SUPERVISION

By TNC
 OBJECTIVES
◦ Define supervision
◦ Recall and understand the concept of supervision in nursing
◦ Describe the importance of supervision in nursing
◦ Apply principles of supervision in clinical setting
◦ Enlist the tips of effective supervision
◦ Describe procedural steps of supervision
◦ Explain the methods of supervision and functions of supervision
◦ Describe tools and techniques in supervision
 INTRODUCTION
◦ Supervision is the one of the important element and essential component of
staffing.It involves the management , direction and leadership of employees.
◦ It operates in functions of supervision,ie planning,organizing, leading,
evaluating, and staffing.
◦ It is generally overseeing the efforts of people in an organizational structure and
report to the manager who sets the guidelines and goals for the organization.
◦ It has an impact on employee satisfaction and it can be only effective when the
supervisors are competent ,technical expert and trainer.
◦ The supervisors give guidance to the subordinates to attain the organizational
goals through delegation of work.
 MEANING AND DEFINITION
◦ The word supervision is derived from two Latin words ‘super’ means
‘above’ and ‘video’ means ‘see’. It means overseeing or
superintending the work of others. Supervision refers to the direct
and immediate guidance and control of subordinates in the
performance.
◦ It is safeguarding the personal from making mistakes for the purpose
of achieving the established objectives
◦ It is a teaching learning process which provides constant observation
,monitoring, evaluating and guidance to subordinates
◦
◦ In nursing service it consist all activities that express leadership in the
improvement of nursing care service. The aim of nursing supervision is the
improvement of human, individual and scientific nursing care of patients.

◦ Clinical supervision is a term used to describe a formal process of professional

support and learning that enables individual practitioners to be competent
and enhance consumer protection and safety in complex clinical situations

◦ It is a two way dynamic and social process undertaken for the specific
purpose of fulfillment of organizational needs, goals and maintaining required
quality of performance
◦ Supervision is the process by which the subordinates are guided
according to their needs by the immediate superiors, so they can make
improve their abilities so as to do their job efficiently and effectively to
fulfill the objectives of the organization
◦ -Williomson
◦ Nursing supervision is a service to improve patient care by promoting ,
stimulating and fostering of personnel growth an dwelfare.it is primarily
concerned with the personnel, physical facilities, equipment, ease and
difficulty of work man ship of personnel
◦ -Perrodin CM
◦ In nursing organization ,where the number of nurses are small, the
supervision is not a problem .It can be managed by direct
observation. But where the number of nurses are large, the
supervision is managed by different nurse supervisors and ward
incharges etc
 OBJECTIVES OF SUPERVISION
GENERAL OBJECTIVES
✓To see that a particular work or task is being done in the expected manner
✓To promote continuing improvement in the performance of nurses
SPECIFIC OBJECTIVES
➢To meet predetermined work objectives of providing nursing care to client in
the health care setting
➢To motivate the staff to use talents and potentialities
➢ To guide the individuals according to their needs

➢ To help the personnel to adjust with the environment

➢To ensure that the nurses at the operational level do what they are
supposed to do

➢To promote team work, as nursing care is one of the component of total
patient care which can be most effective

➢To evaluate the quality of nursing care rendered by a them

➢To bridge the gap between the nurses personal goals and the
organizational goals by providing guidance in the right direction
 PURPOSE OF SUPERVISION
Getting the work done in an organization
◦ Main purpose is to ensure that the work has been accomplished within
the expected framework .The supervision is carried out at various levels.
The nurse manager has to ensure that there is appropriate
infrastructure for the nurses to work in various units .

◦ During the work supervisor must exercise occasional checks and

carrying out inspections to see everything is in order.
Observing,assessing ,checking and amending
◦ During the act of supervision, defects in planning,and strengths and
weakness of each staff are evaluated and accordingly the re-
planning is done
Improvement in the staff efforts individually and effectively
◦ Not only fault finding and punishing defaulters, but also
improvement of staff efforts individually and collectively for
shortcomings ahead is needed at appropriate time.
◦ Supervision helps the staff to become self directive

◦ It gives sense of security and confidence to staff in their ability to analyze

and solve the problems

◦ Helps the nurse to work together as a team ,share their views ,discuss
their ideas for the improvement of the department

◦ The staff is motivated to do the work and their morale is built ,hence
they work for the betterment of organization and thus supervision helps
to bridge the gap between personal goals and organizational goals
 PRINCIPLES OF SUPERVISION
◦ The subordinates must understand clearly what is expected of them
◦ It should be focused on the attainment of goal ,giving high quality nursing
care

