The mental health nursing is one of the crucial parts in the health care and nursing practices. The mental health nursing is specialized in mental health or psychological care to the patients, who have psychological disorders, like schizophrenia, psychosis, depression, bipolar disorder, dementia, anxiety and other disorders. As psychological care is significantly important and complex in nature, due to wide range of differences among patients and the types of disease symptoms, the nursing staffs, who have responsibilities to provide adequate care for people, needs to show additional skills and competencies to handle complex patients (Butterworth & Faugier, 2013). For this, continuous monitoring and self evaluation of nursing staff’s performance is necessary. In this context, clinical supervision and training sessions play a crucial role in promoting skill building in psychiatric nurses. It has been revealed from several literatures that the clinical supervision has a key role in supporting safe and effective mental health care. In this context, it is crucial to evaluate the arrangements for clinical supervision present at workplace, to ensure safe mental health practice. In this essay, the key focus is to evaluate the role of clinical supervision in mental health practice, as a strategy for improving safety of effective psychiatric nursing practices.
Clinical supervision is referred to a clinical activity that promotes the collaborating of supervisors and practitioners in their work for reflecting upon their practices. Through this practice, the nurse or other staffs becomes able to improve their knowledge and skills, by identifying those areas, where they are lagging behind. Therefore, it can be said that clinical supervision is significantly helping nursing staffs to improve their strategies of care provision along with competency building (Campbell, 2011).
Clinical supervision consists of meetings of practitioners with the supervisors, where they discuss casework and other professional issues in a structured way. There are several reasons, why clinical supervision is important in health care context, for instance, to enhance supervisee’s skills, competence and confidence, to assist them with professional development, to provide reflective space and emotional support, to ensure a safe and ethical environment provision to the care users, to ensure compliance with professional an organizational treatment standards and practices (Fleming & Steen, 2013). Therefore, clinical supervision can be defined as a formal and disciplined working association, where the key practioner clinical work is being reviewed and reflected upon, in order to ensure care user’s welfare, to support the supervisee to complete her responsibilities along with the professional development of the supervisee. However, this is different from managerial supervision, which is needed to support workers in human service organizations for providing a better, more confident and creative service to the clients. Rather, here the key concentration is upon how workers can extend themselves related to their practice.
In this context, both supervisors and supervisee have crucial roles, which needed to be fulfilled, in order to achieve success from the clinical supervision sessions. For instance, choosing what aspect of their practice to focus on and explore, offering feedback about the experience of the supervisory process and the relationship, determining how the supervisor-supervisee dyad works together and developing and being accountable to their own professional standards (Falender & Shafranske, 2012). In this context, supervision is a process of guided reflection rather than simply a top-down exchange emphasising the organisation’s expectations.
In mental health nursing, clinical supervision plays a critical role in shaping nurse’s role, to deal with complex mental health cases. In addition to that, mental health nursing staffs undergoes difficulties in handling several critical cases, which demotivates the nursing staffs to give their best efforts. These clinical supervision sessions also help them to improve their skills and competencies to cope with such difficult situations in their working environment (Haynes, Corey & Moulton, 2013).
Clinical supervision is a key component of contemporary professionals’ mental health nursing practice as well as central to participating within the Australian mental health nurses. In nursing settings, it is usually conducted in one-to-one or in small groups of 6-8 people, who are being supervised. In this context, it has been revealed that there are several models, which are being used in mental health nursing. For instance, throughout 25 years, the Proctor model of clinical supervision has been identifies to be the most influential and widely adopted model to be adopted in nursing context (Bond & Holland, 2011). This model included three key domains including normative, restorative and formative. In the normative domain, the promotion of standards and clinical audit issues are addressed; in restorative domain, the persona wellbeing of supervisee is developed; and in formative domain, knowledge and clinical skills of the supervisee are developed.
