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Clinical Supervision (clinical + supervision)
Selected AbstractsClinical supervision in the alcohol and other drugs field: an imperative or an option?DRUG AND ALCOHOL REVIEW, Issue 3 2007ANN M. ROCHE Abstract There is a growing interest in Clinical Supervision (CS) as a central workforce development (WFD) strategy. This paper provides a definition of and rationale for CS, characterises its various forms, identifies selection and training issues, and advises on policy and implementation issues central to redressing shortcomings in supervision practice within the alcohol and other drugs (AOD) field. Relevant selective literature is reviewed. Key conceptual issues were identified, and strategies developed to address implementation barriers and facilitate relevant policy. There is a common conceptual confusion between administrative supervision and CS. Clarification of the role, function and implementation of CS is required. Priority issues for the AOD field include: enhancing belief in CS; ensuring adequate resource allocation; developing evaluation protocols; and addressing specific arrangements under which supervision should occur. CS has been underutilised to date but holds considerable potential as a WFD strategy. It is fundamental to workers' professional development, can contribute to worker satisfaction and retention, and may improve client outcomes. Critical next steps are to establish the generalisability to the AOD field of the benefits observed from CS in other disciplines, and evaluate longer-term gains of CS programs. [source] Clinical supervision is important to the quality of health-care provisionINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 5 2008Alun Jones No abstract is available for this article. [source] Community mental health nursing and early intervention in dementia: developing practice through a single case historyJOURNAL OF CLINICAL NURSING, Issue 2004John Keady PhD This paper reports on a single case history taken from the ,Dementia Action Research and Education' project, a 15-month primary care intervention study that was undertaken in North Wales in the early part of 2000. The study sought to address the meaning, context and diversity of early intervention in dementia care and employed a community mental health nurse and a psychiatric social worker to undertake early and psychosocial interventions with older people with dementia (aged 75 years and over) and their families. The workers tape-recorded, documented and analysed their interventions with 27 older people with dementia and their families over the 15-month duration of the study. Clinical supervision was also undertaken during the intervention phase. One case history is presented in this paper to illustrate the work of the community mental health nurse and to identify areas of practice development. Greater role transparency, collaborative working and improvement in educational preparation for practice are called for. [source] Clinical supervision: what do we know and what do we need to know?JOURNAL OF NURSING MANAGEMENT, Issue 8 2006A review, commentary Aims, This study is addressed to nurses but the issues are of equal concern to both midwives and health visitors. Clinical supervision ideally both challenges nurses as well as help their practice. There is need to identify critical elements that help professional practice and understand more clearly the changing nature of supervisory relationships. Background, Clinical supervision in nursing is over a decade old in the UK and yet emerging nursing literature suggests that many ideas remain unfamiliar to nursing practice. The resistance shown by nurse towards clinical supervising remains perplexing. Moreover, ideas concerning clinical supervision have been applied without a substantive evidence base. Methods, The discussion draws on varied ideas concerning supervision, including those outside of nursing, to ask what do we know and still need to know about clinical supervision. This study suggests that, a single approach to clinical supervision could be unhelpful to nursing. Findings and conclusion, Nursing knowledge concerning many aspects of clinical supervision is increasing because of research. Much of the literature suggests that clinical supervision is scholarly activity requiring much the same attention to relationships as the therapeutic activities it supports. This discussion concludes with the idea that clinical supervision might work at its best as a quiet activity allowing nurses to think about nursing work in ways that suit individual learning styles. [source] Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelinesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2007F. RICE rmn msc Nurses work in a constantly challenging and changing environment. Within this context, there is a continuing need for support. Such support will help increase morale, decrease strain and burnout, and encourage self-awareness and self-expression. Clinical supervision address all these issues and enhances the quality of care for patients. While clinical supervision is a policy imperative in Northern Ireland, it was clear that there were problems in its implementation in mental health nursing. The aim of this project was to explore ways to make clinical supervision available to all mental health nurses and to improve and evaluate their contribution to patient care. The research team undertook a comprehensive literature review and a baseline survey of relevant stakeholders. Results represent the outcome of the group work. They will assist healthcare providers to develop local policies and procedures on clinical supervision for practising mental health nurses. [source] Multiprofessional clinical supervision: challenges for mental health nursesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2001K. Mullarkey