Challenges in Clinical Supervision: Mental Health Nursing Perspectives

This essay examines the challenges and misunderstandings surrounding clinical supervision in mental health nursing. It highlights that despite its importance, clinical supervision faces challenges with acceptance and implementation. The essay discusses the role of clinical supervision in developing nurses' knowledge and skills, improving patient care, and fostering a competent workforce. However, it points out that factors like workforce shortages, high workloads, and negative perceptions of supervision contribute to its misunderstanding. The essay also addresses the importance of interprofessional group work and the need for supportive environments. Ultimately, it emphasizes that a lack of understanding and effective implementation of clinical supervision can hinder its benefits, impacting the quality of care and patient outcomes. The essay references several studies and authors to support its claims, including Cleary, Horsfall & Happell (2010), Dilworth et al. (2013), and Snowdon, Leggat & Taylor (2017).

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CLINICAL SUPERVISION IN NURSING
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CLINICAL SUPERVISION IN NURSING
Despite of the discussion on implications of clinical supervision in the mental health
setting, evidences have shown that acute mental health settings continue to face challenges with
the acceptance of clinical supervision and the underlying implementation process (Cleary,
Horsfall & Happell, 2010). In the recent years, clinical supervision has been proved to be an
important component of psychiatry, mental health nursing and social work. Clinical supervision
is therefore considered to be an important factor for managing and maintaining an effective
mental health competent nursing workforce. However, the healthcare organizations have faced
significant challenges in this area since nursing workforce are found to be reluctant in pursuing
clinical supervision (Cleary, Horsfall & Happell, 2010).
Clinical supervision is an important aspect of delivering high quality care to the patients
enabling the nurses to develop their knowledge and skills through a process of continuous
research and learning with professional support and supervision with experienced colleague
(Snowdon, Leggat & Taylor, 2017). Although, recent evidences have shown that clinical
supervision has improved the quality of nursing care, it is not well established and often
misunderstood in the practice setting. Through the process of clinical supervision, it is possible
to improve the quality of practice in nurses by enriching the activity that aims to provide a forum
for shared knowledge and understanding on healthcare (Dilworth et al., 2013). According to the
authors, clinical supervision has the ability to develop more creative and innovative approaches
to healthcare through a shared expertise and experience (Dilworth et al., 2013). However, unless
clinical supervision is well understood and effectively implemented, expectations will not be met
(Cleary, Horsfall & Happell, 2010).

CLINICAL SUPERVISION IN NURSING
Evidences have shown that the healthcare professionals continuously struggles with
limited resources, a high demand for clinical supervision, workforce shortages, an increased
acuteness and patients complexity. Considering the same, it has been argued that clinical
supervisions may prevent the tension involving what is expected and what is achievable with
relevance to patient centered care, implementing the guidelines of clinical practice and utilizing
the researches in a healthcare environment which is highly evidence based. Such a diverse
expectation in this area has led to a lack of acknowledging the roles and benefits of clinical
supervisions (Dilworth et al., 2013).
Another important aspect identified in this area is the challenges faced in carrying out
interprofessional group work. Group work is believed to provoke anxiety among the nurses. Care
model brings together the skills and knowledge of the experts from a diverse discipline to
improve communication and integrate in their care strategies an effective and coordinated care
planning. Training and education among the healthcare professionals act as a bridge between
health disciplines with the help of interprofessional education and trainings (Dilworth et al.,
2013).
There are different approaches or models of care in different settings. In the mental
healthcare settings, it is primarily achieved through engagement and interaction of a nurse with
another Registered Nurses (RN). Clinical supervision can also be carried out by another member
within the group with similar profession providing opportunity to the workforce for reviewing
the professional standards, keeping updated with the developments in their profession and
identifying the needs of professional trainings and developmental needs and to ensure that they
are practicing by aligning with the professional codes of standards (Martin et al., 2015). On the

CLINICAL SUPERVISION IN NURSING
contrary, Clinical supervision is considered to be an important mechanism in the provision of
safe and high quality care. However, evidences have shown that clinical supervision is getting
challenging in this area, particularly, within the team for community mental health. This is likely
to increase since nurse staffing has become hard to sustain. As a result, nurses do not have
adequate time to give or receive clinical supervision due to an increasing workload (Cleary,
Horsfall & Happell, 2010). An ineffective group cohesion, nurse bullying, unsupportive
behaviors, burnout due to a huge work pressure and less nurse staffing, taking reviews and
feedbacks negatively contribute to misunderstanding of clinical supervision in practice. In
addition to this, lack of motivation in giving and receiving supervision and other related factors
act as barriers to deliver quality healthcare that improves health outcome of patients. Narrative
supervision is particularly appropriate for creating an open, inquiring and supportive culture.
However, every nurse does not take this in the same manner. To some nurses, seeking for
clinical supervision is a sign of weakness and they self-criticize themselves (Tomlinson, 2015).

CLINICAL SUPERVISION IN NURSING
References:
Cleary, M., Horsfall, J., &Happell, B. (2010). Establishing clinical supervision in acute mental
health inpatient units: acknowledging the challenges. Issues in Mental Health
Nursing, 31(8), 525-531.
Dilworth, S., Higgins, I., Parker, V., Kelly, B., & Turner, J. (2013). Finding a way forward: A
literature review on the current debates around clinical supervision. Contemporary
Nurse, 45(1), 22-32.
Martin, P., Kumar, S., Lizarondo, L., &VanErp, A. (2015). Enablers of and barriers to high
quality clinical supervision among occupational therapists across Queensland in
Australia: findings from a qualitative study. BMC health services research, 15(1), 413.
Snowdon, D. A., Leggat, S. G., & Taylor, N. F. (2017). Does clinical supervision of healthcare
professionals improve effectiveness of care and patient experience? A systematic
review. BMC health services research, 17(1), 786.
Tomlinson, J. (2015). Using clinical supervision to improve the quality and safety of patient
care: a response to Berwick and Francis. BMC medical education, 15(1), 103.