Healing the Healers in New York

The nurses of the New York State Public Employees Federation (PEF) are nurse practitioners, doctors of nursing practice, associate nurses, and registered nurses; we work in public hospitals, psychiatric facilities, prisons, clinics, drug and rehab facilities, and home settings. Our Code Red campaign targets the staffing and retention issues our nurses are experiencing in their various regions and agencies. For example, nurses leave SUNY Downstate University Hospital in Brooklyn because they can make $20,000 more at the city hospital across the street or at nearby private hospitals. At SUNY Upstate, in Syracuse, 30 percent or more of some units are staffed by travelers, so there’s a lack of institutional knowledge.

These issues fuel nurse burnout, trauma, and moral injury. Some nurses even take their own lives.* We need sustainability in public nursing so we don’t keep losing people to the private sector—and so we can better care for the mental and emotional health of our nurses.

We have some longer-term legislative goals, like making sure language in staffing laws applies to nurses in nonhospital settings, but our primary Code Red campaign goal is to heal the healers. We do that by using our collective power in bargaining, committee work, and advocacy to get state agencies to invest in nurses. Like so many other issues, that comes down to staffing: we need to recruit and retain enough nurses on the floor so we can do our jobs safely.

In PEF’s recent contract negotiations, nurses won a 10 to 22 percent increase in base salary. We secured an additional $600 per year for nurses who hold advanced degrees or certifications, which is a good start that we hope to build on. We also now get paid for licensing and renewals, up to $1,600 a year to attend professional conferences and workshops, and 12 weeks of paid parental leave when having, adopting, or fostering a child. This all came from Code Red.

Those are big wins, but we can’t stop there. We desperately need better training and support structures for nurses, so now we’re focusing on developing preceptor and mentoring programs. Within six months of starting their jobs, our new nurses are questioning what they’re doing here. Sometimes they’re pulled off orientation early, which sets them up to fail despite their best intentions. Other times, their preceptor hasn’t been there long enough to know how to do the job well themselves, let alone teach it.

We’re establishing our own preceptor standards for state facilities so that nurses who orient new staff have enough experience and appropriate skills. We found a terrific training program used by Massachusetts General Hospital in Boston under the guidance of the Norman Knight Nursing Center for Clinical and Professional Development. We’re working to get approval to adapt it for nurses in New York state. Our long-term goal is for both the training and the precepting to be appropriately compensated as part of the job; we’ve developed a bill to pay preceptors trained through our program that we expect to be introduced this fall.

We’re also working on a mentorship program for nurses who are new or changing fields. A precepting program builds your career and professionalism, but a mentoring program builds your spirit: Do you see yourself here for five years? Becoming a nurse practitioner? Going into education? Do you see that this isn’t for you? Having a trusted person to talk to can quell anxiety and help people realize it’s OK to not be perfect. We’re still working on identifying the right mentor training program, so we may begin more informally. But we’ll know a lot more about what works and what doesn’t once we get started.

An important part of developing both programs is internal coalition building—getting nurses from agencies across the state to come together on our shared goals. In September, members of the statewide nurses committee had a training with a leadership and mentoring expert so we could learn to set up and facilitate these programs. We’re also taking advantage of the resources of the AFT. We’re creating a webpage for people to learn about the preceptor program, and we’re getting social media training so we can create more effective campaigns. We hope to use these tools to begin to connect our more- and less-experienced members and build a statewide movement.

Having better support programs can give public nursing an edge over private facilities. But we also want to establish these programs because we know nurses and health professionals need to be valued as human beings. We hope that with these supports in place, more people will stay.

Amy Lee Pacholk, MSN, AGNP, APRN, is a critical care nurse in a surgical trauma ICU, an executive board member for the New York State Public Employees Federation (PEF), the council leader for PEF Division 225, and the chair of PEF’s Statewide Nurses Committee. She is also an adult geriatric nurse practitioner, a professor of adult health and obstetrics, and a lecturer on neurotrauma.

*To learn more, see “Deaths by Suicide Among Nurses: A Rapid Response Call” by Kathryn Lee and Christopher Friese in the Journal of Psychosocial Nursing and Mental Health Services. For suicide prevention help, dial 988. (return to article)

[photo: courtesy of PEF]