ma bsc(hons) rn cpncert rnt Recent reform and developments in mental health care provision have increasingly espoused the value of multiprofessional teamwork in order to ensure that clients are offered co-ordinated packages of care that draw on the full range of appropriate services available (DoH 1999a; DoH 2000). Supervision in some form is seen as a key part of all professional practice to provide support to practitioners, enhance ongoing learning, and, to a greater or lesser degree, offer some protection to the public (Brown & Bourne 1996, UKCC 1996). Clinical supervision has gained increasing momentum within the nursing profession, but to a large extent this has been within a uni-professional framework , nurses supervising other nurses. This paper seeks to explore the ways in which multiprofessional working and clinical supervision interlink, and whether supervision across professional boundaries might be desirable, possible, and/or justifiable. Whilst our own view is that multiprofessional supervision is both possible and desirable, we seek to open up a debate, from our perspective as mental health nurses, about some of the issues related to the concept. Our motivation to explore this topic area emanates from our experiences as supervisors to colleagues within multiprofessional teams, as well as the experiences of those attending supervisor training courses. Following a brief overview of the development of clinical supervision in mental health care and recent policy guidelines, some models of clinical supervision are reviewed in terms of their suitability and applicability for multiprofessional working. [source] Egalitarian consultation meetings: an alternative to received wisdom about clinical supervision in psychiatric nursing practiceJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2000C. Stevenson RMN BA (HONS) PhD Clinical supervision (CS) has become a watchword for psychiatric nursing. Yet, there are contradictions and controversies in academic and professional discourse in relation to the nature of CS, both structure and process, its effectiveness and how this is ascertained, the preparation of supervisor and supervisee, and the quality of the supervisory relationship. The perception of such discord encouraged the authors of this paper to step outside the debate and enact a different kind of CS, which came to be known as egalitarian consultation (EC). Egalitarian consultation meetings (ECMs) were established with the postmodern turn in psychiatric nursing as a reference point. A space was created in which participants could construct their particular version of CS. The authors and six G-grade community psychiatric nurses engaged with each other for six videotaped meetings. The data from the recordings were analysed using a hermeneutic grounded theory approach (Strauss & Corbin 1994), in keeping with the style of the research, which combined the roles of researcher and practitioner for the authors. The aim was to produce local knowledge of CS. The ECMs were characterized by a sense of freedom in relation to existing rules about hierarchy and truth. The participants, each as expert in her/his own case world, produced engrossing narratives about and for practice. The group developed a cohesiveness based in closeness and this encouraged radical talk and action , a questioning of practice systems. However, for some group members, radical equated to dangerous in terms of the watchful organization and a return to ,real' work (case supervision) was observed. Innovation in relation to CS may benefit from a change in institutional culture. [source] Effective supervision in clinical practice settings: a literature reviewMEDICAL EDUCATION, Issue 10 2000S M Kilminster Context Clinical supervision has a vital role in postgraduate and, to some extent, undergraduate medical education. However it is probably the least investigated, discussed and developed aspect of clinical education. This large-scale, interdisciplinary review of literature addressing supervision is the first from a medical education perspective. Purpose To review the literature on effective supervision in practice settings in order to identify what is known about effective supervision. Content The empirical basis of the literature is discussed and the literature reviewed to identify understandings and definitions of supervision and its purpose; theoretical models of supervision; availability, structure and content of supervision; effective supervision; skills and qualities of effective supervisors; and supervisor training and its effectiveness. Conclusions The evidence only partially answers our original questions and suggests others. The supervision relationship is probably the single most important factor for the effectiveness of supervision, more important than the supervisory methods used. Feedback is essential and must be clear. It is important that the trainee has some control over and input into the supervisory process. Finding sufficient time for supervision can be a problem. Trainee behaviours and attitudes towards supervision require more investigation; some behaviours are detrimental both to patient care and learning. Current supervisory practice in medicine has very little empirical or theoretical basis. This review demonstrates the need for more structured and methodologically sound programmes of research into supervision in practice settings so that detailed models of effective supervision can be developed and thereby inform practice. [source] Retaining the mental health nursing workforce: Early indicators of retention and attritionINTERNATIONAL JOURNAL OF MENTAL HEALTH NURSING, Issue 4 2005Sarah Robinson ABSTRACT:, In the UK, strategies to improve retention of the mental health workforce feature prominently in health policy. This paper reports on a longitudinal national