is anyone familiar with the phrase 'Clinical Supervision'?

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I have just been to a small locally given presentation on this and been told it will soon be a compulsary part of a RN's personal development plan to be actively involved in this.

To me it seems more like a kinda a counselling,and the name misrepresents it. Still not sure what it is all about other than supporting staff.

Can anyone give me more insight into this, I do believe it is going to become an important part of practice.

caliotter3

38,333 Posts

Never heard of this. Does sound as if it is some way of documenting supervision of some sort.

Specializes in still to decide.

From what I took from the talk it was like a kinda counselling, one to one with another colleague whom is registered (gone through the training for this) where we let off steam and address how we are feeling/getting on at work. We are supposed to establish boundaries etc, on the first session. I was wondering if this is to address mental health issues surrounding the nursing profession addressing the pressures etc., I only qualified a couple of years ago and I sorta remember going to lectures and some of the lecturers going on about the nhs going to be doing something to improve the mental health issues of the job.

I think that the overall theme is that if you can support staff to identify/ address issues, strenghs etc., their professional practice will be improved, as will their pt experience's

Silverdragon102, BSN

1 Article; 39,477 Posts

Specializes in Medical and general practice now LTC.

I did a couple of sessions a few years ago when I worked in Wakefield. It could be useful

allnurses Guide

herring_RN, ASN, BSN

3,651 Posts

Specializes in Critical care, tele, Medical-Surgical.

"Clinical Supervision" is a "Term of Art" in my state. This means it has a legal definition. Effective clinical supervision requires that the supervising RN be both present on the unit and immediately available to provide that supervision at all times. The RN assignment must never require that nurse to be in more than one place at a time.

Often the charge nurse and RN assigned to a patient share clinical supervision responsibilities.

Effective Clinical Supervision

The ability of the RN to assess real or potential harm to the client regarding patient care procedures is

seen as integral to determining which tasks may be performed by unlicensed assistive personnel. Section

1443.5(4) speaks to the RN's ability to "effectively supervise" other health care personnel.

Such effective clinical supervision must take into account patient safety, the competency of the unlicensed care giver to perform the task, the number and acuity of patients, the number and complexity of tasks, and the number of staff which the direct care RN is clinically supervising.

Staffing patterns must allow the direct care RN to independently make decision regarding assignment of tasks for a client, based upon the direct care RN's nursing judgment. Policies and procedures within each institution will reflect the above factors in determining the number of care givers an RN will be supervising at any one time.

Nurses who are floated cannot be assigned total responsibility for patient care including duties and responsibilities for planning and implementing patient care, and providing clinical supervision and coordination of care given by LVNs and unlicensed nursing personnel, until all the standards for competency for that unit have been

met.

Nursing students and interim permitees always require clinical supervision because they are not yet licensed.

http://www.rn.ca.gov/pdfs/regulations/npr-b-21.pdf

http://www.rn.ca.gov/pdfs/regulations/npr-b-16.pdf

http://www.rn.ca.gov/pdfs/schools/edp-i-32.pdf

http://www.rn.ca.gov/pdfs/regulations/npr-b-05.pdf

elkpark

14,633 Posts

In psych disciplines, inc. psych nursing, "clinical supervision" is a common term and practice, and is entirely different from what herring_RN is talking about -- it does sorta mean "counseling", but counseling in terms of your professional practice and development. You meet regularly with a more experienced (and often with a higher level of education) colleague to talk about how things are going in your clinical practice and how you can grow and improve professionally, and become more effective at doing your job.

In order to be done "right," the clinical supervisor must be someone who is not your boss; and the clinical supervision must be a neutral situation where you can, for instance, discuss openly mistakes made at work and how you could handle a situation better in the future, without worrying about getting into "trouble" or getting disciplined for the mistake. Very much like mentoring, but usually a more formal arrangement (lots of psych people pay for clinical supervision, or have an assigned clinical supervisor as part of their formal training). Or like psychotherapy, but the discussion is all work-related, not about your personal life!

