Journal Entries (Wk1-7): Clinical Supervision



Journal Entries (Wk1-7): Clinical Supervision Trina Skinner Stenberg CollegeJOURNAL ENTRY No. 1 (2 April-8 April)Session One: Definitions, history and background of Clinical Supervision1. What did you expect clinical supervision would be about prior to starting this course?To be perfectly honest I did not even begin to get the hang of the way the program is designed until this week (9 April-15 April). I wasn’t even aware of how to navigate Moodle after the orientation weekend; since so many concepts were abstract as no courses were open I found it very difficult. It is rather embarrassing to admit but I was not even aware that all the courses had opened up and the first week was a complete loss for me in terms of first impressions on instructors and progress. I was ill beyond normal function and could not mentally process even the most simple of tasks for the better part of two weeks and I am trying to get back on track as quickly/effectively as possible. I thought that “Clinical Supervision” was as simple as it sounds- supervision of students during clinical placement. I was rather confused and not sure what to inspect in terms of clinical supervision as a course.2. What were your weekly expectations?Again, I honestly had no idea what to expect in terms of what our weekly expectations would be regarding Clinical Supervision as I was under the impression that Clinical Supervision existed only in clinical practice- with all the other confusion surrounding the start of the program and the state of my personal life I had not even considered what I thought a Clinical Supervision course would entail as I have never heard of such a course offered in a nursing program prior to orientation at Stenberg. Clinical Supervision as a course was not really discussed throughout the orientation or perhaps I missed that aspect- so I did not have a real chance to consider what to expect.3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week.In regards to Week 1- my participation in Clinical Supervision was non-existent (as I tried to explain Vicky, although it probably made no sense as to how someone could be so out of touch with the program content). It was not until Week 2 (April 9-15) that I began to get a grasp of what our Clinical Supervision course was/is all about.JOURNAL ENTRY No. 2 (9 April-15 April)Session Two: The Rudimentary Features of Clinical Supervision2. What were your weekly expectations?As I am becoming more acquainted with the idea of ‘Clinical Supervision’ as an actual course this week I still must say I have no idea as to what to expect throughout our weekly sessions! Upon completion of this week’s assigned activities I can say that I am very excited about what is to come as I am slowly starting to understand the importance of this course and what it will offer us in the future weeks to come!3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week.This week I was surprised at the level of material related to ‘Clinical Supervision’ I came into contact with throughout my search to yield articles pertaining to the ‘rudimentary features of Clinical Supervision’. Based not only on the papers I referenced in my forum post for the week, but many others I came across it has begun to become extremely obvious that ‘Clinical Supervision is a serious subject that is surrounded by controversy and a lack of agreement across various nursing disciplines as to not only what the concept of ‘Clinical Supervision’ means, but also how it is to be applied effectively and in what context? I found (Wilkin’s) statement that “Through the process of clinical supervision, the raptures of and heartaches of PMHN’S [psychiatric-mental health nurses] clinical experiences will slowly ripen into experiences of learning” particularly moving and appreciated that it captured the raw emotions that occur throughout the practice of psychiatric nursing at a clinical level not only for the patients, but for the RPN’s as well. The emotional component to the statement , rather than it being primarily focused on scientific language as so many of the articles we study are, really emphasized the importance of the application of ‘Clinical Supervision’ in nursing, especially psych nursing, in my opinion, as we are working on a more holistic/humanistic level with patients as opposed to general medical-based nursing.JOURNAL ENTRY No. 3 (16 April- 22 April)Session Three: The History and Background of Clinical Supervision2. What were your weekly expectations?Prior to conducting any research on the this week’s topic I anticipated development of a better comprehension of ‘Clinical Supervision’ based on the notion that we would be locating research articles/papers that discuss the then vs. now aspect of the subject of ‘CS’ and looked forward to gaining insight into the history of ‘CS’ in comparison to the current role of ‘Clinical Supervision’ in nursing.3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week.By this week I feel that I am finally starting to get a firm grasp of the concept of ‘Clinical Supervision’, the aim/intention behind the practice, and further establish my belief in ‘CS’ as a critical component to the evolution of effective nursing practice. I stated in this week’s forum that although “I understand the controversy surrounding Clinical Supervision… one can’t help another understand his/herself and apply therapeutic strategies if one does not understand themselves” (Skinner, 2012); I believe that based on our introduction to the history/background of ‘CS’ this week that this is the most important principle guiding the practice of ‘Clinical Supervision’ once the controversy/politics/misunderstanding is stripped away, it is the opportunity to provide an RPN a safe, effective environment to self-reflect and increase self-awareness in order to strengthen their practice that is the fundamental basis for the creation of ‘Clinical Supervision’ some 100 years ago. JOURNAL ENTRY No. 4 (23 April-29 April)Session Four: Reflection and reflective practice in Clinical Supervision2. What