Clinical Supervision in Mental Care - Essay Example

? Clinical Supervision in Mental Care Number Clinical Supervision in Mental Care Clinical supervision refers to an oversight that is provided by senior clinicians to junior members of the same occupation for purposes of improving the standard of care given to patients (Sloan, 2006). The relationship between senior and junior officers is basically a permanent, evaluative program which is aimed at enhancing the implementation of expertise in the operations of the inexperienced members of staff. In a mental facility, clinical supervision’s main purpose is to uphold the value of the professional services by transforming psychiatric facilities in to better governed safe havens that facilitate the quick recovery of clients . For better treatment outcomes, the positive change should be crafted in model of national professional bodies for care providers (Bryant, 2010). A better governed facility therefore should be one that is motivating to work in, and removes apportionment of blame and has an enlightening environment (Edwards, Cooper, Burnard, Hanningam, Adams, Fothergill, & Coyle, 2005). It should support a learning culture in the sense that people base their learning upon experience; enjoy unlimited access to relevant information; and permits coordination among people from all levels hierarchies and departments of the care facility. Clinical supervision should also be motivational to staff through rewards, and career development opportunities to improve better administration and quality of services. Nonetheless, clinical supervision based on traditional, tested processes threatens new governance strategies and innovations aimed at improving patient care in mental care facilities. This paper critically evaluates the role of clinical supervision as a governance strategy designed to support safe and effective mental health care. Clinical supervision as governance strategy Whereas there has been an increasing interest in setting a causal link between clinical supervision of nurses and greater benefits on mental health patients, the debate remains continues (Sloan, 2006). Supervision provides a coordinated approach to clinical practice and an opportunity to participate in a preceptored reflection of work, as far as patient safety is concerned (Edwards et al, 2005). Clinical supervision is intended to nurture and facilitate best practices in future, in relation to continuing professional link between a preceptee and a preceptor. According to Fuller, Perkins, Parker, Holdsworth, Kelly, Roberts, Martinez, and Fragar (2011), international interest in clinical supervision among mental health nurses has increased over the past two decades, with the focus of most researchers being corroborating the authenticity of findings. In general, mental health nurses, especially in the West were the first to adopt the practice but, with modest gains arguably stretching to the current world (Bryant, 2010). Nonetheless, clinical supervision in a mental care facility has been attributed to three main positive outcomes: firstly, there has been a greater degree of self-esteem, impetus, job satisfaction, more skills and expertise, greater personal and career development of nurses (Coldridge, 2012). Secondly, clinical supervision has witnessed better standards care, and more effective interdisciplinary communication which generally, guarantee them a safer treatment environment (Sloan, 2006). Finally, clinical supervision improves governance in a mental health facility by limiting absenteeism among nurses and turnover rates, as they are guaranteed an exciting working environment where they can apply their innovativeness in response to different mental cases they handle (Edwards et al, 2005). According to Coldridge (2012) support within organizations can be rendered through clinical supervision that integrates reflective practice, provides room for continuous training and learning as well as deliver a proper assessment various strategies for the practitioners. Moreover, clinical supervision provides opportunities to audit and use the outcomes for networking various departments such those in charge of diagnosis, treatment and disorder management for the mentally ill for purposes of enhancing their safety and quick recovery (Sloan, 2006). Bryant (2010) argues that this would create an enabling environment where clinical supervision is viewed as part of clinical governance, based on individual nurses and their role within the organizational system.   Although several strategies for providing supervision have been developed, practically this is normally achieved by lean groups of half a dozen practitioners attending an organized meeting with a qualified supervisor for about one hour daily throughout the month (Edwards et al, 2005). According to Coldridge (2012), focus on supervision has increased with more concerns being raised about the level of supervision and preparation for mental care providers. Nonetheless, the concerns being raised are associated with the likelihood of more limited freedom and treatment options in mental health care facilities (Bryant, 2010). Improved clinician-patient relationship Clinical supervision lowers high levels of emotional burnout which are usually associated with the provision of mental health care (Sloan, 2006). It also solves the unpredictable nature of patients and minimal support which nurses enjoy in such facilities (Fuller et al, 2011). In