Restorative clinical supervision (RCS) In the Cab model-by Anna Price
Tuesday, 31 January, 2023
Anna Price is a Registered Nurse employed by the East of England Ambulance Service NHS Trust since 2003. Anna has held a number of roles within the service including being one of the Freedom to Speak up Guardians and remains clinically focussed with Ambulance shifts. Anna was successful in undertaking the Professional Nurse Advocate (PNA) course at the Anglian Ruskin University (ARU) in 2022. Anna's current role is within the Safeguarding team.
Anna Price writes...
In March 2021 the Professional Nurse Advocate (PNA) role was launched by NHS England. This is a professional clinical leadership programme that delivers training to registered Nurses to facilitate restorative clinical supervision (RCS) to colleagues across all healthcare settings in England. Developed by Nurses for Nurses and building on the success of the Professional Midwifery Advocate (PMA) programme. The ambition is to have one in twenty NHS registered Nurses trained as PNAs by 2025. Ensuring all NHS healthcare staff have access to RCS.
As part of the Professional Nursing Advocate module I completed a presentation on active listening. A concept was born for the implementation of Restorative Clinical Supervision (RCS) within the Ambulance Service called the "In the Cab" (ITC) model. This delivers restorative clinical conversations;
In the cab
In the car
In the classroom
In the control room
Restorative clinical supervision (RCS) is one element of the A-EQUIP model (Advocating & Educating for Quality Improvement) and is for all areas of our Ambulance workforce and for all grades of staff.
Promoting the education and development of healthcare workers. Professional nurse advocate A-EQUIP model, a model of clinical supervision for nurses v1, November 2021:
The rationale behind this approach was how as an ambulance service which is predominantly mobile, remote & under constant extreme pressure could increase opportunities for listening and reflection to staff/volunteers. The benefits of this is that it can improve morale & enable staff to speak up about things that may be impacting their delivery of patient care. We know that releasing staff from duties is a difficult task with the current operational pressures the NHS is facing. However, if we do not look after staff we cannot care for patients.
I was asked to lead on this project by the Trust Director of Nursing, Quality and Safety who was supportive of the Implementation of the Professional Nurse Advocate role and the concept of the ITC model. The role was placed within the clinical team led by our Deputy Clinical Director who has the portfolio for all supervision. This model works alongside and compliments formative & managerial supervision.
My idea was that an RCS conversation could take place within the shift rather than adopting a set time and place for staff to attend. This made the model more attractive and able to meet ambulance operational models.
The content of the RSC session is absolutely confidential, unless the clinician shares information which could pose a risk to self or others or if a crime has been committed.
The second model of delivery of Restorative clinical supervision is being used within our Ambulance Emergency Operations Centre (EOC) which are our emergency control rooms who take 999 calls and dispatch ambulances. The model works on the use of set time slots offered for staff to book onto. This model works better within the control room as the staff are within one space for a period of time and cover can be provided by other clinicians.
A Q & A sheet is given to all members of staff/volunteer prior to the session which will give guidance of what the session will involve. These include a confidentially statement, what to expect during the session & the three anonymous questions that will be asked.
Following the session, a pack is handed out with signposting information for staff to refer to in their own time if needed. I have also included a positive affirmation card for each pack.
I would really like to see if we can extend this programme to include Professional Paramedic Advocates. I am in such a fortunate position to work with some outstanding AHPs. Having them recognised for the work they do would be fantastic. Also growing the number of advocates within the organisation will help me deliver the sessions!
For further information or to contact Anna click here
This article first appeared in Ambulance Life newspaper. To subscribe to a free copy every month via email Click here for a free subscription
