It seems to me that practice development doesn’t easily sit within healthcare provider organisations or within universities either. It’s what I call an ‘in-betweener’ or in some cases, the ‘unwelcome guest at the table’. Now….., if this table were a tea table then we could easily enough be gazing on a mad tea party courtesy of ‘Alice’s Adventures in Wonderland’ (Carroll, 1865):

‘The distinguishing features of this tea party is that there is always a tea party going on (a meeting of some sorts), time is either stuck or running out. At the party the participants switch places on the table at any given time (frequent changing of roles), making personal remarks about other people, ask unanswerable riddles (practice challenges) and recite nonsensical poetry (evidence). All of which eventually drive Alice away. The Hatter of course, is adept at changing his guise and reappearing elsewhere and getting through by his whiskers. Finally, we shouldn’t forget the sleeping dormouse who sleeps for most of the tea party’

 This may (or hopefully may not) sound like a work place near you.

So why is practice development an uncomfortable guest? To begin with practice developers tend to influence what goes on around the table. Looking at how we talk to each other and how we act is a fundamental representation of our values. This is one recurring part of the daily work of many practice developers. More broadly, both organisations present the practice developer with riddles.

Question: What does the University have in common with the healthcare provider when the former demands end point outputs generalisable to national and international contexts and the latter to localised and particular contexts?

To be a practice developer means having to accommodate the needs of diverse guests or stakeholders, who often, on the surface of it, have competing needs. The irony is that practice development can contribute significantly to both academic and provider organisational targets and needs. However, both organisations seem to have vested interests in being different to each other. It is this space of ‘difference’ or diversity and multiple needs that practice development and the effective practice developer learn how to dwell in.

The first challenge for the practice developer is to learn how to sit on an uncomfortable seat – to be perched on a critical edge at the table. However, a tension emerges for the practice developer here. Everyone working in an organisation wants to feel comfortable – in some ways to feel at home. For the practice developer this is not possible and may even become a problem should it happen. Most practice developers need to be inside the organisation for things about it (the workplace cultures) to become familiar and yet, things need to stand out as ‘not familiar’ in order that we are curious about them and want to explore them. This can range from routines and rituals, language and discourse, trolleys being used for certain procedures, gloves that are worn for almost every procedure they aren’t indicated for, and those home-made signs and pieces of documentation that keep reappearing.

Being familiar and comfortable is probably essential for our own safety and security as well as enabling us to thrive and ultimately flourish in the workplace as a person. However, if we are too familiar it may follow that we become too comfortable and therefore less effective in our work and development of our personhood. Perching on the edge and living with the tensions that exist between familiarity and unfamiliarity, being at home and being in a strange place can be emotionally demanding work. Those of us more experienced in practice development need to support novice practice developers through this process so that they feel comfortable in their own skin even if not that comfortable at the table and the tea party.

‘Only a creature that knows how to dwell can paint, dance, think and write.’

Jager (2001, p 134)

The first challenge is probably around how we learn to dwell within a work place to become familiar with it, and yet retain and then enhance a capacity for the unfamiliar as this will feed our creativity. In this issue we can see some of the ways in which practice developers are reaping the rewards of the different types of dwelling they are engaging with. We have a wide range of papers and reflective pieces covering different aspects of dwelling and other dimensions of practice development. We are also introducing a new feature; our novice or first time writer publication. For this issue this is Helen Hunnisett, a Senior Physiotherapist working in the NHS and a novice practice developer.

Thank you to all the authors, reviewers and commentators for your contributions to this issue and the first issue. We are coming to the end of our first year and turning our gaze towards 2012.

I hope you enjoy this issue of the journal and find it useful for your work. Please let other people know about the journal and let us know if you’ve got feedback or are interested in publishing with us.

References

Jager, B. (2001) The birth of poetry and the creation of the human world. Journal of Phenomenological Psychology. Vol. 32. No. 2. pp 131-152.
Lewis, C. (1865) Alice’s Adventures in Wonderland. London: Macmillan and Co.

Jan Dewing (PhD, MN, BSc, RN, RNT, Dip Nurs Ed, Dip Nurs), Academic Editor, International Practice Development Journal; Professor of Person-centred Research and Practice Development, East Sussex Healthcare NHS Trust and Canterbury Christchurch University, Kent, England. Visiting Professor, Person-centred Practice Research Centre University of Ulster, Northern Ireland. Visiting Professor Aged Care and Practice Development, School of Nursing Midwifery and Indigenous Health Studies, University of Wollongong NSW (in partnership with Uniting Care Ageing SE Region).

This article by Jan Dewing is licensed under a Creative Commons Attribution Non-Commercial 3.0 License.