1. Setting Up Peer Group Supervision
Presented by
Gytha Lancaster
New Zealand Institute of Rural Health

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

3. 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:

4. 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
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

6. 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.

7. 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.

8. 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

9. How to overcome misconceptions and mistrust

10. 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

11. 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

12. Distance solutions Teleconference
SKYPE: either group or single person to attend a group. Small charge for groups free for single, free download
If travelling: central location, or take turns
May need to have mixed professions e.g. Nurse, social worker, doctor, Occupational therapist

13. Structure
Facilitator
ensures group
members keep
on track

14. 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

15. Format to explore issues
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.

16. Explore Options 4. Actions to be taken
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

17. 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, what’s wrong with advice
Ethics and responsibilities
Suggested structure
Set of examples of contracts, proposal/guideline and other forms supplied for adaptation.

18. 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