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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.

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Setting up peer group supervision

Setting Up Peer Group Supervision

Presented by

Gytha Lancaster

New Zealand Institute of Rural Health


Background
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
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
Setting up Peer group supervision and Overcoming barriers

  • Allaying fears, misconceptions, and changing attitudes

  • Cost and time

  • Structure

  • Supervision skills workshops


Misconception and mistrust
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



What s in it for me and why should i have it
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.


Setting up peer group supervision

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
How to overcome misconceptions and mistrust ensures the highest professional standards are upheld.


Cost and time
Cost and Time ensures the highest professional standards are upheld.

  • 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 ensures the highest professional standards are upheld.

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
Distance solutions ensures the highest professional standards are upheld.

  • 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
Structure ensures the highest professional standards are upheld.

Facilitator

ensures group

members keep

on track


Structure1
Structure ensures the highest professional standards are upheld.

  • 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
Format to explore issues ensures the highest professional standards are upheld.

  • 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.

  • 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.


Setting up peer group supervision

Explore Options ensures the highest professional standards are upheld.

  • 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
Supervision skills workshops, ensures the highest professional standards are upheld.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, what’s wrong with advice

  • Ethics and responsibilities

  • Suggested structure

  • Set of examples of contracts, proposal/guideline and other forms supplied for adaptation.


Conclusion
Conclusion ensures the highest professional standards are upheld.

  • 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