light of this, there is a causal link between the challenges that mental nurses register and the alleged advantages of supervision (Edwards et al, 2005). Clinical supervision arguably creates and or facilitates an atmosphere that allows for the growth of spontaneity and innovativeness in the supervisees that will enable them to weather various impasses encountered when attending to the mentally ill; for instance, locking up some extreme cases in isolated rooms in some instances to uphold their safety within the facility, and helping them with personal grooming. Supervision enables participants to have the ability to tend to the various health risks facing the mental health patients with a greater sense of confidence (Fuller et al, 2011). Clinical supervision arguably improves the relationship between nurses handling the mentally ill and their clients (Sloan, 2006). It creates a positive, courteous and non-prejudicial environment for the patients, hence they safety and quick recovery. Through a collegial approach to care, the supervisee is given adequate room to conceptualize and implement the best practices for patient care on an individual basis. In light of this, supervision enhances the level of consciousness within the nurses in relation to their immediate environment and of those values of the individuality that are involved in this rapport (Gask, Rogers, Campbell, & Sheaff, 2008; Wright, 2012). Edwards et al (2005) argue that improved understanding limits anxiety within the health care facility, which in turn evokes more spontaneity. Creativity and innovativeness in the care for mentally ill patients brings about the exploration of more effective therapeutic interventions, while preserving patient and nurse autonomy (Bryant, 2010). By contrast, whereas the most important aspect of good supervision lies in the relationship within a health care facility, striking the balance between proper supervision which allows room for creativity and high-handedness is often hard to achieve (Fuller et al, 2011). Regardless, within this association lies the likelihood of reflection, ushering in the development of greater appreciation and responses to the therapeutic interventions. Such an environment recreates and facilitates the evolution of the client condition from that of misery based on respect and professionalism (Sloan, 2006). Conversely, it is arguable that reflection which occasions more understanding demands stoicism; a readiness to work at a slower pace and explore unique treatment options for individual patients; and living with not knowing the eventual outcomes (Wright, 2012). These pitfalls hamper the realization of various treatment objectives. Supervision in Nursing Practice Clinical supervision is complex in nursing care. Coldridge (2012) argues that whereas it is apparent that clinical supervision in psychotherapy is based on the unique needs of clients and the association between the patients and supervisees, in mental care nursing the parameters within which to work are not as defined, perhaps due to the unpredictable cases that need care. The nurses work in an entirely different atmosphere where collegial and specialist relationships have a great bearing on the client. According to Fuller et al (2011), nurses are rarely in charge of the mental patient care, since most of them are locked up in isolated rooms for the better part of the day. The challenges attributed to clinical supervision in such facilities can be attributed to somewhat unique nursing practices (Bryant, 2010). In every clinical workplace setting, for instance, there are workmates to whom the buck stops as the shift runs out. There are supervisors whose duties are broader and whose approach to work may be different from their supervisees. Moreover, there are psychiatrists who are in charge of the overall operations and who due to their work-related anxiety may be too rigid to tolerate divergent opinion with regards to the treatment processes for the mentally ill (Sloan, & Grant, 2012). Yet there are participants within the healthcare environment who have their unique ways of adjusting to the challenging environment of a mental health facility (Sloan, 2006). In light of these differences, the best care for the clients can only be achieved in an environment where cordial relationships between all care providers exist. However, achieving such a harmony is normally a tall order, considering the different approaches to care by various segments of service providers, which sometimes degenerate into paternalistic tendencies and overlapping roles among care providers.   All of these pitfalls boil down to the point that maybe clinical supervision in mental health care nursing should factor in deeper elements of care than those which feature in other forms of care (Edwards et al, 2005). Negative feelings of clinicians to their mandate, problems with the administration and managerial competence, and negative responses toward claimed arrogance of psychiatrists and nurses have limited the positive outcomes of respectful, coordinated care in several teams (Coldridge, 2012). According to Coldridge (2012), clinical supervision could hamper genuine coordination in mental care providers, which will affect the recovery of the patients. Nurse supervision in mental care facilities are arguably lifesavers. This means nurses are charged with the responsibility of exploring remedies which are more viable that outdated forms of disorder