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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Whitireia Nursing Journal, 13, 68–69.
Abstract: Based on the author's thesis, this research project explored nurses' perceptions of clinical leadership in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses.
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Nichols, J. (2004). An exploration of clinical supervision within mental health nursing. Vision: A Journal of Nursing, (November).
Abstract: The purpose of this paper is to shed some light on the concept of clinical supervision specifically in relation to mental health nursing. The author talks briefly about the naming and history of clinical supervision and aims to provide some clarity around defining the concept. There is discussion around the role, value and objectives of clinical supervision before critical examination of two models of clinical supervision within two different contexts. Finally the strengths and weaknesses of each model are discussed, and the differences illustrate some of the contextual factors of clinical supervision.
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Kennedy, W. (2007). Professional supervision to enhance nursing practice. Available online from Eastern Institute of Technology, 14(2), 3–6.
Abstract: This article examines the concept of clinical supervision as “professional supervision”. Professional supervision contains many elements, is structured and not without effort. Fundamentally it is about being safe and professional. 'Reflective learning' and 'Live/tutorial' models are reviewed in different contexts for assisting nurses work through everyday issues, conflicts and problems of their role. The author concludes that regardless of which model is used there are benefits for safety and professionalism.
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Burrow, M., Gilmour, J., & Cook, C. (2017). Healthcare assistants and aged residential care: A challenging policy and contractual environment. Nursing Praxis in New Zealand, 33(2), http://www.nursingpraxis.org.
Abstract: Examines NZ policy and care demands in aged residential care. Maintains that registered nurses need to understand the socio-political, economic and educational factors that influence care delivery in aged residential care. Presents an overview of the current role of healthcare assistants (HCAs)in aged residential care, based on a review of the existing grey literature, current national policy, DHB contract agreements and NZNO collective agreements.
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Koorey, R. (2008). Is there a place for clinical supervision in perioperative nursing? Dissector, 35(4), 15–17.
Abstract: This article explores the concept of clinical supervision and outlines a brief history of implications for nursing practice. Models of clinical supervision are outlined and examples of how they may be applicable to the clinical setting of perioperative nursing are provided.
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McLeland, A., & Williams, A. (2002). An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries. Contemporary Nurse, 12(2), 185–193.
Abstract: The purpose of this qualitative study was to analyse the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalisation; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalisation. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues. The students' negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability.
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Haggerty, C. (2000). Critical case study: Supporting the new graduate entering specialist psychiatric mental health nursing practice. Ph.D. thesis, , .
Abstract: This critical case study was undertaken for the purposes of illuminating information relating to new graduate nurses' experiences in their first clinical placement, in order to consider ways an established entry to practice programme can better support and enhance the students' transition from student nurse to staff nurse within psychiatric mental health nursing practice. Seven current students of the programme participated in the research. This provided the researcher with a variety of challenges related to her dual role as researcher and programme coordinator. Data was collected through the use of discussion groups, with participants and researcher jointly identifying the themes that were explored. These themes related to preceptorship and support, socialisation of the new graduate and risk management. The research has provided rich data that has already, and will continue to be used to inform future developments within both the educational and clinical components of the programme. The research has also provided opportunities for personal and professional growth through the sharing of experiences, and working together to identify emancipatory action which has in turn lead to transformation.
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Findlay, W. (2006). The effect of peer learning and review groups on practice nurses' clinical practice: A mixed method survey. Ph.D. thesis, , .
Abstract: The aim of the study was to explore how practice nurses perceive engagement in Peer Learning and Review Groups impacts personally and professionally on their clinical practice. An anonymous self-administered postal questionnaire was completed by 55 practice nurses who attend Peer Learning and Review Groups in the South Island. A mixed method design was utilised to obtain both qualitative and quantitative data. Practice nurses considered group attendance was important for professional development with the majority perceiving that their attendance had a positive effect on their clinical practice. The nurses perceived clear linkages between the significant learning that occurred in the groups and changes in delivery of patient care. Additional benefits included improved collegial relationships, professional awareness and personal growth. The author concludes that, together, these findings underline the importance of Peer Learning and Review Groups as an effective tool for ongoing personal and professional development within nursing.
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Sims, D. A. (2004). The benefits and challenges of one New Zealand nursing undergraduate clinical education model: A case study. Ph.D. thesis, , .
Abstract: This research project utilised a case study approach to give ward managers a voice in the literature, by exploring and describing from their perspective the benefits and challenges of one particular nursing undergraduate clinical education model. The tertiary education provider contracts the health provider to provide Clinical Nurse Educators (CNEs) to support second and third year undergraduate nursing students during their clinical experiences. The CNEs are seconded from their respective wards to meet the organisation's contractual obligations. Data were gathered from two ward managers using semi-structured interviews. The findings elucidate the role of the undergraduate CNE, highlighting benefits such as the CNE being supernumerary to ward rosters and having time to teach, not only supervise students. CNEs are student-focused and easily accessible as they are based on site. The CNE was the one person who was 'there' for a student as a student's preceptor can change shift-by-shift and day-by-day. One significant challenge which emerged was the replacement of ward staff, not only of senior nurses who can leave their wards for up to 12 weeks to undertake the CNE role but also that of the student's preceptor if the student's preceptor was on annual, sick or study leave. Other challenges such as the inability of ward managers to pre-book casual staff; preceptor work-loads; skill-mix issues and fluctuating fulltime equivalents are also discussed.
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Kwai, K. (2004). The value of a programme of clinical supervision for graduate nurses: An evaluative study. Ph.D. thesis, , .
