomes in the same period of time, because you've got more resources that you mentioned to use, like? Is it getting better outcomes?

Nikki Wells 20:27

I think so. Another environment so I work in a day hospital setting where people have been in the inpatient ward and then they're ready to transition home, but they're still needing intensive therapy. So for those patients, previously they would have to come back into hospital five days a week. They usually are not able to drive because they've recently had a stroke, so they're reliant on family bringing them in or using public transport to get in for those sessions. So telehealth has meant that we are able to maintain the intensity of therapy that they need, because instead of having to come in five days a week and then them not being able to make it because it's just too much, they are able to come in twice a week and have three days a week of telehealth instead.

Kate Coomber 21:28

So good to support it, isn't it? Do you think that we'd be here if we hadn't come through COVID, like, do you think we would be doing so much?

Sam Miklos 21:36

telehealth now. Like when you say fast-tracked, we sort of had to do it. So has it really fast-tracked it.

Kate Coomber 21:41

Fast tracked, we sort of had to do it. So has it really, yeah, fast tracked it, or would we be here anyway?

Nikki Wells 21:46

I think we'd probably be here. Anyway, I think it was evolving and there was certainly more research coming out prior to covid about the use of telehealth.

Sam Miklos 22:01

I remember as a grad 10 years ago, slash 15, it was like it was available then, but there was not a great uptake, like it was almost a rare event. It was a special event. There's a telehealth, yes.

Kate Coomber 22:17

Yeah, if you meet a certain criteria.

Nikki Wells 22:20

Yeah, yes and I think what COVID did was show us the benefits of it, because I think prior to that we were all possibly a bit focused on how hard it would be, and now we've been able to see the benefits and try to maintain that.

Sam Miklos 22:37

Almost outweighs the negatives there, like it really fast-tracked that yeah.

Nikki Wells 22:41

And there certainly were some negatives, so I had. So one of the things that can happen with aphasia is that you lose your ability to understand numbers, which is very challenging for people when it comes to pin numbers. So when we first started doing telehealth, we had to use a system where you had to put in a pin number. So we spent an hour speech pathology session trying to get this poor man to be able to put in a five digit pin number to get into the session, and so we were saying the numbers to him but he couldn't understand the numbers and he was trying to put them in and was putting in incorrect numbers and it's been so stressful for him too, like that would have yeah like that would have had an impact on your confidence.

Understanding Aphasia and Family Support

Kate Coomber 23:30

And, yeah, like, steps forward, steps backwards, yeah just listening to you over the years and knowing that you work with people around their speech or you know being able to eat and things like that, I really I feel I was just a bit naive and hadn't thought about the ability to understand as well. That hadn't really. I hadn't realised that, because that's just an extra element, isn't it? Learning to speak is one thing, but if you can't understand as well, that's really challenging for someone. It's so impactful the work that you do. Can you share maybe a couple of instances where you feel like that's really I'm doing what I'm meant to be doing and it's something you're really proud of.

Nikki Wells 24:14

We've had a real impact, real impact or so, again, there have been so many of those moments. I think for me it's always the firsts. So being there for someone where you've been working on them being able to say their grandchildren's names again, and the first time they say their grandchildren's names, or someone who's lost their ability to swallow after having a stroke, and the first time that they're able to have a cup of tea again. So being with people for those firsts and I get some really lovely feedback from people and I've had one particular patient. Can I read out? Yeah?

Kate Coomber 25:08

Because it must be hard as well when you sometimes send people on their way, maybe after your sessions have finished, I imagine, and you must, I mean I know, I would be wondering, I wonder how they're doing, I wonder how are they?

Sam Miklos 25:18

Did they progress?

Kate Coomber 25:19

Did it stop? Did it continue Like I know? I sort of like need to know stuff, so that would really be difficult for me. Yeah, yeah, do you ever get that you know, learn in the future of what's happened and outcomes.

Nikki Wells 25:31

Yes, sometimes you do. Sometimes they come back and that's really lovely, like they come back and visit and you get to see how they're doing, which is always, yeah, it's always really lovely. But yeah, there are certainly some that stay with you and you think I wonder whatever happened and how they yeah, where they are now where they are now yeah yeah, so you've got some feedback yes, so I got this to give context.

