SCHENECTADY — On a recent Wednesday at Ellis Hospital, an elderly patient was surprised to find Chief Operating Officer Leslyn Williamson helping him put in his dentures.
“You still do that?” the man said.
“Yes, I still do that!” said Williamson.
Williamson’s career has spanned from a low-paid dietary assistant job to attaining the double title of chief operating officer and chief nursing officer at Ellis Medicine, effectively making her the No. 2 executive in the organization, which has four major facilities, more than 3,300 employees and over $430 million in annual revenue.
She started in that role three years ago, but her fascination with health care began during her childhood in Jamaica.
“As a kid in the Caribbean, when a relative would pass away they didn’t go to a morgue. They stayed in the house until they were buried,” said Williamson. “I thought it was cool to take the mirror and put it up to see if I could see any fog come from the breathing.”
Now 52, one of Williamson’s duties is teaching staff courses, including one on how to treat dying patients and administer life support.
She still remembers her family’s immigration to an apartment in the northern Bronx, where she helped care for her great-grandmother, who lived to 104 yet never set foot in a hospital.
“When someone’s really ill or someone has no one to help them get the care they need done, you may not know how to navigate the health care system,” said Williamson. “So advocating for people who don’t know was important to me.”
As a teenager, Williamson volunteered as a hospital candy striper when her family moved a few miles north to Port Chester — she pushed around a book cart, took phone calls and talked to patients, all while dressed in the pink and white stripes that gave the position its name.
“I had my daughter mimic that and be a candy striper in northern Westchester at Mount Kisco. But it’s changed to just a pink smock. So I said ‘Hey, what happened to the white stripes?’ ”
Williamson gets what she calls her “street credibility” with the board of directors at Ellis from a remarkable career path that began when she was a dietician’s aide in Port Chester, then a unit clerk transcribing doctors’ famously sloppy handwriting for nurses and answering phones.
Williamson became a mother at a very young age, then worked as a phlebotomist through her first stint in college, during which she earned an associate degree in nursing. She earned a series of successively more advanced degrees while raising her four children.
She moved to East Fishkill in 1991. From there, she would commute to be nurse manager at Sound Shore Medical Center and later Montefiore Medical Center. She still lives there today, returning home for weekends.
“I’m never one to look at the distance of my commute to work. There’s things I get done in the car when I’m driving, like I always have those books on tape. I have something in my ear. I’ve had meetings while I’m driving on the bluetooth in the car,” she said.
Her fascination with health care strategy is evident from her advanced degrees: a doctorate of nursing practice from Rutgers; a master's of science in nursing from Mercy College; and a master's of public health from New York Medical College.
She came to Schenectady in June 2017, taking the reins of the nursing operations at Ellis Medicine, the umbrella organization for Ellis Hospital, Bellevue Woman’s Center and the McClellan Street campus that formerly was St. Clare’s Hospital.
Working out of Ellis’ brick edifice on Nott Street, Williams oversees the work of nearly 1,000 nurses in 20 units.
Her role puts her at the forefront of many of health care’s pressing issues: nurse burnout, understaffing, long wait times and more.
She’s found that in Schenectady, the community connection with patients is what keeps her nurses going.
“A majority of our nurses are from this community. So when the nurses see patients that they knew and they still know on the outside that they’re now providing care to, that’s very important to them.”
Nonetheless, Ellis does grapple with understaffing, Williamson said, along with Albany Medical Center, St. Peters and most other hospitals in the Capital Region.
“I would say we’re all in the same boat. We’re all short nurses because we’re sharing the same pool of recruits, but we’ve bridged that gap by having traveling nurses and agency nurses.”
One of her first policy changes upon arrival at Ellis was mandating that all nurse managers experience both day shifts and night shifts
“Health care is 24/7. You have a 24/7 responsibility. So if you’re needed at 2 a.m., you can’t say ‘I’m not coming.’ ”
Night shifts and on-call responsibilities contribute to what is a physically taxing job for nurses. Research from the National Institute for Occupational Safety and Health found that long hours and irregular shifts in health care settings can disrupt sleeping patterns and affect neurocognitive functioning, potentially leading to injury and worker errors.
Williamson said her policy, designed to help managers understand all sides of health care, was inspired by her experience as a nurse manager in Queens.
“You have to know your employees. In any hospital, you have a different culture in the day shift and the night shift.”
Stress and burnout have long been problems in health care. California implemented the nation’s first mandatory nurse-to-patient ratios in 2003, which specify the minimum number of nurses a hospital must assign to its patients in various settings each day.
The measure has been controversial and hospitals have long resisted proposals to pass such laws in other states, including New York, where it is near the top of the wish list for nursing unions.
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Williamson said a ratio law in New York would do the most damage to rural communities such as those served by Nathan Littauer Hospital in Gloversville.
“They send transfers here all the time when the patients are too complex for them to handle,” she said. “Imagine now we’re at our max. They have a patient that’s critically ill they need to send to us, but they can’t because we’re at that max. The patient is the one that suffers.”
She said the answer to understaffing is matching nurses with patients they can handle based on their experience, a task she delegates to the nurse managers at Ellis.
“A new nurse, I would not have her with a complex patient that would require you to critically think about what’s next,” said Williamson. “I would have her with a patient with a chronic disease that we already know the pathway to treat that disease.
“You have to match the complexity of the patient with the expert education level of the staff, where they are in their career. Are they a two-year nurse or are they 20-year nurse?” she said.
Williamson herself has been in the health care industry for more than 30 years and has no plans to quit. She still teaches and she still walks rounds at all three Ellis facilities.
“Health care’s in my system. If you asked me to do something different, it would be very hard to do.”