Clinical Supervision Essay Example

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Role of clinical supervision as a governance strategy designed to support safe and effective mental health care




Health is perceived as a reserve for day after day life as well as general quest of a higher value of time for human beings. The term “clinical supervision” refers to the daily supervision of health personnel on patients’ wellbeing or sometimes it entails supervision of a trainee’s performance. The practice of supervision is somewhat confusing; Couzo and Murray (2009) define clinical supervision as the practice or intervention carried out by a senior medical officer to a junior member within the same profession. The key aim of this practice is to enhance professional functioning of this junior member in evaluating and assessing the quality of professional services.

Clinical supervision has been a common thing in mental health nursing, especially in acute mental health set ups which continue to struggle with implementation process (Michelle Cleary, RN,(2013) The extension of life expectancy and reduction of mortality rates have always been a main interest of medical research and an indicator of public health progress. Life expectancy has shown patterns of continuous growth, and the trends in mortality rates continue to decline in many countries over the past half-century (Pearce, C. & Haikerwal,2010). However, many countries without effective governance usually result into anguish from across-the-board inefficiencies as well as wasted resources in the country, and eventually lead to poor economic outcomes and living conditions (Barker, 1998). This paper focus on role of clinical supervision as a governance strategy designed to support safe and effective mental health care and delineate the key aspects of clinical supervision especially the factors that contribute to the complexity of mental health care delivery and inhibit change.

Mental Health-Care

Clinical supervision is paramount especially in mental-related sicknesses as a governance strategy designed comes in handy to support safe and effective mental health care. Mental health care enables provision of medical care to junior officers in helping them cope with the normal duties of patient’s stresses of life and any mental sicknesses (Paul Cassedy, 2013) Mental illness supervision may vary based on the neurological conditions and ranges from depression to schizophrenia. In nursing, certain conditions may be used to expound on relapse, like aggravation, hospital admission and medical care. Its medication is after 6 months, and failure to treat may cause cognitive impairment leading to brain damage and distress. Prevention of this illness poses a financial constraint on health care and government systems, thus having socio-economic implications on the total population (Burns and Grove, 2005).Regardless of the therapeutic development in global research in nursing, relapse in schizophrenia remains a key challenge to people, especially to junior officers who have enrolled in the practice. The higher cost of medication which affects patients with relapse in schizophrenia also remains to be a nightmare to senior officers who face intricacy of choices to curb the menace (Paul Cassedy, 2013) The existence of co-morbid depression moods, poor adherence to medication and nursing owing to deficiency in prescription insight as well as lack of enough mental health facilities appear to be the main factors that could swell the threat of a relapse in schizophrenia. It is very important for the stakeholders in health sector to build enough health facilities and employ enough psychiatrists to treat mood features and educate people locally to adhere to treatment.

The significant costs associated with the relapse confirm that the danger posed by this mental illness is high. Therefore, people should take cautionary measures keeping in mind that a delayed to visit a clinician should mean the escalation of medication costs. More importantly, one should understand that a reduced relapse rate imply reduced damage to his or her health (wellbeing) and better family life. Psycho education and other medication programmes should be adhered to as they help in detecting prodromal signs of relapse, and this could minimize the cost of hospitalization (Courtney, 2005). Family members need also to work closely with their members who may be suffering from this illness or take them immediately to hospital when symptoms of relapse are detected.


During clinical supervision, the senior medical officers utilize clinical issues and dilemmas as material to reflect upon and analyze the mental state of patients with an aim of identifying strategies to improve patient care. Thе provison of еffесtivе clinical supervision and intеrvеntiоns in рrоmоting mental health care is pivotal for equitable development. Achieving healthcare improvements call for the collaborative effort among the health professionals to work as a team in their respective positions (Barker, 1998). Clinical supervision in mental health care may fall into two categories to accentuate the efficiency, namely patients’ satisfaction- systems approach to quality and safety and recall systems. In clinical supervision, what is examined is the effect of the patients suffering on the nurse’s ability to respond, interact and to think’ (Yegdich, 1996).

Patients’ satisfaction- systems approach to quality and safety

Research advises that unpleasant circumstances relating to mental health care medicines are exhibited in primary healthcare, where medication error are widely dominant among health professionals and that a attenuation in prescription errors needs a systems approach such as recall systems. However, there is a presumption for healthcare team to accentuate prescription errors as one of using wrong antibiotics for the organism, as a breach of standards by an individual. Barker (1998, p.34) asserts that a system approach will help to identify illness contributing factors and management history, and recommends for a best cure against potential harm. This approach takes a complimentary role to competence of a person. Mental health officers from high performing teams usually have a clear understanding of their roles, along with the demand of their colleagues, hence working in setting of honesty and trust where team leaders are receptive to different views. A patient’s safety culture recognizes the certainty of error and keenly search for the establishment of patient protection. Quality improvement requires a joint effort from health professionals team, who should feel empowered to contribute to quality of care and safety (Bodenheimer et al, 2002, p.177).