Nikki Wells 25:59

So this was one of the patients that I was able to see for a year, and when I first started seeing him, he couldn't produce any sound at all. So that's sort of where we were starting from, and he'd had a stroke. So he had had a stroke.

Kate Coomber 26:19

Yeah, and how long did you work?

Nikki Wells 26:20

with him For about a year. We worked together and he was very, very motivated and he would do a huge amount of practice and he got back to be able to talk in conversations yeah, so he sent me this card when he finished with me. So when I met you for the first time, I'd fallen down at the bottom of a deep hole. It was stark, dark. I was wordless, I was hopeless, I was nothing and meaningless. I even did not know how to move my mouth. I totally forgot it. You shared my feelings of desperate need. You guided me to the right direction. You've done a hell of a good job.

Sam Miklos 27:10

Now I can see the light at the end of the tunnel yep that is so beautiful that is did you get that at the end of the one year?

Kate Coomber 27:23

yes, yeah oh my gosh and just for patients like that to understand that little bit of feedback. Yeah, obviously impactful. That is to you that you're so invested in their journey.

Sam Miklos 27:34

Yeah, that, that, that's absolutely beautiful. Like to see that I feel like I need a tissue now I'm like there's one down there there is, so that's a lot to walk through. I was just about to say that. I'm like does that happen all the time? Because, yes, if you're like, even if You're carrying that with them. Yeah, and those hard days of therapy when, like you said, they're in the darkest place.

Kate Coomber 28:01

People must get angry as well, Like, do you have a lot of patience? I'm just trying to put myself in that position. You know you'd go through such a wave and you're there nursing them through it, guiding them, Keeping them motivated, keeping them yeah.

Nikki Wells 28:15

Yeah, yeah, so we do. Yes, you get the full breadth of emotions. Yes, you get the full breadth of emotions. I'm very fortunate to work as part of an incredible MDT what's MDT? So multidisciplinary team and we have a psychologist on the team and we have social workers the team and we have social workers and we have amazing doctors that work on the team that are really we use the term MDT focused.

Nikki Wells 28:49

So it's where they really value the opinions of everybody in the team, and so being able to work in that team means that those patients are supported by the whole team, not just by us as one individual. So we're not having to carry that load individually.

Sam Miklos 29:11

It's shared amongst the team and you also got each other there as well. Yeah, like a good, a good team yeah, what do you do personally?

Kate Coomber 29:19

like you're a pretty busy person, you make me feel like I should do more, a lot. What do you do to balance that out and make sure that your well-being is looked after, to make sure you can?

Nikki Wells 29:35

keep supporting others and your family. I drink wine with you. I do.

Sam Miklos 29:39

That was the theme of the season. Just to be clear for those listening, Nikki drinks wine with kate I believe she has drunk I don't know um.

Technology Transforming Speech Therapy

Nikki Wells 29:51

My big thing is running, so I do. You're a big runner, I'm a big runner in all. We're not talking a couple of k'sathons yes, so I've done a marathon, yeah, so that's Trail running marathons, mud obstacles you know, do you do that because you love that, what like. So I love it. I love. That was a weird question, but I was more like is it because you love it or is there?

Kate Coomber 30:17

another reason behind it. It's a valid question. And you push yourself, even on a day like you might have had a really late night and maybe you don't feel like it because maybe you've been at my house or something, but you still, I talk to you later. You're like, yeah, yeah, I went for that 25K run this morning and I was like what I just managed? A piece of toast. What do you mean, you push yourself through?

Nikki Wells 30:38

Yes, push yourself through. Yes, why do you do it? Um, I love it, I love, I think, I love the sense of achievement, um, and I am very goal driven, which I think lends itself to working in rehab, and so I like, with running, that I set myself a goal of I'm going to run a marathon and I will run a marathon.

Kate Coomber 31:03

Yeah.

Nikki Wells 31:04

So if I set myself a goal, I will make sure that I achieve it.

