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Martin P, Lizarondo L, Kumar S, Snowdon D. Impact of clinical supervision on healthcare organisational outcomes: A mixed methods systematic review. PLoS One 2021; 16:e0260156. [PMID: 34797897 PMCID: PMC8604366 DOI: 10.1371/journal.pone.0260156] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/03/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To review the impact of clinical supervision of post-registration/qualification healthcare professionals on healthcare organisational outcomes. BACKGROUND Clinical supervision is a professional support mechanism that benefits patients, healthcare professionals and healthcare organisations. Whilst evidence is growing on the impact of clinical supervision on patient and healthcare professional outcomes, the evidence base for the impact of clinical supervision on organisational outcomes remains weak. METHODS This review used a convergent segregated approach to synthesise and integrate quantitative and qualitative research findings, as per the Joanna Briggs Institute's recommendations for mixed methods systematic reviews. Databases searched included CINAHL, Embase, PubMed, PschINFO, and Scopus. Whilst a narrative synthesis was performed to present the findings of the quantitative and qualitative studies, the evidence from both quantitative and qualitative studies was subsequently integrated for a combined presentation. The review followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS Thirty-two studies including 27 quantitative, two qualitative and three mixed methods studies, were included in the review. The results of the quantitative analysis showed that effective clinical supervision was associated with lower burnout and greater staff retention, and effective supervisor was associated with lower burnout and greater job satisfaction. Qualitative findings showed that healthcare professionals believed that adequate clinical supervision could mitigate the risk of burnout, facilitate staff retention, and improve the work environment, while inadequate clinical supervision can lead to stress and burnout. The evidence from quantitative and qualitative studies were complementary of each other. CONCLUSION Clinical supervision can have a variable effect on healthcare organisational outcomes. The direction of this effect appears to be influenced by the effectiveness of both the clinical supervision provided and that of the clinical supervisor. This highlights the need for organisations to invest in high quality supervision practices if maximal gains from clinical supervision are to be attained.
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Affiliation(s)
- Priya Martin
- Senior Research Fellow, Rural Clinical School, Faculty of Medicine, The University of Queensland, Toowoomba, QLD, Australia
- Advanced Clinical Educator Interprofessional, Advance Queensland Industry Research Fellow, Cunningham Centre, Darling Downs Health, Toowoomba, QLD, Australia
| | - Lucylynn Lizarondo
- Research Fellow: Implementation Science, Joanna Briggs Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Saravana Kumar
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David Snowdon
- Research Fellow, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, Australia
- Allied Health Research Lead, Academic Unit, Peninsula Health, Melbourne, VIC, Australia
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Musie A, Wolvaardt JE. Risk and reward: Experiences of healthcare professionals caring for drug-resistant tuberculosis patients. SOUTH AFRICAN JOURNAL OF HUMAN RESOURCE MANAGEMENT 2021. [DOI: 10.4102/sajhrm.v19i0.1191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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3
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Francis A, Bulman C. In what ways might group clinical supervision affect the development of resilience in hospice nurses? Int J Palliat Nurs 2020; 25:387-396. [PMID: 31437109 DOI: 10.12968/ijpn.2019.25.8.387] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Resilience is important to sustain hospice nurses through a challenging career. Clinical supervision is a commonly cited support strategy, but there is limited evidence which focuses on its influence on the development of resilience in hospice nurses. AIMS To explore how group clinical supervision might affect the development of resilience in hospice nurses. METHOD A pragmatic approach and mixed methods research design was employed. Quantitative questionnaire data and qualitative focus group data were collected from community hospice nurses participating in group clinical supervision. FINDINGS The findings identified the importance of an effective group reflective process on the benefits to be gained from clinical supervision. Clinical supervision was found to affect the development of resilience by developing confidence at work, regulating emotions, offering a coping strategy, managing expectations, and developing self-awareness. This was dependent upon individual preference and experience, the local organisational context, and wider social and political factors. CONCLUSION This research contributes insight into group clinical supervision as an intervention to support resilience in hospice nurses. It offers recommendations for practice, to enhance the development of resilience through clinical supervision, and recommendations for future research.
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Affiliation(s)
| | - Chris Bulman
- Senior Lecturer, Oxford Brookes University, Oxford
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4
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Hegarty MM, Breaden KM, Swetenham CM, Grbich C. Learning to Work with the “Unsolvable”: Building Capacity for Working with Refractory Suffering. J Palliat Care 2018. [DOI: 10.1177/082585971002600405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article reports on a preliminary study of the experiences and perceptions of palliative care clinicians in developing capacity for effective, sustainable practice in their work with people who have refractory suffering. Members of a purposive sample of 17 clinicians (10 nurses, 5 doctors, and 2 allied health professionals) were either interviewed (13) or responded to an online questionnaire (4). The study's findings provide insight into these palliative care clinicians’ experiences and their perceptions of the capabilities they require, effective learning methods for developing these capabilities, and the supports that can facilitate this capacity building.
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Affiliation(s)
- Margaret Mary Hegarty
- M Hegarty (corresponding author): Palliative and Supportive Studies, School of Medicine, Flinders University, GPO Box 2100, Adelaide, South Australia 5001
| | - Katrina Margaret Breaden
- KM Breaden: Palliative and Supportive Studies, School of Medicine, Flinders University, Adelaide, South Australia
| | | | - Carol Grbich
- C Grbich: Social Health Sciences, School of Medicine, Flinders University, Adelaide, South Australia
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Cutcliffe JR, Sloan G, Bashaw M. A systematic review of clinical supervision evaluation studies in nursing. Int J Ment Health Nurs 2018; 27:1344-1363. [PMID: 29446513 DOI: 10.1111/inm.12443] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 11/27/2022]
Abstract
According to the international, extant literature published during the last 20 years or so, clinical supervision (CS) in nursing is now a reasonably common phenomenon. Nevertheless, what appears to be noticeably 'thin on the ground' in this body of literature are empirical evaluations of CS, especially those pertaining to client outcomes. Accordingly, the authors undertook a systematic review of empirical evaluations of CS in nursing to determine the state of the science. Adopting the approach documented by Stroup et al. (JAMA, 283, 2000, 2008), the authors searched for reports of evaluation studies of CS in nursing - published during the years 1995 to 2015. Keywords for the search were 'clinical supervision', 'evaluation', 'efficacy', 'nursing', and combinations of these keywords. Electronic databases used were CINAHL, MEDLINE, PsychLIT, and the British Nursing Index. The research evidence from twenty-eight (28) studies reviewed is presented, outlining the main findings with an overview of each study presented. The following broad themes were identified and are each discussed in the study: narrative/anecdotal accounts of positive outcomes for clinical supervision, narrative/anecdotal accounts of negative outcomes for clinical supervision, empirical positive outcomes reported by supervisee, and empirical findings showing no effect by supervisee.