However, it has been reported that the effects of these three domains are different in speed. For instance, changes in the Normative and Restorative are likely to precede measurable changes in the Formative. Therefore, this model demonstrates that successful clinical supervision has a key role in establishing organizational couture, where staff wellbeing and attention to continuous clinical audits have been promoted, i.e. improving the overall quality of mental health services provided by the mental health organization (Milne & Reiser, 2012).
Evidences are showing that clinical supervision is significantly improving the overall well being of supervisee, i.e. improved self-confidence, self awareness, reduced emotional strain and burnout has been reported upon implementation of clinical supervision. In addition, workforce concerns has also been improved with the implementation of clinical supervision, for instance, improve staff morale, job satisfaction and retention have been found along with improved professional growth of staffs. Staffs have gained greater reflection on practice, enhanced knowledge; awareness of possible solutions towards the clinical issues has also been noted. It has also been revealed that both the supervisor and supervisee has been benefited from the clinical supervision program (Farnan et al., 2012).
Previous literatures have also claimed that the training the supervisors get, the quality of supervision they provide, the culture in which the CS endeavour is located as well as the managerial staff’s attitude are shaping the fate of clinical supervision held in the mental health care organizations. Based on these outcomes, there is a positive relationship has been pointed within the success of the clinical supervision program and the patient outcomes ensured by the supervisee mental health nursing staffs.
Mental health care is all about improving the psychological condition of the patients through the nursing staffs. In this context, it can be said that overall the clinical supervision is a focused clinical work, which involves clinical teaching of one another in a collaborative and beneficial way, where both the supervisor and supervisee are benefited. It is also the ongoing relationship building within the organizational culture. As mental health nurses need to focus upon relationship building, in order to provide person centred care, which is a key approach in mental health practice, these days (Gonge & Buus, 2011). Therefore, relationship building and critical thinking skills are vital for the mental health nursing practitioners, which they gain significantly from the clinical supervision session. With more positive relationship building the patient satisfaction is also enhanced.
In a mental health care organization, the clinical supervision program needed to be implemented through a systematic process, which would lead to a sustainable success in the nursing practice. To implement sustainable development of clinical supervision, there should be adequate commitment from both supervisees’s and supervisor’s end. While implementing the process in the workplace, positive support for clinical supervision should be evident at every level of service management, which is accepted as a dominant feature of organizational culture. The clinical supervision mainstream status should be written into the workplace portfolio, for ensuring engagement of all the staffs. In addition, explicit protocols should be in place in order to confirm the arrangements required for implementing the service in a sustainable way throughout the organization. The size of the supervision group may be 6 to 8, as a team or 1:1 only (Stuart, 2014). The frequency and duration of the sessions should also need to be determined and noted in the protocol. For instance, frequency should be monthly or once in 2 months; duration should not less than 60 minutes, it can be 2-3 hours also, in order to get good results from the supervision process. In addition, while building the protocol, the ground rules about confidentiality and other ethical considerations should be provided.
In this context, the rules would be developed in such a way that supervisees are provided the opportunity to choose the clinical supervisors from their end. Prior that the organization needs to ensure that the supervisors have adequate training and experience, which embedded required skills in the supervisors. Supervisors should not hold an operational or managerial responsibility for the supervisee. Through the training, the supervisors should be educationally prepared appropriately for completing their role, to a potential standard. This event should be followed by an appropriate budget plan, which would be included in organizational annual budget and evaluated in order to fulfil all the criteria for the clinical supervision (Bogo et al., 2011). The service managers should hold the responsibilities for the staff roster, based on which budget should be provided with required support, in order to ensure effective clinical supervision, without any kinds of negative impact upon the clinical contact time.
Once the program is included in the organizational operation in appropriate manner, it is important to evaluate the program, continuously, to improve the quality of supervision, to address any kinds of inadequacy that is happening during the sessions, which could be eliminated or improved, in order to improve the overall quality and meet the goals. While making the plan, it is important to develop an evaluation plan also, to eliminate conflicts during the sessions. The clinical supervision arrangements should be demonstrated and reported in regular basis, to point out the areas of improvement. In addition, suitable administrative records are needed to be kept, with the use of Clinical Supervision Agreement Template from the ACMHN website (Buus et al., 2011).
