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

The implementation of a model of person-centred practice in older person settings
didn’t engage. The internal facilitator and PD group contributed to significant cultural
changes in participating areas within the organization and have managed to sustain
the cultural development work in those areas.
In another site there was such opposition from peers and unions to the PD work that
it caused great pressure and distress at times for the group members. Coupled with
this was also the lack of support at senior management so that there was no public
affirmation or recognition of the work and achievements. This was demoralising for
the group and the internal facilitator. They were under constant criticism from
colleagues in other sites and because of rotating staffing systems had to cope with
staff from other sites constantly undermining the work they were doing until they
reached a critical mass within the unit and the undermining became less effective.
They had to find their support from within the group until they became strong enough
to start challenging the system.
Another site had a significant challenge with sharing power and including support
staff in PD work and in the PD group. The realisation that nurses alone couldn’t
achieve this culture change without the involvement and participation of the support
staff became more obvious as the programme progressed. However the involvement
of support staff in programme days proved very challenging for some senior nurses
who were uncomfortable with being challenged when support staff were present. For
this group the ‘group process review’ was very challenging.
Conclusion
This report has focused on the broad developments of the three PD groups in the
Mid West. Some of the processes in the programme may not have been as
successful as others at the time and this is due in part to the nature of emancipatory
practice development which is based on critical social science concepts where the
emphasis is on the growth and development of the individual and the culture and
contexts of the workplace to bring about sustainable change (Manley et al 2008).
Deeper meaning and understanding grows within the group over time and some
processes that appeared to have little meaning can become clearer as knowledge
grows. It is unclear if the skills and benefits of reflection were ever fully appreciated
by everyone in the three sites, as the obligation to complete reflections was a
constant issue for many individuals within the groups. It would appear that in the
three sites there is a greater focus on keeping the person at the centre of care and
that there is greater involvement of residents/guests and their families and
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