Egalitarian consultation meetings: an alternative to received wisdom about clinical supervision in psychiatric nursing practice.
Clinical supervision (CS) has become a watchword for psychiatric nursing. Yet, there are contradictions and controversies in academic and professional discourse in relation to the nature of CS, both structure and process, its effectiveness and how this is ascertained, the preparation of supervisor and supervisee, and the quality of the supervisory relationship. The perception of such discord encouraged the authors of this paper to step outside the debate and enact a different kind of CS, which came to be known as egalitarian consultation (EC). Egalitarian consultation meetings (ECMs) were established with the postmodern turn in psychiatric nursing as a reference point. A space was created in which participants could construct their particular version of CS. The authors and six G-grade community psychiatric nurses engaged with each other for six videotaped meetings. The data from the recordings were analysed using a hermeneutic grounded theory approach (Strauss & Corbin 1994), in keeping with the style of the research, which combined the roles of researcher and practitioner for the authors. The aim was to produce local knowledge of CS. The ECMs were characterized by a sense of freedom in relation to existing rules about hierarchy and truth. The participants, each as expert in her/his own case world, produced engrossing narratives about and for practice. The group developed a cohesiveness based in closeness and this encouraged radical talk and action--a questioning of practice systems. However, for some group members, radical equated to dangerous in terms of the watchful organization and a return to 'real' work (case supervision) was observed. Innovation in relation to CS may benefit from a change in institutional culture.
Stevenson
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C
Department of Psychiatry, University of Newcastle, 1-2 Claremont Terrace, Newcastle, NE2 4AE, UK.
Jackson
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B
D006801:Humans; D009745:Nursing, Supervisory; D011568:Psychiatric Nursing; D012017:Referral and Consultation