Practice makes perfect

In the second of three articles on the issue of OHNeducation in the absence
of a national standard, we look at how students can best gain practical
expertise.  By Annette Chorley and Jo

What is expected of a newly qualified OH nurse and what is meant by
"practice" and "supervision". And how can OHN students best
gain practical skills and knowledge? These are the thorny questions which posed
a problem for the RCNI as it reviewed student practice and its degree course.

The vast majority of the nursing literature centres on clinical supervision,
as does the UKCC1, and terms such as facilitation and mentorship were
identified to describe concepts with elements important to the
"practice" and "supervision" of students. These include
support, learning, observation, participation and reflection.

Professional supervision

It is recognised that many OHNs do not perform clinical roles and instead
work within proactive preventative services. The concepts of clinical
supervision did not therefore provide the high challenge and support felt
necessary for OHN education – especially given that OHN students may already be
or could go on to work autonomously in isolated settings. Hence the term
"professional supervision" was felt more appropriate and adopted by
the programme.

Professional supervision is distinguished by striving for high challenge and
constructive criticism in a climate of support. It is a practice-focused professional
relationship involving a practitioner reflecting on practice, guided by a
skilled supervisor1.

The rationale for professional supervision is to encourage reflection on
practice issues to enhance practitioner skills, knowledge and professional values,
thereby promoting lifelong learning2. It has therefore been used not simply as
a way of attaining Specialist Practitioner status but also to address OH issues
raised and as a strategy to broaden the knowledge base and experience in the OH
profession. This should enable OH nurse practitioners to develop
problem-solving and analytical skills and to transform practice.

Practice placements

Students are required to undertake at least 90 days of practice during their
studies, with regular contact maintained with their supervisor either in the
workplace or by telephone. The requirements of post-registration education and
practice – Prep3 – are re-enforced throughout the programme, and documentation
completed will form a part of the students’ Prep portfolios.

In the past the RCNI found that a disproportionate amount of time was spent
arranging student placements and in orientation to the workplace and OH nurse
role, with students often not able to practice or use fully their developing
skills. This therefore needed to progress into a programme that met both the
requirements of the UKCC for Specialist Practitioner status and developed the
salient practical and theoretical skills required of a qualified OHN.

The professional supervisor

It is an ENB requirement that professional supervisors are qualified OH
nurses and this qualification can be at certificate, diploma, degree or Masters
level. Other fundamental basics include enthusiasm, commitment and experience.
We are delighted to note that, contrary to the view that there would be a lack
of interest in becoming professional supervisors, we now have an active body of
more than 100 supervisors who are keen to participate in the continual
development of OHN students’ education.

The workplace/organisation

For the OHN student, the range of experience and practice available is as
varied as the industries and organisations they access. Although one main
supervisor is ideally maintained throughout – and for part-time students most
of their experience will be in their own workplaces – all students are advised
to visit or gain experience in a range of workplaces and types of OH teams.

Annette Chorley is an OHN lecturer and the professional supervision
programme coordinator at the RCNI. Jo Kitney is a freelance occupational health
and training consultant

The first article in this series was published in Occupational Health,
February 2000


1 UKCC, 1996, Position statement on clinical supervision for nursing and
health visiting. UKCC, London

2 ENB, 1995, Creating lifelong learning – partnerships for care. ENB, London

3 UKCC, 1997, Prep and you. UKCC, London

The professional supervision programme

In devising its structure, the programme aimed to change the focus of
placements from being an "onerous" task that needed to be completed
to attain qualification, to one that is rewarding, worthwhile and beneficial
for all involved. It fundamentally changed the system of "placements"

– Encouraging students to find their own supervisor and complete a learning
contract. This was essential to establish a trusting and meaningful
relationship between student and professional supervisor.

– Where possible, a student would have a main professional supervisor for
the duration of their studies. This would encourage a progressive relationship
and for skills to be practised and used in line with theoretical learning.

– The student would become part of the OH team and have a greater depth and
range of experience, which would benefit the organisation, supervisor and

– Students would be encouraged to visit other organisations, OH departments
or members of the OH team to aid translation of skills and knowledge in these
work areas.

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