Jeff Anderson, DNP, MS, PMHNP-BC, began his role as Regional Clinical Faculty (RCF) in the PMHNP program at FNU in March 2020, just as the COVID-19 Pandemic became widespread throughout the United States. Just like the other RCFs and students, Anderson had to adjust quickly to a new way of work.
As clinics began to shut down or reduce on-site personnel due to the pandemic, many students were faced with the prospect of losing their clinical sites.
“There have been several instances where either the preceptor or the clinic stopped taking students as the COVID numbers went up,” said Anderson, who resides in Idaho and works with students primarily in the northwestern part of the country. “In those cases, we had to suspend the preceptor relationship because the student was no longer allowed in the clinic. We have had students who, because a clinical site shut down, had to go on academic hiatus.”
Anderson himself faced hurdles connecting with preceptors. Instead of meeting with preceptors face to face, as is the norm, the meetings have largely been held via video.
“In the time I’ve been with Frontier, I’ve only traveled once to meet with a preceptor face to face,” Anderson said. “It’s kind of the way business is done now.”
Not only has video conferencing enabled Anderson to meet with preceptors, but it has also enabled many of his psychiatric mental health nurse practitioner (PMHNP) students to continue to progress at their clinical sites. Anderson said that most of the roughly 30 students he has had over the past few terms have transitioned to at least some level of telehealth with their preceptors.
“For the students who have found a good situation with a preceptor, it has really been convenient for them to do telehealth from their own home,” he said. “We have had students do clinicals in which they stay at home and they log in to a Zoom type meeting with the patient and the preceptor. We have also have the situation where the preceptor is still going to their office and the student meets them in their office, so the student and preceptor are both in the office but the patient joins via telehealth.”
Though there are some drawbacks such as not being able to see a patient’s body language, Anderson said that telehealth provides a viable option, particularly for PMHNP students.
“Mental health is unique compared to the other specialties at Frontier because mental health treatment really lends itself to telehealth,” he said. “I don’t see a big drop in the quality with telehealth versus face to face. In my own practice, when I see patients, it’s 100 percent telehealth now. Because of the jumpstart provided by COVID, telehealth is going to be significantly more prevalent in the future. It is a very important part of the students’ education to participate in and understand telehealth because it may be a big piece of their practices going forward.”
Anderson said that even post-pandemic, telehealth might prove to be the preferred option for many patients who otherwise might have difficulty attending an appointment. In mental health care, virtual visits have not often been an option as insurance companies have been resistant to pay for telehealth.
“It is hard to say there’s anything positive coming from the pandemic, but if there was it would be that insurance companies that have in the past have been somewhat reluctant to pay for telehealth now will have a year’s worth of data showing that it is just as effective,” Anderson said. “In some ways, I think telehealth might be more effective because the no-show rates go down. Mental health patients can telehealth right from their home where they are more comfortable.”
Most of the PMHNP students who have been able to have face-to-face visits with patients have done so where the patients are admitted and living on-site. Other students have found telehealth to be a tool to acquire clinical hours with preceptors in other states.
“Telehealth actually opened some doors for precepting in that a lot of states are compact states where an RN license from one state is valid in the other state,” Anderson said. “What that allows is that, if we have a student in Colorado who can’t find any sites in their state, they can reach out to any other compact state and look for a provider that’s doing telehealth and willing to take on a student. They’re really not limited to their state anymore. I’ve actually had some students who have obtained an RN license in a non-compact state because they had a willing telehealth preceptor in that state.”
While an end to the pandemic will surely result in a significant return to in-person healthcare, Anderson said that the past year has shown that telehealth is here to stay.
“This is a real-world experience,” he said of the widespread adjustment to and implementation of telehealth. “Telehealth is definitely an important aspect of the psychiatric mental health NP student’s education at this point and moving forward.”