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Clinical Supervision

Clinical supervision is a supportive and ongoing practice for healthcare professionals which involves development, monitoring and enhancement of professional functioning. It is implemented by more experienced healthcare professionals who have required skills and knowledge about the practices which should be undertaken while providing care to the patient. Supervision in mental health nursing services is also very significant as mental health patients are more vulnerable than others (Allan et al., 2017). Supervision is the main part of the development and education of mental healthcare professionals. In studies, it has been found that supervision helps in improving patient outcomes and also increases adherence towards their treatment and fidelity. Supervision involves training and feedback from supervisors by session recording or via direct observation. Clinical supervision is required for safe delivery care so that patient satisfaction and health enhances (Choy-Brown & Stanhope, 2018). Therefore, in this assignment, the role of clinical supervision will be critically evaluated as a strategy which is designed to support safe and effective health nursing practices. With that, the focus will also be given towards, how a person can contribute to establishing clinical supervision in the workplace and what strategies could be used so that it is implemented successfully.

Clinical supervision is implemented in the healthcare services throughout. It is a process which is practised by experienced healthcare professionals such as doctors or nurses so that they can oversee and guide those individuals who are new to healthcare practice in order to increase the safety of the nursing care which is being given to the patient. It is provided to people so that they can improve their nursing practice and become more qualified healthcare professionals with time. By doing this, less experienced individuals could gain knowledge and information for their nursing practice by their seniors or supervisor (Kühne et al., 2019). It also helps in bridging any knowledge gap which could enhance the clinical performance of the healthcare professional. Generally, clinical supervision facilitates three component of care. They are the care which is provided is clinically effective, the care is safe and that the diseased individual is having a positive or satisfying experience. Clinically effective care includes the offering of beneficial interventions to the patient at the right time which involves estimating the patient outcome (Kühne et al., 2019; Snowdon et al., 2017). Safe care refers to the care which prevents any harm or danger to the mental and physical wellbeing of the patient and having positive experiences by diseased individual means to make sure that every need and requirement of the patient is taken care of. For measuring clinical supervision, it is required that the effect on care quality is measured. This can be done by looking at patient safety and their outcomes (Kühne et al., 2019; Snowdon et al., 2017).

Clinical supervision is very crucial in mental health nursing practices so that safe and quality practice could be delivered to the mental health patient. Mental health patients are more vulnerable and thus require more help from healthcare professionals. By doing clinical supervision in a mental health institute, training could be provided to new healthcare professionals so that they can also give the utmost quality care (Allan et al., 2017). In a mental health setting, a mental health professional could be psychotherapists, social workers, psychiatrists, pastoral counsellor, family therapist, counsellors, psychologists, mental health nurses, couple or marriage counsellor and so on. Therefore, these people could provide help and supervision so that evidence-based and person-centred practise could be performed. Because of supervision in the institute, risk factors which could damage people wellbeing could be more effectively be recognized and known. With that, supervision also facilitates in enhancement of patients socio-emotional, behavioural, psychological and interpersonal functioning. Clinical supervision is needed in mental health nursing practices because of three major things (Allan et al., 2017). One is to enhance and promote the competencies of mental health nursing professionals, two is to increase the working practice and treatment which is based on evidence and three is to reduce or eliminate unnecessary or unrequited intervention. In addition to that, clinical supervision also facilitates in decreasing the cost which is associated with healthcare and the time in the waitlist. Therefore, it can be said the diseased individual outcomes are more improved by this practice. It acts as a mechanism which ensures the quality nursing practice and thus helps mental healthcare professionals to develop skills, abilities and competencies. Furthermore, it also helps the professionals to critically evaluate their nursing practices and they can also found out which practice of there, could harm or have a negative implication on the patient and his safety (Allan et al., 2017).

Clinical supervision in mental health nursing is significant because it increases the job satisfaction of the nurses which in turn help them to develop and work on their skills and capabilities which will help them in their profession. It also gives confidence to nurses to effectively solve problems which strengthen their self-esteem and their professional competency. It offers support to nurses who work in the mental health institute by deducting their frustration with the work (Howard & Eddy-Imishue, 2020). It aids them in showing empathy towards the patient and their condition and thus facilitates in maintaining relationships with them which are therapeutic in nature. Clinical supervision in nursing also assists in lowering down the emotional burden which is faced by mental healthcare nursing professional. It facilitates in restoring their energies and offers them a new and fresh perspective (Howard & Eddy-Imishue, 2020).

