The quarterly re-certs are much more tolerable, if that's not what you did last time. It takes about 10 minutes to demonstrate compressions and breaths on an adult and an infant, and then you're done. I very much prefer that to the 4 hour chunks that were required, along with all the other parts of the live in-class demonstrations, with the 2-year certifications.
Pros: live wherever you want, no commuting/parking, you take breaks in your home, no COVID exposure, potentially increased tour flexibility
And especially when the rates of 'failure' are so low. They are essentially implemented as pro forma exercises of, 'everybody has won and all must have prizes' the most impactful result of which is hastening deforestation due to the wasting of reams upon reams of paper on the associates forms and reports. But I realize this may differ by organizational setting.
Gotta pay that expensive rent some how. The local IVF folks are minting money in the fancy parts of town.
We got...$0.00. Though we've been seeing patients face-to-face nonstop since all this began, lol.
Yeah, we didn't get anything for quite a while, but I think our supervisors and lead psychologist went to bat for us. May have also had something to do with lots of people leaving.
I received it 3 of the 5 or so years I worked there. It was nice. But not a big enough carrot to kill yourself for IMO. Also, curious how those who don’t like the eval would like it to be different? What would you do instead? Asking for two reasons: 1) I am in a position in my non-VA hospital admin gig to set some of these policies and 2) in one of my jobs I got no feedback at all, which was very anxiety provoking.
For me personally, I like the idea of the evaluation itself (like you've said, it's an opportunity to receive feedback). But some of the ratings and categories were unnecessarily limiting to certain types of providers in terms of requirements for being anything beyond "fully successful;" more options for showing how you go above and beyond would've been appreciated.
cams-care.com
Thank you SO much, erg923!CAMS-care: Evidence-Based Suicide Treatment
CAMS Framework®: an evidence-based approach to assessing and treating suicidal risk with patient-centered tools like the Suicide Status Form.
Thank you so much, Sanman! CAMS and CT-SP are great resources that I was not aware of. I also reached out to NAMI for possible local resources. 🙂
Maybe? There's the literal learning curve (that also changes over time as new admin or political priorities emerge) and then perhaps some type of radical acceptance process if the goal is to stay longer-term and have it be sustainable-ish.
This definitely serves as verification that you're a VA clinician lol. All joking aside, this sucks and I imagine many of us feel/have felt that way.
As a trainee, I would ask about SI/HI explicitly during my phone contacts to veterans for scheduling or whatever but now don't, unless I feel a clinical need. Instead, I've shifted to asking people if they have any general concerns and will document that they did/did not and that they did not appear in crisis or voice having acute needs in my phone notes.
That's the most VA thing ever....
IMO, one of the big benefits of VA employment is that they actually keep you to 40 hours a week and don't expect more than that.
It definitely feels like there is a cumulative agenda to eliminate clinical judgment by somehow coming up with a sufficient number of linear mandatory checklists, forms, and rigid mandates for clinical practice regardless of context, nuance, readiness to change or individualized case formulation. Obviously, the organization contradicts itself by taking this eliminative approach to clinical judgment in context while simultaneously (ostensibly) rating us on our 'clinical competence' during peer reviews and annual performance reviews. As I've always maintained, (a) if you feel the need to construct endlessly complicated 'checklists' to prevent your doctoral-level providers from harming/neglecting your patient population then your organization has a far more serious and fundamental problem than any checklist can possibly address, (b) if I were to have approached my practice as a psychologist in grad school with the same level of concrete thinking/operations as the VA apparently wants me to adopt...I'd never have made it through grad school in the first place.
I approach the task of routinely addressing 'clinical reminders' with the same casual automaticity (and lack of zeal) as I approach swatting away mosquitos or sweeping off my front porch. It's something to get out of the way so I can get to the real clinical work.
We are required to directly ask. It also has to be documented in the chart that they are directly asked.
Correction, you are being asked to document that you directly asked.
This is a very good point...
Yeah, every single session. It's a new thing that received a lot of pushback. It wasn't something I had to do as an intern last year. I will need to work on my rebellious side for sure.
Agree with everything that everyone shared here. As long as you are practicing under someone else's license, you are to follow the license holder's instructions. In the VA system, there are some rigid rules that supervisors are compelled to follow. In my experience (VA internship, postdoc, and now a staff psychologist), I have found an early career supervisor much more rigid than seasoned supervisors who have been with the VA for good number of years. There are loopholes in any systems; however, an early career supervisor might be more conscientious to protect their license and afraid of violating any rules. This theory may or may not be true, but it helped to keep my head down, follow instructions, and do not ask questions that could cause big waives.
