Psychologists are essentially more concerned with the study of the human mind. People need not subject their minds to dogmatism. Hence, issues that are akin to critical evaluation of human behaviors must be clear and concise. For this reason, consideration of supervision in the clinical context demands a clear definition of the application of supervision in the clinical setting, as well as a thorough evaluation of its relevance and scope.
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Definition of clinical Supervision is indeed essential to avoid illogical arguments on its role in fostering certain human behaviors within clinical facilities. This paper recognizes that clinical supervision fosters better therapy outcomes helping employees to build better clinical skills (Johns, 1993, p.56: Darley, 1995, p.23: Morrison, 2001, p.90: Stuart, 2004, p.12). In this context, ardent knowledge in clinical supervision in the nursing profession settings leads to an immense embracement of various multiple interests among nursing professionals often leading to better client welfare management (Heron, 2001) and security in the nursing profession (Fish & Twinn, 1997, p.54).
It also aids in promoting the well-being of the supervisee with the consequential repercussion of his or her improved professional development (Driscoll, 2000, p.33). Upon recognizing the benefits of competition in nursing supervision, the paper dedicates to defining clinical supervision, scrutinizing its importance in the contexts of the supervisee, supervisor, and the clients’ welfare. It then concludes by scrutinizing its scope.
Definition of clinical supervision
The term supervision concerning nursing practice attracts differing definitions. According to Powel and Brodsky (2004), supervision entails a disciplined tutorial process in which nursing principles become transformed into various practical skills in a spectrum of four foci: evaluative, supportive, clinical, and administrative (p.11). Scholars argue these four foci in practice as being overlapping. Hence, it is upon supervisors to derive a mechanism for their balance to attain the demands of the profession. On the other hand, Bernard and Goodyear see nursing supervision as interventions accorded to junior nursing staff or members by more senior nursing staff members who are experienced in the profession (2004, p.54). The relationship established between junior and senior members henceforth is predominantly evaluative.
It “extends over time, and has the simultaneous purposes of enhancing the professional functioning of the more junior person(s), monitoring the quality of professional services offered to the clients that she, he, or they see, and serving as a gatekeeper of those who are to enter the particular profession” (Bernard & Goodyear, 2004, p. 8). In this context, it is arguable that supervision, as defined by Bernard and Goodyear (2004), is ideally an extension of the description of the four foci argued by Powel and Brodsky (2004) as embracing all the concerns of supervision in nursing practice.
Butterworth and Woods (1998) reckon supervision as “an exchange between practicing professionals to enable the development of professional skills” (p.3). This rather provides a more precise definition of supervision. From this definition, supervision does not only entail administrative roles but rather constitutes a process of social influence, which takes place over time. In the due course of this time, supervisors proactively participate with the team of supervisees to enhance the delivery of quality clinical care to the clients (Horton, 1993, p.92). There are three types of supervision: line managerial, professional support, and professional standards teaching or rather monitoring (Fowler, 1996, p.18).
Consideration of the demands of various nursing professional bodies in respect to the achievement of requirements of these three types of supervision makes it apparent that supervision is not a choice but the only option in some disciplines. For instance, “the Healthcare Commission Standards for Better Health, Core Standard C5b (9) requires that clinical care and treatment are carried out under careful supervision and leadership” (Bernard & Goodyear, 2004, p.43). Moreover, some disciplines’ standards maintain that supervision is mandatory. Such disciplines include art therapists, counselors, and even psychologists. The rationales behind making supervision mandatory perhaps warrant the introspection of its importance and its scope, which is the concern of the next sections.
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Importance of clinical supervision
For many past decades, a myriad of professions including nursing has predominantly depended on seniors colleagues to help and guide non-experienced professionals to maneuver through their new crafts. In this regard, supervision incredibly aids in fostering the professional development of the junior staff. Consequently, organizations become better equipped to achieve their noble roles of delivering quality care to their patients coupled with the improvement of the wellbeing of its most valuable resource: its personnel. Those accorded the responsibilities of supervision oversee various clinical functionalities under implementation.
Since such functions have ethical and legal consequences in terms of how healthcare is delivered to the clients, the supervision arm serves as the mitigating force against the emergence of conflicts of interest. In this regard, supervision is principal in the achievement of quests to enhance counselors’ professional developments and sustenance of health programs procedures and policies (Gibson, Swartz & Sandenbergh, 2003, p.34). Essentially, clinical supervision permits registered nurses to acquire professional supervision within their workplaces through skilled supervisors. Stuart (2004) upholders this importance of clinical supervision and further adds that it aids in knowledge and skills development among midwives and nurses; something that results in improved health care among the public (p.39).
Ideally, clinical supervision enhances improved healthcare in the public domain because it helps in the identification of problems and their solutions. It enhances understanding of myriads of issues within the nursing profession and practices, and more importantly, enhances care delivery to the patients.
Clinical supervision constitutes a central element in clinical programs. This means that it helps in the development of requisite knowledge for activities of an organization helping in the integration of clinical aims, mission and treatment philosophies, evidence-based appropriate practices, clinical theories, and goals of clinical organizations. According to Tingle (1995), clinical supervision also aids in promoting and enhancement of hiked staff morale and hence their retention (p.793). Clinical supervision forms “…the crucible in which various ethical practices are developed and further reinforced” (Dewar & Walker, 1999, p.1459).
