This course reviews the benefits of having a mentorship program within an institution to support nurses in their careers for an extended period. Mentorship programs can increase job satisfaction, decrease workplace stress, and ultimately increase retention rates.
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en the mentor and the mentee, offering both parties the opportunity to grow professionally. This relationship should begin following the completion of a nurse residency program or orientation and last throughout a nurse's career until retirement. Mentorship helps facilitate and support role transition, growth, and career advancement (Jakubik et al., 2017).
There are defining attributes of mentoring relationships in nursing. A literature review conducted by Olaolorunpo (2019) discovered six significant characteristics of a successful mentorship relationship:
Role models exhibit behaviors that others can emulate and teach by example. Mentees should observe, reflect, and emulate the behaviors of their role model. Role models that maintain a positive attitude and are approachable play a critical role in supporting mentees.
Nurturing is caring for and protecting someone or something while they grow. Nurturing mentors provide a caring, stable, and open environment for the mentee to learn.
Friendship is a relationship with another individual that can be trusted and is reliable during times of need. A mentor may become a friend that the mentee trusts and respects. The relationship between the mentor and mentee is supportive and mutually beneficial.
An experienced person is a knowledgeable and skillful individual in a particular field or specialty. The experienced individual can guide, educate, and support the less experienced mentee when acting as a mentor.
Regular meetings are held at set intervals. The frequency of meetings is based on the mentorship program policies for formal mentorship relationships. For informal relationships, the meetings must happen at least periodically. These meetings must occur for the mentorship to be successful and meaningful.
Endurance is necessary as this relationship is meant to be a long-lasting, mutually beneficial arrangement.
Nursing Theory
The concept of mentorship has been around for as long as the nursing profession. Florence Nightingale was the first to incorporate mentoring into nursing practice and was commonly referred to as the 'mentor of matrons' (Olaolorunpo, 2019). The mentoring process effectively supports new nurses entering the workforce, those changing practice settings, and students before graduation from a nursing program. When examining the history of mentorship in nursing and medical education, a discussion of some of the traditional teaching-learning methods used is pertinent. The concept of 'see one, do one, teach one' has been used for decades in medical and nursing education to teach psychomotor skills. The McGraw-Hill Concise Dictionary of Modern Medicine (2002) defines 'see one, do one, teach one' as "a traditional format for acquiring medical skills, based on a three-step process: visualize, perform, regurgitate" (para. 1). The 'see one, do one, teach one' method aligns with the internship, residency, or apprenticeship model commonly used in healthcare education; however, a more comprehensive, long-term approach to career development for healthcare professionals is needed in today's fast-paced and ever-changing healthcare environment (Evans et al., 2020).
Patricia Benner's 1984 nursing theory, Stages of Clinical Competence, describes five stages of how mentorship can help nurses progress through the different clinical competence levels. Mentorship supports nurses as they move through the stages of Benner's theory. The stages of Benner's theory are novice, advanced beginner, competent, proficient, and expert. Benner (Mitchell et al., 2018; Nursing Theory, 2020) defines each stage as:
Novice is a beginner with little to no previous experience. Their behavior is inflexible and governed by rules. They understand general rules to perform assigned tasks and follow instructions. A novice nurse with previous experience working in another nursing role will transition to the next stage quicker than a new graduate nurse with no experience.
Advanced beginners have prior experience in real-life nursing situations from which they can draw.
Competent nurses have at least 2-3 years of experience in their current role. As a result, these individuals have more perspective, efficiency, and organization. They are also more aware of long-term goals and the steps needed to achieve them.
Proficient nurses can understand the larger picture and how interventions affect outcomes. They have learned from their experiences and know what to expect from situations. They are also adaptable and able to modify plans when needed. Proficient nurses should be encouraged to participate in a mentorship program as a mentor.
Expert nurses no longer need to rely on rules or guidelines to determine which action to take in a particular situation. They are flexible and highly proficient in their role. Due to their extensive background and experience, they have a firm grasp of clinical situations. Expert nurses should be encouraged to participate in a mentorship program as a mentor.
