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  2. 2. CENTRAL OBJECTIVE:By the end of the seminar the group gain knowledge regarding faculty supervisorposition,appreciate its importance in nursing and effectively use this method in their futurepractice.SPECIFIC OBJECTIVES:At the end of the seminar the group will;recognize the concept of faculty supervisor dual roleexplain clinical supervisiondescribe qualities of a goodsupervisorexplain job description of nursing supervisoridentify the role of nursing facultyexplain the role of faculty supervisordescribe the collaboration between nursing education and serviceexplainmodels of collaboration between education and serviceidentifycollaboration of nursing education and service in Indiaexplainstrategies for clinical nurses considering a dual role
  3. 3. INTRODUCTION "sarvebhavantusukhinah, sarveshantuniramayah, sarvebhandranipashyanthu maakaschiddukhabhagabhavet."This literally means: (Let all be happy, Let all be free from diseases, Let all see the auspicious things,Let nobody suffer from grief.)Applying this to our professionThe budding nurses should be so prepared that they make clients free of diseases,remove theirsorrows and provide happiness and hope to them.Nursing education prepares nurses to practice in a variety of settings. The impact ofmodernization, globalization and liberalization on the society has brought tremendous changes ingeneral and nursing education. The significant trends in modern education are creativity,changes in teaching - learning process and advanced educational technology.The current trends in nursing education are numerous. The scientific and technological advancesin medicine along with social changes have resulted in emergence of new diseases and thedevelopment of specialities and super specialities. Advanced nurse practice enables nurses topractice in new roles such as nurse practitioners and clinical nurse specialists. Nursingprofession ensures a promising career in India with job opportunities abroad. Large number ofprivate nursing educational institutions have been set up, which require faculty with postgraduateeducation. In developed countries, great emphasis is given on preparing individuals with criticalthinking and problem solving skills.Faculty need to be role models especially in the aspect of caring in nursing.The concept of faculty supervisor position(dual role) in nursing has evolved sincea decade.Butthe practice has not been implemented in a wide range.Only very few institutions are practicing ittoday.The main reason for the emergence of dual role is the shortage of nursing faculty andclinical nurses.Its been widely seen in the Indian setting that highly competent faculty members
  4. 4. areconfined only to academic aspects only thus ignoring their clinical competencies.So it hasbeen suggested in that the faculty of an educational institution in nursing has to work as asupervisor in the parent hospital or affiliated hospital.SUPERVISIONConcepts of supervision have changed in recent years.Today there is more democracy insupervision.Educators think of supervision either as guidance or working together for commongoals.Supervision of graduate staff nurses differs from that of student nurses in one aspect.Supervision of the student has two goals,the development of the student and the improvement ofnursing care.With graduate nurse supervision is focused on the attainment of one goal,the givingof high quality care.A good supervisor is one who has broad professional and cultural interestsand vision and enthusiasm for work.As per dual role supervision can be of student nurses asfaculty or the supervision of staff nurses as ward in charge.QUALITIES OF A GOOD SUPERVISOR1.First andmost important,a supervisor must have something to give which is greater than thatwhich is possessed by the individual whom he/she is supervising.2.A good supervisor inspires confidence by his ability and his high expectation.3.A good supervisor has enthusiasm for nursing and a consuming interest in patients and theircare.4.A good supervisor is approachable.5.A good supervisor is also a good leader.6.A good supervisor is fair: Treats each individual impartially but with accordance of his ownspecial interests.7.A supervisor should have infinite patience and hope.8.A good supervisor is able to look at himself objectively: To try to put himself in the otherpersons place and see how he will be affected by his own actions.NURSING SUPERVISOR JOB DESCRIPTION The following is Nursing Supervisor Job Description with details about education, skills, experience and duties. A Nursing Supervisor leads a team of registered nurses, nurse aids and trainee nurses. They
  5. 5. ensure that there is adequate nursing staff during all the shifts. It is also their responsibility to make sure that nurses are properly educated and trained to handle different diseases and illnesses. They organize and monitor nursing staff and nursing procedures. The nursing department functions under their guidance adhering to the hospital policies and principles. The Nursing Supervisor position combines both nursing skills and managerial abilities.Nursing Supervisors Job Duties:A Nursing Supervisor may work in corporate hospitals or nursing homes. Usually, they work inbig hospitals or healthcare units where a group of nurses serve. They play a leadership roleguiding nurses. Their duties are to:1) Take care of patients, sometimes just like any other registered nurse.2) See to it that patients are getting the best care from the nurses.3) Get the nursing station organized.4) Hire adequately qualified and trained nurses.5) Assign shifts and job responsibilities to various nurses.6) Monitor them and make sure that they are adhering to the hospitals’ guidelines.7) Give in-service training to nurses.8) Resolve any issues with the nursing staff.9) Ensure that medicines and other essentials are always in full stock and readily available foruse.10) Minimize wastage.11) Meet and appraise higher ups about the functioning, issues and developments with thenursing department.12) Suggest improvements in nursing care.Nursing Supervisor Knowledge and Skills:1) Should be caring with thorough knowledge of nursing practice.2) Good knowledge of more than one branch of nursing and specialized knowledge in onebranch is essential.3) Good at emergency care.4) Leadership abilities and the ability to lead through demonstrations and actions.5) Always alert during the shift.6) Attend to patients whenever there is need and help nurses when they cannot cope with aparticular patient or situation.7) Good computer skills.