study into the careers of mental health nurses in the UK. The findings reveal little attrition during the first 6 months after qualification. Investigation of career experiences showed that the main sources of job satisfaction were caregiving opportunities and supportive working relationships. The main sources of dissatisfaction were pay in relation to responsibility, paperwork, continuing education opportunities, and career guidance. Participants were asked whether they predicted being in nursing in the future. Gender and ethnicity were related to likelihood to remain in nursing in 5 years time. Age, having children, educational background, ethnic background, and time in first job were associated with likelihood of remaining in nursing at 10 years. Associations between elements of job satisfaction (quality of clinical supervision, ratio of qualified to unqualified staff, support from immediate line manager, and paperwork) and anticipated retention are complex and there are likely to be interaction effects because of the complexity of the issues. Sustaining positive experiences, remedying sources of dissatisfaction, and supporting diplomates from all backgrounds should be central to the development of retention strategies. [source] Caregivers' strong commitment to their relationship with older peopleINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 2 2010Elisabeth Häggström RNT PhD Häggström E, Mamhidir, A-G, Kihlgren A. International Journal of Nursing Practice 2010; 16: 99,105 Caregivers' strong commitment to their relationship with older people The aim of the present study was to describe caregivers' good as well as bad experiences of working with older people. The study was based on five focus group interviews. One theme emerged from a latent content analysis: strong commitment to the relationship. This theme functioned as a thread of underlying meaning throughout the entire interpretative process of 48 caregivers' experiences of work. A delicate relationship existed that could be vulnerable and could reveal itself in feelings of lack of knowledge, guilt and fear. The caregivers' committed relationship to the older adults created independency in the ways in which they protected the older people's needs. Further studies are needed that focus on caregivers' transition from dependency to independency. The findings highlight the importance of clinical supervision to personal development and identity, and to promoting caregivers' self-esteem and maintaining a committed relationship. Commitment is a deep human feeling, and it should be promoted in order to maintain and further develop quality care for older adults. [source] Reflective practice and clinical supervision: meticulous rituals of the confessionalJOURNAL OF ADVANCED NURSING, Issue 2 2001Tony Gilbert BA MSc PhD RN PGCE Reflective practice and clinical supervision: meticulous rituals of the confessional Background.,Reflective practice and clinical supervision are progressively asserting hegemony upon nursing practice with claims of emancipation and empowerment. However, this is being achieved in an environment where there is little critical debate about the assumptions on which these practices are based. Aim.,This paper sets out to challenge the basis upon which reflective practice and clinical supervision are promoted within nursing discourse by employing Michel Foucault's (1982) concept of governmentality. Theme.,A broad Foucauldian perspective is used to demonstrate how the technologies of reflective practice and clinical supervision have been accommodated within modern forms of government. These technologies are consistent with the flattened hierarchies and increasing dispersal of practitioners in contemporary health care. In this context reflective practice and clinical supervision can be shown to function in two independent but interrelated ways. First as modes of surveillance disciplining the activity of professionals. Second, as ,confessional' practices that work to produce particular identities , autonomous and self-regulating. [source] John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United KingdomJOURNAL OF ADVANCED NURSING, Issue 2 2001Graham Sloan BSc DipN RMN RGN DipCogPsychotherapy John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom Aims.,This paper provides a critique of how Heron's six-category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed. Background.,Heron's six-category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses' perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized. Findings.,Returning to Heron's original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing's emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing. Conclusion.,We argue that Heron's six-category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework's theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron's framework have equal relevance to its contribution in nursing as a supervision model. [source] A critical essay on professional development in dietetics through a process of reflection and clinical supervisionJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 5 2000S. Burton Background The concept of clinical supervision is well known within the nursing profession though numerous definitions and theoretical models proposed for implementation have led to a degree of confusion. The debate within dietetics is just beginning, with the recent formation of a BDA working group seeking to clarify clinical supervision for the profession. Aims This essay provides an overview of clinical supervision together with reflection which is considered to be integral to the process and proposes that clinical supervision can provide a vehicle for supporting continuous professional development for all dietitans. It is perhaps unfortunate that the descriptive ,clinical' is used