As part of the Change Makers in Washington Nursing series, WCN interviewed Darcy Jaffe, MN, APRN, and Senior Vice President for Clinical Excellence at the Washington State Hospital Association. Jaffe’s distinguished career reflects a sustained dedication to advancing health equity, strengthening patient advocacy, and fostering collaboration across complex healthcare systems. Her professional journey—from early work in public health to senior leadership—offers valuable insights into resilience, effective leadership, and the essential role of nurses in driving systemic equity and healthcare transformation.

WCN: Can you share with us a little about yourself?

Jaffe: I’ve lived in Washington my whole life and grew up in the small town of Port Orchard. My grandmother was a nurse, and I remember watching the way she connected with veterans at the Retsil Veterans Home. Even as a child, I could see the respect and warmth in those relationships. That stuck with me.

When I entered the University of Washington’s nursing program, I wasn’t entirely sure where it would lead, but I knew I wanted to do work that mattered. Nursing gave me the perfect mix of science, problem-solving, and human connection. I also loved that it offered so many pathways — I could take it anywhere.

While many of my peers were preparing for hospital rotations, I pursued something different. One of the nurses I worked with as a student had shifts at the King County Jail and encouraged me to check it out. The idea of working in correctional health care intrigued me.

I did my senior practicum in psychiatry at the jail, and it changed my life. The work demanded compassion without judgment. We weren’t there to make value judgments about why people were incarcerated — we were there to care for them. That lesson has stayed with me throughout my career.

The autonomy was also incredible. As nurses, we were often the ones leading suicide risk assessments, determining safe housing placements, and coordinating care with physicians and the courts. It was a crash course in leadership. More importantly, it opened my eyes to inequities and gave me a deep respect for people whose life circumstances were so different from mine.

One of the most memorable experiences from those years was organizing a camping trip for a group of patients from the jail diversion program. Many of them had never been camping before — some had never even left the city. We went up near Deception Pass, built campfires, played music, and simply enjoyed being outdoors together. For a weekend, they weren’t “inmates” or “patients” — they were just people, laughing, sharing stories, and experiencing something new. It reminded me that behind every label is a human being, and it deepened my belief that dignity and connection are essential parts of healing.

I believe every nurse should start in public health. It gives you a completely different perspective on people and the systems that shape their lives. When you see patients outside the hospital walls — in their communities, in vulnerable situations — you understand health in a much broader, more human way. That perspective has guided every step of my career.

WCN: Can you tell us about your nursing journey so far?

Jaffe: Working in the jail was foundational. It taught me to listen deeply, to respect every individual, and to find creative ways to build trust, even with people who were severely ill or profoundly marginalized. Those lessons became the backbone of my leadership style.

I also saw firsthand how social conditions, poverty, and mental illness intersect. You can’t provide good care if you only look at the clinical side. That’s why I’ve always believed nurses need to have a strong voice in shaping systems, policies, and laws — because health is never just about the hospital bed.

After several years working at the jail, I transitioned to Harborview, where I grew as both a nurse and a leader. I started on the psychiatric intensive care unit, where patients were acutely ill and required a high level of care. Like the jail, it was another environment where I had autonomy, and I thrived on that responsibility.

Over time, I was promoted to manage multiple psychiatric units, and eventually became Director of Inpatient Psychiatry. That role gave me the chance to bring together units that had historically been siloed. We created shared programs and treatment opportunities so that patients could access the full spectrum of care, not just what was offered on their unit. It was challenging, but it was incredibly rewarding to see the staff embrace collaboration and innovation.

I became Chief Nurse at Harborview, which is not something I had planned. In fact, I was hesitant at first. But I believed strongly in the CEO’s vision, and I wanted nursing to have a powerful voice at the table.

Leadership at that level requires you to balance two perspectives: the professional growth of nurses and the operational demands of an entire hospital. I fought hard to ensure nurses had the autonomy and recognition they deserved. For example, I created Associate Chief Nursing Officer roles to mirror the structure on the medical side. That parity was important — it showed that nursing leadership was equal to medical leadership.