  6. 6. Nursing Supervisor Educational Qualification and Experience:1) A master’s degree in nursing and certification is essential for a Nursing Supervisor’s position..2) Ideal to begin their careers as registered nurses and experience as a registered nurse in largehospitals.NURSING FACULTYThe teaching staff and members of the administrative staff having academic rank in school orcollege of nursing.Clinical faculty members are essential for the success of nursing students. It is impossible tolearn nursing without effective clinical experiences provided in an environment that providessupport and respect for students while they learn the art and science of nursing.PRIMARY ORGANIZATIONAL RELATIONSHIPNursing faculty members are responsible to the Principal and management authorities and also to theaffiliated University.JOB SUMMARYProvides students with instruction of the highest standards, evaluate student progress, assist inpreparation of syllabi, assist in activities furthering the work of the institution, communicatenecessary information to students, provide academic advice to students as needed and serve onstanding and ad hoc committees as needed.EDUCATIONA master’s degree in nursing and certification or a basic degree or post basic degree in Nursing.RESPONSIBILITIES Provide competent instruction in the clinical and theoretical areas of nursing. Maintain high standards and promote excellence in education. Participate in and contribute to the team-teaching of classroom and clinical courses and model team-enhancing behavior for students. Serve as a role model for students in professional interaction with other health workers and with clinical facilities. Promote positive and productive relationships with service area hospitals and community Assist the Coordinator of Nursing in scheduling and confirming use of clinical sites. Assist the coordinator of nursing in scheduling curriculum content and classroom scheduling. Maintain relationships with clinical sites and professional peers that support the reputation of the College and the Practical Nursing Program
  7. 7. Continue as competent faculty in nursing by seeking new knowledge,improving nursing skills,and updating professional competencies. Maintain attendance records for classes taught. Evaluate the progress of students in all classes according to institutional, divisional, departmental, and individual criteria. Prepare or assist in the preparation of materials such as those used in academic administration when requested, including course syllabi, program outlines, articulation, and catalog materials. Participate in scheduled in-service activities. Promote student development through enrichment and mentoring experiences. Serve as academic advisors and mentors. Become familiar with institutional policies and procedures as outlined in the College Catalog, and the Faculty Handbook and follow such policies and procedures. Perform any other professional duties as assigned by the authorities.CONCEPT OF FACULTY SUPERVISORAccording to National League for Nursing(NLN),the main competency of faculty role isdescribed as “Creating an environment in classroom,laboratory and clinical setting that facilitatesstudent learning and an achievement of desieredcognitive,affective and psychomotor outcomes”.A clinical nurse is one who is practicing in the clinical instituition such as hospital.So a facultysupervisor is a nurse who is employed by an academic instituition to teach nursing and whoworks in the parent or affiliated hospital supervising students and staff in a particular area on aregular basis.She/he will be accountable to all the activities performed by students and staff andalso regarding the proceedings of the ward.NEED FOR COLLABORATION BETWEEN EDUCATION AND SERVICE  Considerable progress has been made in nursing and midwifery over the past several decades, especially in the area of education. Countries have either developed new, or strengthened and re-oriented the existing nursing educational programmes in order to ensure that the graduates have the essential competence to make effective contributions in improving people’s health and quality of life. As a result nursing education has made rapid qualitative advances. However, the expected comparable improvements in the quality of nursing service have not taken place as rapidly.  The gap between nursing practice and education has its historical roots in the separation of nursing schools from the control of hospitals to which they were attached. At the time