throughout the literature as this often leads to an incorrect assumption that the scope of the process is limited to acute services. However, as patient care takes many forms within a range of environments, the broader meaning of ,clinical' as pertaining to ,patient care' needs to be acknowledged. Caution in choosing a model for the profession is advised, as any model needs to fit the practice and not vice versa. [source] Vital signs for vital people: an exploratory study into the role of the Healthcare Assistant in recognising, recording and responding to the acutely ill patient in the general ward settingJOURNAL OF NURSING MANAGEMENT, Issue 5 2010JAYNE JAMES RN., Ortho. james j., butler-williams c., hunt j. & cox h. (2010) Journal of Nursing Management18, 548,555 Vital signs for vital people: an exploratory study into the role of the Healthcare Assistant in recognising, recording and responding to the acutely ill patient in the general ward setting Aim, To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and recorder of acutely ill patients within the general ward setting. Background, Concerns have been highlighted regarding the recognition and management of the acutely ill patient within the general ward setting. The contribution of the HCA role to this process has been given limited attention. Methods, A postal survey of HCAs was piloted and conducted within two district general hospitals. Open and closed questions were used. Results, Results suggest that on a regular basis HCAs are caring for acutely ill patients. Contextual issues and inaccuracies in some aspects of patient assessment were highlighted. It would appear normal communication channels and hierarchies were bypassed when patients' safety was of concern. Educational needs were identified including scenario-based learning and the importance of ensuring mandatory training is current. Conclusions and implications for nursing management, HCAs play a significant role in the detection and monitoring of acutely ill patients. Acknowledgement is needed of the contextual factors in the general ward setting which may influence the quality of this process. The educational needs identified by this study can assist managers to improve clinical supervision and educational input in order to improve the quality of care for acutely ill patients. [source] Building the capacity for evidence-based clinical nursing leadership: the role of executive co-coaching and group clinical supervision for quality patient servicesJOURNAL OF NURSING MANAGEMENT, Issue 2 2007BA (Hons), JO ALLEYNE DProf Aim, The general aims of this article were to facilitate primary care nurses (District Nurse Team Leaders) to link management and leadership theories with clinical practice and to improve the quality of the service provided to their patients. The specific aim was to identify, create and evaluate effective processes for collaborative working so that the nurses' capacity for clinical decision-making could be improved. Background, This article, part of a doctoral study on Clinical Leadership in Nursing, has wider application in the workplace of the future where professional standards based on collaboration will be more critical in a world of work that will be increasingly complex and uncertain. This article heralds the type of research and development activities that the nursing and midwifery professions should give premier attention to, particularly given the recent developments within the National Health Service in the United Kingdom. The implications of: Agenda for Change, the Knowledge and Skills Framework, ,Our Health, Our Care, Our Say' and the recent proposals from the article Modernising Nursing Career, to name but a few, are the key influences impacting on and demanding new ways of clinical supervision for nurses and midwives to improve the quality of patient management and services. Method, The overall approach was based on an action research using a collaborative enquiry within a case study. This was facilitated by a process of executive co-coaching for focused group clinical supervision sessions involving six district nurses as co-researchers and two professional doctoral candidates as the main researchers. The enquiry conducted over a period of two and a half years used evidence-based management and leadership interventions to assist the participants to develop ,actionable knowledge'. Group clinical supervision was not practised in this study as a form of ,therapy' but as a focus for the development of actionable knowledge, knowledge needed for effective clinical management and leadership in the workplace. Findings, ,,Management and leadership interventions and approaches have significantly influenced the participants' capacity to improve the quality of services provided to their patients. ,,Using various techniques, tools, methods and frameworks presented at the sessions increased participants' confidence to perform. ,,A structured approach like the Clinical Nursing Leadership Learning and Action Process (CLINLAP) model makes implementing change more practical and manageable within a turbulent care environment. The process of Stakeholder Mapping and Management made getting agreement to do things differently much easier. Generally it is clear that many nurses and midwives, according to the participants, have to carry out management and leadership activities in their day-to-day practice. The traditional boundary between the private, the public and the voluntary sector management is increasingly becoming blurred. Conclusion, It is conclusive that the district nurses on this innovative programme demonstrated how they were making sense of patterns from the past, planning for the future and facilitating the clinical nursing leadership processes today to improve quality patient services tomorrow. Their improved capacity to manage change and lead