Clinical Supervision for Nurses - Essay Example

Clinical supervision may mean different things to different people; as such, no single definition can be used to refer to the term. In the practice of Nursing, the term refers to a form of intervention provided to a junior member of the profession by a senior member of the same profession. Thus, the relationship between the supervisor and the supervisee can be termed as evaluative. This essay seeks to explore the application of clinical supervision in Nursing. More specifically, the essay will focus on the appropriate model that a clinical supervisor can use with a supervisee, who has had a promotion to an E grade Nurse. In addition, the essay will focus on using the model to assist the nurse cope with challenges of the new grade. According to Johns (2003), Clinical supervision serves to enhance professional functioning of the junior members under the supervision; the supervisors monitor the quality of services given to patients. Supervision also creates an environment that promotes creativity in supervisees; this supports them so that they have the ability to face patients confidently. As Benfer (1979) asserts, during clinical supervision, as a clinical supervisor, I will assess the work of the nurse and give her guidelines on how to best deals with patients. Bernard and Good year claim that clinical supervision is similar to training in that it involves a formal process of learning and professional support, which enables the supervisees to develop competence and knowledge in their profession. Because of clinical supervision, nurses identify room for improving their nursing practice (Bernard & Goodyear 1998). Falender& Shafranske (2004) argue that a variety of approaches and models can be applied in clinical supervision; in order to assist nurses faced with difficulties. McDaniel, Weber, & McKeever (1983) assert that clinical supervisors often apply various models when training nurses and other supervisees. The most common models of clinical supervision include the developmental model, key issue model, functions model, and process model. As a Clinical supervisor, I would use these models to serve the nurse facing challenges, in her profession. Based on this, the various models of supervision can be used when the training needs of the supervisees vary from one supervisee to another. In training the nurse, who has difficulties in dealing with patients, I would use the developmental model (Benfer 1979). The developmental model proposes that the trainees pass through several stages, which both the supervisors and the supervisees have to take into account. Using this model, I would train the supervisee to cope with the challenges, resulting from complexity of duties (Johns 2003). Therefore, as a clinical supervisor, I would apply this model to train the nurse, who has had a promotion to grade E. A nurse who has been promoted to a higher level needs to develop the necessary skills required to perform better in the new position. Promotions come with additional responsibilities in one’s profession. Based on this, I would train the nurse how to deal with the additional responsibilities in the new and busy ward (Bernard & Goodyear 1998 p60). Deaths mean that the supervisee has to face the reality of the expectations in the new position, as a grade E nurse. Being assigned newer duties means that the nurse will be experiencing what she was never used to before she got the promotion. Therefore, I would teach her to learn and integrate the expectations of her new position (Gallon 2002, p.17). As a supervisor, I would train her not to get worried by the deaths, and cancer in the ward. Using the model, I would teach her to grow in her profession. Based on this, I would make her learn to accept that the challenges serve to make her develop in her career (Falender. & Shafranske 2004). Therefore, I would tell her not get extremely worried by frequents deaths and cancer, in the new ward. Besides, in the nursing profession, one cannot evade such experiences. Thus, I would encourage her to develop courage, which will enable her to cope with the new experiences. Bernard & Goodyear (1998, p.66) asserts that this model of supervision purports that the supervisee may find themselves depending on the supervisors; to help in administering therapy to patients. Initially, the supervisee may highly depend on the supervisor, who will help them develop plans of action, necessary to address the patient’s problems. According to Gallon (2002, p.17), this also applies to nurses; they may have difficulties in concentrating on their roles and develop the fear about their newly assigned duties. The nurse, who has been promoted to grade E, has difficulties in focusing, is concerned, and anxious about her role as a grade E nurse. While using this model, I would teach the nurse to focus on her duties; through teaching her to perform the new roles perfectly. In addition, I would teach her to change from being dependent on the supervisors to gain autonomy in doing her work (Stoltenberg & Delworth 1987, p.24). According to McDaniel, Weber & McKeever (1983, p.30), supervisees should be trained to be less anxious, while doing their work. Based on this, I would teach her the need to gain confidence with her work. As a clinical supervisor, I would also teach the nurse how to conceptualize her newly assigned roles. As Stoltenberg & Delworth (1987, p.25) claims, I would do this through training her on the skills needed to perform her duties as a grade E nurse. Additionally, I would teach her to learn about the roles of the new position, so that she can gain professional expertise in being a grade E nurse. In doing so, she will perform duties with a lot of certainty. I would also urge her to consult her supervisors, since they have adequate experience. Therefore, it could be appropriate that the nurse asks the clinical supervisor how to deal with patients, in instances when they face difficulties in understanding their duties. According to Benfer (1979, p.35), the developmental model of clinical supervision can be used to teach teamwork among nurses. Being the clinical supervisor, I would apply the model in teaching the nurse how to develop teamwork