Making sense of supervision : a narrative study of the supervision experiences of mental health nurses and midwives

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

Mirror coating solution for the cryogenic Einstein telescope

Planned, cryogenic gravitational-wave detectors will require improved coatings with a strain thermal noise reduced by a factor of 25 compared to Advanced LIGO. In this article, we present investigations of HfO2 doped with SiO2 as a new coating material for future detectors. Our measurements show an extinction coefficient of k=6×10−6 and a mechanical loss of ϕ=3.8×10−4 at 10,K, which is a factor of 2 below that of SiO2, the currently used low refractive-index coating material. These properties make HfO2 doped with SiO2 ideally suited as a low-index partner material for use with a-Si in the lower part of a multimaterial coating. Based on these results we present a multimaterial coating design which, for the first time, can simultaneously meet the strict requirements on optical absorption and thermal noise of the cryogenic Einstein Telescope

Selective phase growth and precise-layer control in MoTe2

Minor structural changes in transition metal dichalcogenides can have dramatic effects on their electronic properties. This makes the quest for key parameters that enable a selective choice between the competing metallic and semiconducting phases in the 2D MoTe2 system compelling. Herein, we report the optimal conditions at which the choice of the initial seed layer dictates the type of crystal structure of atomically-thin MoTe2 films grown by chemical vapour deposition (CVD). When Mo metal is used as a seed layer, semiconducting 2H-MoTe2 is the only product. Conversely, MoO3 leads to the preferential growth of metallic 1T-MoTe2. The control over phase growth allows for simultaneous deposition of both 2H-MoTe2 and 1T '-MoTe2 phases on a single substrate during one CVD reaction. Furthermore, Rhodamine 6G dye can be detected using few-layered 1T '-MoTe2 films down to 5 nM concentration, demonstrating surface enhanced Raman spectroscopy (SERS) with sensitivity several orders of magnitude higher than for bulk 1T '-MoTe2

A kaleidoscope of understandings: spiritual nursing in a multi-faith society

Background. Spirituality is an increasingly discussed topic in nursing. In some parts of the UK there is a policy requirement to establish policies of spiritual health care which are appropriate to a multi-cultural society. In the nursing literature, spirituality is discussed from religious and secular perspectives which seem impossible to reconcile into a coherent philosophy.Aims. To discuss the relationship of spirituality to nursing and to suggest how we can think about spirituality as nurses working in a society of many faiths and cultures.Discussion. Spirituality can be thought of in relation to individual patients and nurses. It also has significance for the profession of nursing and for health care as a whole. The difficulty of defining spirituality is discussed, and it is suggested that a definition of 'spiritual nursing' may be more achievable. Different concepts of spirituality are compared, including religious and secular spirituality. The relationship between religion and spirituality is seen as potentially problematic, with some religions denying the existence of secular spirituality. Secular spirituality and New Age movements are non-religious but spiritually influential phenomena. The problem for nursing is how to reconcile the immense variety of approaches to spirituality.Conclusions. The concept of spirituality as a meta-narrative is considered, and a postmodern appreciation of pluralism is employed as a way of embracing different spiritual realities. Spiritual nursing can be an opportunity for nurses to enlarge their understanding of the human condition rather than a narrowly defined concept to be applied within a model of practice

Mental health nurses' experiences of managing work-related emotions through supervision

AimThe aim of this study was to explore emotion cultures constructed in supervision and consider how supervision functions as an emotionally safe space promoting critical reflection.BackgroundResearch published between 1995–2015 suggests supervision has a positive impact on nurses' emotional well‐being, but there is little understanding of the processes involved in this and how styles of emotion interaction are established in supervision.DesignA narrative approach was used to investigate mental health nurses' understandings and experiences of supervision.MethodsEight semi‐structured interviews were conducted with community mental health nurses in the UK during 2011. Analysis of audio data used features of speech to identify narrative discourse and illuminate meanings. A topic‐centred analysis of interview narratives explored discourses shared between the participants. This supported the identification of feeling rules in participants' narratives and the exploration of the emotion context of supervision.FindingsEffective supervision was associated with three feeling rules: safety and reflexivity; staying professional; managing feelings. These feeling rules allowed the expression and exploration of emotions, promoting critical reflection. A contrast was identified between the emotion culture of supervision and the nurses' experience of their workplace cultures as requiring the suppression of difficult emotions. Despite this, contrast supervision functioned as an emotion micro‐culture with its own distinctive feeling rules.ConclusionsThe analytical construct of feeling rules allows us to connect individual emotional experiences to shared normative discourses, highlighting how these shape emotional processes taking place in supervision. This understanding supports an explanation of how supervision may positively influence nurses' emotion management and perhaps reduce burnout

Discombobulations and Transitions: Using Blogs to Make Meaning of and From Within Liminal Experiences

We live in a digitalized world, where social media have become an integral part of scholarly life. Digital tools like blogs can facilitate various research-related activities, from recruitment, to data collection, to communication of research findings. In this article, we analyze our experience of blogging to suggest that they provide a useful resource for qualitative researchers working with reflexive accounts of personal experience. Through our personal story of engaging with blogging while traveling abroad to participate in a conference, we explore how we used the blog in different ways to concretize transitional processes, to engage in public storytelling, and to form a network of relationships (self, others, and blog). We argue that the technology of blogging is particularly suited to creating sense-making narratives from liminal or discombobulating experiences, and highlight the usefulness of understanding the production of data through blogging as culturally located within networks of relationships and normative discourses