Nurse supervisors' actions in relation to their decision-making style and ethical approach to clinical supervision


  • Ingela Berggren MSc RNT,

    1. Lecturer, Department of Nursing Science, University of Trollhättan – Uddevalla, Vänersborg, Sweden; and Doctoral Student at University of Oslo, Institute for Nursing Science, Oslo, Norway
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  • Elisabeth Severinsson MCSc DrPH RPN RNT

    1. Professor of Mental Health Nursing, Hedmark University College, Faculty of Health Studies; and Associate Professor at University of Oslo, Institute of Nursing Science, Oslo, Norway
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Ingela Berggren,
Ör, PL 7709,
SE-464 50 Dals Rostock,


Aim. The aim of the study was to explore the decision-making style and ethical approach of nurse supervisors by focusing on their priorities and interventions in the supervision process.

Background. Clinical supervision promotes ethical awareness and behaviour in the nursing profession.

Methods. A focus group comprised of four clinical nurse supervisors with considerable experience was studied using qualitative hermeneutic content analysis.

Findings. The essence of the nurse supervisors' decision-making style is deliberations and priorities. The nurse supervisors' willingness, preparedness, knowledge and awareness constitute and form their way of creating a relationship. The nurse supervisors' ethical approach focused on patient situations and ethical principles. The core components of nursing supervision interventions, as demonstrated in supervision sessions, are: guilt, reconciliation, integrity, responsibility, conscience and challenge. The nurse supervisors' interventions involved sharing knowledge and values with the supervisees and recognizing them as nurses and human beings.

Conclusion. Nurse supervisors frequently reflected upon the ethical principle of autonomy and the concept and substance of integrity. The nurse supervisors used an ethical approach that focused on caring situations in order to enhance the provision of patient care. They acted as role models, shared nursing knowledge and ethical codes, and focused on patient related situations. This type of decision-making can strengthen the supervisees' professional identity. The clinical nurse supervisors in the study were experienced and used evaluation decisions as their form of clinical decision-making activity. The findings underline the need for further research and greater knowledge in order to improve the understanding of the ethical approach to supervision.