Supervised to Independent Practice - A Transition of Courage

Novice to Expert 

Independent Expert Practice

AND LETTING THEM FLY SOLO

"Takes Courage" 

This week I reviewed a remarkable portfolio of clinical evidence from an Advanced Practitioner. The evidence ranged over the domains of Practice, Education, Research and Leadership. It cannot be understated that the Portfolio demonstrated and evidenced a perfection of Expert Nursing Practice. But this was not only by dry statistical evidence, audits, numbers, budgets and performance indicators. No, there was also a tapestry of personal reflections rooted in the theoretical foundation and critically evaluated, these leading to professional insights that enabled a level of true Expert Practice. 

I would like to share with you the essence of one of these reflections, and the commentary of the expert mentor who reviewed this remarkable narrative - I will leave you to draw your own conclusions.

This account is naturally annonymised. 

The Advanced Practitioner is a Nurse. Her role has her acting as a significant member of the On Call Rota. In the reflective account she described her experience whilst on the Consultant Round. The round attended a patient who urgently required the insertion of a surgical drain. The Consultant requested that she undertook this procedure. At first she was pleased, even flattered, having done the procedure under supervision on a number of previous occasions. Initially she assumed that the Consultant would be scrubbed with her, ready to step in if situation required. 

However, she was then inwardly dismayed when the Consultant explained that he would finish the Round, whilst she undertook the procedure immediately as clinically the situation demanded it. 

   She described her fear, her trepidation, her conflict - torn by the evident pressing need of her patient, her acknowledgement of her own ability to undertake the life saving procedure, and yet her fear of flying "Solo". She described he inner disquiet has she prepared the patient, and stood by the patient, surrounded by others, drain in hand, hands trembling. 

At that moment her Consultant appeared at her side. She inwarded gasped with relief - he would help her. But no - he stood there and looked at her - "You can do this - on your own"... he commented quietly.  Step by step he talked her through it - and when at 1st it DID NOT succeed she persisted, determined - and eventually the drain was successfully in and secured, and the patient made well. 

Her reflection. A personal step of faith and belief in herself, of trusting, testing and evidencing her emergent expert judgement and skill, in evaluating critically her ability, and moving that forward to new horizons of practice and patient care. A step in facing the "fear" of Taking Full Professional Responsibility - with ALL the ramifications that this entailed. 

I would like to finish with Mentors (Consultants) comments, after he had read her reflection - and this may explain why I was SO impressed with this evidence of Expert Practice - and its implication and outcome.  

"WHAT SHE HAS ACHIEVED IS THAT AGONISING STEP THAT WE HAVE TO MAKE AS WE MOVE FROM SUPERVISED PRACTICE TO TRULY INDEPENDENT PRACTICE. 

THAT IS A STEP THAT TAKES REAL COURAGE." 

INDEPENDENT EXPERT CLINICAL PRACTICE TAKES COURAGE 

AND Expert Mentorship also takes the Expertise and  Courage to enable the next generation of Experts Clinicians and Practitioners

Letting them FLY SOLO