Over the course of my career, I've been both a recipient and provider of clinical supervision -- it can be a v. positive experience, and a real help in your professional and career growth, when done correctly.

karenG

1,049 Posts

Specializes in midwifery, ophthalmics, general practice.

Im a clinical supervisor and its not seen the way Herring RN describes it! well at least not where I work.

basically, its a safe enviroment in which to discuss clinical issues, and look ways of solving them. back in the old days, we'd go down the pub, drink a few beers and pour out the stress of the day! clinical supervision or support as we prefer to call it, is a formal way of doing this. everything discussed in clinical support is confidential. it can be individual or group. while a nurses manager is aware they come for clinical support to me, I am under no obligation to tell anyone what is discussed. It is a way of helping nurses deal with the situations they find themselves in. how many times have you done something and been scared to tell anyone?? this provides a safe enviroment to discuss anything work related.

at least thats how we see it in primary care.. it is a very positive thing... at least you dont end up with a hangover as we used to in the bad old days!

I've been a clinical supervisor for 10 yrs now.. its been around for awhile!

Karen

elkpark

14,633 Posts

Im a clinical supervisor and its not seen the way Herring RN describes it! well at least not where I work.

basically, its a safe enviroment in which to discuss clinical issues, and look ways of solving them. back in the old days, we'd go down the pub, drink a few beers and pour out the stress of the day! clinical supervision or support as we prefer to call it, is a formal way of doing this. everything discussed in clinical support is confidential. it can be individual or group. while a nurses manager is aware they come for clinical support to me, I am under no obligation to tell anyone what is discussed. It is a way of helping nurses deal with the situations they find themselves in. how many times have you done something and been scared to tell anyone?? this provides a safe enviroment to discuss anything work related.

at least thats how we see it in primary care.. it is a very positive thing... at least you dont end up with a hangover as we used to in the bad old days!

I've been a clinical supervisor for 10 yrs now.. its been around for awhile!

Karen

Yes -- this is how it works in psych.

Specializes in still to decide.

Thanx everone...I thought it was something like that:) This will be a positive thing, I think

madeleine

42 Posts

First of all HerringRN would seem to be posting from the U.S.A. where clearly 'Clinical Supervision' does not have the same meaning as in the U.K.

Secondly, I am astonished that the first two posters appear to have no knowedge of Clinical Supervision. Presumably, they are not unique in the nursing world. Clinical Supervision has been around for quite a number of YEARS. How can any nurse claim to be keeping up to date and signing the NMC form to affirm such if they don't know something so basic.

Some of the questions posted on this Board are worrying - what are the nurse tutors doing? Have the entry 'gateways' for nurse education been lowered too much?

Recent experience of a relative in hospital where potentially FATAL drug advice was given by a nurse prior to discharge is yet another example of poor standards of knowledge.

It is essential that nurses continue to learn and read journals etc. after they are qualified. The qualification is not the end of learning - it is the beginning.

Specializes in still to decide.

Madeleine. Sorry to astonish you, but no I have only the knowledge of this that I have posted about here.

This is not because I do not keep my practice as up to date as best I can in respect to my working environment. It is because until very recently I had no idea that this was on the go. A colleague of mine has not long ago attended a three day course to educate them and train them as clinical supervisors, so they can introduce it to us. At the meeting my colleague held to inform us of this service no-one in the room had any experience of this - even our CN, and many of these people have had many years service behind them. Why would they be 'introducing' something that was already part of the system here? Also why, after 2.5 years practicing have I not had a clinical superviser, or supervision if it was so widespread?

Thank you for pointing out how we have to keep up to date with our practice. Now I know that about clinical supervision, I will welcome it. I can honestly say that I do strive to stay on top of developments, although it can be difficult with all the other pressures of living, I do what I can.

elkpark

14,633 Posts

BTW, I am in the US -- but clinical supervision in mental health disciplines in the US sounds like the same process being discussed in general nursing in the UK. I wish nursing in the US would embrace the idea of clinical supervision more broadly -- as noted, the US non-psych nurses who responded here were talking about "supervision" in an entirely different context, in the sense of running the unit during a shift.

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