I believe that engagement with ongoing support and oversight of our practice (clinical supervision) is important for improvements in the service we deliver, patient safety and essential for the maintenance of well being. I confess to have not been offered or accessed clinical supervision for the majority of my career but I have learnt over the last 3 years that without it we are at risk of being overcome by stressors, strains and pressures in the work environment. With the wisdom of hindsight I now realise that if I had been given the opportunity to discuss and problem solve some of the challenges I faced in my career I may not have been quite so overcome by the difficulties.

I am currently on a supervision course with counsellors and therapists and I have reflected a great deal on the contrast between their positive and constructive attitudes to supervision and that of many doctors and nurses who often comment on it being surveillance and akin to micromanagement. I have been fascinated by this and have had a number of interesting conversations about this particularly within the context of end of life care where some HCPs see it as a sign of weakness to talk about challenging situations and deny any difficulties or challenges in relationships or in how they face their emotionally charged encounters.

With this is mind I have begun to wonder how creative writing and the expressive arts might have a role in helping practitioners process their thoughts and feelings. Instead of bottling and brewing their emotions gentle facilitation might help them with cathartic exploration through poetry, collage making and other artistic endeavours.My experience of these activities with health care professionals suggests that absorption in creative activity surfaces thoughts and feelings in a more authentic way and unconscious actions become conscious and an increased understanding of issues then becomes possible.In this tweet chat we will pose four questions :-

1.What are the challenges to adequate clinical supervision in end of life care?

2.What experiences do people have of creative activities within the context of end of life care?

3.Is it possible to envisage a role for creative activities within the context of clinical supervision in end of life care?

4.How might we evaluate the effectiveness of creative approaches to clinical supervision?

For the purposes of this chat I am drawing on John Driscoll’s work (http://www.supervisionandcoaching.com/) and his definition of clinical supervision as a planned and intentional event that has agreed boundaries and is an opportunity to reflect and learn from actions and relationships in practice. The intention of the event is to support the practitioner, explore experiential knowledge and have a positive impact on practice.

Suggested reading

Williams, B. (2000) Collage work as a medium for guided reflection in the clinical supervision relationship. Nurse Education Today, 20. 273-278

Shepard B.C. & Guenette (2010) Magazine Picture Collage in group Supervision Canadian journal of Counselling 296-306

Deaver S. P. & Shiflett C. (2011) Art-based Supervision Techniques The Clincial Supervisor, 30: 257-276

Fish B. J ((2017) Art- based Supervision Cultivating Therapeutic Insight Through Imagery Abingdon, Routledge