What influences palliative care nurses in their choice to engage in or decline clinical supervision?

BACKGROUND: Clinical supervision (CS) has been around since the early 1990s in the UK and has been endorsed by government and professional bodies. Levels of engagement range from 18% to 85%. AIM: To investigate what influences palliative care nurses in their choice to engage in or decline clinical supervision. METHOD: A qualitative study was undertaken in an inpatient hospice in England and employed two focus groups to compare the views of participants and non-participants in CS. Data were audio recorded and transcribed verbatim by the researchers and analysed using systematic text condensation. FINDINGS: Palliative care nurses all used informal team support for 'in the moment' support. Some engaged in formal CS to reflect 'on action' and to challenge practice. Nurses reported a lack of clarity regarding CS but, once this was overcome and engagement with CS was established, it led to changes in practice, identification of training needs and team building. The option of choice between group and individual supervision was found to be important. Group supervision led to enhanced understanding of group members which also led to team building, individual sessions were useful for individual issues. Protected time was essential for staff to be able to engage in CS. Staff who worked in larger teams reported higher levels of engagement, whereas a small team reported less need due to more informal team support. CONCLUSION: These findings are positive as they illuminate the importance of choice for support. Nurses need to be aware of their options for support and ultimately how this support affects the care they provide. The Palliative Care Nurse's Model of Support was developed, which shows the effects of each choice and how this may lead to team-building.

Cohesive short-stretch vs four-layer bandages for venous leg ulcers.

Nurses today are employing more and more evidence base within their practice. This must be carefully balanced with their ability to offer patients choice about treatment options for venous leg ulceration. Knowledge of only one particular compression bandage system is inadequate for nurses working within this area. This article aims to examine the evidence base for the use of compression bandaging in the treatment of leg ulceration. It explores results of current randomised controlled trials in this area pertaining to four-later bandage (4LB) and cohesive short-stretch bandage (CSSB) systems. The advantages and disadvantages of the 4LB and CSSB are explored and application method of CSSB is explained. Concordance is and important issue that affects successful leg ulcer management (Moffatt, 2004a): if this can be achieved through offering patients choice of treatment bandages, then more successful treatment will be achieved for patients.