Clinical supervision under pressure: a qualitative study amongst health care professionals working on the ICU during COVID-19

ABSTRACT

Purpose

The unprecedented influx of patients in 2020 with COVID-19 to intensive care units (ICU) required redeployment of healthcare professionals without adequate previous ICU-training. In these extraordinary circumstances, pivotal elements of effective clinical supervision emerged. This study sets out to explore the nature, aspects and key features of supervision under highly demanding circumstances among certified and redeployed health-care professionals on COVID-19 ICUs.

Materials and methods

A prospective qualitative, single center, semi-structured interview study among healthcare professionals at COVID-19 ICUs at University Medical Center Utrecht, the Netherlands between July and December 2020. Interview data were analyzed using an inductive coding style.

Results

A total of 13 certified and 13 redeployed health'hcare professionals, including physicians, nurses, and operation room technicians participated. Seven themes were identified as essential for both certified (supervisors) and redeployed (trainees) personnel: an open attitude, observing boundaries, gauging coworkers’ capacities, being available, providing feedback, continuity in care and teams, and combining supervision with workload.

Conclusions

This study provides seven recommendations for both supervisors and trainees to help optimize clinical supervision. They align with the known five factors determining entrustment and supervision (trainee, supervisor, task, context, and relationship). To ensure good clinical supervision, be it either during normal circumstances or under pressure, efforts should primarily focus on factors that are within a supervisor or trainee’s span of control.

MeSH

Clinical supervision, interprofessional, COVID-19, Intensive Care

Keywords:

• Clinical supervision
• interprofessional
• COVID-19
• Intensive Care

Acknowledgments

The authors would like to thank all participating healthcare professionals.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The interviews that support the findings of this study are accessible via Appendix S2.

Author contributions

MPH is the guarantor of the content of the manuscript, including the data and analysis. MPH and OtC conceived the study and designed the questionnaire, MvD and MH and collaboratively wrote the first and final versions of the manuscript. HH conducted and analyzed all interviews. MPH and MvD organized the interview administration and collected and analyzed data and together with HH, RH, and OtC critically reviewed multiple versions of the manuscript for important critical contributions. All authors reviewed multiple versions of the manuscript and approved the final version.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/10872981.2023.2231614

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was funded by regular employments of the authors; no separate funding was obtained.