END OF THEIR SHIFT — It’s morning, but PEF members Jerry Holmes and Grace James are just ending their workdays as nurses on the night shift at Pilgrim Psychiatric Center on Long Island. — Photos by Rick Kaiser By SHERRY HALBROOK Nursing beautiful but troubled minds back to health is not for everyone. The hours are long and challenging. Sometimes they are dangerous. And you may have to hang on 20 years or more just to get weekends off. But nurses at Pilgrim Psychiatric Center on Long Island say they love their jobs. “I love working with the patients. I really do,” says psychiatric nurse 2 Linda Keenan. Her sentiments are echoed again and again by PEF nurses at Pilgrim. Their stories show clearly why PEF and all of America pauses to salute nurses during National Nurses’ Week (May 6-12) and every day. Jerry Holmes, RN After beginning as a licensed practical nurse (LPN) at Central Islip Psychiatric Center, Jerry Holmes earned his RN degree. With 21 years of service there, he transferred five years ago to Pilgrim. He is delighted with many of the changes he has seen over those 26 years with OMH. “I’ve seen a tremendous improvement in the quality of care and in the level of respect for the patients,” Holmes says. “The treatments today are very effective. And we’re in a beautiful environment. All of the equipment is up-to-date. Everything is spotless and new. The food is much nicer. Even the patients’ appearance is better. It’s hard to tell the patients are patients. And the place is so bright and cheery that it lifts their spirits,” he says. “They love it.” Holmes said he began his health care career in medical/surgical nursing at a Brooklyn hospital in 1967, but began to feel drawn to psychiatric nursing. “I knew about bodies, but I wanted to learn more about the brain,” he says. “And I found that I had an ability to talk with people and put them at ease.” Although his shift starts at 11:40 p.m. and ends at 7:40 a.m., there are always a few night owls on the ward who want someone to talk to. “Most psychiatric patients have a need to verbalize. So, I try to set aside time on my shift to listen,” Holmes says. Holmes says he has never been seriously hurt by a patient. “Most patients are not violent or assaultive. Sometimes you have to tell them their behavior is unacceptable and won’t be tolerated. And it really helps to keep your sense of humor.” The 28 patients on the ward where Holmes has worked for the last two years are all older women. “The staff becomes the surrogate families for many of them,” he says. “I try my best to make time to talk with them, but it’s so easy to get bogged down with paper work and not have enough time for patient interaction. Sometimes I feel more like a clerk or secretary than a nurse,” he says. Holmes has his own high standards for relating to patients. “I always try to be up front with them. I treat them the way I would want to be treated.” It’s a formula that produces good results for the patients and for him, Holmes says. “It feels good when my patients tell me they are glad to see me. Or if I’m tired or down, and they tell me, ‘I like you. Don’t be sad. You’re a good person.’ “It’s because of them that I love this job.” Grace James, RN For years, her husband urged Grace James to come to work at Pilgrim, where he was a social worker. But she continued to work as an RN in the intensive-care and cardiac-care units at a local hospital. “I took about five or six years off from nursing to raise our children. But then my husband died, and I had to go back to work. I bought a house near Pilgrim and went to work there. That was 15 years ago, and now I would not leave it,” James says. It’s been long enough for her to see improvements take hold. “I work the night shift on a ward of chronic patients, all men. Until about a year ago, an RN had to work two wards at a time on the night shift. And for the first six or seven years I was here, they had just one day-shift nurse for two wards on the weekends.” She says mandatory overtime has become rare for Pilgrim nurses in the last year or two. “Overall, things are much better for the patients and the staff. The newer medications make a big difference,” she says. “Even I am happier now.” But one problem still chafes. “It’s really frustrating that I still can’t get the weekends off as my regular pass days. I can take a Saturday or Sunday, but I have to spend one of my vacation days or other accruals to get it,” she says. “That’s a hard position to be in when you are a single parent.” Working weekends and holidays is not the only hardship she has faced at Pilgrim. “I’ve been assaulted by patients many times,” she says. The worst instance was five or six years ago. “I was just coming through a door when a patient whacked me in the head and knocked me off my feet,” Grace says. “Fortunately, a therapy aide was standing near enough to catch me. I was off work for two months, and I still feel pain from it sometimes.” Although she says “quite a few of the 28 patients on my ward are assaultive.” Grace adds, “I still like them.” She finds many of the patients are extremely appreciative of her efforts. “They make me feel so good by the way they change and respond to a little extra care and attention,” she says. “They really thank me for it.” • Nurses, families, share burdens of understaffing CLICK HERE FOR STORY • PEF asks nurses: What issues matter most to you? CLICK HERE FOR ANSWERS Attention PEF nurses: Get the latest news for nurses. Just visit the PEF Website at www.pef.org and click on RN.

