“It astounds me that there’s still such ignorance about clinical supervision” – Bernadette Towner
If you hear the words ‘clinical supervision’ and think of a senior practitioner supervising the work of a more junior nurse or midwife, you’re not alone. It is a continuing source of frustration for Bernadette Towner, who offers clinical supervision as part of her private practice and is a co-facilitator of the ANMF (Vic Branch) clinical supervision course.
While up to a maximum of two hours per month clinical supervision is provided for in the public sector mental health agreement for mental health nurses and is integral to working as a psychotherapist or counsellor, it is not yet commonplace in general nursing. However there is a growing recognition that clinical supervision is important for all health professionals who provide care in environments that are often challenging
Clinical supervision is an opportunity to reflect on one’s own practice with clients and to explore issues with an experienced colleague. In this sense, clinical supervision for nurses and midwives is about nurturing and good self-care, rather than being overseen.
As a practitioner offering clinical supervision, Ms Towner meets regularly with clients and explores their experience of their work, including the frustrations and dilemmas that they may have with patients/clients or their organisation. Issues explored can include interactions with patients and staff members, traumatic experiences in the delivery of care, and professional boundaries.
Ms Towner is one of a group of Victorian members of the Australian Clinical Supervision Association which represents the association at the nursing expo, to encourage nurses and midwives to consider supervision as part of their self-care.
‘So many of the nurses – well experienced nurses in education, in various public systems, advanced practitioners – think they don’t need it because they’re not undergraduates or new graduates. Their concept of ‘supervisor’ is someone watching over what you do,’ Ms Towner said.
Ms Towner’s career began with general nursing training followed by mental health nursing. She spent 14 years with the ambulance service (College of Pre-hospital Care) in Perth, training and lecturing the general public, and pre-employment and voluntary ambulance officers, in interpersonal communication and psychosocial subjects.
Her own first experiences with clinical supervision came about while working in high schools with the mental health of students and staff, and as a nurse in a drug and alcohol detox unit. As an example of how clinical supervision can support a practitioner, Ms Towner offers a story of trying to help a young mother who was experiencing ‘dilemmas around her own behaviours’ and parenting difficulties. Talking through the case with a clinical supervisor helped Ms Towner clarify the client’s issues and relieve the pressure of only having six sessions to work with the client. ‘Exploring it through clinical supervision made me step back and reinforce that it was OK to sit back and explore (with the client) and allow her to evolve with what she could do.’
More recently, while running a private practice, Ms Towner worked in the mental health nurse incentive program, a formerly federally-funded program for people with severe and complex mental health conditions. For the past year, Ms Towner has been working solely in private practice as a clinical supervisor, educator, psychotherapist and counsellor.
Ms Towner strongly believes that clinical supervision could be more widely utilised in nursing and midwifery.
‘It’s a burn-out preventative as well as expanding your knowledge,’ she explains. While debriefing with colleagues or friends over a post-work glass of wine has its place, Ms Towner says, clinical supervision offers a constructive and confidential way to reflect on work as a nurse or midwife. Also, friends and colleagues are not necessarily able to provide the objective point of view and counselling skillset of a professional offering clinical supervision.
ANMF (Vic Branch) began offering training in providing clinical supervision in February this year, with Ms Towner one of the co-facilitators delivering the course.
In Australia, clinical supervision is increasingly being included in health policy, guidelines and position descriptions, and there is a need for trained supervisors.
Clinical Supervision for Role Development Training involves eight days of training.
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Read about further news and events in the September 2016 On The Record publication