Setting Up Peer Group Supervision

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Setting Up Peer Group Supervision

• Presented by
• Gytha Lancaster
• New Zealand Institute of Rural Health

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Background

• Rural nurses wanting to know about supervision
• Lack of available trained supervisors
• Nurses requesting supervision
• How to provide supervision for rural nurses

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Hurdles and barriers

• Hidden
• Misconception and mistrust what is supervision,
  whose it for and why have it?
• Attitude Whats in it for me?
• Actual
• Cost Who pays?
• Time Work time or family time?
• Distance Cant travel, no one near to talk to
• Lack of trained supervisors

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Setting up Peer group supervision and Overcoming
barriers

• Allaying fears, misconceptions, and changing
  attitudes
• Cost and time
• Structure
• Supervision skills workshops

5
Misconception and mistrust

• Supervision is just another way for management to
  oversee your practice
• Theres nothing wrong with my practice so I dont
  need it
• Its only for people who have been told to have it
  by nursing council because of poor practice
• Its the same as having a mentor

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Differences between preceptoring, mentoring and
supervision
Preceptorship Mentoring Supervision
A preceptor is more experienced in a particular area of nursing and works with a less experienced nurses while they learn the necessary skills for their new role Mentoring is a long term relationship to meet a developmental need to help develop full potential and benefits all partners (Suzanne Faure as quoted by the New Zealand Mentoring and Coaching Centre,2010) Supervision is a process where the supervisee is given the opportunity to have in depth reflection on their practice in order to achieve, sustain and creatively develop a high quality of practice.
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Whats in it for me and why should I have it

• Focuses on issues of education and development of
  skills by reflecting on experience in practice.
• Supports personal well being
• Encourages self development
• Creates awareness of how stresses and distress in
  working practice affects individuals.
• Helps maintain boundaries, stability and
  emotional distance.
• Focuses on accountability and quality of care
  practiced by the supervisee.

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• Encourages awareness of blind spots and
  prejudices and ensures the highest professional
  standards are upheld.
• Ensures that policies, practices and procedures
  are followed
• Increases practitioners confidence in their
  practice.
• Reduces staff turn over
• Reflections from the supervision may be used
  within the portfolio for nursing council
  competency and peers can confirm practice.
• A protected environment.
• Maintains and safeguards standards of practice

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How to overcome misconceptions and mistrust
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Cost and Time

• Peer group supervision reduces cost
• Supervision skills workshops provided by NZIRH
  for rural nurses within certain DHB areas
• Supervision proposal/guideline demonstrates
  benefits to employers
• 1to 1 1/2 hours per month (at a time negotiated
  by group)
• Time most want supervision in working day
  times before starting work, lunch time or other

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Guidelines

• Guidelines for successful peer supervision
• Set clear boundaries e.g. no gossip, discussion
  of stories after the session, no post mortems
• Clear ground rule over confidentiality
• Have a contract
• Keep to the process or structure
• Always have someone as the facilitator
• When getting feedback, listen, reflect, check
  whether it is accurate or relevant and take what
  is useful and leave the rest.
• Focus on the person who is getting the
  supervision
• Its ok to make mistakes and learn from them, you
  dont always have to look competent
• Prioritise the sessions and put a high value on
  it
• Respect each other, yourself and your
  patients/clients

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Distance solutions

• Teleconference
• SKYPE either group or single person to attend a
  group. Small charge for groups free for single,
  free download http//www.skype.com/intl/en/prices
• If travelling central location, or take turns
• May need to have mixed professions e.g. Nurse,
  social worker, doctor, Occupational therapist

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Structure
Facilitator ensures group members keep on track
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Structure

• Peer group members 3 to 5
• Group contract/ground rules
• Facilitator
• Always appoint a facilitator for the session
  whose responsibility is to keep the group on
  task, keeping to the structure, agenda, and time
  keeping. (The person facilitating alters each
  time to ensure everyone takes turns)
• Minutes Minutes to be recorded, one person is
  allocated on the roster/facilitation plan (this
  alters each time to ensure everyone takes turns)
  to record the session.
• Members bring issues
• Audit 6 to 12 monthly audit of process to ensure
  achieving goals

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Format to explore issues

• Identify the issue or whats happening now
• Use clarifying questions to get to exactly whats
  happening and the current reality.
• Identify key issues and strengths.
• Describe how you would like it to be different
• Use the questions to build a picture of how they
  would like it to be
• Using open ended questions enable them to develop
  specific goals or what they want to happen
• Find out what is stopping them from achieving
  this right now.

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• Explore Options
• Use open ended questions to generate options
  beginning with ideas from the supervisee
• Explore different avenues or actions they could
  take
• If they appear to be out of ideas offer
  suggestions carefully or give examples of similar
  experiences (only if required)
• Make sure options address the key issues
• 4. Actions to be taken
• Ensure they make specific commitments to actions
  to be taken with a time frame to accomplish them
• Identify any foreseeable obstacles or problems
  and identify plans to overcome these
• Wrap up and close the session

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Supervision skills workshops, what they entail

• 1 day workshop (certificate of attendance)
• Interactive, role play, enjoyable
• Explore definitions of supervision
• Function of supervision
• What to bring to supervision
• Skills, active/reflective listening, asking open
  questions
• Format to use to explore issues
• Feedback good and when not useful
• Sharing information, whats wrong with advice
• Ethics and responsibilities
• Suggested structure
• Set of examples of contracts, proposal/guideline
  and other forms supplied for adaptation.

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Conclusion

• Education re supervision to reduce barriers
• SKYPE or teleconference, or central meeting place
• Supervision proposal/guidelines to get employer
  buy in
• Protected valued time for supervision sessions
• Formal structure of Peer group sessions
• Regular audit to ensure Peer group supervision
  achieving goals