Rhonda Rotterman-Palmiero, ’88: Promoting a Different Way of Caring
A chance encounter with a frail woman set Rhonda (Goodberry) Rotterman-Palmiero on a career path that she never expected.
Nursing jobs at hospitals were scarce when Rhonda, a member of the College of Nursing’s Class of 1988, graduated. Despite the fact geriatrics was one of her least favorite clinical rotations, she began applying for jobs at nursing homes to supplement her income and help pay for educational expenses. While completing an application at a local facility, Rhonda heard a woman screaming for help. No one came to assist the woman, so she went over and began to talk to her about her family, her home, and her pets. The conversation had a calming effect on the woman, named Mary.
Later that week, when Rhonda was offered the job, she remembered Mary and decided to accept the position, thinking she could make a difference for her. “It was certainly not a career that I chose. I always tell people it kind of chose me, and Mary was the catalyst.”
As Rhonda pursued her career in long-term care, she began to recognize that the focus on task, rather than on people as individuals with unique needs and desires, was leading to poor outcomes: apathy, behavioral outbursts, and feelings of loneliness, helplessness, and boredom.
“I used to define success as getting all my tasks done by the end of my shift,” she says. “My epiphany came when I would see that the people we were trying so hard to make a difference for, were absolutely miserable. By health care’s definitions, maybe I was successful, but by my patients’ and their families’ definitions, I was failing miserably. And that became more important to me.”
So Rhonda began looking beyond the classic standards of care to the people themselves to find ways to bring a meaningful existence to them. This completely changed the way she did her job, and she became a passionate advocate for person-centered care, an approach that focuses on the uniqueness of the person, and on their relationships, life experiences, abilities, and preferences.
“The social world that surrounds people can have a positive or negative effect on well-being,” she says. “There’s so much more to life than three square meals a day, making sure you get your medications, and Bingo on Tuesdays. Person-centered care really speaks to knowing the people as individuals and bringing a quality of life to them, whatever that means for them, as opposed to the health care environment dictating everything.”
Rhonda’s change in perspective enabled her to improve care and services for the people she directly interacted with, but she wanted to effect change on a broader scale. In 2002, she earned a master’s degree in health care administration and quickly moved into executive-level positions.
At these organizations, Rhonda led by example and encouraged her staff to engage the people they cared for in the process of life, including assisting in developing activities that were meaningful to them and offering them the opportunity to take on work functions that interested them.
“Giving these individuals responsibilities provided a deep sense of purpose,” Rhonda says, “and gave staff a feeling of empowerment in making a difference for those they cared for, which had positive effects for everyone involved in both their emotional and physical health.”
In 2009, Rhonda was named executive director of the Western New York Alliance for Person-Centered Care, a grant-funded initiative sponsored by the John R. Oishei Foundation that was launched to assist nursing homes and assisted living facilities transition from institutional environments to person-centered care environments. The one-year grant was extended to three years because of the significant progress the alliance made.
As executive director, Rhonda developed and provided training and educational resources for providers, spoke at national conferences, and lobbied for regulatory changes in long-term care. After the funding expired, she joined the University at Buffalo, where she assisted in creating the Institute for Person-Centered Care, a collaborative effort of UB faculty members and the WNYAPCC. As program director, Rhonda was instrumental in developing credit and non-credit bearing courses, workshops and continuing education programs for both professional and lay caregivers. She also became involved in the university’s interprofessional educational initiative by partnering with several other departments to create a culture of “positivity” that focuses on autonomy and a sense of self-worth and purpose, despite physical or cognitive impairment.
When her contract with UB ended in December 2013, Rhonda shifted her attention to managed care programs and joined Family Choice of NY, a subsidiary of Independent Health, as staff development coordinator.
“Managed care is the direction health care is going in, so it’s imperative that I get person-centered care into that forum,” she says.
Rhonda’s efforts have helped to transition health care to a more holistic model, which is really the foundation of the nursing profession, she points out, and she is proud to be part of this national paradigm shift.
“I get to share this new philosophy with thousands of people,” she says, “who then take that information and go and make a difference for millions of people because they’ve learned that we can care in a different way. A way that has positive impact on those providing service but, more importantly, a way that has tremendous impact for those receiving services, and that is really what it’s all about.”
Editor’s Note: In addition to her work in health care, Rhonda has made physical fitness a priority. In 2011, at the age of 44, she entered her first body building competition and took second place in three divisions. Since then, she has been the first-place finisher in three National Physique Committee competitions, and now competes at a national level in competitions across the U.S. She has been featured in No Nonsense Magazine, a national publication on fitness and health, and in “Refresh Buffalo,” published by The Buffalo News. A certified personal trainer and dietary consultant, Rhonda enjoys sharing her journey in health and wellness to inspire others on their own fitness paths. One of her recent blogs appears here.