Delegation and supervision of health care assistants’ work in the daily management of uncertain and the unexpected in clinical practice: invisible learning among newly qualified nurses

Allan, H; Magnusson, C; Evans, K; Ball, E; Westwood, S; Curtis, K; Horton, K; Johnson, M

Abstract

The invisibility of nursing work has been discussed in the international literature but not in relation to learning clinical skills. Evans and Guile’s (2012) theory of recontextualisation is used to explore the ways in which invisible or unplanned and unrecognised learning takes place as newly qualified nurses learn to delegate to and supervise the work of the health care assistant. In the British context, delegation and supervision are thought of as skills which are learnt ‘on the job’. We suggest that learning ‘on-the-job’ is the invisible construction of knowledge in clinical practice and that delegation is a particularly telling area of nursing practice which illustrates invisible learning. Using an ethnographic case study approach in three hospital sites in England from 2011-2014, we undertook participant observation, interviews with newly qualified nurses, ward managers and health care assistants. We discuss the invisible ways newly qualified nurses learn in the practice environment and present the invisible steps to learning which encompass the embodied, affective and social, as much as the cognitive components to learning. We argue that there is a need for greater understanding of the ‘invisible learning’ which occurs as newly qualified nurses learn to delegate and supervise.
Key words: newly qualified nurses, delegation, invisible learning, preceptorship

Citation

Allan, H., Magnusson, C., Evans, K., Ball, E., Westwood, S., Curtis, K., …Johnson, M. (2016). Delegation and supervision of health care assistants’ work in the daily management of uncertain and the unexpected in clinical practice: invisible learning among newly qualified nurses. Nursing Inquiry, 23(4), 377-385. https://doi.org/10.1111/nin.12155

• Journal Article Type: Article
• Acceptance Date: Jul 10, 2016
• Online Publication Date: Sep 5, 2016
• Publication Date: Sep 5, 2016
• Deposit Date: Jul 27, 2016
• Publicly Available Date: Sep 5, 2017
• Journal: Nursing Inquiry
• Print ISSN: 1320-7881
• Electronic ISSN: 1440-1800
• Publisher: Wiley
• Volume: 23
• Issue: 4
• Pages: 377-385
• DOI: https://doi.org/10.1111/nin.12155
• Publisher URL: http://onlinelibrary.wiley.com/doi/10.1111/nin.12155/abstract
• Related Public URLs: http://eprints.mdx.ac.uk/; http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1440-1800
• Additional Information: Funders : GNC Trust; Projects : Aark Project