Clinical supervision: from staff nurse to nurse consultant. Part 2: clarity of terms John Fowler
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them achieve learning objectives and assessing their progress. The second use of mentoring in nursing relates to its more popular meaning of a mentor as someone who befriends a more junior or inexperienced person and helps them through a period of their life. Schools often use mentoring systems to help new students or vulnerable students to settle into a new school, often calling it a ‘buddying’ system. Businesses too use a mentoring system to help staff take on new management roles or fast tracking programmes. The aim of mentoring is to develop a nurturing relationship between a more experienced person and a less experienced person. This sort of relationship can often be found in nursing and the healthcare services, but it is usually informal and not part of a structured developmental programme. Clinical supervision, as discussed in the first article, is often interpreted and implemented in various ways. Core to clinical supervision is the idea of two or more clinicians meeting together on a regular basis to focus on clinical practice. Elements of learning, support and monitoring usually underpin clinical supervision. This is an ongoing process that is not limited to junior staff or those in transition of roles. Clinical supervision is seen to be a process that should ideally be part of all registrants’ practice. You can begin to see that these three terms incorporate similar ideas and philosophies and yet there are significant differences. The similarities are that they are all concerned with a relationship between a more experienced and a less experienced practitioner. It is the quality of that relationship rather than the simple content of the meetings that influences the development of the individual. Within all three practices, the elements of support, learning and assessment feedback can usually be recognised, but their emphasis and dominance vary considerably. Differences also exist. Mentoring, apart from its use with student nurses, is a relationship between two people that often develops to meet a specific need, usually role transition. This may be when a nurse is newly appointed as a ward manager,
clinical nurse specialist, nursing lecturer or other similar role. The newly appointed person will often seek out someone they respect and draw from them support and advice regarding their new role. Only occasionally in nursing does the more experienced person seek out the junior. It is usually time limited until the person feels confident in their new role. There is no formal documentation of meetings or the relationship. Preceptorship is a formal relationship that focuses on set learning objectives and periodic assessments. It is carried out within standard employment time and is usually part of contractual arrangements. Preceptorship is normally organised by the in-service training department of the organisation. Clinical supervision, in theory, should happen throughout a practitioner’s career, not just at the beginning or at times of transition. Some organisations implement it formally; others leave it as an informal process. Although valued by the professional organisations and quality reviews as ‘good practice’, clinical supervision has no national structure of agreed outcomes. Clinical supervision remains on most people’s agendas as an optional extra. It is felt to be of value and its implementation an indicator of good care standards. When the workload increases and the resources reduce, clinical supervision often disappears from practice settings. Sadly it is at this time that BJN clinical supervision is most needed. Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2013 MA Healthcare Ltd
T
his series will help you examine how clinical supervision can be used to advance your practice, whether you are a staff nurse or nurse consultant. The previous article (BJN, 11–24 July, 2013) examined the reasons why the concept of clinical supervision entered the nursing culture in the 1980s and described the normative, restorative and formative principles on which it was based. Future articles will examine the practical steps of setting up clinical supervision, implementation, the use of records and confidentiality, evaluation and how you can create time for clinical supervision. There are three terms used within nursing that have similar concepts and are often used interchangeably. These are: mentoring, preceptorship and clinical supervision. All three terms are used quite frequently within our daily practice; we may speak of a period of preceptorship for a newly qualified staff nurse and the importance of identifying a good mentor and role model for the staff nurse to learn from. We may also arrange for that staff nurse to join a clinical supervision group. What is the connection between all of these practices? In what ways are they similar and what, if anything, is the difference? Preceptorship is probably the easiest to define, as it is an official term used by the Nursing and Midwifery Council (NMC). It is the support and guidance that enables a newly qualified nurse, or a nurse new to a clinical area, to develop skills and confidence to perform as a qualified nurse in that area. Most clinical areas have developed a formal programme of preceptorship for new registrants in their first year of qualified status.This usually encompasses support and training to meet locally set learning objectives and periods of regular assessment. Mentoring is used in two ways in nursing. The formal use relates to student nurses and the allocation of the student to a qualified nurse who has undergone the ‘mentorship’ programme. This mentor is then responsible for supporting the student during the placement, helping
British Journal of Nursing, 2013, Vol 22, No 14
British Journal of Nursing. Downloaded from magonlinelibrary.com by 139.080.123.049 on November 23, 2015. For personal use only. No other uses without permission. . All rights reserved.
