Member spotlight: Elyssa Wheatley, Psychiatric RN
Elyssa Wheatley is a Psychiatric Registered Nurse and NUHW Steward at Kaiser Permanente Bostonia Psychiatry Offices in El Cajon, California.
How long have you been a nurse?
I have been a nurse for 16 years, spending the majority of my career in psychiatric nursing.
Please briefly describe the type of nursing work you do.
Since 2014, I have worked as a psychiatric RN in Kaiser’s San Diego region Psychiatry Department. My role is to be the main point of contact, care coordinator, and educational resource for patients receiving psychiatry services. I work with patients primarily over the phone (our telehealth model predated the Covid pandemic).
Psychiatry patients typically see numerous providers and need assistance navigating multiple therapeutic modalities. I help patients understand what each member of their care team is responsible for, monitor their adherence to labwork and treatment schedules, and answer questions between appointments with providers. (For some patients, there may be several weeks between appointments with their treating clinicians.) I also educate patients about their medications, helping them to understand when medications will start to work and what side effects to expect. Providing this education is especially important because many patients find inaccurate information online or may be exploring alternative treatments that are unsafe in combination with their prescribed medications.
Most importantly, I support patients when they are frustrated, overwhelmed, confused, or in crisis. This involves lots of active listening, empathy, and validation. In the case of patients in crisis, I work with my colleagues to keep the patient safe by arranging a same-day appointment with a therapist or, if needed, getting the patient emergency services.
You are an NUHW steward. How long have you been an NUHW steward and what made you decide to become one?
I have been a steward for 2 years. Prior to that, I was active in my bargaining unit, and I saw up close the importance of steward work because my husband—also a psychiatric RN in the Kaiser San Diego Region—was a RN steward in our bargaining unit.
I decided to become a steward after watching our management make many, rapid changes without input from nurses during the height of the pandemic at a time of significant understaffing. These changes negatively impacted my patients and my coworkers and contributed to widespread burnout. I knew we needed to get more organized to address this situation and having more trained leaders in our bargaining unit was essential. So I went through the NUHW steward training and started as a steward in January 2022.
As nurses, advocating for our patients is a key part of our work. How does being a steward help you advocate for your patients?
Working directly with patients and an interdisciplinary care team, nurses are intimately aware of the needs of patients and staff. But managers often lack this knowledge and may have competing priorities like cutting costs or climbing the corporate ladder. Being a steward gives me a formal mechanism to inform managers about issues and hold them accountable to putting patients first.
Before I was a steward I would often send emails to management and speak up in meetings about problems in the clinic, but I was mostly ignored. Then when I became a steward, suddenly my emails got prompt responses and management followed up on concerns I raised in meetings. This really demonstrated the power of using the structures of our union: Once management knew I was representing my coworkers as a union steward, my voice as an advocate for my patients and coworkers was amplified. Now, I always wear a sticker on my RN employee badge that states that I am an NUHW steward.
Nurses across our union—whether in inpatient or outpatient settings—face common problems including understaffing and management practices that compromise the quality of patient care. Can you share one example of how you and your coworkers fought to remedy one of these problems in your workplace?
Between 2020 and 2021 we entered a period of severe understaffing. We needed to hire more per diem nurses but, when we brought this request to management, they decided to create a new supervisory position to help management run the clinic. Instead of getting more nurses to do direct patient care, we just got more management! Unsurprisingly, the decline in quality of patient care as a result of understaffing continued.
So my coworkers and I started a campaign of Objection to Assignment (OTA) forms to document every time we worked a shift that was understaffed. Management immediately received each OTA form and, since every nurse in our clinic consistently participated in this campaign, we quickly accumulated a mass of documentation that highlighted our unsustainable workload and delays in patient care. We then used this papertrail to file a really thorough grievance.
This OTA campaign and the subsequent grievance really got management’s attention and in response Kaiser hired eight additional per diem RNs. These new hires—all NUHW members—ensured we had coverage for nurses on vacation or sick leave, and made a huge difference in our ability to provide quality care to our patients. Kaiser has also recently hired more LVNs, which is a huge help.
Our organized response to understaffing has also shifted our relationship with management. Before we got organized, management would just inform us of changes after they had already decided to make them.Today, we have a much more collaborative relationship. Management now involves nurses when considering changes to workflow, staffing, and other clinic operations. Our patients finally have true advocates at the decision-making table.
NUHW nurse membership is growing and we have organized many nurses into our union over the past two years. Do you have any advice for nurses who are new to NUHW?
Find out who your stewards are and reach out to them right away! Don’t wait just because you are new and need time “to get the lay of the land.” Connecting with your stewards immediately will give you an accurate picture of both what’s going well and what needs improvement in your workplace. Your steward is also a sounding board for your ideas (because all nurses—whether new hires or old timers—have important ideas about working conditions and patient care) and a source of information and support if you encounter any problems with management.
I also encourage everyone (even newer union members) to become a steward. The more stewards we have, the louder our collective voice on behalf of our patients! You can also use the skills and training NUHW provides to stewards to become a leader and advocate outside the workplace, in your larger community, on issues that are important to you.