people was demonstrated, for example, through their questioning attitudes about the dominance of general practitioners. They did this, for example, by initiating and leading case conferences with the multi-disciplinary teams. It became evident from this study that to use group clinical supervision with an executive co-coaching approach for the implementation and to sustain quality service demand that ,good nursing' is accepted as being synonymous with ,good management'. This is the future of ,new nursing'. [source] Clinical supervision: what do we know and what do we need to know?JOURNAL OF NURSING MANAGEMENT, Issue 8 2006A review, commentary Aims, This study is addressed to nurses but the issues are of equal concern to both midwives and health visitors. Clinical supervision ideally both challenges nurses as well as help their practice. There is need to identify critical elements that help professional practice and understand more clearly the changing nature of supervisory relationships. Background, Clinical supervision in nursing is over a decade old in the UK and yet emerging nursing literature suggests that many ideas remain unfamiliar to nursing practice. The resistance shown by nurse towards clinical supervising remains perplexing. Moreover, ideas concerning clinical supervision have been applied without a substantive evidence base. Methods, The discussion draws on varied ideas concerning supervision, including those outside of nursing, to ask what do we know and still need to know about clinical supervision. This study suggests that, a single approach to clinical supervision could be unhelpful to nursing. Findings and conclusion, Nursing knowledge concerning many aspects of clinical supervision is increasing because of research. Much of the literature suggests that clinical supervision is scholarly activity requiring much the same attention to relationships as the therapeutic activities it supports. This discussion concludes with the idea that clinical supervision might work at its best as a quiet activity allowing nurses to think about nursing work in ways that suit individual learning styles. [source] A collaborative approach to the implementation of clinical supervisionJOURNAL OF NURSING MANAGEMENT, Issue 2 2002C. Spence MSc Aim,This paper discusses a collaborative approach to implementing clinical supervision, which was initiated between a primary care trust and a school of nursing and midwifery. Background,To enable clinical supervision to proceed successfully and to be perceived as beneficial, this necessitates a collaborative partnership between clinicians, managers and educationalists. Key issues,The different stages of the initiative will be explored and the paper will consider examples of the collaborative processes involved. The evaluation of the project is examined and suggestions for the future continuation of the initiative are discussed. Conclusion,There is evidence that this has been a successful initiative and that a collaborative way of working can be beneficial when implementing clinical supervision. [source] Cost,benefit analysis of team supervision: the development of an innovative model and its application as a case study in one Finnish university hospitalJOURNAL OF NURSING MANAGEMENT, Issue 5 2001Kristiina Hyrkäs Lic. Aim To develop a model of costs and benefits of team supervision and a formula, which are examined more closely by means of an example. Background The popularity of clinical supervision (CS) as one of the methods of supporting health care practitioners' professional development (formative function), coping (restorative function) and quality improvement (normative function) has increased in the 1990s. CS may take the form of one-to-one or group supervision. Team supervision is a special form of group supervision. It means a group that has an interrelated work life outside the group. A host of literature and articles is available on CS. However, the costs and benefits of CS are less examined even though these have given rise to discussion particularly among decision-makers, because the monetary benefit of CS remains unsolved. Method A nominal group technique was used to develop a model of costs and benefits of team supervision and a formula was derived on the basis of the model. The existing statistical data, for example a hospital ward's annual reports, data on sick days and reports on indemnities were utilized in the application of the formula. Findings and conclusion Team supervision was efficient in economic terms on the example ward. The model and the formula constitute a first attempt to ascertain the net present benefit of team supervision. Both the model and the formula need to be further tested, specified and refined. [source] Depending on the intent and emphasis of the supervisor, clinical supervision can be a different experienceJOURNAL OF NURSING MANAGEMENT, Issue 3 2001C. Johns RN The paper proposes that clinical supervision can be a very different experience for the practitioner depending on the intent and emphasis of the supervisor. Utilizing Habermas's typology of knowledge constituted interests (1971), clinical supervision can be viewed as a dialectic between technical and emancipatory interests. The rhetoric and spirit of supervision would suggest an emancipatory approach yet the reality is that when supervision is accommodated with bureaucratic cultures, the technical interest will be dominant, especially when supervisors are in line-management roles to practitioners. This raises issues around the nature and role of clinical leadership, and ways of bridging the tension between emancipatory and technical interests. [source] Some emerging implications for clinical supervision in British mental health nursingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2007A. GRANT ba(hons) ma phd enb650 rmn [source] Clinical