Mentorship Skills
For experienced nurses to be successful as a mentor, there are mentorship skills that they must have to provide novice nurses with the support that they need to be successful. Nurse mentors must have extensive and comprehensive knowledge about nursing practice. This knowledge and experience are required to guide and educate the mentee. Mentees should choose a mentor with relevant knowledge and expertise in their chosen nursing practice environment. For example, a medical-surgical nurse would not necessarily make a good mentor for a new emergency room nurse. Nurse mentors must also have excellent communication skills. Communication must be direct, open, and honest to have a productive and successful mentor-mentee relationship. Both parties should feel comfortable communicating with each other about expectations and areas of improvement. Mentors must also have strong problem-solving and decision-making abilities. Mentors are experienced nurses and, therefore, should have the ability to quickly problem-solve and implement decision-making techniques during time-sensitive patient-related events. These skills can be used in the mentorship relationship when developing training approaches to help the mentee understand the real-world demands on nurses. An effective nurse mentor should have patience and empathy. Due to the vulnerability that accompanies starting a new nursing role, mentors should be patient with their mentees as they develop the new skills and knowledge needed to succeed in their new role. It is also helpful when a mentor can remember how they felt as a novice nurse to understand better their mentee's needs and feelings (Duquesne University School of Nursing, 2020).
Mentoring
Currently, there is a shortage of bedside nurses and nurse faculty in the US. It is estimated that hospitals cannot fill 20% of their vacant nursing positions. As the nursing workforce ages, the US Bureau of Labor Statistics predicts that by 2024 there will be over 500,000 open nursing positions (Evans et al., 2020). The shortage of nursing faculty compounds this shortage of nurses. The lack of qualified nursing faculty has negatively impacted the number of new nurses that are graduating and entering practice each year. According to the American Association of Colleges of Nursing (AACN, 2020), the national faculty vacancy rate was 7.2% in 2019. This contributed to over 80,000 qualified applicants being rejected from enrollment in nursing school due to the insufficient number of faculty and clinical instructors (AACN, 2020).
Academia
Mentorship can occur in academic and practice settings (Duquesne University School of Nursing, 2020). Mentoring in academia is two-fold. First, it is essential to mentor new nurse faculty as they transition to a very distinct area of nursing outside of direct patient care. It is also important that faculty members prioritize the mentorship of students within the nursing department (Evans et al., 2020; Gunberg Ross & Silver Dunker, 2019).
Transitioning from being a proficient or expert clinician to a novice nurse educator can be stressful and overwhelming as the responsibilities for each role are very different. Nurse faculty and clinical instructors with graduate nursing degrees are often not trained on how to fulfill the role of nurse educator. Unfortunately, the orientation process for these roles is lacking or non-existent at many institutions. Mentoring new faculty members in higher education has evolved over the last decade to become an integral part of the transition from practice to academia (Gunberg Ross & Silver Dunker, 2019). Implementing a faculty-to-faculty mentorship program can support faculty members while conducting research, advancing professional development, maintaining or improving their clinical skills, and improving teaching techniques (Evans et al., 2020). Strong mentorship programs may alleviate the nurse faculty shortage seen in colleges and universities. Transitioning from clinical practice to academia is difficult for many nurses, leading to high turnover rates of new faculty. A mentorship program's training, guidance, and support may prevent promising new nurse faculty members from prematurely leaving academia. In addition to increased retention, other desired outcomes from a mentorship program include increased faculty research, engagement in scholarship activities, increased rank and tenure, and increased intradepartmental socialization and collaboration. Some institutions provide faculty mentors with development tools, such as workshops, to prepare them for their role as a mentor. In the academic setting, administrative support for the mentorship program and faculty involvement are paramount to the program's success and longevity. This support is needed to offset the cost (money, time, and energy) of implementing and maintaining a mentorship program. These costs are associated with faculty training, implementing and monitoring the program, and measuring positive outcomes. The savings to the institution on recruiting and training new faculty members and the possible increase in grant funding when faculty support allows for more research and other scholarly activities should offset the cost of the mentorship program (Nowell et al., 2017).
Nursing faculty are responsible for preparing nursing students to enter a healthcare setting that is ever-changing and increasingly complex. Through faculty-led mentorship programs, students are paired with faculty mentors. This allows students to experience educational opportunities and growth outside the classroom setting. Being involved in a mentoring relationship can increase students' self-esteem, confidence, comfort in their role, and skill competence (Evans et al., 2020). Some institutions have implemented group mentorship programs. These programs pair senior nursing students with nurses currently practicing in a healthcare setting to facilitate transitioning from nursing student to practicing nurse. The nurse mentors are often alumni of the nursing program or nurses working for an affiliated healthcare organization. Research has found that nursing students often have an incomplete and unrealistic understanding of the daily work required of nurses in the clinical setting. This lack of knowledge of responsibilities, the need to adapt to shift work (often night shift for new nurse graduates), heavy workloads, and a lack of professional development skills causes new nurses increased stress. Having an experienced nurse fulfill the role of nurse mentor before graduation can prepare the nursing student for the realities of working in the clinical setting, provide needed support, and help them navigate the nuances of their new role within an organization (Lavoie-Tremblay et al., 2018).