◦ It strives to make nursing unit a good learning situation and consider

supervision as a teaching learning process in which it should keep staff
improve ,develop and refine knowledge and skills
◦ It should be well planned. Objectives and methods of supervision criteria for
judging success need to be planned
◦ Subordinates must have guidance in their work and should be helped to attain
objectives

◦ It should ensure staff development and creat good work culture and climate for
productive work

◦ Should emphasize on activities and give constructive criticism on poor work and
recognition of good work

◦ Provide opportunities to them so that they can improve themselves

◦ Create a safe and healthful environment to the subordinates to do their work

◦ Supervision should be particularly and democratic in nature

 PROCEDURAL STEPS FOR SUPERVISION
PREPARATION
The nurse supervisor carry out the activities such as,
✓Have knowledge regarding relevant problem which may arise
✓Assess the performance of individual staff
✓Study the hospital policy ,routine, rules, regulation, guidelines,
procedural manuals, job specification, standard norms, targets etc.
✓Prioritize areas,activities and tasks related to nursing care which
should be supervised
✓Prepare checklist for observation, prepare plan, schedule and
content for supervision
◦ ACTUAL SUPERVISION

◦ Tools that may be used in actual act include job description, task
description,weekly time table and tools for supervision
◦ Establish contact with subordinates ,clients and their relatives and with
other team members
◦ Review the objectives with other team members
◦ Review job description
◦ Observe nursing staff’s motivation,interest towards work
◦ Observe the performance of all staff tasks with regard to skill, attitude
◦ identify gaps and needs for follow up and action
◦ FOLLOW UP OF SUPERVISION

◦ Prepare report of supervision or observations

◦ Plan for follow up actions on;

➢Organizing in service training programmes

➢Recognition of time table/work plan/duty roster
➢Guidance and counseling of staff members
➢Initiating action on staff welfare activities
CONTENT FOR SUPERVISION
Patient care

Material
Nursing staff mangement
 METHODS OF SUPERVISION
◦ Selection of technique
The factors need to be considered during selection of technique of
supervision include,

▪Personality of the individual being supervised

▪Ability of the person

▪Activities for which the method will be used

▪Individual needs of the nurses

DIRECT METHODS
◦ These are the observation made on staff.Directly the nurse of operational
level are observed in the participatory or non participatory methods.During
the performance or activity time their skill, knowledge, expertise,strength
and weakness are assessed.
INDIRECT METHODS
◦ It is done through records and reports.The observation are done
retrospectively to compare performance against indicators such as,
➢What type of activities has been performed?
➢To what extent the activities are performed and quality assured?
➢What are the relationship of performed activities with the achievement of
objectives?
◦ OTHER METHODS
◦ Staff meetings
◦ Individual conference
◦ Group conferences
◦ Rounds
 TOOLS OF SUPERVISION
◦ The most important tools of supervision used by the middle nurse
managerial supervisors are;

▪Job description

▪Task description

▪Weekly timetable

▪Checklist
▪Rating scale
◦ Observation checklist
◦ It is simply a list of expected behaviour associated with a particular
nursing intervention on overall expected behaviour in the clinical area
◦ It include the knowledge, attitude and skills and there will be space to
put tick mark whether or not
◦ Rating scale
◦ It is to obtain the degree to which the particular characteristic is
expressed which is not readily detected through simple
observation
◦ It show the straight line with the range of behaviour on the scale
 FUNCTIONS OF SUPERVISION
◦ Procter(1992) sees supervision as the exchange between professionals to enable
development of professional skills. The main functions of supervision based on
Procter’s model are ; Normative ,formative and supportive functions

◦ NORMATIVE FUNCTIONS
◦ It is also called managerial and quality control aspects of professional
practice,maintaining appropriate standards of care, delivering efficient and
effective care.The functions of the supervisor include assessment of the workload
of individuals and groups according to their physical and mental competence of
the works and assigning duties and preparing duty rosters.Identifies the needs of
supplies and problems faced by the staff and others.
◦ FORMATIVE FUNCTIONS
◦ It is also called as educative functions. The part of supervision connected with
the educational development of the staff through expansion and maintenance
of skills and knowledge.Orientaion of new staff, teaching the subordinates by
sharing knowledge and providing technical guidance, plan and conduct in
service educational programmes and ensuring staff development.

