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One of nursing major concerns in this era of health care reform is the supervision of unlicensed assistive workers in ambulatory settings. The downsizing of acute care hospitals has had two results, the increase in very sick patients in ambulatory care settings and in jobs for experienced nurses in such settings. This experience, however, sometimes does not extend to supervisory skills. Effective supervisors should know their assistive workers, block out time for supervision, adhere to patient care standards, and give timely positive and negative feedback., Many of the concerns related to health care reform, downsizing, and the implementation of care delivery models employing multiple levels of assistive personnel have been identified and discussed as they [...]