848
them achieve learning objectives and assessing their progress. The second use of mentoring in nursing relates to its more popular meaning of a mentor as someone who befriends a more junior or inexperienced person and helps them through a period of their life. Schools often use mentoring systems to help new students or vulnerable students to settle into a new school, often calling it a ‘buddying’ system. Businesses too use a mentoring system to help staff take on new management roles or fast tracking programmes. The aim of mentoring is to develop a nurturing relationship between a more experienced person and a less experienced person. This sort of relationship can often be found in nursing and the healthcare services, but it is usually informal and not part of a structured developmental programme. Clinical supervision, as discussed in the first article, is often interpreted and implemented in various ways. Core to clinical supervision is the idea of two or more clinicians meeting together on a regular basis to focus on clinical practice. Elements of learning, support and monitoring usually underpin clinical supervision. This is an ongoing process that is not limited to junior staff or those in transition of roles. Clinical supervision is seen to be a process that should ideally be part of all registrants’ practice. You can begin to see that these three terms incorporate similar ideas and philosophies and yet there are significant differences. The similarities are that they are all concerned with a relationship between a more experienced and a less experienced practitioner. It is the quality of that relationship rather than the simple content of the meetings that influences the development of the individual. Within all three practices, the elements of support, learning and assessment feedback can usually be recognised, but their emphasis and dominance vary considerably. Differences also exist. Mentoring, apart from its use with student nurses, is a relationship between two people that often develops to meet a specific need, usually role transition. This may be when a nurse is newly appointed as a ward manager,
clinical nurse specialist, nursing lecturer or other similar role. The newly appointed person will often seek out someone they respect and draw from them support and advice regarding their new role. Only occasionally in nursing does the more experienced person seek out the junior. It is usually time limited until the person feels confident in their new role. There is no formal documentation of meetings or the relationship. Preceptorship is a formal relationship that focuses on set learning objectives and periodic assessments. It is carried out within standard employment time and is usually part of contractual arrangements. Preceptorship is normally organised by the in-service training department of the organisation. Clinical supervision, in theory, should happen throughout a practitioner’s career, not just at the beginning or at times of transition. Some organisations implement it formally; others leave it as an informal process. Although valued by the professional organisations and quality reviews as ‘good practice’, clinical supervision has no national structure of agreed outcomes. Clinical supervision remains on most people’s agendas as an optional extra. It is felt to be of value and its implementation an indicator of good care standards. When the workload increases and the resources reduce, clinical supervision often disappears from practice settings. Sadly it is at this time that BJN clinical supervision is most needed. Dr John Fowler is a general and mental health nurse. He has worked as an Educational Consultant to primary care trusts and as a Principal Lecturer in Nursing for many years. He has published widely on educational and professional topics and is series editor of the Fundamental Aspects of Nursing Series and the Nurse Survival Guide Series for Quay Books
© 2013 MA Healthcare Ltd
T
his series will help you examine how clinical supervision can be used to advance your practice, whether you are a staff nurse or nurse consultant. The previous article (BJN, 11–24 July, 2013) examined the reasons why the concept of clinical supervision entered the nursing culture in the 1980s and described the normative, restorative and formative principles on which it was based. Future articles will examine the practical steps of setting up clinical supervision, implementation, the use of records and confidentiality, evaluation and how you can create time for clinical supervision. There are three terms used within nursing that have similar concepts and are often used interchangeably. These are: mentoring, preceptorship and clinical supervision. All three terms are used quite frequently within our daily practice; we may speak of a period of preceptorship for a newly qualified staff nurse and the importance of identifying a good mentor and role model for the staff nurse to learn from. We may also arrange for that staff nurse to join a clinical supervision group. What is the connection between all of these practices? In what ways are they similar and what, if anything, is the difference? Preceptorship is probably the easiest to define, as it is an official term used by the Nursing and Midwifery Council (NMC). It is the support and guidance that enables a newly qualified nurse, or a nurse new to a clinical area, to develop skills and confidence to perform as a qualified nurse in that area. Most clinical areas have developed a formal programme of preceptorship for new registrants in their first year of qualified status.This usually encompasses support and training to meet locally set learning objectives and periods of regular assessment. Mentoring is used in two ways in nursing. The formal use relates to student nurses and the allocation of the student to a qualified nurse who has undergone the ‘mentorship’ programme. This mentor is then responsible for supporting the student during the placement, helping
British Journal of Nursing, 2013, Vol 22, No 14
British Journal of Nursing. Downloaded from magonlinelibrary.com by 139.080.123.049 on November 23, 2015. For personal use only. No other uses without permission. . All rights reserved.
