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Observation 1: Site Description and Demographics

Im using my work place, which is Cedar Sinai Medical Center in West Los
Angeles. I work in their patient food service department so I will be observing that
department. I chose this setting because it was convenient for me but also because I think
that I work with a diverse group of people.
I work with males and females ranging in age from their early twenties to their
early sixties. Many languages are spoken there but the main ones are: English, Spanish
and Tagalog. Some of my co-workers immigrated here from other countries while others
are like me are 3rd or 4th generation Americans. In the kitchen I will be observing there are
people of Russian decent, Mexican, El Salvadorian, Armenian, Japanese, Filipino,
African and African American. Most of my co-workers are from working class or middle
class backgrounds. I dont speak Spanish; this was an obstacle for me when I first started
working there because people made certain assumptions about me, for example some
people think I pretend not to speak Spanish to act white. I am from a working class
family which many of my co-workers also are which helped me find common ground
with some people and give them the opportunity to get to know me beyond Delilah, she
is Mexican but she doesnt speak Spanish.
I work in patient food services, we are the people who prepare the food and serve
patients in their rooms. The floor that I work on has mostly brain and spinal surgery
patients. I also work in the VIP food service which is like room service but in a hospital,
that service is often utilized by the hospitals more high profile patients.
The hierarchy of my department is as follows, starting from the bottom; Servers
(me) have the main responsibility of bringing/picking up meal trays and snacks to the
patient rooms as well as doing the dishes and dumping the trash that come with it. The
person who prepares the food is called the captain, they dont actually cook they heat preportioned meals/items. The people responsible for collecting orders are referred to as the
NCRs, there are also clinical DTRs to get the order of patients that are on restricted diets.
In addition to that we have supervisor DTRs who assist with various issues that occur on
the floors. In the kitchen we often have to communicate with the nursing staff because
they are the ones who get the okay from the doctors to change the diets.

Its a diverse group, there are many different cultures and personalities as well as
age differences. I would say that working in a hospital is a stressful environment for one
because hospitals never close and they are huge places with lots of rules. What I notice
the most about the group that Im observing is that teamwork is not always a constant. I
think that teamwork is not always present because it is such a big facility and it is
difficult to get everyone on the same page, especially between different departments
because they dont fully understand one anothers system/policies/routines and all of the
other particulars of each department.
Observation 2: Shadow Study- Power Dynamics and Leadership/Supervision
In food service at my hospital we have upper management and middle
management. Our upper management consists of the director, administrative coordinators
and a number of other positions that I dont know their exact titles. I interact with middle
management the most while I am working. The supervisor that I decided to observe is a
gentleman named Cesar, he holds a middle management positions and is one of our
newest supervisors. He has only been at Cedars for 8 month but he informed me that he
has 10-15 years of experience as a manager.
He is one of our newer supervisors but he seems to emphasize teamwork and
communication. As I followed him he explained that the most important thing for him is
to build a team because as he learned no one can do everything on their own. On the day
that I was following him there were a number of call ins and the managers were
scrambling to find coverage. He helped another one of our supervisors find coverage for
her area even though it wasnt something that he had to help her with, he explained to me
If I know that my co workers are struggling it would be selfish of me to ignore it. I also
witnessed him help an employee to try to find coverage for her shift next Sunday, even
though that isnt his responsibility. He asked her to write down the shift and date that she
needed covered and said that he would talk to the scheduler to see what they could do.
Since he is a new supervisor I am still getting to know his management style but after
observing him I have even more respect for it. He emphasized teamwork, communication

and building connections with patients/employees/coworkers. The attitude that he

displays is exactly what we need in our department and I would take a similar approach.
I think that he still treads lightly with many employees because he is still getting
to know people and learning the ins and outs of our department. He is very willing to help
and learn everything he can. In our department many of the employees, myself included,
think/have experienced supervisors being disrespectful; this is not the case with Cesar. He
has empathy and talks/treats people with respect. He mentioned that it breaks his heart
when has to ask someone who has already worked 6 days straight to work a 7th day but it
happens often and when it does he tries to work it out so that maybe they can get different
day off, because when you work that much thats why people get sick and hurt or call
out. He said understanding psychology and culture help one be a better manager. He
mentioned that being helpful does not mean letting you self get taken advantage of. He
also said that hes willing to help employees with their work because, I like walking and
I dont mind doing dishes, if I have to dump or pick up trash I have to do it because my
job is to make sure the operation runs as perfect as possible. I know that there are a lot
of different personalities there and I realize that it is difficult to manage all of those
personalities. Again I respect his communication and I think I would conduct my self in a
similar fashion if I were in his position.
He emphasizes communication, teamwork and building connections at the same
time he understands that he is a manager and not buddies with the employees that he
manages. He is respectful and very helpful but he explained that sometimes people view
his helpfulness as a weakness to exploit, thinking Cesar will do your work for you,
which is not the case. He said that it is important to know you limits and what you can
and cannot do. He is friendly but knows how to be assertive; he also mentioned that it is
important not to take things personal at work. People often lash out because of the
situation: they are under stress, in pain or even terminally ill so he keep that in mind and
it helps him not take things personal. As understanding as he is he said that as a manger it
is important to be able to distinguish when people are being genuinely disrespect and to
put a stop to it. You have to focus on the facts not your emotions. I respect his
leadership style and would operate under a similar model.

