Clinical Supervision: What is it about?

The term Clinical Supervision has different meanings for different people. It may conjure up images of someone peering at you while you do your first injection or trigger the fear that if you need supervision of any sort, you must be lacking in something and need remedial teaching. However, once we understand the intention of Clinical Supervision as a professional support, you can forget about its name and just enjoy the benefits that high quality, regular Clinical Supervision can bring to your professional practice and well-being.

Clinical Supervision is a professional development activity based on adult learning principles, which focuses on reflective learning. It is not about teaching nurses and midwives to carry out a complex procedure at the point of care delivery, but rather entails a critical reflection on recent work experiences that need further exploration and understanding. 

Central to its effectiveness is the trusting professional alliance that develops between the supervisee and supervisor. A skilled clinical supervisor meets with one or more supervisees regularly and uses their interpersonal and communication skills to create a safe space for reflection on nursing work and all the uncertainty it carries. 

It is not about the supervisor judging or directing you, but being able to look over your work together — it is like taking a Birds Eye View, seeing your work from a distance. Supervision is a collaborative relationship to review and improve practice together. Trust develops over time enabling the reflective work to become more productive.

Clinical Supervision is different from line management supervision or operational reporting where you meet with your manager regularly. While this is also an important professional support, it is not Clinical Supervision or a substitute for Clinical Supervision. To be truly effective, the supervisor must be someone who does not have organisational responsibility for the supervisee’s performance. Their organisational independence promotes honesty and prevents a conflict of interest. 

In 2018 the Australian Colleges of Mental Health Nurses, Midwives and Nursing worked together to develop a Position Statement, Clinical Supervision for Nurses & Midwives which was launched in April 2019. The statement says that:

Clinical Supervision is a formally structured professional arrangement between a supervisor and one or more supervisees. It is a purposely constructed regular meeting that provides for critical reflection on the work issues brought to that space by the supervisee(s). It is a confidential relationship within the ethical and legal parameters of practice. Clinical Supervision facilitates development of reflective practice and the professional skills of the supervisee(s) through increased awareness and understanding of the complex human and ethical issues within their workplace.

Clinical Supervision can take place in many different forms, and often involves one-to-one conversations or small group sessions, either in person or over the phone or internet. The college’s position statement lays out the expected elements of effective Clinical Supervision on page 6.

Clinical Supervision creates a space to process the emotional impact and ethical challenges of day-to-day nursing practice. It is about developing the skill of reflecting on practice after the event and away from the point of care environment. By regularly engaging in this form of structured reflection on practice, we become more skilled at reflecting in practice and before practice. Improving reflective skills increases our ability to respond effectively in the moment and reduces the risk of impulsive reactions that we may regret later. This results in the increased possibility of a helpful or productive intervention with patients, carers and colleagues, less emotional drain on the individual, and an increased ability to practise with awareness.

Personally, I would like to see all nurses and midwives introduced to Clinical Supervision as a professional support strategy in their undergraduate education so that they understand that this is one of many professional supports that will assist them to have a long and healthy career in nursing (Sharrock, 2020). The COVID-19 pandemic has reinforced the importance of robust professional support structures for all nurses and midwives, and it is now more important than ever that clinical supervision is viewed as a support strategy to assist nurses and midwives during this time.

Want to talk? Reach out to Nurse & Midwife Support on 1800 667 877 or send us an email.   

Julie Sharrock, RN, Credentialed MHN
CertCritCare, CertPsychNurs, BEd, AdvDip(GestaltTher), MHSc(PsychNurs), PhD Candidate
FACMHN, MACN, MACSA.

Mental Health Nurse Consultant, Clinical Supervisor and Educator
Julie commenced her nursing career in 1977 specialising in general and intensive care nursing for 10 years before beginning Psychiatric Nursing. During her career, Julie spent 38 years in clinical practice, ceasing in January 2017.  She has often been asked how she was able to do this type of work for so long, work which focused on human suffering and resilience building. In her words  and without doubt, a key component of her survival in health care was good Clinical Supervision. To this day she continues to receive and provide regular Clinical Supervision and is now a clinical supervisor trainer. Julie has contributed to the Framework for Clinical Supervision for Mental Health Nurses in Victoria and led the development of a Joint Position Statement Clinical Supervision for Nurses and Midwives in Australia.