Running Head: HEALTHCARE VILLAGE 1

It Takes a Healthcare Village: Part 2

Nicole Cory

Ferris State University

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Abstract

This paper is a summary of an interview with Ruth Sommerfeldt, Director of Emergency

Services at Memorial Medical Center of West Michigan. The topics of discussion were the

manager’s ability to deal with these issues: cultural diversity, power, influence, research, legal

issues, ethical issues, decision making, and the resolution of conflict. Ruth Sommerfeldt, RN is a

democratic leader with a philosophy of “people first”. She fell into the role of manager when her

own manager left the position. Ruth feels power is not something she ever sought, and has never

abused the power she holds as manager. She believes in collaboration with the staff and building

a team from within. Ruth reads many research studies for her job as it is her duty to evaluate and

institute evidence based practice policies for the unit.

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It Takes a Healthcare Village: Part 2

Ruth Sommerfeldt, RN is the Director of Nursing Services at Memorial Medical Center

of West Michigan in Ludington, Michigan. Her career began in 1980 when she graduated as an

LPN from a nearby community college. After graduation, Ruth was hired to work on the medical

surgical floor and worked there for one and a half years. By the end of her time working on the

medical-surgical unit she had been trained to work in the pediatrics, orthopedics, nursery, post-

partum, and psychiatric areas. One night while she was working, the emergency department

called to see if anyone could be spared to help them as they were very busy. Ruth volunteered to

help out, and that is when her love for emergency nursing began.

Ruth went on to graduate from an ADN program in 1984. She worked in the emergency

department as a staff nurse for fifteen years until her boss left. During this time Ruth took a

number of EMT courses and fulfilled the role of charge nurse for several years.

When her own boss left, Ruth was asked to fill in as an interim manager until a

replacement could be hired. She was asked to take the job permanently but was hesitant due to

her love for patient care. Eventually Ruth agreed to take the job and she has been in this role

since.

Cultural Diversity

Memorial Medical Center is not a very culturally diverse facility. The population of the

service area is 94% Caucasian (City-Data, 2008). The diversity that Ruth states she most has to

deal with in her role is in the age differences of the staff (Sommerfeldt, 2009). “There is a great

difference in the practices, values, and ideals of the staff who are 60 and those who are in their

early 20s” (Sommerfeldt, 2009).

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The average age of RNs in the United States has increased substantially from 37.4 years

in 1983, to 41.9 years in 1996 and 44.5 years in 2000 (Letvak, 2002). The percentage of working

women ages 55 to 64 has increased from 30% to 56.8% during the same period (Letvak, 2002).

An initial step for managers and nurses is to acknowledge ageism in our society and reflect on

their own views about aging and older nurses (Letvak, 2002). Managers can take steps to combat

ageism in their workplace by staying informed of facts about older workers and examining their

attitudes and actions to eliminate those that express ageism. It is advised to refrain from telling or

laughing at ageist jokes or using ageist language. Nurses are encouraged to write letters to editors

when ageism is noted in newspapers and journals. Another way to combat ageism is by

conducting research on the positive aspects of aging (Letvak, 2002).

A recent study described benefits from multigenerational workforces, but it was also

found that younger workers were more sensitive to generational issues and were more likely to

feel they weren’t taken seriously by older coworkers (Northam, 2009). When multigenerational

workers come together on a nursing unit an environment of disrespect and incivility may exist

(Ellis and Hartley, 2009, p. 338). The best way to address multigenerational conflicts have been

through coaching and mentoring staff to teach communication techniques in which each party

states honestly how they feel, what they value, and agree to try to understand one another (Ellis

and Hartley, 2009).

It is important to be aware of cultural differences in the health care field. As a nurse

manager one must consider these differences and foster a culturally appropriate attitude among

staff. The use of appropriate language, assisting in the comprehension of different health beliefs,

and incorporating cultural differences in care planning are all techniques used to provide

culturally appropriate care (Ellis and Hartley, 2009).

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Legal or Ethical Issues

Ethics “deals with concerns about right and wrong or good and evil” (Ellis and Hartley,

2009). The ANA provides a Nursing Code of Ethics for nurses to consider. It is advised that

nurses should “become aware of our own attitudes, beliefs, and values so that we might provide

the best possible care to our clients, free of personal biases and prejudices (Ellis and Hartley,

2009). The nursing code of ethics touches on several ethical aspects of nursing care including

participation in the advancement of the profession, collaboration with other healthcare

professionals, and maintenance of the integrity of the profession (Lachman, 2009).

The Director of Emergency Services position requires more time in the courtroom than

anyone else in the department (Sommerfeldt, 2009). Ruth states that she has been a witness in a

number of legal cases that went to court and were subsequently won (Sommerfeldt, 2009).