This means that clinical supervisors model cute and sound legal and ethical practices, which they include in the supervisor-supervisee relationship. This provides incredible platforms for addressing ethical challenges that might arise in the supervisees’ due long journey in the professional nursing practice. The overall repercussion is thus a translation of ethical practices into a set of appropriate nursing practice behaviors. This behavior goes handy in helping the supervisees to counter new ethical challenges likely to arise in their profession.
Scope of clinical supervision
As a clinical supervisor, a person carries an immense umbrella of responsibilities to ensure that best clinical practices are observed. From one end, the supervisor facilitates the integration of the supervisees’ self-awareness, clinical knowledge development, skills development, theatrical grounding, and professional practices and functions. The scope of clinical supervision roles, more often than not overlap with the supervisory relationship contexts. This implies that clinical supervisors occupy a unique position within the clinical facility settings as a counselor, mentors, agency advocates, and an advocate of the clients.
Arguably, therefore, a clinical supervisor is a teacher in many aspects. This is evidenced by the fact that the supervisor “assists in the development of supervisee’s knowledge and skills by identifying learning needs, determining supervisees’ strengths, promoting self-awareness, and transmitting knowledge for practical use and professional growth” (Dewar & Walker, 1999, p.1459). Essentially, the scope of clinical supervision considers a supervisor as being the foundational link between staff members in the front line and the administration (Scanlon & Weir, 1997).
This scope is achieved through ensuring subtle interpretation and surveillance of agency goals, procedures, and policies compliance. The supervisor also acts as the bridge through which the supervisee and client’s needs are articulated with those of the administration. It is also within the sphere of the scope of the supervisor’s roles to ensure that feedback is provided to the supervisees once he or she has tabled their needs before the administration. Precisely, therefore, the supervisor is the medium for up-to-down and down-to-up communication process with a clinical facility.
The scope of a professional’s clinical supervisor also embraces the enhancement of the clinical supervision process. In this context, the supervisor plays critical roles in the maintenance of supervision register, supervision partnerships establishments, and as an engineer of supervision sessions agendas (Power, 1999, pp. 6-7). In this context, the scope of professional supervision embraces prioritization of various supervision sessions coupled with maintenance of their reliability, setting of time boundaries, balancing of supervisee responsibilities to those of patients and patients trust, ensuring that supervisees stick to the accepted professional’s codes of ethics and support commitments, and making an appropriate judgmental decision on the performance of the supervisees.
Given that the nursing employees within clinical facilities deal with strenuous activities, the scope of clinical supervision pays incredible concerns to burnout management. Consequently, within the scope of clinical supervision, supervisors have an immense responsibility to help supervisees in the identification of situations that lead to stress coupled with helping them on how to handle such a situation in a manner that is consistent with the main aim of clinical supervision profession: better health care delivery to the clients. The supervisor’s scope goes the extra mile to incorporate strategies of training supervisees on likely indicators of primary stress, secondary trauma, vicarious trauma, compassion fatigue, and burnout (Pålsson, Hallberg, Norberg & Bjorvell, 1996, p.102).
Indeed, this is achievable through teaching staff the need to embrace positive work habits. Embracing positive work habits helps by far in reduction of daily wear and improvement of clinical staff mental health (Scaife, 2001, p.45). Daily wear has a high probability of eroding the well-being of the staff; a situation that leads to burnout. Responsiveness of the staff to mitigation strategies of dealing with the strenuous situation is arguably dependent on their ability to inculcate the spirit of emotional resilience. The scope of supervisor indeed engulfs this noble challenge.
Stemming from the above discussions, the scope of a clinical supervisor entails training, monitoring, and controlling the process of inculcating best nursing practices among the new entrants in the profession. The capacity of the supervisor to achieve such a scope precisely is evident based on the supervisee’s experiences on supervision (Taylor, 2010, p.32). For instance, a response by a supervisee that the supervisor allows him or her to learn and think about certain things without pressure is an indicator of the supervisor’s compliance to the best supervisory practices.
Where the supervisees report on the supervisors capacity to affirm the supervisees’ communication abilities, appreciation of such abilities, and willingness of the supervisor to listen to the supervisees points of view, it is evident that the supervisor is effective in precisely achieving the requisite roles falling within his or her scope of work. Indeed, this reflects best practices in professional nursing supervision.
In the paper, supervision has been discussed as a critical area in nursing practice that is deemed as an essential ingredient for consideration in the training of therapists,’ psychologists’ and counselors’. Amid many valid definitions of clinical supervision, the paper held that clinical supervision is “an exchange between practicing professionals to enable the development of professional skills” (Butterworth and Woods, 1998, p.3). In this context, the paper argued out that the interrelationships between supervisors and supervisees, lead to inculcation and development of appropriate behaviors that lead to improvement of the clients’ welfare.
Development of human behaviors is, in particular, a critical area of concern in psychology with the sub-discipline of behavioral psychology reserved to look into it. Having shown in the paper that clinical supervision leads to the development of appropriate behaviors among clinical professionals, it becomes a relevant area for consideration by behavioral psychologists. It is in this regard that the paper has ardently scrutinized both the importance and the scope of professional nursing supervision.
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