were your weekly expectations?As soon as the details of ‘Session four’ opened up and I skimmed the content I instantly became apprehensive. Journaling for some reason has always perpetuated an anxious response within me for whatever reason. When I initially studied and reflected on the content of ‘Session four’ I felt stressed because expressing myself, or reflecting on my experience through the process of writing has always proved difficult for me, I must admit that I entered this session on ‘journaling’ with some negative connotation in mind.3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week.Ironically the intimidation and anxiety that the topic of ‘journaling’ created in my mind provided an opportunity to self- reflect on why it is that I become so uneasy concerning the subject. I remember from a young age, about the time I entered puberty and was diagnosed with anxiety disorder it was recommended that I ‘journal’ to keep a record of my thoughts and feelings and to use as an outlet for some of the irrational thoughts that were circling my mind due to my anxiety. I have always been a strong “English/lit” student and grew up (and continue to be) fascinated by the beauty of language and expression, I feel as though in previous attempts at various points of my life to initiate the exercise of ‘journaling’ my biggest drawback was that I would become too caught up in the way I wrote, I was very judgmental of my writing upon reflection or during the writing process so it would understandably come to a halt as I became increasingly frustrated with my lack of articulation. I would allow my mind to become caught up in thoughts like “that sounds ridiculous” or “that makes no sense, or these thoughts are so disorganized and pointless”, obviously missing the point that my written words were ‘choppy and disorganized’ as they reflected my thought pattern at the time- I would tear out pages and continually rob myself of the therapeutic value of journaling at the expense of trying to sound deep and profound as if I were going to be the next literary genius rather than use the journal as it was intended, as a method of self- reflection. As I mentioned briefly in this week’s post I have often regretted not keeping any sort of reflective writing log in my years as a healthcare assistant as I do not rely heavily on memory as it is not as reliable as the average person assumes, I believe based on my knowledge of memory processes gained in previous psychology studies that people generally give our memory much more credit than it deserves and it often fails us. The only absolute way to ensure accurate recording of events and future opportunity for self-reflection is through written example. I am delighted at the chance to finally put my irrational fear of journaling behind me once and for all and embark on this journey that I trust will serve me well throughout my experience as an RPN student and future RPN regarding my practice. One of the readings this week states that “Nursing practice is, by nature, reflective, in that nurses build their own knowledge with experience... By reflecting, nursing students gain their own personal nursing knowledge for practice. By applying reflective journaling to clinical practice and to leadership/management situations, they learn to more critically think about clinical issues as well as conflict resolution, team building, communications, and other administrative issues” (Fortson & Sisk, 2007). I am now ready and willing to embrace reflective journaling as a means to develop and demonstrate all of the skills mentioned above and more! It is never too late to start!Consequently as a result of my decision to come of an SNRI after long term use with the agreement of my physician that it be a suitable choice at this point in my life I have initiated the process of developing a personal journal to help me work through the process of ‘weaning’ off the medication and some of the rather difficult effects and turbulent experiences regarding withdrawal that have arisen along the way. I just write, with no judgment and reflect on how I am feeling day to day when I become overwhelmed by the chemical changes my body/mind are experiencing throughout this process, and it is a liberating, extremely informative experience that helps guide me through when the journey becomes increasingly challenging.JOURNAL ENTRY No.5 (30 April-6 May)Session Five: Regulation of Psychiatric Nursing in Canada2. What were your weekly expectations?Every week when the session content ‘opens up’ I skim over the required reading and forum posts to get an idea of what is expected of us that week. I must say this week I was initially overwhelmed at the amount of information detailed in this session. It is very difficult for me to read and comprehend this type of material (i.e. ethical standards of nursing practice). This is a great example of why one should not judge prior to experience as I actually gained a considerable amount of knowledge and insight into the guidelines that regulate psychiatric nursing in Canada and the resources provided were presented in a way that allowed my mind to absorb pertinent information. I am sure it helps that the content is related to my chosen area of study, a discipline of nursing that as we go I continue to become increasingly interested and thirsty for knowledge as the weeks move forward 3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week.This is a great example of why one should not judge prior to experience as I actually gained a considerable amount of knowledge and insight into the guidelines that regulate psychiatric nursing in Canada and the resources provided were presented in a way that allowed my mind to absorb pertinent information. I am sure it helps that the content is related to my chosen area of study, a discipline of nursing that as we go I continue to become increasingly interested and thirsty for knowledge as the weeks move forward Some of the content material presented this week that I found particularly useful and demonstrated the position of