Sam Miklos 31:10

I suppose when you're working with patients and you're setting them goals, if you weren't someone who was that way inclined setting your own goals there might not be that empathy on the days where they don't feel like it or helping them to break that goal down into mini steps and you're not going to run a marathon on day one it's because they must have setbacks, just like you would in your running.

Kate Coomber 31:29

Yeah, huge, you know.

Sam Miklos 31:30

You spoke recently about me in my shred that I'm going on at the moment 10 days, and then I had a setback already but you did a big run recently and I know you were telling me about, you know, in the first 5Ks of what?

Kate Coomber 31:43

25Ks or something 30.

Nikki Wells 31:45

30. Like you were.

Kate Coomber 31:46

You know you were struggling.

Nikki Wells 31:47

Yeah, and.

Kate Coomber 31:48

I was like, why didn't you just stop, like it wasn't, like you had five to go, like that would be an okay moment for anyone, I think, to go maybe today's not the day, like maybe it's just not today.

Sam Miklos 32:04

Maybe next time, yeah but you're like no, I paid my money, I was doing that right, I'm gonna get my money's worth.

Kate Coomber 32:07

But you do, I imagine you. You manage patients who are having those setbacks all the time.

Nikki Wells 32:11

Yes, yeah, and it's obviously not in any way comparable um the journey that they're going through compared to my self-imposed punishment.

Sam Miklos 32:23

Yeah.

Nikki Wells 32:24

But I think, yes, it certainly does like having that mindset of you're there to work towards a goal. And I think being able to talk to patients about that and working through those barriers, and how do we get through it to get to where you want to be? Yeah, there certainly is some crossover.

Sam Miklos 32:48

What's something that people you know misunderstand about speech or don't know about speech Like I think about as an OT. Everyone just assumed we just did grab rails and shower chairs.

Nikki Wells 32:57

Yeah, you're like yes, I do, there was more. No, I'm definitely aware of that misconception. There's that, yeah.

Sam Miklos 33:04

Is there a misconception about speech or something that you wish people understood more? That might attract more people into the profession.

Nikki Wells 33:13

Yeah, I think the biggest misconception is that we only work with children, and that certainly isn't the case with children, and that certainly isn't the case Like in my week. I will do. I do x-rays on people's swallows, so we're in working with radiographers, radiologists, doing x-rays of people's swallows to work out what the problem with their swallow is. We're seeing people in acute wards.

Nikki Wells 33:47

I have colleagues that work in ICU, so in the intensive care unit we're working across a huge range of settings, and then there are lots of people that work in the community, so there's a huge breadth to it. And I think the other misconception is that there is so much learning. So it's an evolving profession and that's what I really love about it is that you can, every day you learn something new, and the more people you get to work with you learn something, and there's so much more evidence and new evidence coming out all the time that it's a really exciting profession to work in, where you're always getting to change your practice and make things better for our patients so that they have the best outcomes possible for our patients so that they have the best outcomes possible, is it when you talk about the breadth?

Sam Miklos 34:48

is it common, then, for someone to start in paediatrics and go to adult, or to specialise in one? And you know like, in terms of your career, do you find most speeches would just stay in the one lane, one specialty?

Nikki Wells 34:59

I think my so my personal experience is that I did work very briefly in paediatrics when I first graduated, but it was very short-lived. I did lots of therapy in a broom cupboard in schools for about six months and then I transitioned across to adults. There are people that work in generalist posts where they get to work across both adults and paediatrics and that's their role.

Kate Coomber 35:26

Imagine if you work in a more rural area. You would have to be a generalist. Would that be right?

Nikki Wells 35:31

Yeah, which I think they're amazing people that are generalists, that are able to sort of switch from yeah, switch gears between adults children.

Kate Coomber 35:40

It's quite different approaches to therapy too.

Sam Miklos 35:43

Yeah absolutely.

Nikki Wells 35:45

But my experience has certainly been that most people will specialise in either adults or paediatrics, and then beyond that you then specialise in different areas and would you change within those areas often?

Sam Miklos 35:58

or is it more like you're going down that stroke, neuro rehab or do you go that, and then you might go head and neck.