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Affiliation(s)
- John R Cutcliffe
- University of Coimbra, Coimbra, Portugal.,International Journal of Mental Health Nursing, Armidale, New South Wales, Australia.,Cutcliffe Consulting, Kingston, Ontario, Canada
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Fahy G, Moran L. Who supports the psychiatric nurse? A qualitative study of the social supports that affect how psychiatric nurses cope with workplace risks and stressors. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/0791603518792366] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The study focuses on how registered psychiatric nurses in a high-dependency unit in Ireland utilise informal and formal supports to cope with risk and trauma in the workplace, including threats of physical violence and verbal abuse. Increasingly, research and policy acknowledge that risk management and emotional trauma affect the workplace performance and general well-being of Registered Psychiatric Nurses. However, there is a paucity of Irish social scientific research on how psychiatric nurses negotiate informal and formal networks, to cope with workplace risks every day. Drawing on qualitative interviews, this paper ascertains how psychiatric nurses interpret everyday risks and how they draw upon support networks (e.g. family, co-workers) to cope with workplace stressors. The findings show that Registered Psychiatric Nurses who were interviewed create boundaries between informal and formal networks that help them to cope with workplace risks. Our study indicates that in this context, organisational supports are seldom used by Registered Psychiatric Nurses, even in times of crisis. A core contribution of the work is that it affirms the importance of co-workers in how Registered Psychiatric Nurses negotiate workplace risks and makes recommendations on how formal organisational supports might be improved.
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Gerace A, Oster C, O'Kane D, Hayman CL, Muir-Cochrane E. Empathic processes during nurse-consumer conflict situations in psychiatric inpatient units: A qualitative study. Int J Ment Health Nurs 2018; 27:92-105. [PMID: 28019705 DOI: 10.1111/inm.12298] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 01/09/2023]
Abstract
Empathy is a central component of nurse-consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was 'my role as a nurse - the role of my nurse'. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers; consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses 'being there'. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self-reflection and building empathy skills in managing conflict.
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Affiliation(s)
- Adam Gerace
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Candice Oster
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Deb O'Kane
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Carly L Hayman
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Eimear Muir-Cochrane
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
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8
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Martin P, Milne D. Choice of clinical supervisor: Cunning or collusion? J Adv Nurs 2017; 74:1229-1230. [DOI: 10.1111/jan.13471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Priya Martin
- Darling Downs Hospital and Health Service; Toowoomba Qld Australia
| | - Derek Milne
- Newcastle University; Newcastle upon Tyne UK
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9
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Vasan A, Mabey DC, Chaudhri S, Brown Epstein HA, Lawn SD. Support and performance improvement for primary health care workers in low- and middle-income countries: a scoping review of intervention design and methods. Health Policy Plan 2017; 32:437-452. [PMID: 27993961 PMCID: PMC5400115 DOI: 10.1093/heapol/czw144] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 11/16/2022] Open
Abstract
Primary health care workers (HCWs) in low- and middle-income settings (LMIC) often work in challenging conditions in remote, rural areas, in isolation from the rest of the health system and particularly specialist care. Much attention has been given to implementation of interventions to support quality and performance improvement for workers in such settings. However, little is known about the design of such initiatives and which approaches predominate, let alone those that are most effective. We aimed for a broad understanding of what distinguishes different approaches to primary HCW support and performance improvement and to clarify the existing evidence as well as gaps in evidence in order to inform decision-making and design of programs intended to support and improve the performance of health workers in these settings. We systematically searched the literature for articles addressing this topic, and undertook a comparative review to document the principal approaches to performance and quality improvement for primary HCWs in LMIC settings. We identified 40 eligible papers reporting on interventions that we categorized into five different approaches: (1) supervision and supportive supervision; (2) mentoring; (3) tools and aids; (4) quality improvement methods, and (5) coaching. The variety of study designs and quality/performance indicators precluded a formal quantitative data synthesis. The most extensive literature was on supervision, but there was little clarity on what defines the most effective approach to the supervision activities themselves, let alone the design and implementation of supervision programs. The mentoring literature was limited, and largely focused on clinical skills building and educational strategies. Further research on how best to incorporate mentorship into pre-service clinical training, while maintaining its function within the routine health system, is needed. There is insufficient evidence to draw conclusions about coaching in this setting, however a review of the corporate and the business school literature is warranted to identify transferrable approaches. A substantial literature exists on tools, but significant variation in approaches makes comparison challenging. We found examples of effective individual projects and designs in specific settings, but there was a lack of comparative research on tools across approaches or across settings, and no systematic analysis within specific approaches to provide evidence with clear generalizability. Future research should prioritize comparative intervention trials to establish clear global standards for performance and quality improvement initiatives. Such standards will be critical to creating and sustaining a well-functioning health workforce and for global initiatives such as universal health coverage.
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Affiliation(s)
- Ashwin Vasan
- Department of Population and Family Health & Department of Medicine, Columbia University, New York, NY, USA.,Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.,Division of Global Health Equity, Department of Medicine, Brigham & Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - David C Mabey
- Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Simran Chaudhri
- Department of Population and Family Health & Department of Medicine, Columbia University, New York, NY, USA
| | | | - Stephen D Lawn
- Department of Clinical Research, Faculty of Infectious & Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.,Desmond Tutu HIV Centre, Institute of Infectious Diseases and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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10
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White E. Claims to the benefits of clinical supervision: A critique of the policy development process and outcomes in New South Wales, Australia. Int J Ment Health Nurs 2017; 26:65-76. [PMID: 28093885 DOI: 10.1111/inm.12292] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/03/2016] [Indexed: 11/27/2022]
Abstract
The historical development of clinical supervision has been variously interpreted in the international literature. Creditable evidence has accumulated, particularly over the past two decades, to show that clinical supervision has a positive demonstrable effect on supervisees. However, comparatively little research evidence has entered the public domain on any effect that clinical supervision might have on other nominated outcomes. In Australia, developments in clinical supervision were recently prompted by initiatives at national and state levels. Since 2010, lead agencies for these have sought feedback from professional bodies and organizations on a number of inter-related draft policy documents. The present article tracked changes over time between the draft and final versions of these documents in New South Wales, and reviewed the original sources of literature cited within them. The strength of evidence upon which the final published versions were reportedly predicated was scrutinized. Upon examination, claims to the wider benefits of clinical supervision were found to be unconvincingly supported, not least because the examples selected by the agencies from the international literature and cited in their respective documents were either silent, parsimonious, or contradictory. Many claims remain at the level of folklore/hypothetical propositions, therefore, and stay worthy of rigorous empirical testing and faithful public reporting. Such investigations have been acknowledged as notoriously difficult to conduct. The present article identified noteworthy examples in the contemporary literature that signpost robust ways forward for empirical outcomes-orientated research, the findings from which might strengthen the evidence base of future policy documents.
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Affiliation(s)
- Edward White
- Osman Consulting Pty Ltd, Sydney, New South Wales, Australia.,School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia.,Personal Social Services Research Unit, The University of Manchester, Manchester, UK
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Ashburner C, Aleyer J, Cotter A, Youog G, Ansell R. Seeing things differently: Evaluating psychodynamically informed group clinical supervision for general hospital nurses. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/136140960400900108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reports the findings from the development of psychodynamically informed group supervision for 52 clinical leaders in nursing at a general NHS hospital over four years. The initiative was evaluated through a variety of methods, underpinned by action research. This paper is based on the findings generated by semi-structured interviews (n=24) and descriptive statistics of staff sickness and turnover. The findings suggest that clinical supervision using a psychodynamically informed approach helps nurses acknowledge their feelings and see their work from a different perspective; builds confidence; provides support through a crisis and reduces their isolation in their role. Other findings suggest that, while having no impact on staff turnover, clinical supervision might reduce staff sickness. However, not all staff were comfortable with the experiential nature of clinical supervision and there was fragmented attendance at sessions. Embedding supervision into nursing practice remains a challenge; this paper offers an approach that has proved sustainable over four years.
