The realities of clinical supervision in an Australian acute inpatient setting

This chapter draws on the findings of an ethnographic study of Australian acute inpatient mental health settings, which sought to better understand the cultural realities of clinical supervision (CS) for this culture/population (see Cleary and Freeman 2005). Having outlined the research design and key findings, this chapter then discusses the findings in light of current literature and highlights some future considerations/ issues that will need resolving, if CS is to become a widespread reality in Australian acute inpatient mental health settings. It is noteworthy that this chapter shows how many of the mental health nurses in acute inpatient mental health units, when asked, formally agree that clinical supervision is important, but informally regard it as having a limited experiential value. This may in part be attributable to many nurses believing that they are already involved in CS, though these experiences do not correspond with established definitions of formal CS. In the view of the editors this chapter, as with some others in this book, offers further evidence of the miscomprehension and misunderstanding that many still have regarding the nature and purpose of CS. This consequently further underscores the need for a shared nomenclature; given that (all) sciences need understandable, stable and internationally-accepted systems for naming and categorising phenomena within the boundaries of the disciplinary area. It can be argued that CS needs this list of agreed names, definitions, principles, rules and recommendations that govern its formation, use and application. Until we have this, there is little surprise that the outcomes of engaging in a variety of practices that share only some (if any) of CS’s rudiments, principals and practices bear little or no resemblance to those outcomes which are more commonly encountered when one engages in real, high quality CS. As the authors point out, the belief that existing structures inherent to nursing practice already convey the benefits of CS may contribute to the culture of passive resistance to it