Nikki Wells 36:04

So it depends on where you're working. So lots of hospitals in particular will have rotational posts where you get the opportunity to rotate through different fields within adults, so you get the opportunity to work in that acute care versus rehab, versus voice therapy and head and neck, and so, yeah, there's lots of so many opportunities. You can get good exposure to then try and guide you to where you might feel is fitting for you. Yeah, and then it tends to be later in your career then that you'll decide on one particular route.

Patient Success Stories and Impact

Sam Miklos 36:39

Do you think we'll ever convince you to take a holiday and go and locum around the country for your annual leave?

Kate Coomber 36:47

You've got the camper trailer. Got the camper trailer Just take Dave and the kids. Yeah, it would be amazing Taking a year off A little sabbatical, a little sabbatical around.

Nikki Wells 36:55

Yeah it would be amazing.

Sam Miklos 36:57

Sign me up. I think you will. I think it's one day. She'll leave you up for some long service leave soon? Oh yeah, Probably. Yeah, You're probably up for that too soon.

Kate Coomber 37:06

Anyway, we can talk about that another time. So with every episode, as you know, CMR donate to a charity of your choice. Can you talk us through where that money was?

Nikki Wells 37:16

going for you.

Nikki Wells 37:18

So I am working on a project in my work at the moment, working on getting people back into the dining room.

Nikki Wells 37:27

So on our rehab ward we have a lovely dining room area and, and prior to COVID, all of the patients every day would come out into the dining room and they would have their meals. It was an opportunity for socialization, a bit of normality as well, because who at home eats their lunch in bed, and also there's lots of evidence around the benefits of eating at a dining table in a shared space. But unfortunately, when COVID happened, that dipped off and so it sadly just hasn't returned. So I'm working on a project to get everybody back into the dining room, and part of that we want to spruce up the dining room a little bit so make it a bit more inviting. It's a very clinical area, and so I would like to donate the money to the Logan Hospital Fund so that we can use that money to buy some things to make the dining room a bit prettier, so a karaoke machine, oh my God, that is not where my mind is going.

Kate Coomber 38:40

I was thinking a nice tablecloth, I was thinking some greenery.

Sam Miklos 38:46

Oh my God, is there like a disco ball as well to go with that. Maybe, maybe.

Nikki Wells 38:50

So why?

Sam Miklos 38:51

karaoke. Can I just ask?

Nikki Wells 38:53

So, again, there's lots of evidence of the power of music. That's certainly not my area of specialty, but we will have people. It's so music is really powerful in that it's something that everybody has in common, even if you don't like the same music you've got music in common.

Running Goals and Rehabilitation Mindset

Nikki Wells 39:15

We also see people who are really impaired have got really impaired communication, but they can still sing, so they can that's incredible recall some of the lines of a song, but they might not be able to talk in sentences, and so it can just be a really uplifting experience for people in at a time when there's not much that's particularly uplifting.

Sam Miklos 39:42

Yeah, I love that. Can you please send us a little clip?

Kate Coomber 39:45

yeah, we learn something every single episode from every guest, like that really, yeah, that was not where my brain went. No, not at all. Not at all.

Sam Miklos 39:54

I love it thank you, nikki, and and thank you for coming and and having this journey with us.

Kate Coomber 39:59

From the beginning, you've been, you know, such a fan and referring your friends, but your whole um team will be really excited although I'm very disappointed.

Nikki Wells 40:09

So all the kids when I was on youtube. I would listen to lorraine's episode and I was expecting wine, sorry, we have a recording.

Sam Miklos 40:15

I should have booked you for the afternoon but that was because lorraine's hobby was wine tasting. Imagine if we'd made you run around the block with us while we were doing this. I'm just glad we didn't get into a run, that is true.

Kate Coomber 40:24

Yes, no, we weren't diving into that hobby.

Sam Miklos 40:26

No, but thank you for your time and thank you for teaching your friend Kate all about speech. Do you know so much more? Now it's going to be a whole different conversation the next time you catch up.

Kate Coomber 40:44

Yeah, yeah, thank you so much Good. Thank you. Thank you for having me. We acknowledge the traditional custodians of the land of which we meet, who for centuries have shared ancient methods of healing and cared for their communities. We pay our respects to elders, past and present.