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Affiliation(s)
| | | | | | - Guy Youog
- Homerton University Hospital, London
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12
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Panda B, Pati S, Nallala S, Chauhan AS, Anasuya A, Som M, Zodpey S. How supportive supervision influences immunization session site practices: a quasi-experimental study in Odisha, India. Glob Health Action 2015; 8:25772. [PMID: 25595596 PMCID: PMC4297277 DOI: 10.3402/gha.v8.25772] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 10/29/2014] [Accepted: 11/27/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Routine immunization (RI) is a key child survival intervention. Ensuring acceptable standards of RI service delivery is critical for optimal outcomes. Accumulated evidences suggest that 'supportive supervision' improves the quality of health care services in general. During 2009-2010, the Government of Odisha and UNICEF jointly piloted this strategy in four districts to improve RI program outcomes. The present study aims to assess the effect of this strategy on improvement of skills and practices at immunization session sites. DESIGN A quasi-experimental 'post-test only' study design was adopted to compare the opinion and practices of frontline health workers and their supervisors in four intervention districts (IDs) with two control districts (CDs). Altogether, we interviewed 111 supervisor-supervisee (health worker) pairs using semi-structured interview schedules and case vignettes. We also directly observed health workers' practices during immunization sessions at 111 sites. Data were analyzed with SPSS version 16.0. RESULTS The mean knowledge score of supervisors in CDs was significantly higher than in intervention groups. Variegated responses were obtained on case vignettes. The control group performed better in solving certain hypothetically asked problems, whereas the intervention group scored better in others. Health workers in IDs gave a lower rating to their respective supervisors' knowledge, skill, and frequency of supervision. Logistics and vaccine availability were better in CDs. CONCLUSION Notwithstanding other limitations, supportive supervision may not have independent effects on improving the quality of immunization services. Addressing systemic issues, such as the availability of essential logistics, supply chain management, timely indenting, and financial resources, could complement the supportive supervision strategy in improving immunization service delivery.
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Affiliation(s)
| | | | | | | | - Anita Anasuya
- DFID, Technical Management and Support Team, Government of Odisha, Odisha, India
| | - Meena Som
- UNICEF State Office for Odisha, Bhubaneswar, Odisha, India
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13
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Fynes E, Martin DSE, Hoy L, Cousley A. Anaesthetic nurse specialist role: leading and facilitation in clinical practice. J Perioper Pract 2014; 24:97-102. [PMID: 24908833 DOI: 10.1177/175045891402400502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Leadership and its effectiveness is becoming more prevalent within the nursing profession with anaesthetic nurse specialists showing their ability to lead, inspire and motivate others to work towards a shared vision in the rapidly changing peri-anaesthesia environment. Anaesthetic nurse specialists must therefore be aware of their personal leadership skills and continually develop these within clinical practice. They are also well placed regarding the facilitation of learning.
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Carver N, Clibbens N, Ashmore R, Sheldon J. Mental health pre-registration nursing students' experiences of group clinical supervision: A UK longitudinal qualitative study. Nurse Educ Pract 2014; 14:123-9. [DOI: 10.1016/j.nepr.2013.08.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 07/26/2013] [Accepted: 08/29/2013] [Indexed: 10/26/2022]
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15
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The effects of group supervision of nurses: A systematic literature review. Int J Nurs Stud 2012; 49:1165-79. [DOI: 10.1016/j.ijnurstu.2011.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 11/23/2011] [Accepted: 11/23/2011] [Indexed: 11/20/2022]
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Koivu A, Saarinen PI, Hyrkas K. Who benefits from clinical supervision and how? The association between clinical supervision and the work-related well-being of female hospital nurses. J Clin Nurs 2012; 21:2567-78. [DOI: 10.1111/j.1365-2702.2011.04041.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Dawson M, Phillips B, Leggat SG. Effective clinical supervision for regional allied health professionals - the supervisee's perspective. AUST HEALTH REV 2012; 36:92-7. [DOI: 10.1071/ah11006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 07/08/2011] [Indexed: 11/23/2022]
Abstract
Aim.
Clinical supervision (CS) for health professionals supports quality clinical practice. This study explored current CS effectiveness for allied health professionals (AHPs) at a regional health service from a supervisee perspective and identified improvements.
Method.
The Manchester Clinical Supervision Scale (MCSS) was completed by 30 supervisees to determine their perceptions of CS effectiveness.
Results.
Supervision sessions typically occurred monthly (56.7%) and were one-to-one (86.2%). The mean total MCSS score was 142.83 (s.d. 15.73), greater than the reported threshold score of 136 for effective CS. The mean subscale scores of ‘trust/rapport’ and ‘improved care/skills’ were high, in contrast to the mean subscale scores for ‘finding time’ and ‘personal issues’, which were significantly lower than the other subscales (P < 0.001). Low scores for ‘finding time’ and ‘personal issues’ subscales may be associated with emotional exhaustion and depersonalisation.
Conclusions.
In this first study evaluating CS for AHPs using the MCSS, CS was reported as being valued and important. However, there is a need for improvement in addressing personal issues that affect work performance and for finding time for CS. As effective CS is an important component of clinical governance by supporting safe and effective healthcare provision, it is vital that CS processes are improved.
What is known about the topic?
There are reports on clinical supervision (CS) effectiveness for nurses, however, there is limited published information about CS for AHPs. Effective CS may enhance clinical skills, improve patient safety and support reflective practice and is a core component of clinical governance. The MCSS has been used to identify CS effectiveness in nurses; however, there have been no previous reports of its use with AHPs.
What does this paper add?
This is the first study to use the MCSS for AHPs and identifies areas for improvement in CS, including scheduling and the need to more effectively address personal issues that affect work performance.
What are the implications for practitioners?
Evaluating the effectiveness of CS in AHPs will lead to improved CS processes and therefore affect the quality of patient care. Effective CS may also affect the wellbeing and job satisfaction for AHPs.
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Peters S, Wearden A, Morriss R, Dowrick CF, Lovell K, Brooks J, Cahill G, Chew-Graham C. Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis. Implement Sci 2011; 6:132. [PMID: 22192566 PMCID: PMC3259041 DOI: 10.1186/1748-5908-6-132] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2011] [Accepted: 12/22/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The evidence base for a range of psychosocial and behavioural interventions in managing and supporting patients with long-term conditions (LTCs) is now well-established. With increasing numbers of such patients being managed in primary care, and a shortage of specialists in psychology and behavioural management to deliver interventions, therapeutic interventions are increasingly being delivered by general nurses with limited training in psychological interventions. It is unknown what issues this raises for the nurses or their patients. The purpose of the study was to examine the challenges faced by non-specialist nurses when delivering psychological interventions for an LTC (chronic fatigue syndrome/myalgic encephalomyelitis [CFS/ME]) within a primary care setting. METHODS A qualitative study nested within a randomised controlled trial [ISRCTN 74156610] explored the experiences and acceptability of two different psychological interventions (pragmatic rehabilitation and supportive listening) from the perspectives of nurses, their supervisors, and patients. Semi structured in-depth interviews were conducted with three nurse therapists, three supervisors, and 46 patients. An iterative approach was used to develop conceptual categories from the dataset. RESULTS Analyses identified four sets of challenges that were common to both interventions: (i) being a novice therapist, (ii) engaging patients in the therapeutic model, (iii) dealing with emotions, and (iv) the complexity of primary care. Each challenge had the potential to cause tension between therapist and patient. A number of strategies were developed by participants to manage the tensions. CONCLUSIONS Tensions existed for nurses when attempting to deliver psychological interventions for patients with CFS/ME in this primary care trial. Such tensions should be addressed before implementing psychological interventions within routine clinical practice. Similar tensions may be found for other LTCs. Our findings have implications for developing therapeutic alliances and highlight the need for regular supervision.