Another form of mentorship in academia, known as peer mentoring, includes mentoring new nursing students entering the program by higher-level nursing students. This type of mentorship is effective in both undergraduate and graduate nursing programs. Due to the rigors of nursing school, nursing students often experience higher levels of stress and anxiety than their peers in other degree programs. Studies have shown that this increase in stress and anxiety is highest at the beginning of the nursing program and during the first clinical experience, which can manifest as psychological and physical ailments. A peer mentor that has already completed and passed a level of schooling can offer the novice student support, guidance, and knowledge. Mentorship has been shown to decrease stress and anxiety in novice nursing students. Other benefits of peer mentoring include increased student retention, engagement, and skill competence (Kachaturoff et al., 2020).
Clinical Practice
New nurses have reported feeling overwhelmed and undersupported when transitioning to a new nursing role. These feelings are exacerbated in areas of high stress, such as the intensive care unit (ICU), intermediate care unit, progressive care unit, emergency room (ER), or operating room (OR). This transitional period and accompanying stress have been termed reality shock. Reality shock is commonly experienced by nurses transitioning from student to practicing nurse, changing roles or departments, or re-entering the clinical setting after holding a non-clinical nursing position or taking a hiatus from healthcare (Schroyer et al., 2020).
Barriers to mentorship in the clinical practice setting include increased workloads, decreased job satisfaction, incivility, and unprofessionalism, resulting in increased turnover rates. Due to increased turnover rates, fewer suitable mentors are available, hindering mentorship opportunities (Olaolorunpo, 2019). However, there are numerous benefits to employing a nurse mentorship program in the clinical practice setting. Studies have shown that novice nurses who participate in a mentorship program experience decreased stress levels and increased job satisfaction in the hospital setting. Institutions that have mentorship programs in place reported a 25% increase in retention rates of new nurses. One study conducted at a community hospital showed a retention rate of mentored nurses of 91% versus a retention rate of non-mentored nurses of 66%. Increased retention rates decrease the institutional costs of recruitment, onboarding, and orientation, estimated to be 82,000 – 88,000 dollars per nurse (Duquesne University School of Nursing, 2020; Schroyer et al., 2020). Benefits of increased retention rates include increased department stability, teamwork, and increased patient satisfaction. Mentoring also has benefits for the mentor. Being involved in a mentorship program as an experienced nurse improves leadership skills, builds professional relationships, enhances problem-solving and decision-making skills, and increases job satisfaction (Schroyer et al., 2020). One study conducted at an integrated healthcare system comprised of five hospitals showed that incorporating a structured mentorship program into clinical practice improved both the mentor's and mentee's knowledge, attitude, and confidence regarding implementing evidence-based practice (EBP; Spiva et al., 2017). Due to the positive impact mentorship has on nursing departments in the clinical setting, the Magnet Recognition Program supports and encourages mentorship in all areas of nursing (Dirks, 2021).
As the population ages, many nurses are leaving the profession for retirement. Unfortunately, this is occurring while the growing older adult population needs more nursing care. A strong mentorship program can retain nurses in general and help retain those nurses who work in specialty departments, including the most high-risk areas described above. Working in a critical care environment requires a solid knowledge base and the ability to act on informed clinical decisions quickly. Individuals able to function successfully in these environments are a precious commodity in healthcare (Dirks, 2021). The need to retain specialty-trained nursing staff with the knowledge and skill to work in critical care was demonstrated during the COVID-19 pandemic.
Finding a Mentor
For some nurses, it can be challenging to navigate the process of finding the right mentor. Nurses can take the following steps to ensure that they find the right mentor (Maryville University, n.d.; Miller, 2020):
- A new or transitioning nurse should identify their needs. The nurse should reflect and think about their career goals and what kind of mentor they would like to support them and help them achieve their goals.
- The nurse should do their research and think about their ideal mentor's traits or career achievements and who would fit their criteria for a mentor.
- The nurse should talk to their preceptor to determine if they would be a good fit as a mentor and if that is a role that they are comfortable taking on. If not, they can be a good resource for finding a mentor within the department or institution.
- Observing nurses while at work can be instructive. Whether a new nurse on the unit or a student nurse, it can be helpful to observe other nurses to determine who has a similar approach to nursing. It can also be valuable to consider who effectively deals with stress and is an instrumental part of the healthcare team.
- Institution-based mentorship programs may not be highly publicized; therefore, new employees may not be aware of their existence. It is advantageous to determine what resources are available to ensure future success in the workplace. If the institution has a mentoring program already established, it is beneficial to join and choose a mentor involved with the program.