◦ RESORTIVE OR SUPPORTIVE FUNCTIONS

◦ This includes creating a therapeutic relationship that nurtures and cares for
the person being supervised. It addresses for the staff’s need for support
through management and minimizing the occupational stress
◦ OTHER FUNCTIONS
◦ COMMUNICATIVE-Supervisor act as the communicator between operational
and other members of the team .facilitates the free flow of communication
among staff members

◦ EVALUATIVE-Each supervisor perform performance appraisal and promote

effective nurses by their work performance under her unit and provide
feedback to improve their efficiency
 FUNCTIONS OF SUPERVISOR
◦ GENERAL
◦ Administrative-assigning duties, preparing duty roster,providing
material etc
◦ Teaching –providing technical guidance
◦ Helping-help to solve the problems
◦ Linking-acting as the communicator between superior and
subordinates
◦ Evaluation-carrying out performance appraisal
◦ TOWARDS SUPERIORS
◦ Identify the activities of hospital nursing authority
◦ Arrange to carryout these activities
◦ Suggest measures for improving efficiency of staff
◦ Act as the liaison between higher authority and subordinates
◦ Refer matters to superiors for proper intervention
◦ TOWARDS SUBORDINATES
◦ Assist in selecting ,orienting, and including new staff
◦ Teach them ,help them assign them duty roster and appraise their
performance
◦ Involve them in planning the patient care
◦ Conduct meetings, conferences, rounds and guide them
◦ Develop e spirit of dedication, teamwork, cooperation and harmony among the
staff
◦ Take interest in the nurses as persons, enabling them to maintain a high
standard of performance at all times
◦ IN TERMS OF COOPERATION
◦ Effective planning within the nursing unit
◦ Just and fair distribution of workload
◦ Timely and effective performance of task
◦ Anticipate difficulties and problems
◦ Maintain coordination with other team members
◦ Look for newer method of improvement
 QUALITIES OF SUPERVISOR
◦ Inter professional and professional skills
◦ Technical knowledge
◦ Thoroughness
◦ General outlook
◦ Initiative
◦ Enthusiastic
◦ Emotionally mature
◦ Teaching abilities
◦ Positive attitude
 CATEGORIES OF SUPERVISION
◦ CLINICAL SUPERVISISON
◦ It is about maintaining an effective balance between various
demands on the health care practicioners including nurses. The
nurse reflects on practice analyze, issues and problems, clarify goals
identifies strategies for goal attainment and establishes an
appropriate plan of action.
◦ MANAGERIAL SUPERVISION
◦ It focus on balancing a weekly workload, administrative
procedures,meetings ,planning,audit activity, recruitment, retention,
issues and communication.
◦ PERSONAL SUPERVISION
◦ This focus on staff’s interpersonal issues, job pressure, motivation,
team issues.Allow staff to express difficult feelings related to work
and climate.
◦ Nurse supervisor act as mentor and exhibit participative and
democratic style of supervision
◦ PROFESSIONAL SUPERVISION
◦ The nurse supervisor reflects her role as a professional within the
multiprofessional team inorder to identify specific training needs
or developmental needs
 TIPS FOR EFFECTIVE PLANNING
◦ Don’t over burden and exert undue pressure on staff
◦ Give autonomy to staff depending on the personality, capability,
knowledge, experience, and competence etc
◦ Be professionally and technically competent
◦ Provide necessary guidance and counseling and encourage staff in
decision making
◦ Communicate with subordinates freely
◦ Provide good leadership
◦ Ensure good planning ,organizing and coordination
◦ Create suitable climate for productive work
◦ Focus on continued and sustained growth of staff
◦ Be flexible, communicate, motivate and try to keep feelings out of
decision making
◦ Be aaceptable,ie respect is earned, not demanded. So make our
self acceptable as a leader.
◦ Say no to favoratism.Be fair and believe in justice
 SUMMARY
◦ Supervision is an element of staffing and directing where the supervisors
give guidance and counseling to their subordinates to attain the
organizational goals. There are different techniques such as direct
supervision indirect supervision and certain other method. Each supervisor
has their own different functions and should be well competent enough
with knowledge, attitude, skills experience etc. Supervisors use different
tools for supervision such as direct supervision, checklists, rating scale etc
under different categories of supervision.
 CONCLUSION

◦Supervsion is an opportunity to bring someone back to

their own mind ,to show them how good the can be
◦ -Nancy kline
 REFERENCES
◦ VATI.J.PRINCIPLES OF NURSING MANAGHEMENT AND ADMINISTRATION.JAYPEE
PUBLICATIONS.PAGE NO:437-443

◦ BASAVANTHAPPA B.T.NURSING ADMINISTRATION AND MANAGEMENT OF NURSING

SERVICES.2ND EDITION.JAYPEE PUBLICATIONS.