Conceptualising the Foundation of an Effective Clinical Supervision Cycle in Mental Health Nursing

Abstract

Clinical supervision is an activity that is interpreted widely in terms of its definition, purpose and its practical application to the practice of mental health nursing. Despite methodological limitations in research, in general terms the weight of evidence significantly supports the view that clinical supervision is effective. It is seen to enhance professional and personal development, provide support in the clinical workplace and consequently by direct and indirect means, facilitates improvement in the provision of care. This small study seeks to develop a greater understanding of the determinants of ‘effective’ clinical supervision from the perspective of the mental health nurse. A cohort of ten Registered Nurses working in a range of nursing positions within a large District Health Board Specialist Mental Health Service was interviewed utilising a semi structured interview format. The descriptive data generated from these interviews was interpreted using thematic analysis and coded into 22 sub-themes. These were the identified factors that participants believed impacted on the effectiveness of their clinical supervision. The sub-themes were organised via sub-thematic clusters into related groupings in most cases. Through an ongoing interpretative process, three over-arching themes emerged.

The themes were subject to a further stage of analysis which allowed synthesised core conceptual meanings to be interpreted and an over-arching framework for effective clinical supervision to be developed. The framework outlines two core requirements, the positive interpersonal relationship and the functional structure. They cumulatively create the working interface of clinical supervision, the effective supervisory environment, thereby fulfilling the essential foundational requirements for effective supervisory function. The consequence for the supervisee is that they are likely to achieve outcomes which are meaningful to them. This it is suggested will reinforce confidence in the interpersonal relationship and effectiveness of the supervisory structure, thus closing the circle and creating the effective clinical supervision cycle.