The professional model

Clinical supervision can place advancement in your own hands by evolving to suit a developing career. 

Have you ever wondered how to progress your career with confidence and certainty and navigate the obstacles you encounter daily within the healthcare system? Clinical supervision can propel you on your journey.

The art and science of personal development have been informed a great deal by the study of successful athletes and business people. Such individuals have achieved and maintained performance and results through their learning and development of knowledge, skills and attitudes – despite the obstacles they too have faced.

Clinical supervision can model these processes for nurses who wish to develop and advance their practice. A supervisor can meet formally with one or more clinicians to reflect, review and resolve issues relating to their daily practices.

The profession is becoming increasingly attracted to clinical supervision to help people evolve professionally. A recent mapping study states the models used in nursing are preceptorship and clinical facilitation.

Preceptorship is provided to new staff by nurses experienced in a clinical specialty and environment. Clinical facilitation is provided to students by advanced practice nurses when they attend clinical placements. These models promote an introduction to roles in the workplace and are a great start to providing support for new workers, but are they enough to support a journey of lifelong reflection and learning?

Patricia Benner, a nurse researcher, describes the novice-to-expert continuum for nurses and states. Novices require directions, guidance and instruction. Preceptorship and clinical facilitation are appropriate modalities of clinical supervision for novice nurses but as they advance in their practice, they develop different support needs. For example, as nurses progress to the competent stage they demonstrate efficiency, co-ordination, confidence and analytical skills and respond productively to support in developing clinical decision-making and increasing their autonomy.

Brigid Proctor, a pioneer of clinical supervision, developed the popular Proctor’s model. It has three domains: normative, formative and restorative. The normative domain is concerned with the clinical governance surrounding a nurse’s practice; the formative is concerned with attaining and developing relevant knowledge and skills; the restorative is concerned with a nurse’s self care and being able to continuously provide high-quality nursing. This model is able to be adapted to any form of clinical supervision, such as preceptorship, clinical facilitation, 1-to-1 or group clinical supervision, mentorship and peer supervision. It provides a framework to identify and organise clinical issues that arise so appropriate action plans can easily and effortlessly be developed to progress and/or resolve clinical issues. Isn’t this what all nurses want?

Although many services promote clinical supervision for nurses, restricted funds and limited resources diminish the possibility of organisations providing it. However, there are many alternatives that all nurses can choose to follow if they are intent on continuously evolving their career. Peer supervision is one such alternative that can be innovated with Proctor’s model. Advanced practice nurses can stimulate in vivo reflections and discussions in ad hoc moments in the clinical arena. For example, they may attend handovers and use the Proctor framework to stimulate discussions with staff to progress the clinical management of any client who is stagnant in their clinical progress.

Nurses have been calling for the same level of recognition as our allied health colleagues for many years. The profession comprises 56 per cent of the Australian health workforce. What might happen if nurses took on the responsibility of seeking and engaging in professional clinical supervision themselves? Might taking responsibility for our individual professional development through clinical supervision, mentoring, practice development or peer supervision lead us further towards maturity and autonomy as a profession and even greater personal satisfaction? Imagine being free to make this type of difference on a regular basis and to move through obstacles encountered daily towards the compelling career and life you know you can have!

Moira Maraun is an RN, CMHN, master practitioner and certified trainer NLP. She provides clinical supervision and other coaching services to professionals to safely develop their abilities and advance their careers. [email protected]

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