Clinical supervision is a good component of clinical governance and it also helps in providing safe and effective mental health nursing practices by the healthcare professionals. However, clinical supervision might be difficult to be implemented in settings where there is less number of staff members or fewer group members in the mental health institute. In addition to that, it is also not necessary that it will enhance the safety of the patient, professional wellbeing and quality care for sure (Tomlinson, 2015). The practise of clinical supervision has been studied extensively for trainees but it is not studied very much in regards to supervisors and consultants. With that, comparison in the studies of clinical supervision is difficult and problematic because the results and forms vary to a great extent. It has also been found out that clinical supervision in nursing practices could be complicated due to lack of staffing and organizational upheaval and management. With that, it also increases the workload on the supervisors and experts (Tomlinson, 2015). Another barrier which can cause the problem in clinical supervision is the non-participation or ineffective participation of the trainee. The trainee could refuse to completely engage in the process and thus it can cause interpersonal disputes and then clinical supervision would not be effective. The organizational barrier could also be present such as a limited amount of time to supervise a person. If time restraint is present then, clinical supervision could not be performed efficiently and thus some proper training would be provided to the nursing professional who is working in a mental health institute. The staff members become more conscious and aware of their shortcomings and moral issues and hence experience more amount of stress while they are working for the patients (Howard & Eddy-Imishue, 2020). Hence, it can be said that with some pros clinical supervision have disadvantages also.

Clinical supervision has not been provided in my workplace. So for that, clinical supervision can be established in the workplace by following multiple steps. The first step in clinical supervision is the setting of goals. Goals or aims are required to be made by the supervisor and the trainee or the person who is receiving clinical supervision. Goals should be made cohesively and they should be realistic, attainable and measurable. With that, they should be having a time limit so that the process does not go on for unnecessary time period (Watkins et al., 2014). The goals which are being made should be aiming to achieve competencies and skills which will enhance the care delivery of the nursing practice. They should also prioritize the learning needs of the trainee. Supervisors are also needed to address every goal in the supervision sessions and should review the progress that has been made by the trainee. The reviewing should be done regularly as the evaluation is necessary to achieve the set goal. The supervisor should also check the skills and capabilities that have been gained by the trainee during the clinical supervision process (Borders, 2014).

Another step to implement clinical supervision in the workplace is by providing feedback to the supervisee. It is important to give constructive feedback to the trainee so that he can improve their nursing practice. The feedbacks should be regular and ongoing. They also need to be manageable, concrete and timely. With that, they should also be descriptive and directive which will promote the development process of supervisee (Goodyear et al., 2016). The advice which should be provided in the feedback should also support the mental health professional and it should also challenge him to do his best for the mental health patient. In addition to that, clinical supervision also consists of supervisor telling trainee to look at the feedback which comes directly from the mental health patient, their families or their peers (Borders, 2014).

Another step which is needed to be taken in establishing clinical supervision in the workplace is conducting proper and effective supervision. Supervision conduction requires the best practices for the people and group. It should adhere to professional policies and standards. Supervision should be conducted face to face or should be done by making use of proper technologies that could enhance the process of learning of the supervisee (Watkins et al., 2014). For appropriate supervision, it is required that structured plans are created so that supervisee could attain the set goals and the welfare of the mental health patient could be modified and enhances. The supervisor should make use of skills, self-awareness and case conceptualization. They also need to make use of effective leadership styles and skills which could encourage the trainee. In addition to that, supervisors should evaluate their supervision which they are providing and its effectiveness on the supervisee and the mental health patient (Borders, 2014).