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Affiliation(s)
- Sarah Peters
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Alison Wearden
- School of Psychological Sciences, University of Manchester, Manchester, UK
| | - Richard Morriss
- School of Community Health Sciences, University of Nottingham, Nottingham, UK
| | - Christopher F Dowrick
- School of Population, Community and Behavioural Sciences, University of Liverpool, Liverpool, UK
| | - Karina Lovell
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
| | - Joanna Brooks
- Centre for Applied Psychological Research, University of Huddersfield, Huddersfield, UK
| | - Greg Cahill
- School of Population, Community and Behavioural Sciences, University of Liverpool, Liverpool, UK
| | - Carolyn Chew-Graham
- School of Community Based Medicine, University of Manchester, Manchester, UK
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19
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Davis C, Burke L. The effectiveness of clinical supervision for a group of ward managers based in a district general hospital: an evaluative study. J Nurs Manag 2011; 20:782-93. [DOI: 10.1111/j.1365-2834.2011.01277.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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KOIVU AIJA, SAARINEN PIRJOI, HYRKAS KRISTIINA. Stress relief or practice development: varied reasons for attending clinical supervision. J Nurs Manag 2011; 19:644-54. [DOI: 10.1111/j.1365-2834.2011.01232.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gonge H, Buus N. Model for investigating the benefits of clinical supervision in psychiatric nursing: a survey study. Int J Ment Health Nurs 2011; 20:102-11. [PMID: 21371225 DOI: 10.1111/j.1447-0349.2010.00717.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objective of this study was to test a model for analysing the possible benefits of clinical supervision. The model suggested a pathway from participation to effectiveness to benefits of clinical supervision, and included possible influences of individual and workplace factors. The study sample was 136 nursing staff members in permanent employment on nine general psychiatric wards and at four community mental health centres at a Danish psychiatric university hospital. Data were collected by means of a set of questionnaires. Participation in clinical supervision was associated with the effectiveness of clinical supervision, as measured by the Manchester Clinical Supervision Scale (MCSS). Furthermore, MCSS scores were associated with benefits, such as increased job satisfaction, vitality, rational coping and less stress, emotional exhaustion, and depersonalization. Multivariate analyses indicated that certain individual and workplace factors were related to subscales of the MCSS, as well as some of the benefits. The study supported the suggested model, but methodological limitations apply.
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Affiliation(s)
- Henrik Gonge
- Psychiatric Department North, Aarhus University Hospital, Risskov, Denmark.
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Refractory suffering: The impact of team dynamics on the interdisciplinary palliative care team. Palliat Support Care 2011; 9:55-62. [DOI: 10.1017/s1478951510000544] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjective:This qualitative study aimed to describe the skill sets that experienced palliative care clinicians possess when managing refractory suffering.Method:Thirteen tape recorded semi-structured interviews and four online questionnaires were completed by participants with at least two years clinical palliative care experience. The research team undertook cross sectional thematic analysis of the transcribed interviews.Results:In the face of refractory suffering, team cohesion was identified as a key requirement to support the interdisciplinary team. However, team cohesion was found to be undermined by philosophical differences between team members, a paradigm shift concerning cure versus care and individual opinions regarding the chosen approach and levels of respect between the individual disciplines involved in the care of a person with a life limiting illness.Significance of results:The findings of this study highlight the precarious nature of the interdisciplinary team when significant challenges are faced. As a result of witnessing refractory suffering the division and fracturing of teams can easily occur; often team members are completely unaware of its cause. The findings of this study contribute to the limited literature on the nature of refractory suffering from the perspective of the interdisciplinary team.
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KOIVU AIJA, HYRKAS KRISTIINA, SAARINEN PIRJOIRMELI. Who attends clinical supervision? The uptake of clinical supervision by hospital nurses. J Nurs Manag 2010; 19:69-79. [DOI: 10.1111/j.1365-2834.2010.01185.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Gonge H, Buus N. Individual and workplace factors that influence psychiatric nursing staff's participation in clinical supervision: a survey study and prospective longitudinal registration. Issues Ment Health Nurs 2010; 31:345-54. [PMID: 20394481 DOI: 10.3109/01612840903427849] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This paper reports findings from a survey of 239 psychiatric nursing staff. This study aimed to investigate how often psychiatric nursing staff participates in clinical supervision and any possible associations among individual and workplace factors in relation to participation. The survey findings are followed by a prospective longitudinal registration of participants in clinical supervision. The registration revealed that participation varies considerably and large numbers of the staff may not participate in clinical supervision at all. Characteristics of the workplace, including organisational location, work shift, and work-environmental factors, are related to participation and, consequently, may affect the outcome of clinical supervision.
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Affiliation(s)
- Henrik Gonge
- Arhus University Hospital, Risskov, 8240 Denmark.
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Seymour J, Almack K, Kennedy S. Implementing advance care planning: a qualitative study of community nurses' views and experiences. BMC Palliat Care 2010; 9:4. [PMID: 20377876 PMCID: PMC2854100 DOI: 10.1186/1472-684x-9-4] [Citation(s) in RCA: 108] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Accepted: 04/08/2010] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Advance care planning (ACP) is a process of discussion about goals of care and a means of setting on record preferences for care of patients who may lose capacity or communication ability in the future. Implementation of ACP is widely promoted by policy makers. This study examined how community palliative care nurses in England understand ACP and their roles within ACP. It sought to identify factors surrounding community nurses' implementation of ACP and nurses' educational needs. METHODS An action research strategy was employed. 23 community nurses from two cancer networks in England were recruited to 6 focus group discussions and three follow up workshops. Data were analysed using a constant comparison approach. FINDINGS Nurses understood ACP to be an important part of practice and to have the potential to be a celebration of good nursing care. Nurses saw their roles in ACP as engaging with patients to elicit care preferences, facilitate family communication and enable a shift of care focus towards palliative care. They perceived challenges to ACP including: timing, how to effect team working in ACP, the policy focus on instructional directives which related poorly to patients' concerns; managing differences in patients' and families' views. Perceived barriers included: lack of resources; lack of public awareness about ACP; difficulties in talking about death. Nurses recommended the following to be included in education programmes: design of realistic scenarios; design of a flow chart; practical advice about communication and documentation; insights into the need for clinical supervision for ACP practice. CONCLUSIONS Nurses working in the community are centrally involved with patients with palliative care needs who may wish to set on record their views about future care and treatment. This study reveals some important areas for practice and educational development to enhance nurses' use and understanding of ACP.
