Superficial supervision
Andrew Gardner
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, City East Campus, Adelaide SA
Helen McCutcheon
Deputy Head, Department of Clinical Nursing, University of Adelaide, Adelaide SA
Maria Fedoruk
School of Nursing and Midwifery, Division of Health Sciences, University of South Australia, Adelaide SA
PP: 258 - 266
Abstract
Mental heath nurses recognise the importance of professional boundaries and therapeutic relationships and understand that clinical supervision is an important component to good clinical practice and their ongoing professional development. This qualitative constructivist grounded theory research has uncovered a potential risk in contemporary mental health clinical practice, where the desire for expedient answers may compromise the outcome of formal structured supervision. The notion of a new concept 'superficial supervision' and its implications for formal structured supervision are explored.
Keywords
supervision, professional boundaries, mental health, grounded theory, mental health nursing
Article Text
Mental health nurses are exposed to intense levels of emotions in the work place such as are problems involving therapeutic relationships and professional boundaries which for many mental health clinicians are an occupational hazard (Simon 1999). If a clinician breaches the professional boundary in their clinical practice, a vulnerable client may become even more vulnerable, feeling emotionally exposed or at risk, and is likely to require additional counselling. Furthermore a professional who has compromised their practice by breaching a professional boundary is likely to face a disciplinary process, (if the breach is exposed), they may also be required to seek ongoing counselling and could even have restrictions placed on their licence to practice.
This paper reports on some early themes as part of an ongoing qualitative study. The focus of the interviews was how clinicians maintain the professional boundary and hence protect the therapeutic relationship, the interview time and space has become the catalyst for deeper reflection and structured time to discuss the subtleties of the interpersonal relationship. Using a constructivist grounded theory approach this research exposes new concepts in the area of therapeutic relationships and professional boundaries that have not previously been well described. Such as therapeutic friendliness: which describes how clinicians engage clients, and superficial supervision; where clinicians may not be engaging in thoughtful reflective supervision as their perceived difficulties have been resolved through informal conversations with their colleagues.
Whilst these concepts and their associated problems are being recognized by mental health nurses it is evident that some of the more subtle issues are not being discussed in formal clinical supervision; despite most mental health professionals identifying that formal clinical supervision is an important part of their professional development.
This paper provides some insights into new emerging concepts from recent interdisciplinary research and will question whether we practice superficial supervision that places mental health nurses and perhaps even clients at risk.
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