Background Clinical Supervision has been around since the early 1990s in the UK and has been endorsed by government and professional bodies. Levels of engagement range from 18%–85% (Butterworth et al., 2008).

Aim To investigate what influences palliative care nurses in their choice to engage in or decline clinical supervision.

Methods A qualitative study was undertaken in an in-patient hospice in England and employed two focus groups to compare the views of participants and non-participants in clinical supervision. Data was audio recorded and transcribed verbatim by the researchers and analysed using Systematic Text Condensation (Malterud, 2012).

Results Palliative care nurses all used informal team support for ‘in the moment’ support. Some engaged in formal clinical supervision to reflect ‘on action’ and to challenge practice. Nurses reported a lack of clarity regarding clinical supervision but, once this was overcome and engagement with clinical supervision was established, it led to changes in practice, identification of training needs and team building. Options of group and individual supervision were found to be important. Group supervision led to enhanced understanding of group members which also led to team building, individual sessions were useful for individual issues. Protected time was essential for staff to be able to engage in clinical supervision. Staff who worked in larger teams reported higher levels of engagement whereas a small team reported less need due to more informal team support. The interview themes allowed development of a Palliative Care Nurses Model of Support.

Conclusions Nurses need to be aware of their options for support and ultimately how this affects the care they provide. The Palliative Care Nurses Model of Support helps to explain the effects of each choice and how this may lead to team-building.