Setting Up Peer Group
Supervision
Presented by
Gytha Lancaster
New Zealand Institute of Rural Health
Background
• Rural nurses wanting to know about supervision
• Lack of available trained supervisors
• Nurses requesting supervision
• How to provide supervision for rural nurses
Hurdles and barriers
Hidden
• Misconception and mistrust: what is supervision,
whose it for and why have it?
• Attitude: What’s in it for me?
Actual
• Cost: Who pays?
• Time: Work time or family time?
• Distance: Can’t travel, no one near to talk to
• Lack of trained supervisors:
Setting up Peer group supervision
and Overcoming barriers
• Allaying fears, misconceptions, and
changing attitudes
• Cost and time
• Structure
• Supervision skills workshops
Misconception and mistrust
• Supervision is just another way for
management to oversee your practice
• There’s nothing wrong with my practice so
I don’t need it
• Its only for people who have been told to
have it by nursing council because of poor
practice
• It’s the same as having a mentor
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
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.
(Suzanne Faure as quoted by
the New Zealand Mentoring and
Coaching Centre,2010)
What’s 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.
• Encourages awareness of blind spots and
prejudices and ensures the highest professional
standards are upheld.
• Ensures that policies, practices and procedures
are followed
• Increases practitioner’s 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
How to overcome misconceptions
and mistrust
Supervision
skills workshops
Open discussion
What is it
Why have it
Learning
questioning,
listening,
and
facilitation skills
Role play
Practicing new skills
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
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 don’t always have
to look competent
• Prioritise the sessions and put a high value on it
• Respect each other, yourself and your patients/clients
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
Structure
The group review the session
what was useful
any changes they want to suggest
or anything else they need to do,
arrange next months session
Check in:
Everyone checks
in at the beginning
how they have been
at work etc before
starting on the agenda
Facilitator
ensures group
members keep
on track
Peer Supervision:
The first person
presents their dilemma/issue
Their peers ask reflective questions
give feedback or share knowledge
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
Format to explore issues
1. Identify the issue or what’s happening now
–
–
Use clarifying questions to get to exactly what’s
happening and the current reality.
Identify key issues and strengths.
2. 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.
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
Supervision skills workshops,
what they entail
•
•
•
•
•
•
•
•
•
•
•
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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, what’s wrong with advice
Ethics and responsibilities
Suggested structure
Set of examples of contracts, proposal/guideline and other forms
supplied for adaptation.
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