Linda Keenan, RN Keenan began her nursing career in general medicine. A registered nurse since 1966, she worked at hospitals and nursing homes before taking time off to start a family. Seven years later, she went back to nursing, but this time as a psychiatric nurse at Pilgrim. “I always felt I had a propensity for psychiatric nursing,” she says. “That was where I scored highest on my state Board (of Nursing) exams. “My temperament is good for this work,” she adds. “I have a slow temper and I like to bring humor to the work.” Keenan finds patients respond well to her cheerful attitude. “With 26 patients on the ward, it can get very noisy and chaotic. Sometimes I catch myself quietly whistling and the patients seem to like it.” And Keenan says she has found that if she suddenly starts to sing, it stops one of the more aggressive patients in her tracks. “She’s a little thing, but she’s always trying to swat at people. I found that if I start singing when she comes after me, it distracts her and she starts to sing along.” It’s a good, if unorthodox, strategy. But Keenan knows that sometimes nothing can keep her safe on the wards. “Usually, we can find some way to calm a patient or intervene before they hurt someone,” she says. “I’ve only been seriously hurt once,” Keenan says. “A patient was apparently angry about an injection I had given him. He asked for a Band-Aid, so I took one out and as I turned to hand it to him, he punched me in the face.” Keenan’s injury was bad enough to keep her out of work for a couple of weeks. But it did not diminish her fundamental love of the job and her patients. “The best part for me is when I see a patient, who was hostile and withdrawn when he came in, start to respond to the treatment and come back (to himself) so he can return to the community.” Cindy DeFilippis, RN Cindy DeFilippis began working at Pilgrim in 1976 as a therapy aide (TA) and became an RN in 1983. Over the years, she has seen the average number of patients per ward dropping from 30 patients to 26. And it is no longer common to have one RN cover two wards. In fact, two RNs per ward is common on the day shift today. However, the number of TAs to help the nurses has dropped from six to three per ward, DeFillipis says. Until recently, the ward where DeFilippis works was designated for research, which meant the patients received new drugs and other innovative treatment therapies. “The treatments are very different now, because of all the new drugs,” DeFilippis says, “and they are much more effective.” ““We see more acute patients today and fewer who are chronic. “Most of our patients are older, but we also have one male who is 19 and another who’s 20. It’s not a good mix. The older patients are sometimes offended by the language and behavior of the younger patients. “The patients don’t stay with us as long as they used to,” she says. “But that doesn’t necessarily mean they get better sooner. We wouldn’t have discharged them (at that point in their recovery) a few years ago.” Although many of the patients on her ward were receiving experimental treatments and require careful monitoring, DeFilippis says she is only now getting a second nurse on the ward after going it alone on the day shift for 10 weeks. “As ward nurses, we have a lot more responsibilities today than we used to have, and 10 times more paperwork. Nurses are held responsible for the work of all the staff on the ward. We are responsible for supervising the ancillary staff. “You have to get medications from the pharmacy, give them to the patients and make sure the ward gets other supplies. You have to attend nurses’ meetings and personally conduct a one-hour treatment or educational program for a small group of patients every day. “You get burned out under those conditions,” DeFilippis says. And yet, she says, it’s still the best job for her. “I hate it when people say to me, ‘Oh, you’re a psychiatric nurse, not a real nurse.’ “This is a more personal interaction. You get to know your patients and have a rapport with them. “I love my patients. When they have a good day, I have a good day.”