How does clinical supervision for nurses support the delegation of healthcare activities

In this blog from Grace Cook, Resilience-Based Clinical Supervision (RBCS) Programme Manager at the Foundation of Nursing Studies (FoNS), she shares how clinical supervision could support delegated healthcare activities.

Delegated healthcare and clinical supervision

A delegated healthcare activity is a health intervention, usually of a clinical nature, that a registered healthcare professional delegates to a paid care worker.

I was really pleased to be involved with a collaborative approach alongside Skills for Care and the Department of Health and Social Care (DHSC) in developing the delegated health care activities guiding principles. These principles can be utilised across a range of settings to support person-centred, safe and effective delegated healthcare interventions.

One of the principles is about learning and development. Reflective practice – which means reflecting on experiences in practice, is vital not only in being able to provide support to individuals but in ensuring that staff feel confident to act, raise concerns and express themselves.

Clinical supervision, a form of reflective practice, is ‘a formal process of professional support, reflection and learning that contributes to individual development and support.’

Clinical supervision is an important form of reflection for nurses but one that often doesn’t get prioritised. I learnt that it can be incredibly difficult for nurses working within social care to access clinical supervision and other external learning activities. This can be due to not hearing about activities and also not being able to take time away from their roles to dedicate time to clinical supervision

As this was recognised, I was delighted to support access to a restorative, or supportive, form of clinical supervision (namely RBCS) for a small group of social care registered nurses as part of the development of the guiding principles.

Resilience-based Clinical Supervision (RBCS)

RBCS is a model for clinical supervision characterised by:

• co-creating a safe space
• integrating mindfulness-based stress reduction exercises
• focusing on the emotional systems motivating our response to a situation
• considering the role of our internal critic in sustaining or underpinning our response to a situation
• maintaining a compassionate flow to self and consequently to others.

This video is a great watch to understand what RBCS is and what it looks like.

Key learnings about RBCS

Similar to other experiences I’ve had facilitating RBCS, the time to stop, reflect, and be listened to was really valuable. Reflection in a psychologically safe space can support people to feel connected to each other, valued as a person and feel empowered to take action, either for themselves or others.

Although I’ve spoken about nurses and clinical supervision previously, being able to reflect and having a supportive space can be beneficial for all members of the team. When considering delegation, I learnt from the programme that this can feel “threatening” for every person involved. For the delegator, it can be the fear of what may happen when they’re not there despite them remaining accountable. For the delegate, there’s the fear of what may happen when they’re on their own completing a task. This requires a lot of trust between everyone involved. RBCS could be beneficial for these individuals to be in a group together to support a greater connection between colleagues and to have an opportunity to reflect and share their experience which may result in an understanding of each other’s roles and the stressors and feelings others have about it.

The challenge with this is release of time to attend. If people aren’t aware of what clinical supervision is and the benefits of it, they may not personally prioritise time to attend. I found that reflecting on clinical supervision together helped to bring new ideas to the forefront and raise awareness of the different types and purpose of clinical supervision. Another challenge for releasing time is if all participants are within the same organisation. It could be that as well as supporting the understanding of different roles and responsibilities, multi-agency supervision could also support release of protected time for individuals to attend regularly. This would help to realise the benefits above.

Next steps

It was an absolutely pleasure to support access to clinical supervision within social care. It’s apparent that this is vital for all individuals that work in care, wherever they work and that multi-agency, multi-disciplinary clinical supervision can add value to all, including reflecting on delegated activities that they may be engaging in.

We at FoNS are really excited that RBCS is expanding into the social care system so watch this space! We would also love to hear about your thoughts and experiences engaging in clinical supervision within social care, so if you would like to share please get in touch with us at rbcs@fons.org. 

Find out more about delegated healthcare activities.

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