I also worked to strengthen the nursing infrastructure: launching a nurse residency program, beginning Harborview’s Magnet journey, and embedding coaching into leadership development. One of the most meaningful initiatives was a program I started called Coach It Forward, which paired nurse leaders with managers to build a culture of mentorship. By the time I left, dozens of leaders had gone through it, and it transformed the way people supported each other.

I’ve always believed that nurses must be at the table when policies are made. During my years at Harborview, I worked with King County and the state on issues ranging from mental health law to Medicaid transformation. I learned that policymakers often don’t have deep knowledge of healthcare realities, and nurses can provide that essential perspective.

Policy work is an extension of patient advocacy. Whether it’s fighting for resources for behavioral health or ensuring equitable access to care, nurses bring a grounded, holistic lens. That’s why I’ve continued to stay engaged at the state and federal levels — because the systems we build determine the kind of care people receive.

I started at the Washington State Hospital Association (WSHA) in 2019, managing a major federal quality contract across Washington, Oregon, and Alaska. A year later, the pandemic hit. Suddenly, our role became coordinating hospitals statewide in a crisis unlike anything we had seen.

In those first months, my team and I were literally calling hospitals every day to track cases because no formal reporting systems were in place. We worked with the Department of Health, set up PPE policies, and helped hospitals align on isolation protocols. When vaccines became available, we collaborated on distribution strategies. It was chaotic, exhausting, and at the same time, a remarkable demonstration of leadership and solidarity.

One of the proudest moments was seeing Washington hospitals commit to sharing resources. Large and small, rural and urban, they agreed that no patient would go without care simply because of where they showed up. That unity saved lives — and it reflected the best of what nursing leadership stands for: collaboration, courage, and compassion.

WCN: Through your leadership, how do you work to impact nursing and the advancement of health equity in Washington?

Jaffe: Equity has to be more than a buzzword — it has to be built into how we practice. At the Hospital Association, I created the role of Director of Health Equity, and we’re now working with hospitals to standardize how we screen for social determinants of health. Consistent data helps us understand where the greatest needs are and how to intervene.

For example, when we looked at Medicaid patients, the data revealed how disproportionately long their hospital stays were, often tied to lack of housing or other social barriers. By surfacing that information, we can push for collective solutions that go beyond the walls of the hospital.

Equity work is also about humility. It means listening to communities, admitting where systems fall short, and committing to change. For me, it goes back to my early days in corrections and psychiatry — every person deserves dignity and care, no matter their circumstances.

WCN: What are some of the overall challenges you face in your work? And how do you work to overcome those challenges?

Jaffe: The financial pressures on hospitals right now are immense, and that affects everything: staffing, resources, and morale. For nursing, the challenge is to ensure we don’t lose sight of professional growth and equity in the midst of those struggles.

We need to keep investing in rural nursing, specialty areas like maternal health, and programs that diversify the workforce. If we want a resilient healthcare system, we have to support nurses not only at the bedside but as leaders, innovators, and policy shapers.

One of the areas we’re focusing on right now is rural nursing. WSHA has partnered with AARP on a rural nursing leadership program, which was very well received, and we’re preparing to do it again. The goal is to give rural nurses more leadership skills and strengthen their connection to their hospitals, since turnover can be especially tough in small communities.

We’re also working with rural hospitals to identify creative partnerships with nursing schools, and even reaching into high schools as early as 9th grade. That’s when students need to start on math and science if they want to pursue nursing. By showing them they can build a career and come back to serve their community, we’re building a sustainable pipeline. Some hospitals are even offering to pay for school if students return to work locally.

WCN: What advice would you give to nurses and future leaders?

Jaffe: First, embrace every opportunity to lead, even if it feels uncomfortable. Leadership isn’t about having all the answers — it’s about being willing to step forward, listen, and make decisions with integrity.

Second, never underestimate the power of your voice. Nurses see the whole picture — patients, families, systems. That perspective is invaluable, and it belongs at every table where decisions are made.

Finally, remember that leadership is about hope. People look to nurses not only for skill but for reassurance that we can find a way forward, even in the hardest times. Hold on to that — because it’s true.