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Affiliation(s)
- Jane Seymour
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Kathryn Almack
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Sheila Kennedy
- School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
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Djibuti M, Gotsadze G, Zoidze A, Mataradze G, Esmail LC, Kohler JC. The role of supportive supervision on immunization program outcome - a randomized field trial from Georgia. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2009; 9 Suppl 1:S11. [PMID: 19828055 PMCID: PMC3226230 DOI: 10.1186/1472-698x-9-s1-s11] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND One of the most common barriers to improving immunization coverage rates is human resources and its management. In the Republic of Georgia, a country where widespread health care reforms have taken place over the last decade, an intervention was recently implemented to strengthen performance of immunization programs. A range of measures were taken to ensure that immunization managers carry out their activities effectively through direct, personal contact on a regular basis to guide, support and assist designated health care facility staff to become more competent in their immunization work. The aim of this study was to document the effects of "supportive" supervision on the performance of the immunization program at the district(s) level in Georgia. METHODS A pre-post experimental research design is used for the quantitative evaluation. Data come from baseline and follow-up surveys of health care providers and immunization managers in 15 intervention and 15 control districts. These data were supplemented by focus group discussions amongst Centre of Public Health and health facility staff. RESULTS The results of the study suggest that the intervention package resulted in a number of expected improvements. Among immunization managers, the intervention independently contributed to improved knowledge of supportive supervision, and helped remove self-perceived barriers to supportive supervision such as availability of resources to supervisors, lack of a clear format for providing supportive supervision, and lack of recognition among providers of the importance of supportive supervision. The intervention independently contributed to relative improvements in district-level service delivery outcomes such as vaccine wastage factors and the DPT-3 immunization coverage rate. The clear positive improvement in all service delivery outcomes across both the intervention and control districts can be attributed to an overall improvement in the Georgian population's access to health care. CONCLUSION Provider-based interventions such as supportive supervision can have independent positive effects on immunization program indicators. Thus, it is recommended to implement supportive supervision within the framework of national immunization programs in Georgia and other countries in transition with similar institutional arrangements for health services organization. ABSTRACT IN RUSSIAN: See the full article online for a translation of this abstract in Russian.
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Affiliation(s)
- Mamuka Djibuti
- Curatio International Foundation, Chavchavadze Avenue, 0162 Tbilisi, Georgia.
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Clinical supervision: The way forward? A review of the literature. Nurse Educ Pract 2008; 9:215-20. [PMID: 19042159 DOI: 10.1016/j.nepr.2008.10.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2008] [Revised: 09/02/2008] [Accepted: 10/12/2008] [Indexed: 11/23/2022]
Abstract
A discussion of clinical supervision to enhance existing support structures such as preceptorship and mentorship to positively influence the recruitment and retention of newly graduate nurses provides the main focus for this paper. The nursing literature provides evidence for alternative but equally worthy perspectives on clinical supervision. Essential to the successful practice of clinical supervision is the need to ascertain whether it is simply a system to ensure an effective workforce or one that will empower nurses to realise their vision of nursing.
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The meaning of nurse–patient intimacy in oncology care settings: From the nurse and patient perspective. Eur J Oncol Nurs 2008; 12:319-28. [DOI: 10.1016/j.ejon.2008.04.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2008] [Revised: 03/29/2008] [Accepted: 04/07/2008] [Indexed: 11/18/2022]
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Nordentoft HM. Changes in emotion work at interdisciplinary conferences following clinical supervision in a palliative outpatient ward. QUALITATIVE HEALTH RESEARCH 2008; 18:913-927. [PMID: 18552318 DOI: 10.1177/1049732308318040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In this article, I describe changes in emotion work at weekly interdisciplinary conferences in a palliative( 1) outpatient ward following clinical supervision (CS). I conceive emotions as constantly negotiated in interaction, and I researched the similarity between how this is done during CS and at interdisciplinary conferences following CS. In this respect, CS is seen as a particular discursive practice for emotion work. The findings show how conferences following supervision become inspired by the "language game" in CS, initiating metaperspectives on the care and treatment of patients. These metaperspectives illuminate a dual aspect of care in the sense that it serves the needs not only of patients but also team members. I argue that this recognition captures one of the great challenges in palliative care, namely, to separate the carer's own needs and emotions from those of patients. I therefore conclude that CS enhances professional development and may prevent burnout in palliative care.
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McNamara P, Bryant J, Forster J, Sharrock J, Happell B. Exploratory study of mental health consultation-liaison nursing in Australia: Part 2. Preparation, support and role satisfaction. Int J Ment Health Nurs 2008; 17:189-96. [PMID: 18460080 DOI: 10.1111/j.1447-0349.2008.00531.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Mental health Consultation-Liaison (CL) nursing continues to develop and gain recognition as a subspecialty of mental health nursing. CL roles are particularly important given the significant number of people experiencing mental illness and other mental health problems within the general health-care settings. However, despite the potential value of these roles, the literature provides little information about these roles and about the nurses who work in these roles. This is the second part of a two-part paper describing a survey of CL nurses in Australia. Part 1 describes demographic data and characteristics of the CL role. Part 2 provides an exploration of the following factors: educational preparation, support, and work satisfaction. The findings identified specific educational needs in preparation and ongoing support for the role. However, overall the participants expressed a high level of satisfaction with their work. Given the current recruitment problems in mental health nursing, the promotion of the CL nursing role might enhance a more positive view of this branch of nursing.
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Fletcher S. Supervision needs of nurses working in the community. Int J Palliat Nurs 2008; 14:196-200. [DOI: 10.12968/ijpn.2008.14.4.29134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Tony B, Louise B, Christine J, Majda P. Wicked spell or magic bullet? A review of the clinical supervision literature 2001-2007. NURSE EDUCATION TODAY 2008; 28:264-72. [PMID: 17624642 DOI: 10.1016/j.nedt.2007.05.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 05/08/2007] [Accepted: 05/08/2007] [Indexed: 05/16/2023]
Abstract
Clinical supervision has become an established part of nursing. Implemented in various different ways it has attracted attention from the research, educator and practice communities. The literature reported and analysed in this paper describes work that may benefit professional practice but there continue to be questions about application and method. Two new messages arise from the literature. The first underscores the responsibility of health care organisations to sustain and develop clinical supervision and the second points to the potential benefit that clinical supervision may have on patient outcomes.
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Affiliation(s)
- Butterworth Tony
- Centre for Clinical and Academic Workforce Innovation, University of Lincoln, Mill 3, Pleasley Vale Business Park, NG19 8RL, UK.
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Arvidsson B, Skärsäter I, Baigi A, Fridlund B. The development of a questionnaire for evaluating process-oriented group supervision during nursing education. Nurse Educ Pract 2008; 8:88-93. [DOI: 10.1016/j.nepr.2007.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Revised: 02/28/2007] [Accepted: 04/04/2007] [Indexed: 11/24/2022]
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Andersson N, Jylli L, Kajermo KN, Klang B. Nurses in paediatric care--self-reported professional self and perceived research utilization. Scand J Caring Sci 2008; 21:426-33. [PMID: 18036005 DOI: 10.1111/j.1471-6712.2006.00486.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim was to describe how nurses in different professional levels evaluated their professional self and perceived barriers to research utilization in paediatric care. The sample consisted of three groups of nurses: control, trainee and specialists (n = 113) employed at two Paediatric University hospitals in Sweden. The control and trainee groups were nurses with a general education and the specialists had a specialist education in paediatric care. The nurses answered the two questionnaires: the Professional Self Description Form (PSDF) and the Barriers Scale. The results showed that the highest scores in the PSDF were found in sensitivity in all the three groups and consideration (in control and specialist group) and creativity (trainee group). The control group scored significantly higher in the item persistence. In the Barriers Scale, the three groups scored the greatest barriers in; 'there is insufficient time on the job to implement new ideas' and 'the nurses do not have time to read research'. The lowest barriers were found in; 'the nurse is unwilling to change/try new ideas' and 'the nurse is unaware of research'. The specialist nurses had significantly higher barriers in; 'the nurse is isolated from knowledgeable colleagues with whom to discuss the research', 'the nurse is unwilling to try new ideas' and 'administration will not allow implementation'. No correlations were found between the PSDF and the Barriers Scale. In conclusion, the self-evaluation of professional self and perceived research utilization showed few differences between the nurses. These findings indicate that the professional self is independent of educational level and work experiences while barriers to research utililization increases with competence and experience.