skills and organize her team properly. The integrated developmental model emphasizes on the need to teach the supervisees the need for competence and maturity in their profession. Therefore, by using the model, I would teach the nurse how to organize her team of nurses. This can be done through teaching the nurse to assign duties to the members of her team; the supervisor helps the nurse to determine the roles to be played by the members of her team (Dunn & Burnett 1995, p.65). I would her how to organize her team of nurses on what they should do, and how to assist each other within the team. Johns (2003) claims that supervisors often use this model to assess the needs of the supervisees; they realize what the trainees need to know in the process of learning. The model aims at enhancing development in the supervisee; so that the supervisor teaches them what they do not know, or the skills they need to know. As Gallon (2002, p.18) notes, I would emphasize the need for teamwork among the nurses, teach her to supervise the team of nurses, and identify weaknesses in the team. I would teach her to develop a training manual, based on the weakness, which will assist in teaching the nurses working as a team. In addition, the supervisor should teach the nurse how to evaluate progress in the team. I would urge her to evaluate progress through checking whether the team members have delivered the services in accordance with the set goals (Gallon 2002, p.20). Dunn & Burnett (1995, p.67) asserts that the developmental model of clinical supervision holds that the supervisees should adhere to the professional requirements, values, and code of ethics. As such, nurses should not give preferential treatment to patients, and they should act professionally when dealing with clients. According to this model, the supervisees should empathize with the clients, but they should also balance the relationship with the clients. Wong & Wong (1987, p.40) notes that nurses should strictly adhere to the rule of their profession and avoid relying on their own judgment in treating patients. On this regard, therefore, I would teach the nurse to adhere to the professional code of conduct. Additionally, I would teach her to avoid being guided by emotions in their work, and instead, do their work as professionals. Although the practice, of nursing places strong emphasis on the role of empathy, I would tell her that she does not need not go to the extent of being carried away by the patients’ problems (Wong & Wong 1987, p.40). Worthington (1987, p.54) argues that the integrated model of clinical supervision can be used to teach nurses the individual differences of the patients they encounter. As the clinical supervisor, I will teach the nurse that patients have varying problems; therefore, they should be treated differently. The nurse should avoid being judgmental when relating with the patients; she should treat al patients equally, without favoring some, and discriminating against others. Clinical supervisors should train nurses to avoid engaging in behavior that can lead to disagreement with fellow colleagues. The nurse should also give patients the required therapy, which should not be based on sympathizing with the client (Falender, & Shafranske 2004). As a clinical supervisor, I will teach the nurse that she should avoid treating patients favorably because they face problems similar to those of her own family members. The relationship between the nurse and patients should be instrumental to allow for professional development in the supervisee (Worthington 1987, p.57). According to Wong & Wong (1987, p.42), supervisees should understand the consequences of their own reactions and responses to their profession. Therefore, I would teach the nurse not feel that her new roles pertain supervision and overseeing others; she should also do bed bathing. I would tell her that when she gets involved in bed bathing, the other members of her team will also be encouraged to perform their duties. This is because the nurse will motivate her teammates, because they observe their leader doing similar work to theirs (Dunn & Burnett 1995, p.70). Supervisees should learn to get involved in activities carried out by their juniors. I would tell her that this promotes integration within the team; besides, the nurse should teach her team members their responsibilities by doing what they do. She can delegate the duties of bed bathing previous patient to other nurses. Though the patient was grateful, it does not mean that only one nurse should be treating her all the time. Thus, I would urge her that other colleagues should also be allowed to do the same, because they have similar training with her (Worthington 1987, p.60). In conclusion, this essay has discussed the developmental approach in clinical supervision. The essay describes the application of the model in training a nurse who has been promoted to a new grade and faces some challenges while performing her duties. The model is appropriate because it enhances autonomy in the supervisee and allows her to deal with anxiety. In addition, the use of this model will ensure that the nurse learns to cope with the challenges in the best way possible. References Benfer, BA 1979, ‘Clinical Supervision as a Support System for the Caregiver’, Perspectives in Psychiatric Care, Vol.17, No 1. Bernard, JM and Goodyear, RG 1998, ‘Fundamentals of Clinical Supervision’, Allyn & Bacon,  Boston. Dunn, SV & Burnett, P 1995, The development of a clinical learning environment scale, Journal of Advanced Nursing 1995, 22:1166-1173 Falender, CA & Shafranske, EP 2004, Clinical supervision: A competency based approach. Washington, D.C, American Psychological association. Gallon, S 2002, Clinical supervision training manual. Portland,Northwest frontier ATTC, Johns, C 2003, Clinical supervision as a model for clinical leadership. Journal of Nursing Management 2003, 11:25-34. McDaniel, S, Weber, T & McKeever, J 1983, Multiple theoretical approaches to supervision Choices in family therapy training. Family Process, 22, 491-500. Stoltenberg, C D & Delworth, U 1987, Supervising counselors and therapists. San Francisco, CA, Jossey-Bass. 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