  8. 8. when schools of nursing were operated by hospitals, it was students who largely staffed the wards and learned the practice of nursing under the guidance of the nursing staff. However, under the then prevailing circumstances, service needs often took precedence over student’s learning needs. The creation of separate institutions for nursing education with independent administrative structures, budget and staff was therefore considered necessary in order to provide an effective educational environment towards enhancing students learning experiences and laying the foundation for further educational development.  While separation was beneficial in advancing education, it has also had adverse effects. Under the divided system, the nurse educators are no longer the practicing nurses in the wards. As a result, they are no longer directlyinvolved in the delivery of nursing services nor are they responsible for quality of care provided in the clinical settings used for student’s learning.  The practicing nurses have little opportunity to share their practical knowledge with students and no longer share the responsibility for ensuring relevance of the training that the students receive. As the gap between education and practice has widened, there are now significant differences between what is taught in the classroom and what is practiced in the service settings.  Most nursing leaders also assert that something has been lost with the move from hospital- based schools of nursing to the collegiate setting. The familiar observation that graduate nurses can theorize but not catheterize reflects the concern that graduate nurses often lack practical skills despite their significant knowledge of nursing process and theory.  Nursing educators know that development of technical expertise in the modern hospital is possible only through on-the-job exposure to the latest equipment and medical interventions.Colleges of nursing have tried to bridge this gap using state-of-the-art simulation laboratories, supervised clinical experiences in the hospital, and internships. However, the competing demands of the classroom and the job site frequently result in a less than optimal allocation of time to learn technical skills and frustration on the part of the nursing student who tries to be both technically and academically expert.  The hospital industry has also recognized the need to support a graduate nurse with additional training. As a result, graduate nurses are required to attend an orientation to the hospital and have additional supervised practice before they can function independently in the hospital. The cost of orienting a new nursing graduate is significant, particularly with high levels of nursing turnover (Reiter, Li.n. Young, &Adamson, 2007).The challenge to nursing education is how to combine theoretical knowledge with sufficienttechnical training to assure a competent performance by a professional nurse in the hospital
  9. 9. setting. Clearly, a partnership between nursing educators and hospital nursing personnel isessential to meet this challenge.MODELS OF COLLABORATION BETWEEN EDUCATION AND SERVICEThe nursing literature presents several collaborative models that have emerged betweeneducational institutions and clinical agencies as a means to integrate education, practice andresearch initiatives (Boswell & Cannon, 2005; McKenna & Roberts, 1998; Acorn, 1990), as wellas, providing a vehicle by which the theory -clinical practice gap is bridged and best practiceoutcomes are achieved (Gerrish& Clayton, 2004; Gaskill et al., 2003). Clinical school of nursing model(1995)The concept of a Clinical School of Nursing is one that encompasses the highest level ofacademic and clinical nursing,research and education. This was the concept of visionary nursesfrom both La Trobe and The Alfred Clinical School of Nursing University. This occurred withina context of a long history of collaboration and cooperation between these two institutions goingback many years and culminating in the establishment of the ClinicalSchool in February, 1995.The development of the ClinicalSchool offers benefits to both hospital and university. It bringsacademic staff to the hospital, with opportunities for exchange of ideas with clinical nurses withincreased opportunities for clinical nursing research. Many educational openings for expertclinical nurses to become involved with the university’s academic program were evolved. Themove to the concept of the clinical school is founded on recognition of the fundamentalimportance of the close and continuing link between the theory and practice of nursing at alllevels. Dedicated Education Unit Clinical Teaching Model (DEU)(1999)In this model a partnership of nurse executives, staff nurses and faculty.This model transforms patient care units into environments of support for nursing students andstaff nurses while continuing the critical work of providing quality care to acutely ill adults.Various methods were used to obtain formative data during the implementation of this model inwhich staff nurses assumed the role of nursing instructors. Results showed high student andnurse satisfaction and a marked increase in clinical capacity that allowed for increasedenrollment.