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Affiliation(s)
- Nina Andersson
- Department of Woman and Child Health, Astrid Lindgren's Children Hospital, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden.
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Kleiser H, Cox DL. The Integration of Clinical and Managerial Supervision: A Critical Literature Review. Br J Occup Ther 2008. [DOI: 10.1177/030802260807100102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The introduction of a new development review process, the Knowledge and Skills Framework (KSF), has placed a greater demand on occupational therapists within the health service to be more accountable for practice. It has been proposed that the KSF may provide a useful structure for supervision in order to ensure continual development. Therefore, this literature review looked at the appropriateness of addressing both clinical and managerial issues within the supervisory process. The results indicate that despite many professions being unsure of how best to deliver supervision, there is a common understanding that a structure combining clinical and managerial supervision, such as the KSF, may be useful. It is, however, recommended that the roles of appraiser and supervisor remain separate, because many researchers found conflict within this duality of role as having an impact upon the effectiveness of supervision. It is also recommended that further research be undertaken in order to evaluate formally the effectiveness of integrating the KSF into supervision.
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Affiliation(s)
| | - Diane L Cox
- University of Cumbria (previously St Martin's College), Lancaster
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Beringer AJ, Eaton NM, Jones GL. Providing a children's palliative care service in the community through fixed-term grants: the staff perspective. Child Care Health Dev 2007; 33:619-24. [PMID: 17725785 DOI: 10.1111/j.1365-2214.2007.00762.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Children's palliative care services have recently been awarded fixed-term grants, aimed at improving the provision of care for children with life-limiting conditions in the community. We report findings of a qualitative study to investigate the experience of a cohort of community children's nurses from teams involved in setting up or extending community-based children's palliative care services. The purpose of the study was to identify factors that affect service delivery, from the staff perspective, and to suggest ways of promoting their sustainable development. METHODS Semi-structured telephone interviews were conducted with 21 nurses from 12 different teams providing palliative care for children at home and in hospices. Participants were questioned about the services they provided and their own roles in that provision. NVIVO qualitative data analysis software was used to explore themes arising from the transcribed recorded interviews. FINDINGS Key findings were the importance of physical location in facilitating multidisciplinary communication, the importance of defining role boundaries between existing and new providers of children's palliative care, and the potentially detrimental impact of insecure funding on referral patterns and recruitment to posts. Staff named the opportunity to offer direct 'hands-on' care to families, access to work-based support and networking opportunities as important factors in helping them cope with the stresses involved in managing finite resources and the emotional challenges of their work. CONCLUSIONS The maintenance of a mixed caseload with a significant proportion of direct care, provision of ongoing support and clearly defined roles are recommended as means of bolstering the ability of staff to develop their services. The deliberate locating of services to enhance communication between staff and guidance on the preparation of funding applications may further contribute to the sustainability of these services.
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Affiliation(s)
- A J Beringer
- University of the West of England Bristol, Bristol, UK.
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Kilcullen N. An analysis of the experiences of clinical supervision on Registered Nurses undertaking MSc/graduate diploma in renal and urological nursing and on their clinical supervisors. J Clin Nurs 2007; 16:1029-38. [PMID: 17518879 DOI: 10.1111/j.1365-2702.2007.01661.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS The aim of this study was to elicit clinical supervisors' and supervisees' experiences of clinical supervision while undertaking MSc/Graduate Diploma Programme in Renal and Urological Nursing. BACKGROUND Formal systems of clinical supervision have not been implemented in the Republic of Ireland. There is a growing awareness of their effectiveness in enhancing analytic skills and in helping to retain staff in clinical practice. Clinical supervision was incorporated in the MSc/Graduate Diploma Programme to enhance professional growth and development for students. DESIGN A qualitative descriptive research design was used in this study. METHODS A purposive sample of 10 Registered Nurses participated in the study; five were clinical supervisors and the other five were supervisees. The study was undertaken at a large teaching hospital in the Republic of Ireland. Data were collected by semi-structured interviews and analysed using content analysis. RESULTS Following data analysis, six major categories emerged. These were, 'positive aspects''negative aspects', 'factors, which had an impact on the process of clinical supervision', 'support', 'formal systems of clinical supervision', 'reflective practice in groups'. CONCLUSIONS There was a general feeling that clinical supervision was a good experience for many members of this study group. The concept of clinical supervision was perceived as an inappropriate term to encompass the complexity of the clinical supervision sessions. This begs the question: is clinical supervision a practice with no name or should it be called something else? Giving a practice an appropriate name may empower registered nurses to implement this practice with confidence. RELEVANCE TO CLINICAL PRACTICE The findings of this study have implications for management and for the clinical environment, in terms of supporting and preparing practitioners to develop their critical and analytic skills.
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MESH Headings
- Attitude of Health Personnel
- Clinical Competence
- Education, Nursing, Graduate/organization & administration
- Factor Analysis, Statistical
- Health Knowledge, Attitudes, Practice
- Health Services Needs and Demand
- Hospitals, Teaching
- Humans
- Interprofessional Relations
- Ireland
- Models, Educational
- Models, Nursing
- Nephrology/education
- Nurse Clinicians/education
- Nurse Clinicians/psychology
- Nursing Education Research
- Nursing Methodology Research
- Nursing Staff, Hospital/psychology
- Nursing, Supervisory/organization & administration
- Qualitative Research
- Social Support
- Thinking
- Urology/education
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Affiliation(s)
- Nora Kilcullen
- School of Nursing, Dublin City University, Dublin, Ireland.
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38
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Kilcullen N. An analysis of the experiences of clinical supervision on Registered Nurses undertaking MSc/graduate diploma in renal and urological nursing and on their clinical supervisors. J Clin Nurs 2007. [DOI: 10.1111/j.1365-2702.2006.01661.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Shaha M, Rabenschlag F. Burdensome situations in everyday nursing: an explorative qualitative action research on a medical ward. Nurs Adm Q 2007; 31:134-45. [PMID: 17413507 DOI: 10.1097/01.naq.0000264862.87335.e4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Everyday nursing care is under marked constraint in the current healthcare environment due to decreasing time resources and competing financial demands. Burden along with stress and burnout is increasing. Stress not only does occur on the individual and organizational level, as has been studied, but also is a significant factor at the team level, particularly with regard to interactions at this level. This project aimed at eliciting nurses' view on burden; identifying areas for intervention on team level; and evaluating the interventions implemented at this level. Focus groups were conducted with 2 nursing teams (n = 36). Data were analyzed with Atlas Ti, Version 4.2. On the basis of the results of the focus groups, interventions were developed and implemented observing the tenets of problem-based learning and evidence-based nursing. Verbal feedback was used to evaluate the impact of the interventions on the nursing team. Fourteen themes were identified for each ward as areas for improvement. Oral evaluation of the group-specific interventions revealed a benefit for the nursing team as a whole. Findings indicate that team actions played an important role when addressing stressful nursing situations. To improve stressful nursing situations, team action needs to be considered.