Recall systems in primary care

A strong primary health care system is fundamental in ensuring that individuals and communities easily access health care at their convenient time. Recall refers to a system to make sure patients receive further medical advice on issues of clinical importance. A recall is mostly for abnormal results where it is vital that the
patient return for a further diagnosis or observation. The rise in computerization of UK’s mental health care for patient and data records has tremendously changed the way in which nurses operate and the way they relate with patients. E-health is perceived to be increasingly important in ensuring recall system efficiencies and improving quality of mental patient care (Pearce, C. & Haikerwal, 2010).The rise in computer use in primary care has been described as responsible for enhancing quality of care and safety because of ease in accessing the largest electronic database of clinical information in the country. The types of recall and reminder systems may include postcards, letters, phone calls, emails, birthday cards, opportunistic screening such as home visits and SMS (Henrik Gonge and Niels Buus, 2011).


  1. Governance issue on population health

Governance is regarded as one of the fundamental determinants of population health due to its effect on social and environmental conditions at the country level. Some studies have shown government effectiveness at the country level to have substantial influence on socioeconomic outcomes, including food security, education, and economic development (Vagero, 2007). Hence, effective governments with better investments in infrastructure related to health can improve people’s daily living environment, quality of life, and health. In contrast, less effective governance cannot improve the key socioeconomic determinants needed to benefit population health. Lack of effective governance has been reported to result in inability to utilize aid resources and eventually in failure to institute a good health care system.

To address this issue, we use life expectancy and under-five mortality as the indicator of population health. Accountable and efficient government should ensure equality of political and social rights in society across groups by setting sound macroeconomic policies and providing public goods such as infrastructure, healthcare and education.

Child health is one of the most frequently discussed indicators of population health because children, may face physiological and behavioral differences, are more susceptible than adults to environmental, political, and socioeconomic factors. The mortality rate of children under the age of five (under-five mortality rate) is one of the major indicators of child health within a country. A nation’s under-five mortality rate reflects social and infrastructure developments such as child nutritional health, immunization, and medical services; clean water and safe sanitation; and the overall safety of children’s environment (Winstanley and White, 2008), Almost one-third of urban dwellers in developing countries currently live in slum conditions.

Retaining competent healthcare professionals

In the present labor market, recruiting and retaining competent health care professionals can be a challenge. This shortage leaves hospitals and primary care overburdened and undermanned (Burns, Bradley, & Weiner, 2011). This also poses a threat to the quality of care received by patients. In circumstances where shortage of this magnitude persists for a long period, the health care system in the country may be crippled by disruptions in care provision (Couzos & Murray, 2003).

  1. Leadership practices

Clinical leadership is regarded as decisive toward keeping abreast of changes that are being experienced at work. Nurses are being call upon to offer leadership in clinical set ups that are grappling with nurse deficiency and turnover. Leaders should suggest and enforce feasible solutions that will stand the test of time. Healthcare organizations that seek to transform their services should recognize their own path toward cultural change and embrace it with effective leadership styles (Winstanley and White, 2008). Additionally, a clear definition of roles and responsibilities should be undertaken to empower the team with paraphernalia for sound decision making, prompt change and long-time process development.

New ways of motivating healthcare staff to enhance quality service delivery

Majority of hospitals embrace competitive motivational programs in recognizing the contribution of medical staff in their service delivery. Physicians and other medical staffs are remunerated an attractive package on basis of service availed by provincial management of healthcare (Burns, Bradley, & Weiner, 2011).The provision of salary is deliberated on by provincial government and medical representatives at the province level. The provincial medication association is a medical staff grouping that airs grievances of its members and bargains for better terms of employment. To effectively motivate medical staffs, Alberta has embarked on equal distribution of responsibilities to avoid overworking of other practitioners. This seems to be a good intervention, as it relieves some doctors of the duties. Healthcare systems of specialization are introduced in the hospitals where a member of staff will get more involved in the field they can do best (Barker, 1998).


In the present labor market, recruiting and retaining competent health care professionals can be a challenge. This shortage leaves hospitals and primary care overburdened and undermanned. This also poses a threat to the quality of care received by patients. The unprecedented global changes in population and economic growth may increase stress on natural, physical and social environments as well as threat population mental health care and development. Macroscopic perspective is needed to understand the combined effects and interplay of these environments on health and health inequalities on a global scale over time as well as to provide global strategies and evidence-based priorities of health, equity and sustainability of human beings.


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