supervision for mental health nurses in Northern Ireland: formulating best practice guidelinesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2007F. RICE rmn msc Nurses work in a constantly challenging and changing environment. Within this context, there is a continuing need for support. Such support will help increase morale, decrease strain and burnout, and encourage self-awareness and self-expression. Clinical supervision address all these issues and enhances the quality of care for patients. While clinical supervision is a policy imperative in Northern Ireland, it was clear that there were problems in its implementation in mental health nursing. The aim of this project was to explore ways to make clinical supervision available to all mental health nurses and to improve and evaluate their contribution to patient care. The research team undertook a comprehensive literature review and a baseline survey of relevant stakeholders. Results represent the outcome of the group work. They will assist healthcare providers to develop local policies and procedures on clinical supervision for practising mental health nurses. [source] Does structured clinical supervision during psychosocial intervention education enhance outcome for mental health nurses and the service users they work with?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2007T. BRADSHAW rmn diphe bsc(hons) mphil This study aimed to assess whether clinical supervision provided by workplace-based supervisors can enhance outcomes for mental health nurses attending a psychosocial intervention education programme and the service users whom they work with. A quasi-experimental controlled design was used. The main outcome measure was student knowledge and attitudes towards individuals with psychosis and their caregivers. Secondary outcome measures for service users included the KGV (M) symptom scale and the Social Functioning Scale. Students in the experimental group demonstrated a significant increase in knowledge of psychological interventions compared with the control group. Service users seen by the students in the experimental group showed significantly greater reductions in positive psychotic symptoms and total symptoms compared with those seen by students in the control group. Workplace clinical supervision may offer additional benefit to nurses attending psychosocial intervention courses. Further research adopting more robust designs is required to support these tentative findings. [source] Reflections on the process of change on acute psychiatric wards during the City Nurse ProjectJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006C. FLOOD rn The intention of this paper is to discuss the process of therapeutic change on two acute psychiatric wards during a research project that aimed to reduce conflict and containment. Analysis of fieldwork notes, reflection, team discussion and supervision. The City Nurse Project successfully reduced patient aggression, self-harm and absconding. This paper reports on the reflections made over the course of the year as changes and developments to acute wards took place. Specifically discussed are the beneficial effects of an action research approach, the role of the City Nurse, support for ward managers, education and training, clinical supervision as well as difficulties and barriers to the overall process of change. At an interim stage of the project, the staff have shown a willingness to engage in efforts to change and improve two acute wards. This paper shows the potential to improve acute wards and produce positive outcomes using a working model. [source] Opening up: psychiatric nurses' experiences of participating in reflection groups focusing on the use of coercionJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2005B. OLOFSSON rn phd Psychiatric staff report that the use of coercion towards patients in psychiatric care engenders feelings of discomfort and conflicts. The aim of this study was to describe psychiatric nurses' experiences of participating in reflection groups focused on the use of coercion, in relation to their views regarding systematic clinical supervision and staff support. Twenty-one nurses who had participated in reflection groups were interviewed retrospectively. The structured interview focused on: (i) their views of clinical supervision and support in general; (ii) their views of clinical supervision and support specifically concerning the use of coercion; and (iii) their experiences of participating in groups reflecting the use of coercion. Nurses were largely positive about participating in reflection groups, as expressed in the subthemes: having time for reflection; being confirmed; gaining new perspectives; sharing fellowship with colleagues; and relating more effectively to patients. Complications concerning participation in the reflection groups and other forms of clinical supervision as reported by nurses were: providing time for participation; having a common aim; being vulnerable in difficult situations; and assuming that the need for supervision and support could indicate that they were not coping with their job. [source] Training in cognitive behavioural interventions on acute psychiatric inpatient wardsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2005E. McCANN phd msc rmn dip psi pgdip (academic practice) There has been a drive towards addressing the types of care and therapeutic interventions available to people with serious mental illness, which is reflected in the latest government mental health policy initiatives. Recent evidence strongly supports the implementation of psychological and social interventions for people with psychosis, and in particular the use of cognitive behavioural techniques. Until now, the main focus has been on people living in the community. This study examines the delivery of psychosocial