Shadowing a supervisor was an eye opening experience for me, I loved that it
gave me chance to observe my workplace from the perspective of my supervisors. I now
have a deeper understanding of the their routine and responsibilities. Im glad that I
followed Cesar because he makes an effort to infuse teamwork, communication and
respect into his management style. One of the times that I followed him there had been a
fire in one of the kitchens and things were very hectic, Cesar was trying to figure out how
to cover a position that someone just called in sick for, but he didnt know who to move
around. He turned to me and asked me What do you think I should do? I gave him a
suggestion; with that information and the help of another supervisor they got things
covered. Cesar still has a lot to learn about our system and its intricacies because he is
still new to our hospital but what I like about him is that he tries to work with us where
many of the supervisors there take the position of ordering us around.
Observation 3: Analysis of the ismss
The way my work place addresses issues of bias/fairness is with orientations that
everyone attends when they get hired and annual refresher presentations. Every year
every employee in the hospital has view a power point followed by a test, the test are
multiple choice and very easy. There are 2 that we take called Cultural
Competency and Cooperate Compliance, these two test emphasize respect in the
workplace and being mindful of cultural differences because we work with a diverse
group of employees and patients. In addition to culture we are also reminded to be
respectful of people with different levels of ability (we have employees and patients in
wheelchairs, with crutches, etc.).
One of my co-workers talked to me about how she thought that she was being
negatively judged because of her ability level. She is in her 60s and less then a year away
from retirement, she has knee problems and needs an operation that was delayed because
of issues with her heart. Her health issues have resulted in her doing her work slower than
most of her counterparts. She often needs assistance lifting some of the heavier boxes that
contain our inventory and she walks very slowly. She told me that on her last evaluation
our supervisor told her that she got a low mark on teamwork because she is disabled and

is barely able to do her own work so she cant help others. My co-worker was very
distraught about this and explained to me Just because Im not fast doesnt mean I cant
help in other ways.
Another thing that I see frequently are male employees from various departments
making inappropriate comments to the females of various departments. Some of the male
nurses and clinical partners will offer back messages to the female nurses and other
female employees. Once in the elevator a male and female doctor that looked like they
were in their 30s. The male doctor made a comment to the female doctor about Hillary
Clinton saying, I hear she is sick look at her she looks awful. Not that she ever looked
very good. I was standing in between them and I couldnt help but look at him and say
What does her appearance have to do with how she will run our country? He didnt say
anything but the female doctor looked at me and said, Right? I want to see a woman
president in my lifetime and I think Hillary could do it. I dont know if all of these
examples are sexism or just examples of how women are constantly sexualized by others
and judged by their appearance.
The hospital as a whole does not condone the type of behavior that I observed but
it is impossible to erase a persons individual beliefs or opinions. If you are brought up in
a society or culture that constantly sexualizes females or doesnt value people with
various disabilities its hard to just erase that mindset when you walk into an institution
that does value and respect differences of all sorts. While discussing isms with the class
I noticed that all of us females brought up issues that were specific to our gender: not
being girly enough, women not advancing as quickly in the workforce and women being
sexualized and judged for their appearance. Its true that women have advanced and made
gains but it is still some time until we are treated/viewed equally to our male

Observation 4: Study Analysis and Reflection

In the past I would just complain about my work setting and how messed up their
system was but I wouldnt think of solutions or ways to improve the situation. Doing the

observations for this class caused me to take a step back and look at my work setting
from different perspectives. There was something that stuck with me from the
Communication Skills PowerPoint that we looked at in the beginning of the semester it
was the phrase experiencing and viewing conflict as an opportunity. I kept that in mind
when doing my SWOT, understanding the causes for conflicts and using that information
to make improvements is a valuable lesson that I learned while taking this class. To be
able to view conflict as learning experience requires many skills including open
communication and understanding the views of another.
One thing I wish I had a formula for would be how to elicit change when you are
not the one in power or when those in power are resistant to change but I know that there
is not a magic solution that will always work. I wish that I knew how to share this
information and what Ive learned from my observations with others so that we could
have a more productive work environment/system.
If I could make 3 recommendations the first thing would be getting nursing and
dietary on the same page, helping nursing understand our system and schedule so that
diet changes can be accommodated. Another big issue is the staffing, I would recommend
that food service do some sort of time analysis study to understand how much time it
takes to serve each patient and how long the other task and responsibilities take. This
could help middle and upper management understand the dire need for more staffing.
Finally I would suggest that the staff have more input in changes to
routines/responsibilities. It may take more time but if the staff felt that they had input into
the changes that are made they might not be so resistant to it. Like the reading mentioned
people are more likely to work together when they have a common goal.