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Srinivasan A
CS is highlighted item on nursing agenda
since (1980)
CS has been described as a formal
arrangement that bring nurses to discuss
their practice regularly with another
experienced professional.
CS is an interpersonal process whereby a
skilled practitioner helps a less skilled or
experienced practitioner to achieve
professional abilities appropriate to their
role, (Barber &Norman, 1987)
CS is a formal process of professional support
and learning which enables practitioners to
develop knowledge and competence, assume
responsibility for their own practice and
enhance consumer protection and the safety
of careits central to the process of
learning encourage self assessment,
analytical and reflective skills. (NHS, 1993 ).
CS brings practitioners and skilled supervisor
together to reflect on practice. Supervision
aims to identify solution to problems, improve
practice and increase understanding of
professional issues. (UKCC position statement,1996).
CS aims
CS is a formal support system that aim :
Steered reflection in practice.
Provide support to avoid mistake
Create an environment where good
practice can challenged, developed,
and improved,
Enhance positive and healthy working
Components of CS
CS require three main components:
Infrastructure; the administrative
foundation that allows work based learning
Relevant experience which provide
opportunity to enhance individual skills
through exposure to learning opportunity.
Learning culture; the value that the
organization and people within place
engaging learning for growth and
Function of CS
There are three main function of CS (Proctor 1986).
Formative; is the educative process of
developing the skills, understanding and
abilities of practitioners.
Restorative; is about supporting the
practitioner to adopt their copping skills, in
relation to the varying levels of stress
within the clinical setting.
Normative; is where the practitioner looks
at the quality of his work and how this fits
within the standards.
Potential benefits of CS
Personnel development/growth .
Identify learning needs.
Improve working relationship.
Enhance reflection on practice.
Opportunity to receive positive
Provide link between research and
practice (Identify research subject).
Provide emotional support for the
practitioner (far from the managements).
Potential benefits of CS
Individual recognition of a sense of
personnel worth and the sense of
being valued.
More effective use of skills,
knowledge and expertise.
Develops innovative practice
Better quality of care for the clients.
Acknowledgment of stress and
difficult workloads.
Potential benefits of CS
Improves patient/ client satisfaction.
Contributes to risk management and
decrease adverse occurrence incidents
Increase staff satisfactions and by
consequence staff retention.
Maintain and safeguards standards.
Improve qualities of care.
Protect the patients receiving care
from the nurses and protect nurses (Barker
Why CS IS Needed ?
External influences summarized:
Presence of patients Charter leading to
increased expectation from the public
(DOH 1992).
Increased awareness of a growing need
to manage risk in modern health service
(Tingle, 1995).
Dynamic changes within current health
system (darley,1995).
Recent innovation in the medical
management and treatment of patients
(Kohner, 1994)
What Elements Constitute
a Support System (SS)?
In each organization there are always
some sort of SS, that can be
classified in two types:
Formal SS: mentorship, Preceptorship,
Performance appraisal, Education program,
Research projects, Clinical supervision, .
Informal SS: Team nursing, Staff
meeting, Morning report, Peer
relationships, Journals, books, Internet
facilities, ward project, Symposium etc
Common Roles of the
Offer individual and professional
Encourage and motivate staff.
Enable identification of the
learning needs.
Facilitate learning.
Offer emotional support.
Approaches to CS
CS can be carried out in many ways
and with different people. (Houston 1990;
Barton-Wright 1994; Faugier &Butterworth).
Self Supervision where the individual
is able to reflect upon his/her work.
Team supervision; among a group of
colleagues who work together (Primary
nurse team).
Network supervision; among people
who do not work together (community nurses)
Clinical Supervisor

Clinical supervisor play essential

role in the success of CS. The
preparation of Clinical supervisors is
crucial, relevant practice,
experience is important as well as
the development of the necessary
skills, qualities and characteristics
to achieve the required outcomes.
Clinical Supervisor
Qualities and characteristics of a good
clinical supervisor (Piemme et al 1986;
Fowler 1995; Mahood et al 1998):
Knowledgeable on the supervisor
roles, supervisees role, supervision
models. clinical credible
Skills: teaching (adult learning) assess
knowledge and experience,
communication, interpersonal,
reflection (can be reflective and facilitate
discussion and reflection).

I would like to ask you answer:

Do you think we need to have
Clinical supervisor ?
If No what is the alterative?
If yes, what you are going to do
to implemented?
Thank you
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