Group clinical supervision for nurses: Process, group cohesion and facilitator effect

Objective: This qualitative research project set out to explore how, and by what means, participation in group clinical supervision might impact nurses. It aimed to describe participant perceptions of the processes within a long running reflective practice group for intensive care nurses and explore these in relation to relevant theory. Background: Interpersonal aspects of care are central to the nursing role, however, the associated emotional labour can develop into moral distress, compassion fatigue and burnout. Australia's peak nursing and midwifery bodies have released a joint position statement on the importance of supervision for nurses. Group supervision interventions, such as reflective practice groups, mitigate stress, promote learning and support interpersonal aspects of nursing. Method: Twenty-two intensive care nurses from a reflective practice group that had been running for 10 years, participated in focus groups convened by an independent researcher. Thematic analysis identified key perceptions relating to process and outcomes. Results: Group identification, voluntary participation and skilled facilitation created an enabling environment for nurses to self-disclose. The sense of universality experienced by participants, along with increased empathy, enabled reflection and selfevaluation relevant to the group prototype of the ideal nurse. Authentic emotional expression was seen to provide respite from emotional labour, thereby regenerating resources for nurses to cope with job demands. Discussion: Key themes can be aligned to social psychology constructs of group identity, task interdependence and homogeneity, supporting earlier studies that suggest group cohesion is comprised of measurable factors. By developing and aligning with these constructs, the facilitator assists the group to establish a safe space whilst conceptualising and aspiring to a model for the professional and compassionate nurse. Conclusion: Social psychology constructs can help develop practice and research of group supervision for nurses. In clinical nursing settings, group identity is particularly salient and facilitator interventions should aim to strengthen this. The development of a sense of universality, when combined with voluntary participation and a focus on intra-group process, can enhance cohesion and create a safe space for selfdisclosure. This enables nurses to explore actions and responses to clinical situations and explore emotions incongruent with the ideal