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Chapter 6 Phase Two
co-researchers were asked to look at various models and approaches to care
planning in order to reach agreement about what they thought might work best
for enhancing resident autonomy. At the same time and as recommended by
Reason and Bradbury (2000) I wrote down my own background and reflected on
how this might influence this phase of the research (reflection excerpt no. 2).
Reflection Excerpt no. 2
I started my nursing career fifteen years ago. All through my undergraduate
training I worked part time with older people in their own homes in the
community. Then when I became a registered nurse I worked in palliative care
also in the community and later began working in a large acute hospital where I
worked on a surgical ward with breast cancer patients and vascular patients. All
through these years I continued to study part time. Then my grandparents who
were very special to me became sick and whilst still working full time and
studying I looked after both of them in their own home until they passed away.
When they were gone I missed them terribly and suddenly found myself drawn to
work in residential care. I was offered a management position in a nursing home
which I really enjoyed and from there I took up a clinical link facilitator and
lecturing role in gerontology in a national university. The clinical link facilitator
role involved working with 19 residential care homes and undertaking change
initiative projects with them. I thrived in this role and felt I had found my niche. I
developed my project management skills, my facilitation skills and my mentoring
skills. I discovered critical companionship and emancipation through education
theories during this employment. It was during this time that the way in which
residential care was provided began to change. Whilst these changes were
warranted and needed it was a difficult and challenging time for residents and
staff. I started to realise that care was often not resident centred and that
institutional care practices were still very apparent. My research question
evolved from this time. I started to read more and more and when I analysed
person centred care I noticed that autonomy was one of its integral ingredients.
One of my work briefs was to introduce person centred care but in order to do
this I needed first to ensure that the integral ingredients were present. However
when I went to the literature to see what resident autonomy actually was, I could
find no consensus and hence this study began – because if we are ever to truly
have person centred care and subsequent quality of life we must first have
autonomy. I applied for a national HRB fellowship for which I was honoured to
receive.
The care planning education focused on the history of care planning and the
future directions for care planning for gerontological care. We discovered that
care planning has its roots in the nursing process which dates back to the 1970’s.
It involves assessment, planning, implementation, evaluation and documentation.
All healthcare professionals automatically carry out this process in their everyday