RPN’s as a self regulatory body, affirming what it is the RPNC stand for is located under the heading “Standards of Practice, Code of Ethics, & Competencies” on the CRPNBC website. Now that I have a chance to reflect on my work for the week I would like to comment on my answer to the question concerning ‘barriers working as an RPN in Canada’. I feel that I focused too much on socio-political issues that act as barriers to RPN’s and could have organized the information I presented in a much more clear, concise manner. I would have liked to touch on some of the more ‘internal’ barriers that an RPN may come up against working in an institutional/hospital setting, as opposed to more ‘external’ factors, such as the government related issues addressed in my forum post. Some of these ‘internal issue to consider include staffing shortages, conflicts with colleagues, problems regarding disorganization and discrepancies in the ‘chain of command’ when conflict does arise, all which may result in weak nursing practice. A further example to consider in this regard is that responsibilities are not delegated or carried out appropriately by management. The aforementioned problems ultimately result in a decline in effective client care and pose barriers to working as an RPN in Canada that I would consider ‘internal’ factors.I found the presentation of the “Standards of Practice” (RPNC) complete with ‘indicators’ that enhanced the reader’s understanding of what constituted each standard ,as opposed to a vague description based on difficult to follow professional language found in many examples of healthcare related material, particularly impressive and extremely informative.JOURNAL ENTRY No. 6 (7 May-13 May)Session Six: CRPNBC Standards of Practice as evaluation in Clinical Supervision2. What were your weekly expectations?I had a good idea of what to expect this week and was looking forward to studying the ‘Four standards of practice’ outlined on the CRNBC website more closely, as I took particular interest in that aspect of the material presented for the purpose of last week’s assignment ‘Regulation of psychiatric nursing in Canada’.3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week. I found the presentation of the “Standards of Practice” (RPNC) complete with ‘indicators’ that enhanced the reader’s understanding of what constituted each standard ,as opposed to a vague description based on difficult to follow professional language found in many examples of healthcare related material, particularly impressive and extremely informative. I feel that the task of assessing how we (RPN students) can and will apply each of the four standards in our role as students extremely effective in allowing us to absorb the content of the material discussed (the four standards of practice) as well as make connections, not just reading about what constitutes each standard but applying each to our own lives and unique experience as RPN students. I found this approach to learning extremely effective in solidifying the important points presented in each element of the ‘standards of practice’ as they pertain to Clinical Supervision as well as promoting critical thinking skills and analysis. Through my personal experience as a healthcare assistant and what I have and continue to learn since the beginning of the RDPN program at Stenberg I value the crucial component of the development of critical thinking/analysis skills among nurses in order to provide effective healthcare in the future. This week’s structure in ‘CS’ was a particularly strong example of how such skills may be cultivated. Based on Dr. Facione’s work, (Ward, C.W.) states that “interpretation, analysis, evaluation, inference, explanation, and self-regulation?are the core skills necessary to critical thinking”. All of these ‘necessary skills’ were utilized this week in regards to the task of breaking down each ‘standard of nursing practice’ and describing how we as RPN students currently/or may begin to apply the ‘indicators’ noted along with each standard outlined on the CRNBC website in our daily lives in preparation of becoming effective nurses with strong capability to think and act from a critical standpoint. JOURNAL ENTRY No.7 (14 May-20 May) 3. Reflect and analyze what you found that was different than you expected each week? Give specifics PER week. As there was no forum this week or required reading material to study in order to allow us to work on our journals prior to submission, I must say I appreciated the week (although swamped with work from four other courses) to reflect on the wealth of information I have obtained from Clinical Supervision thus far and how grateful I am that Stenberg has ‘CS’ available to students not only throughout clinical experience but offered as an entire course! I would be lying if I said the work is not daunting at times with attempting to balance all five courses in a learning environment completely foreign to me (on-line that is). However, from week to week I am able to recognize the necessity of Clinical Supervision, especially in regards to Psychiatric Nursing and this is one resource that I intend to take full advantage of while we are so fortunate to have it offered to us as students- thank you Vicki for your dedication and support, you most certainly play a pivotal role in our journey towards becoming “Canada’s next top Psych nurses” :pReferencesCollege of Registered Psychiatric Nurses of British Columbia (2012). Our History. Retrieved April 30, 2012, from: , A., & Sisk, R. (2007). Reflective journaling as assessment and teaching. Retrieved April 23, 2012 from: stenbergcollege.file.php/344/Reflective_journaling_asassessment_and_teaching.pdfWard, C.W. (2006). Developing Critical Thinking in Nursing. Med-Surg Matters (MEDSURG MATTERS). 15(5): 1,14-5 (18 ref). Retrieved from:, P. (n.d.). Clinical supervision. In P. Barker (Ed.), Psychiatric and mental health nursing:the craft of caring (2nd ed., pp. 665-662). London, United Kingdom: Hodder Arnold. ................
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