  10. 10. Key Features of the DEU are• Uses existing resources• Supports the professional development of nurses• Potential recruiting and retention tool• Allows for the clinical education of increased numbers of students• Exclusive use of the clinical unit by School of Nursing• Use of staff nurses who want to teach as clinical instructors• Preparation of clinical instructors for their teaching role through collaborative staff andfacultydevelopment activities• Commitment by all to collaborate to build an optimal learning environment.Research Joint Appointments (Clinical Chair) (2000)A Joint Appointment has been defined by Lantz et al. (1994), as “a formalised agreementbetween two institutions where an individual holds a position in each institution and carries outspecific and defined responsibilities”.The goal of this approach is to use the implementation of research findings as a basis forimproving critical thinking and clinical decision-making of nurses. In this arrangement theresearcher is a faculty member at the educational institution with credibility in conductingresearch and with an interest in developing a research programme in the clinical setting. TheDirector of Nursing Research, provides education regarding research and assists with the conductof research in the practice setting. She/he also lectures or supervises in the educationalinstitution. A formal agreement exists within the two organisations regarding specificresponsibilities and the percentage of time allocated between each. Salary and benefits are sharedbetween the two organisations.The Collaborative Learning Unit (British Columbia) Model, 2005In the CLU model, students practice and learn on a nursing unit, each following an individual setrotation and choosing their learning assignment (and therefore the Registered Nurse with whomthey partner), according to their learning plans. Unlike the traditional one-to-one preceptorship-,an emphasis is placed on student responsibility for self-guiding, and for communicating theirlearning plan with faculty and clinical nurses (e.g., the approaches to learning and theresponsibility they are seeking to assume). All nursing staff members on the CollaborativeLearning Unit are involved in this model and, therefore, not only do the students gain a wide
  11. 11. variety of knowledge but the unit also has the ability to provide practice experiences for a largernumber of students.Specifically, a Collaborative Learning Unit is a nursing unit where all members of the staff,together with students and faculty, work together to create a positive learning environment andprovide high quality nursing care.The Collaborative Approach to Nursing Care (CAN- Care) Model (2006)The essence of the CAN-Care model is the relationship between the nurse learner (student) andnurse expert (unit-based nurse), within the context of each nursing situation. The learner isresponsible and accountable for engaging in the learning process and for taking an active role inestablishing a dyadic learning partnership with the nurse expert. Unit-based nurses are experts inthe work of nursing care. The work of the faculty is re-conceptualized as the creator of theenvironment to support learning and professional growth as opposed to the direct teaching ofpreselected content.In this model, the healthcare organization becomes an active participant in creating learningenvironments and contributing to the learning activities, as opposed to just being a setting inwhich college-affiliated faculty appear with students for a teaching encounter. In return, thecollege becomes an active partner in the professional development and retention of nurses at thepractice facility.COLLABORATION OF NURSING EDUCATION AND SERVICE IN INDIAWe have two institutions which are practicing dual role, education & practice:  NIMHANS, Bangalore  CMC, Vellore.More institutions need to adopt this model. This will help improve the quality of NursingEducation with overall objective of improving the quality of nursing care to the patients andcommunity at large.Dual role model in NIMHANSFollowing the amalgamation of 1974 resulting in NIMHANS, the faculty of the nursingdepartment took up the dual responsibility of providing clinical services as well as conductingteaching programs. In 1975, all the Grade II nursing superintendents working in the hospitalwere designated tutors to maintain uniformity in the department. Combined workshops wereconducted under the guidance of WHO consultant Mrs.Morril to prepare the tutors who camefrom Grade II Nursing Superintendent cadre for teaching purpose and to make the Lectures and
