The burden that we bear and the importance of clinical supervision

Get any group of health professionals together and it doesn’t take long before they start talking shop and sharing war stories.

Every one of us has them:

That open fracture which bled horrendously, that 30-something-year-old heart attack patient survived by a young family or that horrific trauma patient who you fought for hours to stabilise but couldn’t save.

It’s not about one-upmanship, it’s a way of coping with the jobs that we do. In our careers, be it as a nurse, doctor, health care assistant or paramedic, patient confidentiality is all.

We deal with extremely traumatic situations and see things that would cause distress to anyone. And yet, outside of work, we aren’t allowed to talk about it at all.

We go home and internalise it.

We carry the memory of patients, for years after our involvement with them. They shape us, our practice, and our life experience.

But what support do we receive in helping to manage the emotions that they evoke?

Clinical supervision and support

Debriefs after trauma calls or resuscitations are useful in allowing us the opportunity to talk about our feelings. However, in busy departments, there is not always the time available to do this.

This is where clinical supervision is helpful, and with revalidation, a necessary part of our practice.

‘It can be used as a tool to promote a person’s awareness of the strengths and weaknesses of their practice. It should be used to review practice and make changes when problems are encountered.’

Meetings with a clinical supervisor should be arranged at least monthly for discussing what we did and how we did it; could we have done anything better and if so, would it have changed anything?

Your clinical supervisor does not have to be senior to you, nor do they even have to have the same job role. A nurse could have supervision with an occupational therapist for instance.

Supervision can be performed both on an individual basis or as a group exercise. It also doesn’t have to be held in a formal workplace, providing confidentiality is maintained.

It may not change anything for that patient, but it helps us to live with the memory of the event and if we have concerns then it can help to talk them through and rationalise them in the safety of our supervision. And it could help us when managing future events.

Some employers are slow to offer supervision, but it has long been recognised as important to practice and it is a recommendation from NICE that it should be offered as part of the Clinical Governance framework.

Staff members who provide clinical supervision should be appropriately trained to support the staff that they supervise. These courses are readily available through both employers and educational institutions.

Ultimately, supervision is there to support staff and operates within a system of trust and confidentiality. It is there to improve our practice and the treatment of our patients, which can only be a good thing, whilst also making the memory of those we cared for easier to live with.