In the fourth of a series of articles about advancing one's nursing practice, Fowler talks about clinical supervision. Clinical supervision has the potential to transform nursing practice and enhance ...advanced practice. Although the principles of clinical supervision are simple, its implementation is more difficult. It requires time, commitment, openness to self reflection, admission of areas of weakness and a wiliness to develop and grow. The implementation of clinical supervision can take many forms, depending on the experience and needs of the practitioner. A junior staff nurse who wants to advance his or her practice with the aim of developing as a specialist nurse in a particular clinical area will need to focus on clinical skills, while a senior staff nurse wanting to progress to a charge nurse will be focusing on leadership and management skills. A specialist nurse who is undertaking the nurse prescribing course will have supervision from a medical prescriber and focus on prescribing knowledge and practice. Aspiring consultant nurses will probably seek supervision from a medical consultant.
TWO REPORTS on midwifery regulation, one by the parliamentary and health service ombudsman (PHSO 2013) and the other by the King’s Fund (2015), have brought into question how midwifery in the UK is ...supervised.
This paper argues that the process of making significant moves towards a patient safety culture requires changes in healthcare education. Improvements in patient safety are a shared international ...priority as too many errors and other forms of unnecessary harm are currently occurring in the process of caring for and treating patients. A description of the patient safety agenda is given followed by a brief analysis of human factors theory and its use in other safety critical industries, most notably aviation. The all too common problem of drug administration errors is used to illustrate the relevance of human factors theory to healthcare education with specific mention made of the Human Factors Analysis and Classification System (HFACS).
Students may be ‘buddied’ with registered nurses during their clinical experience since the designated clinical facilitator cannot be available for each student at all times. Little is known about ...the way registered nurses understand this informal role.
The rationale for this study was to gain an insight of the variation of understanding registered nurses have of their role with students, and explored the qualitatively different ways registered nurses perceive their role with students on clinical experience and the implications of this understanding for student learning.
A phenomenographic approach was used to identify the variation of understanding and meaning of the role of the registered nurse with students on clinical practice from the perspective of the registered nurse. Phenomenography is a field of descriptive research concerned with the variation in ways people experience and understand similar phenomena.
A purposive sample of 30 registered nurses from 15 public and private hospitals in central and south eastern Queensland, Australia.
Individual semi-structured interviews from a final sample of 28 interviews were analysed to identify Categories of Description.
Eight variations of understanding registered nurses have of their informal role with students were identified. The registered nurses’ understanding varies from a focus that is ‘student-centred’, to ‘completion of workload-centred’, to ‘registered nurse control’, to a preference for no contact with students. As a consequence some students may have positive learning experiences while others will have limited learning opportunities.
The research highlights the varied ways registered nurses understand their role with students that may promote or impede the quality of student learning and development to meet professional competency standards. Formal recognition of the complexity of the registered nurse role by health care agencies and tertiary education providers is essential to ensure registered nurses have adequate preparation for their role with students.
In a practice environment characterised by diversity and unpredictability, the role of rural nurses is described as challenging. Developing strategies to support rural nurses is important, for ...recruitment and retention, and to ensure that nurses provide quality services for rural communities. Most researchers recommend ongoing education as almost a panacea to the challenges that rural nurses face. In this Australian study, there was interest in exploring the potential for clinical supervision as a mechanism for supporting rural nurses. Clinical supervision has been identified as a useful means of reflecting on practice, building resilience, reducing stress and avoiding burnout. A six month clinical supervision programme was developed and implemented with twenty two rural nurses. Using an interpretive descriptive design, a group discussion on participant views of the programme was conducted. Using a thematic network approach, three themes; becoming reflective, understanding and commitment, and losing the client were developed. While in no way devaluing the usefulness of clinical supervision, the findings from this study provide guidance for others introducing similar programmes and indicate that clinical supervision must be focused, well planned and supported.
The study describes the representations of nursing graduate, by professionals involved in their socialization work. The study is a qualitative one. A convenience sample of 19 individuals was set up, ...graduate nurses (10), head nurses (6) and nurses’ manager (3)were interviewed. A semi structured interviewed was carried out. aimed at investigate their own beliefs about relational competence, technical-operational and organizational skills, desired and held by graduates. The interviews were audio recorded and transcribed. The corpus was analyzed using appropriate software, comparing the three roles involved with respect to the three areas of expertise. Results show a lack of relational competences and emotional control by Graduates both with colleagues and patients. In addition to this, an overall reluctance of established teams to adopt new working methods and graduate competences too focused on theory. The results with respect to competences highlight the need to strength the training with respect to care and relationship with patients for recent graduate, the difficulty of management to set up technical and operational innovations, the need for an interactional approach of the three professional profiles. The study proposes actions aimed at a better graduates’ social and professional integration using the contributions of professionals directly involved in the organization. Furthermore positive action were suggested both during university studies and within organizational contexts in nursing profession.
Workplace bullying is a serious problem affecting nursing. Abusive workplaces result in lack of job satisfaction, poor retention, and adverse patient outcomes. The purpose of this article is to ...present the history of this problem in nursing and offer potential solutions.
Aim To report a literature study of leadership for learning in clinical practice in the United Kingdom.
Background Previous research in the United Kingdom showed that the ward sister was central to ...creating a positive learning environment for student nurses. Since the 1990s, the ward mentor has emerged as the key to student nurses’ learning in the United Kingdom.
Methods A literature study of new leadership roles and their influence on student nurse learning (restricted to the United Kingdom) which includes an analysis of ten qualitative interviews with stakeholders in higher education in the United Kingdom undertaken as part of the literature study.
Results Learning in clinical placements is led by practice teaching roles such as mentors, clinical practice facilitators and practice educators rather than new leadership roles. However, workforce changes in clinical placements has restricted the opportunities for trained nurses to role model caring activities for student nurses and university based lecturers are increasingly distant from clinical practice.
Conclusions and implications for practice Leadership for learning in clinical practice poses three unresolved questions for nurse managers, practitioners and educators – what is nursing, what should student nurses learn and from whom?
Implications for nursing management Leadership for student nurse learning has passed to new learning and teaching roles with Trusts and away from nursing managers. This has implications for workforce planning and role modelling within the profession.
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