Breakthroughs The hardest part of the change process was changing the way we think and do things. Very caring staff had to trust the process and be willing to move out of their comfort zone, which is where most of us feel safe. We had to look at every role in place and redesign them to fit a new way of caring and organising our day. People were asked or volunteered to change roles, do things completely different than ever before, give up offices and work in the houses, come out of the main kitchen and become a homemaker etc. The final nugget of change was the removal of all uniforms. This created huge anxiety and confusion, as exampled by some of the following comments and concerns raised: “We won’t know who is who”,“How will I know the Nurse,” “Staff will look like visitors,”“Residents will be confused”. Now we have nurses more empowered not by the colour of their uniform but by what they do. The people who live here when looking for help call ‘Mary’ or ‘Liam’, not ‘nurse,’ as people know each other better than ever before. One of the most significant breakthroughs came from the “learning circle,” a group discussion of representatives from all walks of life in Castleross. Our maintenance man Pat suggested we refer to residents as “the people who live here” and staff “the people who work”. For many it took a long time to understand what he meant but now we know. We have 98 people who live in Castleross and 120 staff who assist them living here. This simple change in how we view the person has enabled a shift in power from the giver to the receiver. Each of our four houses now have their own dedicated staff, shift patterns, meal times and ways of doing things driven by the specific needs of the people living there. So for example Mary at 89 years of age can get up in the morning at 11 am if she wishes, have her breakfast prepared by the
Clockwise from left: ...
Homemaker present in Castleross Household Kitchen The village centre in Castleross, with Rev David Cole pictured. Castleross Garden in Dementia care Household
homemaker and because of this have a light lunch and dinner in the evening. This is all because the systems and culture allows this to happen. Mary now has control and independence at a level she is comfortable with. Many people in nursing homes when asked have struggled with loss of independence. Mary is now living in Castleross, rather than a resident of an ‘institution’ called Castleross Nursing and Convalescent Centre. We now simply refer to Castleross Nursing & Convalescent centre as Castleross.
Best Practice is a feature in NHI News that focusses on best and innovative practices in nursing homes. Nursing Homes are invited to make us aware of practices the wider public should be aware of and can contact firstname.lastname@example.org if interested in contributing an article P NHI NEWS — 20
NHI News Summer 2013