  12. 12. tutors associated with educational programmes (DPN course& 9-months course in psychiatricnursing) comfortable with clinical supervision. After both groups felt comfortable to assume thedual responsibility, the areas of supervision were designated. The Head of the Department ofNursing was given the responsibility for both the service and the education component of thedepartment.Integration of education with service raised the quality of patient care and also improved thequality of learning experiences for nursing students, under the close supervision of teachers whowere also practitioners.Integrative Service-Education approach in CMC VelloreCollege of Nursing under Christian Medical College, Vellore, where nurse educators arepracticing in the wards or directly involving in the delivery of nursing services. This enables thepracticing nurse to share her practical knowledge to the student nurse who is practicing in theconcerned wards.Government of India conducted a pilot study on bridging the gap between education and servicein select institutions like one ward of AIIMS. The project was successful, patients and medicalpersonnel appreciated the move but it required financial resources to replicate this process.Strategies for Clinical Nurses Considering a Dual RoleA clinical nurse is a nurse who is practicing in a clinical institution, such as a hospital. A facultymember is a nurse who is employed by an academic institution to teach nursing. If considering adual role as both a clinical nurse and a faculty member, a critical care nurse will want to acquirea significant amount of information about the nature of a faculty position, the requirements andresponsibilities of faculty members, and the day-to-day realities of a dual role. As clinical nursescollect information, they will be comparing their interests and abilities with the varying aspectsof the faculty role, deciding whether a dual role is the right role at the right time for themThe focus of faculty members is to facilitate the learning of students. Nursing faculty preparelicensed practical nurses (LPNs) and RNs for entry into the practice of nursing. Nursing facultyalso teach in graduate programs at the masters and doctoral level, where nurses are prepared asAPNs, nurse educators, nursing administrators, nurse researchers, and in other leadership roles.The NLN is an organization that oversees all facets of nursing education in the United States.
  13. 13. A main competency of the faculty role is described by the NLN as "creating an environment inclassroom, laboratory and clinical settings that facilitates student learning and the achievementof desired cognitive, affective, and psychomotor outcomes"In past decades, faculty members lectured while students passively listened. However, in thecurrent paradigm of education, faculty do not simply teach information but rather supportstudents learning. The difference between teaching and supporting learning is an important one that critical carenurses will want to explore as they consider a faculty role. For example, rather than lecture for 2hours on hemodynamic monitoring, an astute faculty member will engage student in presenting"real-life" case scenarios along with hemodynamic monitor printouts. The faculty and students together will explore possible interpretations and propose decisionsbased on the data set. Alternately, the "real-life" hemodynamic case scenarios may be availableon-line for students and faculty to review and discuss asynchronously.Clinical expertise is a necessary, but not sufficient, criterion for teaching nursing students. Expertcritical care nurses may have the clinical knowledge to try a dual role if they are willing to learnthe science of teaching and learning. Just as there is evidence required for clinical nursingpractice, evidence also guides the teaching practices of faculty members. For example, researchsuggests that nursing students learn some skills best in simulated contexts. Therefore, facultymust now plan and use computerized patient simulation scenarios and actual simulators, alongwith branching logic software that may accompany nursing textbooks.Advantages and disadvantages of dual role Advantages 1. Abundant learning opportunities. 2. Improves clinical competencies. 3. Professional recognition and status. 4. Variety and novelty in work 5. Gets authority both in hospital and educational instituition. Disadvantages 1. Requires atleastagraduate degree and competency in teaching and clinical skills.
  14. 14. 2. Requires expert knowledge and skills both in nursing and in education. 3. Have to set firm boundaries on time and energy spent in both roles. 4. Can be overburdened with work;sometimes adversely affecting the teaching process.Conclusion Many nursing service administrators believe that academic nurse educators, removed from therealities of the employment setting, are preparing students to function in ideal environments thatrarely exist in the real and extremely diverse worlds of work.For preparing high qualityprofessionals and to prevent the dilution of practice standards ,the faculty themselves need to beoriented to the actual clinical situations.So dual role is extremely important in nursing.All the models pursue collaboration as a means of developing trust, recognizing the equal valueof stakeholders and bringing mutual benefit to both partners in order to promote high qualityresearch, continued professional education and quality health care.BIBLIOGRAPHYBook referenceYoung E.Young,Paterson L Barbara “Teaching Nursing” 1st editionLippincott Williams and wilkins.pp 523TomeyMarrine Ann “Nursing Management and Leadership” 5th edition Mosby publishers.pp 201-220Barrett Jean “Ward Management And Teaching”1st editionKonarkpublishers.pp 434-440Net