Abstract: The function and implementation of clinical supervision in the practice setting presents a number of challenges for new graduate programmes for registered comprehensive nurses. There have been numerous reports and papers promoting its benefits as important and providing the impetus for change. Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in mental health nursing and midwifery. Its utilisation for graduate nurses is clearly important and should be seen as integral to professional practice. This study evaluated a programme of clinical supervision as a component of a new graduate nurse programme in a secondary health care practice environment. The clinical supervision component aimed to support graduate registered nurses' transition from the role of student nurse to staff nurse in the context of professional clinical practice. This report is also intended to inform the ongoing provision of clinical supervision at Hutt Valley District Health Board. The evaluation process was guided by the work of Owen (1990) and used utilisation focussed evaluation as the framework on which to undertake the evaluation. A mix of quantitative and qualitative methodology was used to collect and analyse the data. Data were collected from nurse graduates of the new graduate programme using a postal questionnaire that covered three areas; clinical supervision, the Hutt Valley District Health Board new graduate programme and an evaluation of stakeholder roles. Twelve of the new graduates responded to the survey. Findings suggest clinical supervision provided professional support and assisted the new graduate in the identification of education needs. Difficulties associated with accessing the structured component of the new graduate programme and clinical supervision were highlighted. The recommendations made to Hutt Valley District Health Board to improve the programme include considering accessibility, consumer rights, acceptability, a comprehensive approach, the Treaty of Waitangi, efficiency and a coordinated approach.
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Robertson, G. (2000). Disquiet in the development of clinical supervision for professional development in nursing practice: A literature review.
Abstract: Nursing literature reflects that nurses have been exploring and experiencing the process of clinical supervision for well over a decade. Nurses in the United States, United Kingdom, Scandinavia, and Australasia have written much over the past fifteen years. However, the author notes that nurses grapple with what clinical supervision is within nursing development and disquiet continues to emerge in the literature. This literature review expands on themes that surround this disquiet. These centre on continued confusion and lack of clear definition; whether psychotherapy is implemented under the guise of clinical supervision, who uses it, and the dearth of empirical evaluation of its effectiveness. The lack of significant empirical evidence of its ability to assist practitioners to deliver improved patient/client care continues despite claims of improved professional and personal development, therapeutic relationship, and occupational stress management. These claims come from both supervisees and supervisors. The manner in which clinical supervision is portrayed in nursing in that it is frequently referred to as a support system, rather than one of learning a complex set of communication skills is also highlighted. The continued debate on what model(s) best suit nurses, or whether line management should provide clinical supervision as a means to ensure quality standards and control over nursing practice and optimal patient care is discussed. Whether nursing should stop borrowing from other fields and develop their own model(s) is also raised. Two emerging stances focus on a process that is practice-based as identified by senior staff and management, or one that continues along the lines of what psychotherapy has developed with practitioner-identified developmental needs. These issues raise many questions for further development in nursing, one being are nurses developed enough in their self-awareness to understand what they are to adopt into their practice? Authentic voices from those nurses experienced in the practice of providing and receiving clinical supervision, are shaping therapeutic practice for nurses in the future, and continue to sharpen the debate. Some reference to unpublished data and local practice in the Wellington area have been included as a stimulus for further incorporation of clinical supervision in local practice development.
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Doughty, L. (2004). Evaluation of the 2002 Auckland District Health Board: First year of clinical practice programme. Ph.D. thesis, , .
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Trimmer, W. C. (2006). The way things are done around here: Perceptions of clinical leadership in mental health nursing. Ph.D. thesis, , .
Abstract: This research project explored nurses' perceptions of clinical leadership in mental health nursing practice. Within New Zealand no research exists that evaluates the role and impact the clinical leadership has in mental health nursing practice. From personal experience and discussion with colleagues the author argues that clinical leadership in terms of support and guidance for nurses is often minimal and that there is a relationship between qualities of clinical leadership and poor retention rates of mental health nurses. The prime objective of this study was to increase knowledge about clinical leadership in mental health nursing practice. This research used a quantitative descriptive methodology, utilising survey design. A questionnaire was used to rank the attributes of the person the respondents identified as a clinical leader. The data was collected from 30 registered nurses working in mental health settings within the central region of New Zealand. Findings indicate that there is room for improvement with regard to clinical leadership in mental health nursing practice. Clinical leadership is perceived to be more effective by nurses in their second year of practice and in community settings. A statistically significant difference was indicated between nurses in their second year of practice and nurses in their third year of practice in terms of their ranking of clinical leadership abilities. Overall the respondents perceived poor communication and poor attitude as the biggest barriers to effective leadership. Support and good role models were said to influence nursing practice positively and the skills that were identified as being helpful in assisting and retaining nurses were mentorship and good communication. The results of the study are discussed in relation to the literature on transformational leadership skills. Finally, the general limitations of the study are outlined and implications for future research are discussed.
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Anderson, P. R. (2008). Determining competency for entry to nursing practice: A grounded theory study. Ph.D. thesis, , .
Abstract: Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented, the author suggests could further enhance the validity and reliability of assessment outcomes.
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Irvine, H. J. (1998). Professional supervision for nurses and midwives.
Abstract: Report to the Winston Churchill Memorial Trust on Professional Supervision for registered Nurses and Midwives, May 1998.
Objective of Project:
To explore the extent of the development of a model of clinical supervision for nurses in the United Kingdom.
Some of the key points that emerged:
- Clinical supervision is a strong and accepted part of nursing culture in Britain. While not mandatory and not available to, or accepted by, all nurses, it is nevertheless generally known about and discussed at main nursing forums
- The strong support and directives coming from nursing leadership is a major factor in the adoption of clinical supervision as a developmental, support and quality control
- The increasing availability of resource material, courses, and in particular the investment made by the Department of Health and the Scottish Home and Health Office in funding a 23 site evaluation project has stimulated implementation of clinical supervision
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