interventions training to qualified psychiatric nurses and unqualified staff on seven acute psychiatric admission wards in London, UK. The approach had the strength of on-site delivery, follow-up role modelling of the interventions and clinical supervision. Despite this, in some cases the training was less successful, mainly because of staffing and leadership weaknesses. The impact of training in these methods and the implications for mental health education and practice development are discussed. [source] The effectiveness of clinical supervision on burnout amongst community mental health nurses in WalesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2003PHILIP BURNARD [source] Multiprofessional clinical supervision: challenges for mental health nursesJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2001K. Mullarkey ma bsc(hons) rn cpncert rnt Recent reform and developments in mental health care provision have increasingly espoused the value of multiprofessional teamwork in order to ensure that clients are offered co-ordinated packages of care that draw on the full range of appropriate services available (DoH 1999a; DoH 2000). Supervision in some form is seen as a key part of all professional practice to provide support to practitioners, enhance ongoing learning, and, to a greater or lesser degree, offer some protection to the public (Brown & Bourne 1996, UKCC 1996). Clinical supervision has gained increasing momentum within the nursing profession, but to a large extent this has been within a uni-professional framework , nurses supervising other nurses. This paper seeks to explore the ways in which multiprofessional working and clinical supervision interlink, and whether supervision across professional boundaries might be desirable, possible, and/or justifiable. Whilst our own view is that multiprofessional supervision is both possible and desirable, we seek to open up a debate, from our perspective as mental health nurses, about some of the issues related to the concept. Our motivation to explore this topic area emanates from our experiences as supervisors to colleagues within multiprofessional teams, as well as the experiences of those attending supervisor training courses. Following a brief overview of the development of clinical supervision in mental health care and recent policy guidelines, some models of clinical supervision are reviewed in terms of their suitability and applicability for multiprofessional working. [source] Egalitarian consultation meetings: an alternative to received wisdom about clinical supervision in psychiatric nursing practiceJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 6 2000C. Stevenson RMN BA (HONS) PhD Clinical supervision (CS) has become a watchword for psychiatric nursing. Yet, there are contradictions and controversies in academic and professional discourse in relation to the nature of CS, both structure and process, its effectiveness and how this is ascertained, the preparation of supervisor and supervisee, and the quality of the supervisory relationship. The perception of such discord encouraged the authors of this paper to step outside the debate and enact a different kind of CS, which came to be known as egalitarian consultation (EC). Egalitarian consultation meetings (ECMs) were established with the postmodern turn in psychiatric nursing as a reference point. A space was created in which participants could construct their particular version of CS. The authors and six G-grade community psychiatric nurses engaged with each other for six videotaped meetings. The data from the recordings were analysed using a hermeneutic grounded theory approach (Strauss & Corbin 1994), in keeping with the style of the research, which combined the roles of researcher and practitioner for the authors. The aim was to produce local knowledge of CS. The ECMs were characterized by a sense of freedom in relation to existing rules about hierarchy and truth. The participants, each as expert in her/his own case world, produced engrossing narratives about and for practice. The group developed a cohesiveness based in closeness and this encouraged radical talk and action , a questioning of practice systems. However, for some group members, radical equated to dangerous in terms of the watchful organization and a return to ,real' work (case supervision) was observed. Innovation in relation to CS may benefit from a change in institutional culture. [source] Developing abilities: the future of clinical supervision?JOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2000Mike Consedine [source] Australian clinical nurse supervisors' ethical decision-making styleNURSING & HEALTH SCIENCES, Issue 1-2 2002Ingela Berggren RNT Abstract This paper explores clinical nurse supervisors' ethical styles with regard to supervision in health care. Eighty-six registered nurses, all with experience of supervising clinical nurses and students in nursing, completed a specifically designed questionnaire. A qualitative interpretative content analysis identified three core themes: (i) ,Is it safe?'; (ii) ,Is it right?'; and (iii) ,Is it kind?', describing the clinical nurse supervisors' ethical styles. The first core theme ,Is it safe?' covered the supervisors' rules, codes and values that guide their supervisory actions, as well as two subthemes: (i) empowerment and (ii) integrity. The second core theme ,Is it right?' described the supervisors' responsibility and advocacy as well as the ethical dilemmas experienced in the supervisory process. The third core theme ,Is it kind?' included the supervisors' relationships with patients, professionals and supervisees. The results demonstrate the value of offering a support system, such as clinical supervision, which helps nurses to explore their professional identity for the benefit of the patients. [source] | |||||||||||||