With that, clinical supervision can be applied by maintaining a supervisory relationship. This relationship should foster and offer mutual trust between the supervisor and the supervisee. The supervisor should be able to look and observe at the resistance and anxiety which is presented by the trainee and thus they should manage them for their growth and development. Supervisor also needs to pay attention to advocacy and diversity consideration among the counselling and supervisory relationships (Simpson‐Southward et al., 2017). In addition to that, ethical consideration should also be highlighted so that best practice should be provided to mental healthcare patients. Therefore, clinical supervision could be executed and employed in the workplace by setting goals for the trainee and working on them. They also need to be made aware of the ethical principles that are needed to be followed so that their practice could promote the mental health patient wellbeing (Borders, 2014).

In conclusion, it can be said that clinical supervision is a very important component of healthcare services. It helps in the promotion of best nursing practice which is evidence-based and also helps individuals to upgrade their skills and knowledge. This concept is needed in the mental health nursing practice because the patients in those institutes are vulnerable and thus require effective practice that would enhance their wellbeing. Clinical supervision thus aids in increasing the competencies of mental health nursing professionals and it also increases the treatment practice which is given to the diseased individual. With that, it aids in removing unnecessary interventions. However, there are some disadvantages also such as it creates more pressure and workload on mental healthcare professionals and so on. Proper and effective clinical supervision could be applied in the workplace by creating goals and aims for the supervisee. With that, effective feedbacks could also be given with accordance to conducting proper supervision. Moreover, by maintaining a supervisory relationship, paying attention to advocacy and diversity consideration and ethical consideration, clinical supervision could be applied appropriately.

References for Empirical Research in Clinical Supervision

Allan, R., McLuckie, A., &Hoffecker, L. (2017). Effects of clinical supervision of mental health professionals on supervisee knowledge, skills, attitudes, and behaviour, and client outcomes: Protocol for a systematic review. The Campbell Collaboration, 1-44.https://doi.org/10.1002/CL2.179

Borders L. D. (2014). Best practices in clinical supervision: Another step in delineating effective supervision practice. American Journal of Psychotherapy68(2), 151–162. https://doi.org/10.1176/appi.psychotherapy.2014.68.2.151

Choy-Brown, M., & Stanhope, V. (2018).The availability of supervision in routine mental health care. Clinical Social Work Journal46(4), 271–280. https://doi.org/10.1007/s10615-018-0687-0

Goodyear, R. K., Borders, L. D., Chang, C. Y., Guiffrida, D. A., Hutman, H., Kemer, G., ... & White, E. (2016). Prioritizing questions and methods for an international and interdisciplinary supervision research agenda: Suggestions by eight scholars. The Clinical Supervisor35(1), 117-154.

Howard, V., & Eddy-Imishue, G. K. (2020). Factors influencing adequate and effective clinical supervision for inpatient mental health nurses' personal and professional development: An integrative review. Journal of Psychiatric and Mental Health Nursing27(5), 640–656. https://doi.org/10.1111/jpm.12604

Kühne, F., Maas, J., Wiesenthal, S., &Weck, F. (2019). Empirical research in clinical supervision: A systematic review and suggestions for future studies. BMC Psychology7(1), 54.https://doi.org/10.1186/s40359-019-0327-7

Simpson‐Southward, C., Waller, G., & Hardy, G. E. (2017). How do we know what makes for “best practice” in clinical supervision for psychological therapists? A content analysis of supervisory models and approaches. Clinical Psychology & Psychotherapy24(6), 1228-1245. https://doi.org/10.1002/cpp.2084

Snowdon, D. A., Leggat, S. G., & Taylor, N. F. (2017). Does clinical supervision of healthcare professionals improve effectiveness of care and patient experience? A systematic review. BMC Health Services Research17(1), 786.https://doi.org/10.1186/s12913-017-2739-5

Tomlinson J. (2015). Using clinical supervision to improve the quality and safety of patient care: A response to Berwick and Francis. BMC Medical Education15, 103.https://doi.org/10.1186/s12909-015-0324-3

Watkins Jr, C. E. (2014). Clinical supervision in the 21st century: Revisiting pressing needs and impressing possibilities. American Journal of Psychotherapy68(2), 251-272.

Watkins, C. E., & Milne, D. L. (2014). Clinical supervision at the international crossroads: Current status and future directions. The Wiley International Handbook of Clinical Supervision, 673-691.

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