If an institution does not have an established mentoring program available, there are virtual options through different nursing organizations. Alternately, leadership may be able to suggest which employees would make good mentors. These additional resources are discussed below.
Additional Resources
There are many professional resources available related to mentorship. These resources offer support and education to make the relationship successful, implement a mentorship program within the workplace, and connect with a mentor or mentee.
- Sigma Theta Tau offers an online mentoring program for members, resources on hot topics in mentorship, and instructions to initiate a mentoring program (Sigma Marketplace, 2022).
- The National League for Nursing (2022) has articles, guides, webinars, and continuing education courses related to mentoring in the academic setting.
- The ANA (n.d.) has online continuing education courses and articles about implementing mentorship programs.
- The AACN (2017) has a tool kit for implementing a mentoring program in an academic setting.
- The National Mentoring Resource Center (2022) provides handbooks, manuals, and curricula for mentors to develop their skills or implement a mentoring program at their institution.
- Campaign for Action (n.d.), funded by the AARP, has videos, articles, and educational activities on its website that address mentorship in healthcare.
Although this is not an inclusive list, it provides a good starting point for understanding mentorship and how nurses can incorporate the process into their practice.
References
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American Nurses Association Massachusetts. (n.d.). Mentoring definitions. Retrieved February 28, 2022, from https://www.anamass.org/page/61
Campaign for Action. (n.d.). Mentoring for success, diversity, and health equity. AARP. Retrieved February 28, 2022, from https://campaignforaction.org/mentor-training/
Dirks, J. L. (2021). Alternative approaches to mentoring. Critical Care Nurse, 41(1), e9-e16. https://doi.org/10.4037/ccn2021789
Duquesne University School of Nursing. (2020). Benefits of a nurse mentorship: Why nurse educators matter. https://onlinenursing.duq.edu/blog/nurse-mentorship/
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Gunberg Ross, J., & Silver Dunker, K. (2019). New clinical nurse faculty orientation: A review of the literature. Nursing Education Perspectives, 40(4), 210-215. https://doi.org/10.1097/01.NEP.000000000000470
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Lavoie-Tremblay, M., Sanzone, L., Primeau, G., & Lavigne, G. L. (2018). Group mentorship programme for graduating nursing students to facilitate their transition: A pilot study. Journal of Nursing Management, 27(1), 66-74. https://doi.org/10.1111/jonm.12649
Maryville University. (n.d.). How to find a mentor in nursing. Retrieved March 1, 2022, from https://online.maryville.edu/blog/mentorship-in-nursing/
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Miller, R. (2020). How to find the right nurse mentor. https://www.aspen.edu/altitude/how-to-find-nurse-mentor/
Mitchell, A., Lucas, C., Cisar, P., Wilson, K., & Bowe, J. (2018). Mentoring novice nurses in healthcare organizations. International Journal of Medical Science and Health Research. 2(1). 91-96. https://ijmshr.com/uploads/pdf/archivepdf/2020/IJMSHR_02_24.pdf
National League for Nursing. (2022). Mentoring. https://www.nln.org/search-results?keywords=mentoring
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Nowell, L., Norris, J. M., Mrklas, K., & White, D. E. (2017). A literature review of mentorship programs in academic nursing. Journal of Professional Nursing, 33, 334-344. https://doi.org/10.1016/j.profnurs.2017.02.007
Nursing Theory. (2020). Dr. Patricia Benner novice to expert: Nursing theorist. https://nursing-theory.org/nursing-theorists/Patricia-Benner
Olaolorunpo, O. (2019). Mentoring in nursing: A concept analysis. International Journal of Caring Sciences, 12(1), 142–148. http://www.internationaljournalofcaringsciences.org/docs/16_olorufremi_12_1.pdf
Schroyer, C. C., Zellers, R., & Abraham, S. (2020). Increasing registered nurse retention using mentors in critical care services. The Healthcare Manager, 35(3), 251-265. https://doi.org/10.1097/HCM.0000000000000118
Sigma Marketplace. (2022). Mentoring. https://www.sigmanursing.org/s-results?searchQuery=mentoring&indexCatalogue=all---updated-with-courses&wordsMode=0
Spiva, L, Hart, P. L., Patrick, S., Waggoner, J., Jackson, C., & Threatt, J. L. (2017). Effectiveness of an evidence-based practice nurse mentor training program. World Views on Evidence-Based Nursing, 14(3), 183-191. https://doi.org/10.1111/wvn.12219
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