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Affiliation(s)
- Maya Shaha
- Centre for Research and Services, University of Applied Sciences Health, Freiburg, Switzerland.
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Rose J, Glass N. Community mental health nurses speak out: the critical relationship between emotional wellbeing and satisfying professional practice. Collegian 2007; 13:27-32. [PMID: 17285828 DOI: 10.1016/s1322-7696(08)60537-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The article reports on selected findings of a research study concerning emotional wellbeing and professional nursing practice (Rose 2002). It highlights the relationship between community mental health nurses' and emotional wellbeing, and their capacity to provide satisfying professional nursing practice (Rose 2002). The notion of emotional wellbeing, factors that impacted upon the participants' emotional wellbeing, and the relationship of emotional wellbeing to professional practice were revealed in the study. These findings were based on a qualitative critical feminist research inquiry and specifically, interviews with five women community mental health nurses in Australia. Whilst complex, emotional wellbeing was found to be both implicitly and explicitly linked to the participants intertwined personal and professional experiences. Four key components were identified: the nebulous notion; the stress relationship; the mind, body, spirit connection; and, inner sense of balance. In terms of emotional wellbeing and professional practice, three themes were revealed. These were: being able to speak out (or not); being autonomous (or not) and being satisfied (or not). The authors argue that the emotional wellbeing of nurses working in community mental health settings is critical to satisfying professional practice. Furthermore nursing work involves emotional work which impacts on one's emotional wellbeing and emotional wellbeing is integrally linked to professional practice. It is recommended that health organisations must be pro-active in addressing the emotional needs of nurses to ensure the delivery of health care that is aligned to professional practice. This approach will ensure nurses will feel more recognised and validated in terms of their nursing practice.
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Affiliation(s)
- Jayln Rose
- Southern Cross University, New South Wales
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41
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Blomberg K, Sahlberg-Blom E. Closeness and distance: a way of handling difficult situations in daily care. J Clin Nurs 2007; 16:244-54. [PMID: 17239059 DOI: 10.1111/j.1365-2702.2005.01503.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to describe how care team members caring for patients with advanced cancer describe how they handle difficult situations in daily care. In this paper 'difficult situations' refers to those situations team members themselves describe as difficult. BACKGROUND Serious illness and impending death involve great changes in a person's life. The care of patients with advanced cancer is complex and many different factors influence each care situation. This places demands on the way care team members handle problems and difficulties in daily care. DESIGN Qualitative descriptive study. METHODS The study is based on 16 focus group discussions with care team members who were caring for patients with advanced cancer at three different care units in two Swedish cities. The focus group discussions included 77 participants. The procedure for data analysis was inspired by the phenomenological method. FINDINGS The results show that care team members handled difficult situations by balancing between being close and distancing themselves. In most situations their choice of strategy seemed spontaneous rather than being a conscious decision, although it was sometimes described as a more conscious approach. Variations of closeness and distance that were identified were Identity, Meaning, Limit-setting and touching, Prioritization, the Team and the Organization. These could also be seen as tools that could facilitate or impede the use of closeness and distance. CONCLUSIONS The results show that care team members have a need to reflect over daily care and to become aware of what governs different care actions. RELEVANCE TO CLINICAL PRACTICE If the experienced difficult situation is not handled in a way that is beneficial to the care team member, patient and relatives, it is assumed that this can result in stress, burnout and, above all, non-optimal care.
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Affiliation(s)
- Karin Blomberg
- Department of Health Sciences, Orebro University, Orebro, Sweden.
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Cutcliffe JR, Hyrkäs K. Multidisciplinary attitudinal positions regarding clinical supervision: a cross-sectional study. J Nurs Manag 2006; 14:617-27. [PMID: 17054735 DOI: 10.1111/j.1365-2934.2006.00720.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to describe multidisciplinary attitudes towards/about Clinical Supervision. BACKGROUND Clinical Supervision continues to be a matter of high interest for nurses and other health care disciplines. Despite the existence of a body of a substantive literature, gaps in our knowledge base remain. DESIGN Data was collected using a form composed of 17 statements. A total sample of 74 participants completed the form and rank-ordered the statements. The sample was comprised of a mix of eight different disciplines: Registered Nurses (hospital based), Chiropodists, Occupational Therapists, Learning Disability Nurses, Registered Nurses (community based), Registered Mental Health Nurses, Health Visitors and Physiotherapists. Data were analyzed by descriptive and non-parametric statistics. RESULTS The respondents' agreement was high concerning the rankings of the item (11) ''Confidentiality is assured and agreed''. Almost all respondents ranked this item as the most important characteristic for group supervision. The respondents shared almost a total agreement concerning the item (17) ''The supervisor should be a manager''. This was ranked as the least important characteristic for group supervision. CONCLUSION The importance of having a clinical supervisory relationship that remains separate from administrative/managerial supervision and one where confidentiality is assured was highlighted by this study. Furthermore, the attitudes were not restricted to one professional or disciplinary group. The effective support system of clinical supervision should therefore not be diluted by awkward and unnecessary amalgamations with administrative/managerial supervision.
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Affiliation(s)
- John R Cutcliffe
- College of Nursing and Health Sciences, University of Texas (Tyler), Tyler, TX 75799, USA.
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Abstract
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.
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Affiliation(s)
- Alun Jones
- School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
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Garrosa E, Moreno-Jiménez B, Liang Y, González JL. The relationship between socio-demographic variables, job stressors, burnout, and hardy personality in nurses: an exploratory study. Int J Nurs Stud 2006; 45:418-27. [PMID: 17109862 DOI: 10.1016/j.ijnurstu.2006.09.003] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Revised: 09/20/2006] [Accepted: 09/24/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND Nursing is considered as a risk profession with high levels of stress and burnout, and these levels are probably increasing. OBJECTIVES A model of prediction of burnout in nursing that includes socio-demographic variables, job stressors, and personal vulnerability, or resistance, is proposed. DESIGN A cross-sectional correlational design was used. A sample of 473 nurses and student nurses in practice from three General Hospitals in Madrid (Spain) completed the "Nursing Burnout Scale". The data were analysed using descriptive statistics, Pearson correlations, and hierarchical multiple regression. RESULTS The proposed model is a good predictor of the diverse burnout sub-dimensions: emotional exhaustion, depersonalisation, and lack of personal accomplishment. Significant predictors of burnout included age, job status, job stressors (workload, experience with pain and death, conflictive interaction, and role ambiguity), and hardy personality (commitment, control, and challenge). CONCLUSIONS Identifying an integrative process of burnout among nurses is an essential step to develop effective managerial strategies so as to reduce the burnout problem. Specifically, the present study suggests that intervention aimed at reducing the risk for burnout may achieve better results if it includes enhancement of workers' hardy personality rather than just decreasing environmental stressors.
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Affiliation(s)
- Eva Garrosa
- Facultad de Psicologia, Universidad Autónoma de Madrid, Spain.
