George Barnes MS CCC SLP

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Rochelle Park, NJ
George Barnes MS CCC SLP

Med SLP specialist in MBSS, trach/vent, and aspiration pneumonia management. Mobile FEES provider. Making Swallowing Simpler

📍Greater NYC 🍎

10/24/2025

Sending you and your patient positive vibes.

What would make your day perfect on Friday? 👇

10/22/2025

There is a startling disparity in how we approach tube feeding for patients with advanced dementia versus what we would choose for ourselves.

The data is eye-opening: 56% of SLPs would recommend tube feeding for patients with advanced dementia. Yet, only 11% reported they would want their own families to approve PEG tubes for them (reference below).

There’s a disconnect going on here...

We often focus on sustaining life (nutrition) when the patient’s goal is honoring life (comfort and social eating).

We must acknowledge that medically provided nutrition is not the same as the socially normative act of eating.

To better serve our patients at the end of life, we need to shift our focus. Thankfully, my good friend, Caitlin Saxtein is an expert in this area.

Her course, “From Food to Sustain Life to Food to Honor Life” changed the way I think about end of life care and is currently available on my site.

Comment “Life” below for a direct link. I know you’re going to enjoy it as much as I did.

Reference: Sharp, H. M., Shega, J. W. (2009). Feeding tube placement in patients with advanced dementia:
the beliefs and practice patterns of speech-language pathologists. American Journal of
Speech-Language Pathology; 18, 222-230.

10/21/2025

Why might a respiratory rate of 30 breaths per minute be a pivotal breaking point for a patient?

Here’s the essential math you need to know...

A swallow takes around 2 seconds from start to finish.

At a respiratory rate over 30, the patient’s lungs require a breath at least every 2 seconds.

We’ve entered a tipping point where there is simply no safe space for a swallow.

This leaves the patient with two risky choices:

They must hold their breath longer, which increases their overall work of breathing OR...

They may inhale during the swallow, risking aspiration.

This single metric provides a powerful, high-yield snapshot of aspiration risk.

By knowing this, you can make smarter, safer decisions.

Should every patient with a respiratory rate of 30 or more be made NPO? Absolutely not.

Should a patient with a respiratory rate in the 30s or 40s be assessed comprehensively and given strategies and close attention? Absolutely.

Learn more in my latest article. Type “SLP” below for full access.

10/16/2025

All I see is black and white.

Been there? Tell us 👇

10/15/2025

What if the biggest risk to your patient’s success isn’t their diagnosis, but whether or not they actually understand your instructions?

Patient education is the bridge between the hospital and home, but if your message isn’t landing, all your clinical expertise goes to waste.

The Three-Step Education Loop:

🧠 Check Readiness: You must know what the patient already knows and if they’re actually ready to learn right now.

🗣️ Teach Clearly: Use plain language and visuals, focusing only on the key priorities: the What, the Why, and the How.

✅ Verify Understanding: This is the crucial step. Close the loop using the Teach-Back method to ensure the information was correctly grasped, not just heard.

What have you found to be helpful when educating the patient? Share your tips! 👇

10/14/2025

The most dangerous psychological bias in healthcare has a name: The Bystander Effect.

Smoke is filling the room...

You’d think everyone would sound the alarm, right?

But an experiment shows people are much less likely to act when others are present.

This same dangerous psychology is why critical, life-saving tasks like oral care and answering call bells are often missed in healthcare.

When we look around and see no one else is acting, we assume the situation isn’t urgent—even when it absolutely is.

For SLPs, this translates to:

“The other SLP probably handled the discharge goals.”

“The ENT should cover the risks of vocal injury.”

Read this week’s article to learn how you can overcome this challenge for yourself and for your patients.

Comment “SLP” for full access 👇

10/09/2025

What are your go to strategies? How can we simplify without oversimplifying? 👇

10/08/2025

The most common themes surrounding AI are that it will take all of our jobs, destroy the world, and lead to the next revolution.

But here’s a more likely scenario and a positive one at that...

AI could allow SLPs and other practitioners to focus on human care again.

The current system often treats us like cogs in a machine designed for productivity metrics, leaving little time for what matters most: the patient.

AI can take over the busy work—the unnecessary tests, the research deep dives—and allow us to reallocate our time to what’s missing...

Actually connecting with our patients on a human level.

Imagine a system where you spend less time charting and more time speaking with your patients, connecting with them, and truly understanding their needs to get them home safely.

This isn’t just about better patient care; it’s about creating a more humane environment for ourselves too.

It’s about choosing quality over quantity and prioritizing deep, meaningful patient interactions.

What’s one piece of “busy work” you wish AI could take over for you today? Share with us! 👇

10/07/2025

“NPO except for meds.”

The term itself is a contradiction...

If a patient is unsafe to swallow food or liquid, why would we assume a potent medication—a concentrated chemical compound—will safely go to its intended destination?

The reality is, aspiration of a pill is a serious concern. Oral medications, designed for the stomach, can cause severe inflammation, airway stenosis, and can even be life-threatening if aspirated.

However, the world isn’t black and white.

We all encounter high-stakes triage scenarios—like a hypertensive crisis—where the patient’s life-threatening medical instability must take precedence over the risk of a single pill aspiration event.

So what is an SLP to do?

The right course of action is determined by critical context, not a mindless default.

Want to learn more? Type “SLP” below to receive my latest article, written with the help of Ed Bice M.Ed., CCC-SLP and Dr. James L. Coyle, PhD, CCC-SLP, BCS-S, ASHA Fellow.

10/01/2025

What are some other signs I’m referring too often? 👇

09/30/2025

Ah, the nuance of normal.

Are you pressured to discontinue trials after laryngeal pe*******on or aspiration?

If so, you’re missing critical information.

Many clinicians “err on the side of caution,” but fear-based practice prevents us from fully understanding the patient’s capacity and what they need to succeed.

And normal can’t be defined by a single number. It’s a spectrum.

For example, a PAS score of 2 (pe*******on with full clearance) occurs in about 15-20% of liquid swallows in healthy people.

To truly understand the how and why of a patient’s aspiration, we must push them during the study.

We aren’t trying to harm the patient; we are trying to do the opposite by strategically identifying their limitations.

We must shine a light on what’s already happening so we can develop tailored behavioral interventions and avoid unnecessary restrictions.

Want to learn more? Comment “SLP” for the full article (with the correct link this time!).

09/24/2025

Interdisciplinary team baby. THAT’s what it’s all about.

Tell us about a time you were lost and needed a IDT savior 👇

Address

96 Parkway
Rochelle Park, NJ
07662

Website

https://www.feesibleswallowsolutions.com/

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