According to Ellis and Hartley (2009), legal issues affect the activities of nurses now more than

ever.

Nursing is considered one of the most moral occupations. As a nurse manager, it is

important to uphold the “legal and ethical standards of care defined by the profession” (Ellis and

Hartley, 2009). In an interview with Ruth Sommerfeldt, she recalled a situation in which a nurse

was upset regarding the manner in which a physician spoke to a patient (Sommerfeldt, 2009).

The nurse felt that her integrity as well as the patient’s integrity had been violated, and the issue

was reported to the Vice President of Nursing Services and the necessary disciplinary action was

taken (Sommerfeldt, 2009). She stated that she felt a great deal of respect for this nurse who felt

so strongly about the veracity of the physician to the patient (Sommerfeldt, 2009).
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Power and Influence

The issues of power and influence were discussed in the interview. Mrs. Sommerfeldt

denies the desire to hold or use power. “There are people who take a position due to their need to

hold power over others” (Sommerfeldt, 2009). “I want power from the people” she stated. Ruth

took this leadership position and told the staff “my responsibility is to see that you have what

you need” (Sommerfeldt, 2009). She told her staff “consider me teacher, coach, not just a boss”

(Sommerfeldt, 2009). Ruth believes in building a team from within, not from above, and she

considers herself more of a servant leader (Sommerfeldt, 2009).

Considering these statements, it is easy to see that Ruth’s leadership style is democratic.

This style of leadership allows leaders to see themselves as coworkers, rather than superior, and

stresses the importance of communication, consensus, and teamwork (Ellis and Hartley, 2009).

This type of leader motivates the employee by involving them in the decision making process

(Ellis and Hartley, 2009). Employees who are involved are more likely to be supportive of the

process or the decision being made (Ellis and Hartley, 2009).

The type of leader on a nursing floor can affect the morale among the nurses, nurse

retention, and overall quality of care. Studies have shown nurses to be more likely to remain

employed at a facility where they feel valued and respected. If a nurse manager leads in a manner

that fosters collaboration and values the input of his or her staff, those staff members will have

increased job satisfaction. Quality of patient care is the number one concern for most direct-

patient care nurses. If nurses are involved the development of quality of care initiatives, they will

be more likely to uphold and support those initiatives (Ellis and Hartley, 2009).

Decision-making, Problem Solving

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When discussing decision making Ruth stated, “People first is my policy” (Sommerfeldt,

2009). “When making decisions I always consider people first. I also consider will it make a

difference for the better? How does it change the practice? What are the negative ramifications

for not getting this done or fixed?” (Sommerfeldt, 2009). Staff nurses are also consulted and

involved in many of the decision making processes. A charge nurse on the day shift and one on

the night shift have been given the duty of scheduling for those shifts. Another staff nurse has

been given the duty of educating staff on EZ-IO training. Other staff nurses have been involved

in other training for the use of new protocols and equipment.

Shared governance is apparent in the emergency department that Ruth manages. This is a

professional practice model in which the nursing staff and nursing management are involved in

making decisions (Ellis and Hartley, 2009). In regards to shared governance, Ellis and Hartley

(2009) state, “This practice allows nurses to have control over their practice and have input into

broader ideas of unit management”.

The effects of shared governance on organizations and nurses have been studied. The

studies demonstrate greater job satisfaction, less staff turnover in institutions, and actual cost

savings in facilities using shared governance (Ellis and Hartley, 2009).

Management and resolution of Conflict

Regarding conflict in the management role, Ruth believes that a “My way or no way”

philosophy is ineffectual. She states there are not many problems at a management or

administrative level, but different personalities cause the most conflict (Sommerfeldt, 2009).

There are many different personalities working together, and it doesn’t go well if you throw a fit.

“It is nice to come to a consensus or resolution, but it doesn’t always happen. Leave personal

issues at the door, take care of patient safety first” (Sommerfeldt, 2009).
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The book Managing and Coordinating Nursing Care describes collaborating as the best method

of conflict resolution especially when an issue requires a consensus (Ellis and Hartley, 2009).

Ruth describes the type of conflict she deals with as mostly interpersonal conflict among the staff

nurses (Sommerfeldt, 2009). This conflict often occurs because of differing values, goals,

actions, or perceptions (Ellis and Hartley, 2009). In an article titled Resolve Conflicts between

Healthcare Professionals Debra Gerardi states, “Resolution of conflict is a misnomer," she says.

"Conflict is often linked to tensions or polarities that have to be balanced, such as the tension

between cost and quality. There is not an end or solution to this tension, so resolution is not the

goal” (Resolve Conflict, 2009).

