The Implementation of a Model of Person-Centred Practice In Older ...

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The implementation of a model of person-centred practice in older person settings HOW DID PROGRAMME PARTICIPANTS MAKE USE OF THEIR LEARNING IN THE WORKPLACE? During day one participants learnt how to commence the first phase of the Values and Beliefs Clarification activity (Dewing and Titchen 2006; Manley and Warfield 1990) with the residents staff and families; to describe the PCN framework to 3 team members and to notice language and make notes on the types of language used in the workplace that they would consider to be more or less person-centred. In order to illustrate the workplace learning activities that were taking place and how the learning activities in the programme days were followed through to the programme days an example is offered here. Between day 2 and day 3 the programme groups were working on five workplace learning activities: Draft vision statement: Sharing and consulting on the draft vision statement and vision in colour was largely a positive experience. However, the challenge posed by their colleagues and others was as to how it would be made a living document or a working statement. “Some good words in statement” ”Just a statement” “Promoted what we expect but does it work?” “Only works if we work as a team” “What is team work?” “Statement too long” All sites had by this point a draft of their vision statement and had sought feedback from staff residents/patients and families. A final draft was prepared for circulation to ensure consensus would it before it became the hospital or facility’s “Vision Statement”. The consultation with staff revealed a range of views about personcentredness, which are captured in these quotes below: “Choice is fundamental to everything we do”. I agree….. but whose choice-the patients or the nurses and carers? As we work (nurse and carer) in a long term setting we become institutionalised, patients get less due to the constraining effects of that institutionalisation. “Overall this is good-however; I think that patients should come before staff” 121
The implementation of a model of person-centred practice in older person settings “Have you ever heard an older person saying the word holistic? And if a person is recognised as a unique individual - is holistic not redundant?” “All are treated with dignity and respect here. Surely this doesn’t need to be written – is this not already here in hospital?” Discussion took place on how their vision statement would be utilised and shared, suggestions included through their hospital booklet, by having a formal launch, displaying it at entrances and all wards and to continue discussing the statements in terms of peoples values and beliefs. Each site came up with their own action plan for which they secured support from the Director of Nursing. Language Posters: All sites identified the inappropriate use of non-person-centred language as an issue of concern. ”I learned that language is not just words but that we have to be careful about how we speak to older people in general i.e. ageism etc” Participants found the posters they had made in day one or day two invaluable in promoting discussion on the use of person-centred language within their work environment. The participants were trying to find appropriate ways to challenge the use of inappropriate language and they were encouraged to continue to raise awareness among their colleagues. In one site the Speech and Language Therapist expressed an interest in being involved in the activity. Cats Skirts and Lipstick Activity: This activity prompted a review of some existing care plans that did not facilitate the recording of this type of information. They should have been asked when they were admitted “what is” and “what was important” to them, not after a few months or years” “Chat could make life better for you here” (Resident) Participants planned to share the learning by facilitating their colleagues to carry out the activity in the clinical area. Participants recognised that there were things they did not know about their residents and that they probably had not really considered 122
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