management, which often present challenges when applied to alleviate current problems (Gask, Rogers, Campbell, & Sheaff, 2008). Whereas overly more room to facilitate innovativeness and creativity could result in the enforcement of new, untested interventions, burnout is often solved with good supervision of the nurses (Sloan, 2006). Too much exhaustion to the degree where the operations of the nurses are barely standard and clearly not enlivening may be risky to patients in mental health facilities. According to Chidarikire (2012), when clinicians are exposed to the same interventions over a long period of time with regards to handling patients with mental disorders, they tend to face a scenario where the imagination of handling tomorrow’s challenges in the same facility becomes more serious than they one can withstand. This is normally the impact of human responses to the workplace environment (Severinsson, & Severinson, 1998). By contrast, supervision provides the chance to explore the invention and nurturing of new and more important responses to the environment, to workmates and especially to the patients within the mental care who are in urgent need of recovery from psychiatric disorders (Sloan, 2006). However, different facilities have different organizational cultures, which could affect the implementation of various treatment options on patients. Regardless of the pitfalls, the discovery of resources that are clinically important and yet previously unexplored is a captivating outcome of clinical supervision (Cohen, 2003). It builds a unique sense of contentment which eliminates anxiety and enables the supervisee to ooze with feelings of practicability in the wake of debilitating challenges. Greater happiness and innovativeness dominate as positive responses and come out fully in the minds of nurses working in mental care units. As a consequence, difficulties fade away as the supervisees welcome the new way of practice (Sloan, 2006). They then recollect in this moment the impetus that once dominated the theoretical aspect of their training, making them ready to offer quality services to their client with greater assurance and skill for better governance of the health care services. Conclusion Effective supervision generates positive results for both mental care cases and the nurse. For the clients it will create a relationship build on genuine commitment to their wellbeing. Such a rapport therefore provides a new sense of safety, and promotes a quicker recovery based on innovative interventions. Through supervision, nurse practitioners will begin to capitalize on other vital relationships, which place the patient at the center of treatment and disease management for better health. Such remedies may be bolstered by domestic clues, friends or other persons within clinical practice. Clinical governance as a strategy which stems from clinical supervision offers an opportunity for continuous quality improvement, and learning. It also supports continuous professional growth which in turn reinforces clinical supervision. To improve quality of care for mental health patients and provide constant learning for their nurses, organizations can only be successful if they provide staff with the necessary support, resources and opportunity to reassess their encounters with such patients. Although, nurturing clinical supervision strategy as an important aspect of clinical governance will guarantee various stakeholders within a mental health facility an opportunity to weather unique challenges in care through reflection, the improvement of the standard of care often depend on the nature of supervision. Good supervision creates an environment of collaboration and innovativeness for purposes of providing quality mental care. References Bryant, L. (2010). Clinical supervision. Practice Nurse, 39(12), 36-41. Chidarikire, S. (2012). Spirituality: The neglected dimension of holistic mental health care. Advances in Mental Health, 10(3), 298-302. Cohen, J.A. (2003). Managed Care and the Evolving Role of the Clinical Social Worker in Mental Health. Social Work, 48(1), 34-43. Coldridge, L. (2012). Reliable witnessing in supervision. Healthcare Counselling & Psychotherapy Journal, 12(1), 11-15. Edwards, D., Cooper, L., Burnard, P., Hanningam, B., Adams, J., Fothergill, A., & Coyle, D. (2005). Factors influencing the effectiveness of clinical supervision. Journal of Psychiatric & Mental Health Nursing, 12(4), 405-414. Fuller, J.D., Perkins, D., Parker, S., Holdsworth, L., Kelly, B., Roberts, R., Martinez, L., & Fragar, L. (2011). Effectiveness of service linkages in primary mental health care: a narrative review part 1. BMC Health Services Research, 11(1), 72-82. Gask, L., Rogers, A., Campbell, S., & Sheaff, R. (2008). Beyond the limits of clinical governance? The case of mental health in English primary care. BMC Health Services Research, 8, 1-10. Severinsson, E.I., & Severinson, E. (1998). Bridging the gap between theory and practice: a supervision programme for nursing students. Journal of Advanced Nursing, 27(6), 1269- 1277. Sloan, G. (2006). Clinical Supervision in Mental Health Nursing. New York: John Wiley & Sons. Sloan, G., & Grant, A. (2012). A rationale for a clinical supervision database for mental health nursing in the UK. Journal of Psychiatric & Mental Health Nursing, 19(5), 466-473. Wright, J. (2012). Clinical supervision: a review of the evidence base. Nursing Standard, 27(3), 44-49. Read More