Judith Gorst: Family Therapist, Victoria 

• Introduction 
• What is clinical supervision for? 
• Confidentiality 
• Why should nurses working in the HIV sector be provided with routine clinical supervision? 
• Remote and indigenous communities 
• The impact of COVID-19 
• Conclusion 
• Resources
  

Introduction 

Clinical supervision is not the norm for people working in nursing and midwifery, though it is well established in mental health nursing (1). There is a general assumption that nurses and midwives, doctors and other health professionals must push on through, regardless of what they may endure at work. This notion may have developed because health workers’ traditional working environments have been in acute settings, with a constant flow of patients; this is the first, formative environment to which all health-care professionals are exposed. The provision of a time and space to discuss, reflect on and question the care being provided as well as the personal impact of the work, may seem unrealistic and is certainly not part of the cultural norm. Healthcare professionals frequently conduct conversations about patient management, but the nature of these discussions tends to be linear, direct and solution focused. Conversations that are more reflective and expansive in nature are less frequently engaged in. 

People with human immunodeficiency virus (HIV) who need nursing or midwifery care often present with an enormous range of clinical, psychosocial, cultural, and ethical challenges. The clients in this group, whether they are being cared for in community or hospital settings, may often be unwell and present with more than one complex, clinical issue. Nurses and midwives may need to use skills more frequently utilised by social workers, community, alcohol and other drug workers, mental health practitioners and pastoral care workers.  

It is worth noting that social workers and healthcare workers in the mental health and drug and alcohol sectors are routinely provided with clinical supervision by their employers. There is also a requirement to access supervision as part of their registration with their professional bodies.