Resilience-based Clinical Supervision – a game changer!

Vikki Garrick, IBD Nurse Specialist, Glasgow

I have been a FoNS Inspire Improvement Fellow since March 2018. It has been one of the most enlightening journeys I have ever been on and my first time trying Resilience-based Clinical Supervision (RBCS) was no different. We were introduced to RBCS, as a group of Fellows, during our September workshops and following my own experience of using it I thought it was something that would be beneficial for the team I lead.

I was quite nervous about how it would go, but (as usual) it was nowhere near as frightening as I imagined and our team thought it was amazing! The ethos of this approach is to promote compassion to ourselves and others by using a structured approach to how the clinical supervision session is organised.

It starts by encouraging everyone in the room to ‘be’ in the room by doing a grounding exercise followed by a ‘check-in’. I work in a very busy clinical team and before the Inspire Improvement programme, this sort of language would have made me (and our team) feel really uncomfortable. The narrative has changed now. That’s a result of this programme and the groundwork that has gone into building a more open and trusting culture for us.

What is so great about RBCS is that is focuses on how people FEEL. It’s not a forum for people to moan or rant (as often happens in these clinical supervision sessions in my experience). It’s a gentle way of encouraging people to reflect on their own feelings and behaviours and through doing this, then be able to understand others’ behaviours too.

As with all things ‘Inspire Improvement’ it is a really human, caring and gentle way to talk about what may have been a challenging situation for a member of the team.

In our case, one member of our team was feeling very overwhelmed by her workload and this was causing her a great deal of stress. Until we had the conversation, no-one else in the team was aware that she was feeling vulnerable. When she explained how she felt, we were able to discuss her feelings and provide support for her as a group. On a more practical level, the reflective discussion within the group also helped her see how she could change some of her ways of working to help her feel less isolated at work. We used the 3 emotional systems to help identify where her specific feelings were coming from. It was so powerful to see the reaction when she was able to see that her feelings of stress and frustration were coming from the ‘Drive system’ – one which stems from a feeling of wanting to do well and be successful. When she reflected on this it was clearly very reassuring to her because she felt she was under-performing at work (of course this wasn’t true!).

Our ‘ending’ consisted of everyone in the room saying how they felt about the discussion and saying something positive about it. Again, I was concerned that this would feel ‘forced’ – but it didn’t. In fact a few of my colleagues sent me personal messages afterwards saying how powerful they felt it was and how much they had enjoyed it. That has never happened to me before – it felt great!

For me, the strength of this approach is that it is both structured but flexible enough to let the reflective discussion ‘flow’. I can see (and feel) the difference this is making to our team and am so delighted that we have found a way of working that helps us focus on what’s really important: Each other.

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