Implementing Group Clinical Supervision for Mental Health Nurses in Acute Adult Inpatient Wards. A Qualitative Descriptive Study.

Abstract

Clinical supervision for health care workers is well established across many disciplines; however, supervision for nurses has proven more difficult to implement and sustain. The purpose of this study was to evaluate the experience of establishing regular, ongoing group clinical supervision for mental health nurses in two acute adult inpatient wards. The study took a qualitative descriptive approach to data collection, gathering and triangulating data from nurses who took part in the supervision sessions, as well as supervision facilitators and ward managers. Data were collected through a brief anonymous online survey with open text options (n = 21) followed up with one-on-one semi-structured interviews (n = 10). Interview questions covered issues such as the experience of taking part in group supervision sessions, barriers and facilitators to implementation, enabling environmental factors, and ways to overcome challenges and build psychological safety for participants as well as a sustainable program. Quantitative survey data were analysed using simple counting, while qualitative data from open-ended survey responses and interviews were coded independently by the authors using an inductive grounded theory approach to identify emergent themes. The study found that successful implementation of group supervision required careful attention to the design and development of the program prior to and during establishment, with support from all levels of management as well as addressing administrative and logistic requirements. Sustainability was ensured through enabling attendance for all staff working the relevant shift, as well as by ensuring skilled facilitation of the sessions. Broader cultural change ensured the meaning, relevance, and value of supervision for nurses was built over time. In addition, a positive experience during the group supervision sessions meant that nurses felt more confident and better supported in their care of patients.