Proper resolution of conflict has a definite impact on patient care. Healthcare

professionals estimate that more than 50% of their time is spent dealing with conflict and that the

majority of that is conflict with each other (Resolve Conflict, 2009). The chair of the Program on

Healthcare Collaboration and Conflict Resolution at Creighton University in Omaha, NE,

Gerardi says that in her experience, those conflicts affect everything from lengths of stay to staff

retention (Resolve Conflict, 2009).

Interpreter or participant of research

Ruth feels her role in research is mainly as a consumer (Sommerfeldt, 2009). She has

participated in celiac research as a study subject, she regularly reviews research studies, but she

states that she has not conducted experiments for many reasons (Sommerfeldt, 2009). Recently

Ruth undertook a review of research regarding emergency department measures (Sommerfeldt,

2009). A new protocol was recently instituted regarding the EZ-IO intraosseous IV insertion. She

reviewed many studies of different types of IO instruments and chose the one that she believed

fostered the best practice (Sommerfeldt, 2009). ENA magazine is the journal she reads most
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frequently (Sommerfeldt, 2009). Ruth states, “I’m the person to take lead on evidence based

practices. There is an increased need to implement evidence based practice due to pressure at

government level to save money in healthcare” (Sommerfeldt, 2009).

Nurses have a duty to identify research needs (Ellis and Hartley, 2009). As a nurse

manager it is important to develop protocols and procedures that are evidence-based (Ellis and

Hartley, 2009). It is also important to continually monitor the effect these changes have had on

patient care (EBP Easy, 2009).

Conclusion

There are many different styles and types of nurse managers. Each nursing unit can

benefit from having a nurse manager who is also an effective leader. Nurse Managers must deal

with things such as conflict among the staff and prepare staff to deal with a culturally diverse

field. Decision-making, problem solving, and legal or ethical issues also impact the role of the

nurse in a leadership position. The nurse manager reads and interprets research and implements

evidence based practices based on the best research available. A nurse manager must also be

aware of the power and influence he or she possesses and utilize this for good.
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References

Ellis, J. R., & Hartley, C. L. (2009). Managing and coordinating nursing care. Philadelphia:

Lippincott Williams & Wilkins.

“Resolve conflicts between healthcare professionals”. (2009). Strategies for Nurse Managers.

Retrieved from http://0-find.galegroup.com.libcat.ferris.edu/ gtx/start.do?prodId=

AONE&userGroupName=lom_ferrissu.

Lachman, V. (2009). Practical use of the Nursing Code of Ethics: Part II. MedSurg Nursing,

18(3). Retrieved November 28, 2009, from http://0find.galegroup.com.libcat.ferris. edu

/gtx/start. do?prodId=AONE&userGroupName=lom_ferrissu

Letvak, S. (2002). Myths and realities of ageism and nursing. AORN Journal volume 75, issue 5

Retrieved from http://0-find.galegroup.com.libcat.ferris.edu

Make EBP as easy as 1-2-3. Strategies for Nurse Managers (2009). Academic OneFile. Web.

Retrieved from http://0-find.galegroup.com.libcat.ferris.edu/gtx/start.do?prod

Id=AONE&userGroupName=lom_ferrissu.

Northam, S. (2009). Conflict in the Workplace. American Journal of Nursing: June 2009 -

Volume 109 - Issue 6 - pp 70-73

Stats about all US cities - real estate, relocation info, house prices, home value estimator, recent

sales, cost of living, crime, race, income, photos, education, maps, weather, houses,

schools, neighborhoods, and more. (n.d.). Stats about all US cities - real estate,

relocation info, house prices, home value estimator, recent sales, cost of living, crime,

race, income, photos, education, maps, weather, houses, schools, neighborhoods, and

more. Retrieved November 28, 2009, from http://City-Data.com

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Paper 2: Analyzing a Nurse in a Leader or Manager Role

Possible Points
Points
Introduction (Background on Nurse Leader 12
or Manager to include education, years in
practice and role, additional qualifications
for role, etc.)
Describe & analyze ability to deal 13
effectively with cultural diversity with Evidence 3
staff/peers & clients/patients (include effect Support 4
on patients and organization) Analysis 6

Describe & analyze a legal or ethical issue 13

this leader or manager has and is managing Evidence 3
(include effect on patients and Support 4
organization) Analysis 6

Describe & analyze use of power and 13

influence (include effect on patients and Evidence 3
organization) Support 4
Analysis 6

Describe & analyze use of decision-making 13

and problem-solving process (include effect Evidence 3
on patients and organization) Support 4
Analysis 6

Describe & analyze management and 13

resolution of conflict (include effect on Evidence 3
patients and organization) Support 4
Analysis 6

Describe & analyze leader or manager as an 13

interpreter and participant in research Evidence 3
(include effect on patients and Support 4
organization) Analysis 6

Sentence structure, spelling, grammar & 10

punctuation; APA Format

TOTAL POINTS 100

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