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Cleary M, Freeman A. Fostering a culture of support in mental health settings: alternatives to traditional models of clinical supervision. Issues Ment Health Nurs 2006; 27:985-1000. [PMID: 16966228 DOI: 10.1080/01612840600899907] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Clinical supervision [CS] for mental health nurses in inpatient settings in Sydney, Australia, is virtually nonexistent despite over a decade of discussion regarding its benefits to staff, patients, and organisations. Whilst there is general agreement about the merit of CS, its ad-hoc implementation and the use of models that do not correspond to the realities of the environment have led to its adoption being somewhat half-hearted. It is unsurprising then that there is an absence of achievable policy regarding CS making its integration into modern inpatient units even harder to attain. In this paper, we outline some pragmatic issues concerning CS and advocate for facility-specific professional development and support processes that incorporate succession planning opportunities. This we believe has the potential to promote professional behaviour, continuous learning and development, cohesive teamwork, and ultimately a change in culture regarding CS.
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Affiliation(s)
- Michelle Cleary
- Sydney South West Area Health Service (Eastern Zone), Rozelle Hospital, Rozelle, NSW, Australia.
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Berggren I, Severinsson E. The significance of nurse supervisors' different ethical decision-making styles. J Nurs Manag 2006; 14:637-43. [PMID: 17054737 DOI: 10.1111/j.1365-2934.2006.00710.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND The role of the nurse supervisor is very important, because of his/her ability to influence the atmosphere within the clinical nursing supervision group. AIM To present and interpret nurse supervisors' different ethical decision-making styles. METHOD A hermeneutic interpretation of three studies on nurse supervisors' different ethical decision-making styles. RESULTS The significance of the nurse supervisor's ethical decision-making style is reflected in the awareness of their responsibility for creating a relationship with the supervisee. The supervisors focus on ensuring safety, integrating theoretical knowledge and clinical practice, willingness and preparedness to supervise on the substance of nursing, sharing the supervisees' feelings and challenging them, reflecting on the content of clinical nursing supervision as well as promoting justice and integrity in clinical nursing supervision. CONCLUSIONS The interpretation highlights the importance of the nurse supervisor's style for the outcome of clinical nursing supervision, as they are role models for the supervisees. There is a need for further research to explore the advantages and disadvantages of nurse supervisors' different ethical decision-making styles, especially in relation to the influence of clinical nursing supervision on the quality of care and various support systems.
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Affiliation(s)
- Ingela Berggren
- Department of Nursing, Health and Culture, University West, Trollhättan, Sweden.
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Botti M, Endacott R, Watts R, Cairns J, Lewis K, Kenny A. Barriers in providing psychosocial support for patients with cancer. Cancer Nurs 2006; 29:309-16. [PMID: 16871099 DOI: 10.1097/00002820-200607000-00010] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is sound evidence to support the notion that the provision of effective psychosocial care improves the outcomes of patients with cancer. Central to the implementation of this care is that health professionals have the necessary communication and assessment skills. This study aimed to identify key issues related to providing effective psychosocial care for adult patients admitted with hematological cancer, as perceived by registered nurses with 3 or more years of clinical experience. An exploratory qualitative design was used for this study. Two focus group interviews were conducted with 15 experienced cancer nurses. The provision of psychosocial care for patients with cancer is a dynamic process that has a professional and personal impact on the nurse. The 5 analytic themes to emerge from the data were as follows: When is it a good time to talk? Building relationships; Being drawn into the emotional world; Providing support throughout the patient's journey; and Breakdown in communication processes. The findings from this study indicate an urgent need to develop a framework to provide nurses with both skill development and ongoing support in order to improve nurses' ability to integrate psychosocial aspects of care and optimize patient outcomes.
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Affiliation(s)
- Mari Botti
- Centre for Clinical Nursing Research, Epworth/Deakin Nursing Research Centre, Richmond Vic 3121, Australia.
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Edwards D, Burnard P, Hannigan B, Cooper L, Adams J, Juggessur T, Fothergil A, Coyle D. Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses. J Clin Nurs 2006; 15:1007-15. [PMID: 16879545 DOI: 10.1111/j.1365-2702.2006.01370.x] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK. METHODS The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey. RESULTS One hundred and eighty-nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty-six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = -0.148, P = 0.050) and the depersonalization subscale (r = -0.220, P = 0.003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization. CONCLUSIONS The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long-term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses. Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include - to seek clinical supervision as and when necessary.
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Affiliation(s)
- Deborah Edwards
- School of Nursing and Midwifery Studies, University of Wales College of Medicine, Cardiff, UK.
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Hyrkäs K, Appelqvist-Schmidlechner K, Haataja R. Efficacy of clinical supervision: influence on job satisfaction, burnout and quality of care. J Adv Nurs 2006; 55:521-35. [PMID: 16866847 DOI: 10.1111/j.1365-2648.2006.03936.x] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This paper reports a study to determine how supervisees' backgrounds and surrounding infrastructure predict the efficacy of clinical supervision among Finnish nursing staff, their job satisfaction, levels of burnout and perceptions of the quality of care. BACKGROUND Several studies have described the effects of clinical supervision, but few have focused on evaluating it. Until recently, no studies have examined how clinical supervision evaluations are related to supervisees' backgrounds, surrounding infrastructure or respondents' levels of burnout, job satisfaction and perceptions of the quality of care. METHODS The survey involved supervisees completing a range of standardized and validated evaluation measures. The respondents were identified from 12 regional, central and university hospitals across Finland (n = 799). The data collection took place from October 2000 to February 2001. FINDINGS The evaluations varied statistically significantly and were associated with statistically significant variations in the respondents' backgrounds. Clinical supervision infrastructure was also strongly related to evaluation scores. Supervisees' age, education, gender, employment status, area of specialty, working hours, work experience and experience as a supervisor were statistically significant predictors for evaluations of the efficacy of clinical supervision. These evaluations of clinical supervision were also found to predict the respondents' job satisfaction, levels of burnout and assessments of good nursing. CONCLUSION Nursing staff, especially those who have over 10 years' work experience, work in general care, have a nursing diploma, are non-tenured, work part-time and work 24-hour rotating shifts can benefit from clinical supervision. However, resources need to be invested in supervisor education and nursing staff need to be encouraged to start working in both supervisor and supervisee roles because of the positive effects on job satisfaction and quality of care.
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Affiliation(s)
- Kristiina Hyrkäs
- Center for Nursing Research and Quality Outcomes, Maine Medical Center, Portland, USA.
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Edwards D, Cooper L, Burnard P, Hannigan B, Hanningan B, Juggesur T, Adams J, Fothergill A, Coyle D. Factors influencing the effectiveness of clinical supervision. J Psychiatr Ment Health Nurs 2005; 12:405-14. [PMID: 16011495 DOI: 10.1111/j.1365-2850.2005.00851.x] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Clinical supervision is widely accepted as an essential prerequisite for high quality nursing care. This paper reports findings from a study that aims to identify the factors that may influence the effectiveness of clinical supervision for community mental health nurses (CMHNs) in Wales, UK. Two hundred and sixty (32%) CMHNs from an estimated total population of 817 completed the Manchester Clinical Supervision Scale (MCCS) and a demographic questionnaire. The MCCS is a 36-item questionnaire measuring the quality and effectiveness of the supervision received. Three-quarters of CMHNs reported having participated in six or more sessions of supervision in their current posts. Clinical supervision was more positively evaluated where sessions lasted for over one hour, and took place on at least a once-monthly basis. Perceived quality of supervision was also higher for those nurses who had chosen their supervisors, and where sessions took place away from the workplace. These findings have important implications for the organization and delivery of mental health nursing services.
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Affiliation(s)
- D Edwards
- School of Nursing and Midwifery Studies, University of Wales College of Medicine, Cardiff CF14 4XN, UK.
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