At the time of implementing clinical supervision, the supervisor should provide the consent to meet all the requirements and should be approved by the board or registration committee of the state. The supervisor should ensure that the relationship with supervisee remains professional. The supervisor needs to provide a clear direction and constructive feedback, should take reasonable steps, which is required by the level of supervision, in order to ensure that the supervisee’s practice is safe and efficient. The supervisor should include measures of individual care review, direct observation and remediation of issues identified for the supervisee (Gonge & Buus, 2011). The supervisor should understand and use the framework for assessing standard practice of mental health nursing; provide honest, responsible and accurate reports, aligning with the guidelines. They should also ensure that the suitable role of person is being delegated by the supervisor, within the scope of competence, capability and training requirement of the supervisee.
On the other hand, the supervisee should effectively work with the supervisor for developing a supervised practice plan for submitting to the registration committee. The supervisee should undertake collaborative commitment in order to put the schedules of regular meeting into practice, should be sufficiently prepared for meetings with the supervisor, participate in assessments conducted by the supervisor in order to determine the progress and future needs of supervision. The supervisee should also identify the limitation of the professional competence and seek guidance and assistance required by the supervisor, while being able to reflect and respond to the supervisor’s feedback immediately (Milne & Reiser, 2012).
In conclusion, it can be interpreted that the clinical supervision is a core component of professional development of nursing staffs, which helps to improve their competency level as well as improves the level of patient’s satisfaction. To ensure high quality mental health service, clinical supervision acts as a key clinical tool. Here, in this essay, initially the clinical supervision has been defined, considering all the domains, which is followed by the needs for implementing clinical supervision at the workplace. Finally, the role of supervisor as well as supervisee has been demonstrated thoroughly, during the implementation of clinical supervision at workplace.
Reference List
Bogo, M., Paterson, J., Tufford, L., & King, R. (2011). Interprofessional clinical supervision in mental health and addiction: Toward identifying common elements. The Clinical Supervisor, 30(1), 124-140.
Bond, M., & Holland, S. (2011). Skills of clinical supervision for nurses: A practical guide for supervisees, clinical supervisors and managers. McGraw-Hill Education (UK).
Butterworth, T., & Faugier, J. (2013). Clinical supervision and mentorship in nursing. Springer.
Buus, N., Angel, S., Traynor, M., & Gonge, H. (2011). Psychiatric nursing staff members’ reflections on participating in group?based clinical supervision: A semistructured interview study. International journal of mental health nursing, 20(2), 95-101.
Campbell, J. M. (2011). Essentials of clinical supervision (Vol. 28). John Wiley & Sons.
Falender, C. A., & Shafranske, E. P. (2012). The importance of competency-based clinical supervision and training in the twenty-first century: why bother?. Journal of Contemporary Psychotherapy, 42(3), 129-137.
Farnan, J. M., Petty, L. A., Georgitis, E., Martin, S., Chiu, E., Prochaska, M., & Arora, V. M. (2012). A systematic review: the effect of clinical supervision on patient and residency education outcomes. Academic Medicine, 87(4), 428-442.
Fleming, I., & Steen, L. (Eds.). (2013). Supervision and clinical psychology: Theory, practice and perspectives. Routledge.
Gonge, H., & Buus, N. (2011). Model for investigating the benefits of clinical supervision in psychiatric nursing: a survey study. International Journal of Mental Health Nursing, 20(2), 102-111.
Haynes, R., Corey, G., & Moulton, P. (2013). Clinical supervision in the helping professions: A practical guide. Reflective Practice: Formation and Supervision in Ministry, 1.
Milne, D., & Reiser, R. P. (2012). A rationale for evidence-based clinical supervision. Journal of Contemporary Psychotherapy, 42(3), 139-149.
Stuart, G. W. (2014). Principles and Practice of Psychiatric Nursing-E-Book. Elsevier Health Sciences.
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