Making sense of supervision : a narrative study of the supervision experiences of mental health nurses and midwives
MacLaren, Jessica Margaret
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This thesis explores mental health nurses’ and midwives’ experiences of supervision. The thesis aims to create a partial and situated understanding of the numerous factors which contribute to practitioners’ experiences of supervision. In particular the thesis investigates the disciplinary context within which supervision takes place, moving from the experiences of individual practitioners to compare and contrast supervision within two distinct professional disciplines which have common areas of interest. Existing research on the topic of supervision in mental health nursing and midwifery tends to reify the concept of supervision. Supervision is assumed to be beneficial, and there is a focus on investigating the effects of supervision without an accompanying understanding of why, how, where and by whom supervision is done. In this thesis, ‘supervision’ is critically conceptualised as indicating a cluster of context-specific practices, and the investigation of supervision is located with the practitioner’s understandings and experiences. The theoretical perspective of the thesis is informed by social constructionism, and ‘experience’ is conceptualised as communicated through meaning-making narratives. The experiences of the study participants were accessed through the collection of data in the form of narratives. Sixteen participants were recruited, comprising eight mental health nurses and eight midwives. Each participant was interviewed once, using a semi-structured interview format. The analysis was influenced by the theories of Gee (1991), Bruner (1986) and Ricoeur (1983/1984), and employed a narrative approach in which the unique meaning-making qualities of narrative were used to interpret the data. The analysis paid close attention to the process of fragmentation and configuration of the data, and produced four composite stories which presented the findings in a holistic and contextualised form. Two themes were identified from the findings: Supervision and Emotions, and Supervision and The Profession, and these were discussed in the light of the two professional contexts explored, and with reference to supervision as an exercise of power. The theme of Emotions recognises the integral role played by emotions in both clinical practice and supervision, and conceptualises supervision and the organisational context as emotional ecologies. Supervision can be constructed as a special emotional ecology with its own feeling rules, and this can both benefit and harm the practitioner. The theme of The Profession responds to the importance of the professional context of supervision practices, and the role of discourses about professional identity and status in determining how supervision is done and with what aim. Comparing supervision practices within two different disciplinary contexts enabled this thesis to challenge tropes about supervision. Supervision cannot be assumed to be either ‘good’ or ‘punitive’, and practices are constructed in the light of particular aims and expectations. This thesis also makes the methodological argument that research into supervision must be politicised and theorised and accommodate contextualised complexity. To simplify or decontextualise the exploration of supervision is to lose the details of practice which make supervision what it is. Supervision is a complex process, enmeshed in its context, and may be constructed to serve different purposes.