The Oxygen Mask Theory teaches us to prioritise our own care before helping others. This may seem unusual for some. However, it reveals an important truth: we can only care for others when we first take care of our own wellbeing.
Nurses and midwives are essential in delivering Trauma-Informed Care (TIC), dedicated to preventing re-traumatisation, fostering compassionate care, and respecting individual autonomy.1 As these professionals skilfully integrate TIC into their practice, it prompts us to reflect on whether they are also embracing similar strategies to nurture their own wellbeing.
The restorative resilience model of clinical supervision offers a valuable approach to mitigating the effects of vicarious trauma, compassion fatigue, and high staff turnover in nursing and midwifery.2 In Australia, restorative resilience clinical supervision3 is endorsed by the Australian College of Mental Health Nursing and, is distinct from operational and task-oriented supervision. It emphasises key themes such as compassion, job satisfaction, and trauma-informed practice, while also promoting the essential qualities of nurses and midwives and encouraging their professional development and resilience. Importantly, restorative resilience clinical supervision is not a form of therapy; it establishes clear boundaries between personal and professional practice and includes referrals for individual counselling when needed.
Evidence supporting the effectiveness of this model comes from quantitative research conducted in the United Kingdom, which found that its implementation correlated with increased compassion satisfaction and a decrease in burnout among nurses and midwives. Initial studies focused on the effects of caring for families dealing with miscarriage and neonatal death on midwives, aiming to determine if restorative clinical supervision could alleviate stress and burnout while enhancing their professional quality of life.4
The researcher utilised the Professional Quality of Life (ProQOL)5 scale to evaluate the influence of restorative clinical supervision on the compassion satisfaction, burnout, and vicarious traumatic stress of 350 maternity staff.4 Despite more than half of the midwives reporting elevated stress levels, the introduction of restorative supervision was found to be beneficial, leading to improved resilience, decreased stress and burnout, and enhanced compassion satisfaction.4 Subsequent research involving larger groups of nurses, doctors, and social workers indicated an average reduction of 40% in burnout and 62% in stress levels.6
Restorative resilience clinical supervision addresses several challenges faced by nurses and midwives:
- Vicarious Trauma: Nurses and midwives often experience secondary trauma indirectly during patient care, which can impact their emotional and mental wellbeing.
- Compassion Fatigue: Continuous exposure to patient suffering can lead to a decrease in the ability to empathise, known as compassion fatigue.
- Burnout: High-stress environments and demanding workloads contribute to burnout, characterised by emotional exhaustion and reduced personal accomplishment.6
By addressing these challenges, restorative resilience clinical supervision aims to enhance the professional quality of life for nurses and midwives, promoting resilience and compassion satisfaction, while reducing their intention to leave the profession.
References
1 Dowdell EB, Speck PM. CE: Trauma-Informed Care in Nursing Practice. AJN, American Journal of Nursing [Internet]. 2022 Apr;122(4):30–8. Available from: http://dx.doi.org/10.1097/01.naj.0000827328.25341.1f
2 Carter V. Can restorative clinical supervision positively impact the psychological safety of midwives and nurses? British Journal of Nursing [Internet]. 2022 Aug 11;31(15):818–20. Available from: http://dx.doi.org/10.12968/bjon.2022.31.15.818.
3 Restorative Resilience Clinical Supervision Workshop – Compassion satisfaction at work [Internet]. Acmhn.org. 2024 [cited 2025 Jul 10]. Available from: https://acmhn.org/Web/Events/Endorsed-Event-pages/Restorative%20Resilience%20Clinical%20Supervision%20Workshop%20-%20Compassion%20satisfaction%20at%20work.aspx
4 Wallbank S. Effectiveness of individual clinical supervision for midwives and doctors in stress reduction: findings from a pilot study. Evidence-Based Midwifery. 2010 Aug 2;65–71.
5 Stamm BH. Professional Quality of Life Scale [Internet]. PsycTESTS Dataset. American Psychological Association (APA); 1995. Available from: http://dx.doi.org/10.1037/t05192-000
6 Dr Sonya Wallbank. Restorative resilience model of supervision. Pavilion Publishing; 2016.
Author:
Debra Klages PhD, RN, BScN, MANP, CMHN, MACN, FACMHN, is Research Fellow at the University of New England
