Covid-19 Related Changes to Internship - Captain James A. Lovell Federal Health Care Center
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Captain James A. Lovell Federal Health Care Center

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Covid-19 Related Changes to Internship

The COVID-19 pandemic has created numerous personal and professional challenges for us all. One of these challenges has been the uncertainty of what will happen. During the initial months of the pandemic, The Captain James A. Lovell Federal Health Care Center responded quickly to ensure the safety of staff and trainees. The training program adapted to allow for trainees at all levels to telework from home when possible. We eventually returned interns to on-site work in March 2021, continuing to prioritize safety by providing PPE, hand sanitizer, and cleaning supplies; we continue to wear face masks and practice social distancing, including when seeing patients in-person. All of our trainees are currently eligible for on-site, free COVID testing and to receive the COVID vaccine.

Now, over one year later, while the situation appears to be changing for the better, we will continue to closely monitor the public health situation and made adjustments as needed to the training year. The training program prides itself on its transparency, providing detailed and accurate information about our program and training opportunities. We anticipate that the 2022-2023 training year will occur on-site and in-person.

However, with COVID, transparency means we cannot definitively predict how specific rotations or adjunctive training opportunities may evolve if the public health situation changes. With confidence, we can say that there will likely be more utilization of telehealth and technology-based delivery platforms, as we have seen over the past year. We do not expect there to be any significant changes to the base clinical services or populations served through rotations and adjunctive experiences described in our materials. Below we have detailed some of the changes that occurred during the 2020-2021 training year. These changes may or may not continue for the 2021-2022 or 2022-2023 training years.

 

Changes to On-Boarding

We do anticipate starting internship on-time and will still require all the normal on-boarding requirements including being up-to-date on immunizations and fingerprinting.  The CDC has stated that keeping up to date on immunizations is important during this time to protect against any other illnesses that may compromise the immune system.  Thus, we view this as an additional public health safety precaution.  Our facility has ruled that finger-printing is an essential function and necessary to protect the interests of our patients.  Thus, finger-printing is also still a requirement and needs to be completed 30 days before the start of internship.  The finger-printing department at Lovell Federal Health Care Center has enacted extra safety measures including all staff wearing masks, extra sanitization, and 30-60 minutes in between appointments.  If the finger-printing office is closed at your nearest VA, please let me know so we can coordinate with our Human Resources as to what the next steps would be. 

 

Telework from Home Arrangements

Captain James A. Lovell Federal Health Care Center views all employees, including trainees, as essential healthcare workers, and are not bound by state shelter-in-place orders.  With that being said and with much consultation from local and national leadership, we may offer telework at home options depending on local conditions. Telework from home arrangements for our interns will not be available until at least second rotation. Teleworking holds significant challenges even for seasoned clinicians and makes it harder to access needed support in standard and emergency situations.  We will need time to assess your competency level and to document this appropriately.  Additionally, some rotations do not allow for telework.  When selecting your training plan, if you feel like you have certain needs that would be more amendable to teleworking, than you should note which rotations are open to telework when selecting your clinical training plan.  At the beginning of the second rotation, if there is still a need for more stringent shelter-in-place orders and we still have emergency tele-supervision allowances from our national and local leadership and you are on a rotation that allows for telework and you have passed your telework competencies, you will be allowed to telework at that time.

Clinics and Rotations that allowed for some or full teleworking during the 2020-2021 training year included Outpatient Mental Health, Outpatient Additions Treatment Program, Home-Based Primary Care, Women’s Health Primary Care, BRIDGE, PCMHI, Trauma Recovery Program, Behavioral Medicine and Pain Management, Administration and Leadership.

Due to the nature of the residential programs, interns during the 2020-2021 training year on residential rotations primarily engaged in on-site work. New patients were quarantined for 14 days and did not have any interaction with trainees during this period; positive or presumed positive COVID cases were removed from the building and sent to quarantine in another building, which the trainees were not permitted to access; all patients and staff wore masks; all patients and staff had their temperatures checked daily (patients 2x a day) and asked screening questions; patients were not allowed to go on pass or leave campus for the duration of their admission (although if Veterans in the Homeless Program had employment, they were permitted to leave in order to work); volunteer/outside services were temporarily stopped; social distancing was enforced: groups were kept small and individuals were assigned to private rooms; trainees had a private space to complete charting.  The supervisor was on-site to assist with emergencies and on-the-fly supervision.

 

Facility Safety Procedures

Our facility has enacted a large number of safety measures to allow for as much social distancing as possible.  Facility-wide safety measures include the following: staff must wear masks at all times when on campus unless they are alone in their office; staff must have their temperatures taken; all staff must stay home if they are not feeling well and cleared by Occupational Health before returning to work if experiencing any COVID symptoms (extra days of leave are allowed under certain circumstances to encourage this); all staff and trainees can present to Occupational Health for treatment and screening if they develop any COVID symptoms at work; trainees will have access to standard surgical masks, hand sanitizer, and CAVI wipes; interns will have their own office.

We will continue to update our public materials as we know more about what will be in store for the 2022-2023 training year.  Please feel free to reach out to us if you have any questions. Despite the changes that have occurred or will occur, our dedication to high-quality clinical care and psychology training and our dedication to the trainees themselves has never been stronger.