Dr. Ian Nicholson is the Manager for Psychology and Audiology at the London Health Sciences Centre (LHSC), and a former President of the CPA. As with most hospitals, the LHSC has had to change many of their practices since early 2020, including the way they deliver instruction as a teaching hospital.
It is a tough time to work in a hospital. Hospitals are, of course, one of the first places to have felt the effects of the COVID-19 pandemic. Even those that are not currently nearing capacity are well aware that an increase in COVID-19 cases in their community could suddenly make beds scarce. Across Ontario, they are planning ahead for this by ensuring there are beds available, all the while dealing with patients in as safe a manner as possible and supporting vaccination clinics for the rest of the community.
London Health Sciences Centre (LHSC) is one of those hospitals. In addition to juggling advance planning, vaccination, and the safety of staff and patients, it has a few other balls in the air as well. An acute care teaching hospital, they have changed the way instruction is delivered across the board. They are also a children’s hospital, and provide a broad range of other physical and mental health acute care services, all of which have had to make major alterations as a result of COVID-19.
Much of this comes under the purview of Dr. Ian Nicholson, the Manager for Psychology and Audiology at LHSC. While COVID-19 in London was not, at the time we spoke, overwhelming the hospital and pushing it to capacity, LHSC was accepting patients from elsewhere in the province where the strain was more severe, and the possibility that such a thing could happen in London was always in the back of everyone’s mind. This means that Dr. Nicholson has to perform a delicate balancing act between keeping his staff safe, both physically and mentally, and providing psychological services to the patients that come through his hospital. Said Dr. Nicholson,
“The primary difficulty from a management standpoint is the balancing of the need to provide psychological services to patients in a way that is both safe to the patients as well as safe to staff. Given the broad ways in which psychologists work with patients in acute care hospitals, that means a broad range of strategies that have to be used to keep everybody safe during this pandemic.”
Those strategies are myriad, and most involve virtual technologies. Students who do not require work hours in a hospital to graduate are not going in. Psychology Residents are being trained to provide care virtually, often by teachers who are themselves just learning how to deliver virtual care. The supervision of residents and their educational activities are also being done virtually. The team of psychologists is still going into the hospital itself for work, but providing much of their expertise virtually, from offices elsewhere in the building.
Dr. Nicholson still goes in to the hospital every day. He gets screened at the front doors, just like the rest of the staff and the patients who enter the building. He spends the bulk of the day in his office, as he did before. The biggest change he sees in his own job is that he misses the casual discussions that would occur thanks to a chance meeting somewhere in the hospital – walking down the hallway, standing in the cafeteria line, those quick chats about a new idea or a new approach.
“In management, very often you have the meeting, but then you also have the chat before the meeting, or the meeting after the meeting to follow up on one of the items. Those things aren’t happening as much now. When you have these virtual meetings (we use WebEx at my hospital) there’s very little opportunity for schmoozing or chit-chat. This makes it more difficult to have the conversations you normally would around other things.”
Much like psychologists in other hospitals, one of the things Dr. Nicholson is seeing in staff is the impact this pandemic is having. Not that they are putting in longer hours than they normally do, but the added layers of protection mean that every procedure, every intake, is a little more difficult now. Constantly thinking about the pandemic takes its toll, as does being prepared for a wave that could come at any time. And, like elsewhere in the province, the pandemic is affecting both the home and work lives of all staff. Thankfully, he believes we are rounding this corner with something of a light at the end of the tunnel – a light that starts at the London Health Sciences Centre.
At the direction of the Government of Ontario, the hospital has set up a vaccination clinic, and they are vaccinating people as quickly as they can, as much as their supply allows. Based on direction from the Ministry of Health, the health units are prioritzing staff and residents of long-term care facilities, but are hoping that with more vaccine supply they can move on to the hospital staff and physicians shortly.
When the end of the pandemic does come, it will be thanks to the efforts of hospitals like London Health Sciences Centre. On that day, it will still be tough to work in a hospital. But rather than being the place where they watched the pandemic begin, they will be able to look at their workplace as the place where it began to end.