Essay Mentoring Nursing

Mentorship: Collaboration for Competency

The success of any nursing student in any program in any clinical setting is multi-faceted enhancing the complicated nature of education and the perception of competencies whether student or educator. This is an important concept to be sensitive to as the process of moving forward with the knowledge and skill-sets needs to be supported and nurtured in order to facilitate the standard of care that is safe, accountable, and competent. The expectations of students within academia and within the staff mix on units can vary giving students a sense of role ambiguity diminishing the sense of belonging and taking away from the clinical learning experience. According to Higgins, Lathlean, Levett-Jones, & McMillan (2009),“Nursing students’ motivation and capacity to learn, self-concept, confidence, the extent to which they are willing to question or conform to poor practice and their future career decisions are influenced by the extent to which they experience belongingness (p.316).”Acceptance by senior and experienced nurses plays a pivotal role in the development of self-concept and application of theoretical perspectives into practice. Negative experiences with staff are detrimental to the learning process by creating environments of stress, anxiety, and an overall feeling of un-acceptance by staff, and at times, instructors. This can be attributed to the many factors that are influencing the profession of nursing including increased workloads, decreased staffing, scope of practice issues, safe work environments, and violence in the workplace (Lofmark et al, 2008). These issues influence nurses perceptions of their jobs and can negatively affect their attitudes towards themselves, colleagues, patients, and students (Ali & Panther, 2008). Addressing these issues is difficult as resources such as funding are scarce. This is creating environments that are not conducive for learning amongst degree bound nurses, and in fact, is contributing to attrition in nursing programs as well as changes in career paths as a nursing degree is achieved (Bray & Nettleton, 2008). Acceptance through effective mentorship beginning once the clinical experience has begun is critical to fostering the minds of tomorrow today. This can be achieved through the implementation of a framework that would act as a guideline for staff nurses who may be paired with students to follow ensuring continuity of the mentoring process. Communication amongst unit staff and nursing schools who place the students is crucial for outlining expectations from the staff and students. This clarification aids in debunking assumptions and provides a better understanding of students’ scope of practice and expectations from potential staff mentors on the floor (Andrews et al, 2006). In the current health care environment, mentorship continues to be a challenge for nurses as finding the balance for the education of a student and completing assigned duties in an already high stressed, high paced nursing environment is diminishing the mentorship process, and in the larger picture, compromising the values and principles of the profession and the quality care we provide.

            Historically, mentorship of nursing students was not the method of choice for education, and in fact, was not widely accepted as the model of choice for student integration in the clinical setting until the early eighties (Ali & Panther, 2008). The working model of acquiring skills and knowledge by self-direction under indirect supervision was the model of choice as the scope of practice in nursing was limited and un-regulated. Many nurses and nursing students in the past found themselves to be autonomous practitioners, learning their skills within the situations they found themselves in without adequate guidance or support (Bray & Nettleton, 2008). As the profession has been radically evolving with the expanding nature of health care in all its multi-faceted discoveries, and the resulting increased demand for nursing services, the fundamental approach to education needed to change (Ali & Panther, 2008). Providing competent, comprehensive, accountable, and safe care founded upon evidence has become the driving force behind fostering the future nurses of tomorrow. According to Ali & Panther (2008), “Mentoring is an important role that every nurse has to assume, formally or informally, sooner or later in their professional life (p.35).”This is a powerful concept as it exposes the fact that we as a nursing collective have an obligation to foster the growth, both academically and clinically, the novice nurses of tomorrow. Utilizing nurse leadership to be pro-active in creating positive and safe work environments through empowerment and support of nursing staff is an effective strategy in addressing barriers to the mentorship perception and process. Pragmatic approaches and follow through with nursing concerns and issues, specific or broad in scope, will bring about better learning environments for both mentor and mentee.

            According to the Practice Standards of College of Nurses of Ontario, “A nurse in an educator role demonstrates sound practice standards by, planning and implementing creative learning opportunities for students, critically analyzing and evaluating nursing practice including education, and creating an environment where learning is encouraged (p.8).” Legally and ethically, nurses are bound to the codes of ethics set forth by our governing bodies. As a collective, advocating for quality work environments which support the opportunities for mentorship and education is sound ethical practice and must be encouraged for successful student outcomes (CNA, 2008). This addresses the dynamic nature of nursing as a self-regulating profession. “Nurses eat their own” was a common expression used to describe the staff-student relationship during the educational process and the acceptance as a novice RN into the profession.  As our profession evolves, and issues are clarified through analysis and subsequent practice standards, this phrase is becoming more uncommon amongst new nurses as the dynamics of nursing is shifting in an accelerated evolution. Mentoring is not a legally binding term but viewing from a professional standpoint, it is an ethically binding term because it is the responsibility of all nurses to represent their profession through attitude, knowledge, accountability, ethical practice, and continuing competence within the scope of education and patient care (CNO, 2002). It is important for all nurses who interact with students to be cognizant of the fact that their knowledge, attitude, and communication skills play a direct role in the educational process no matter how small the interaction. One negative experience can influence a students perspective on the profession and affect their practice with patients and colleagues. Providing mentorship within the ethical and legal framework improves student performance and boosts self-confidence leading to successful outcomes (Ali & Panther, 2008).

            Providing culturally appropriate care within a professional relationship within the context of mentorship is crucial in attaining mutual respect and trust. Identifying cultural characteristics and working within the parameters of that particular individuals defining concept of belief and approach provides opportunities for beneficial educational experiences for both mentor and mentee (Belgrave & Cecilia, 2009). Taking into consideration and being respectful of the differences of ethnicity, culture, and belief structures provides a strong basis for mentorship and enhances the learning experience as both nurse and student are comfortable and confident with the established relationship. Cultural competency is an integral part to nursing practice and nurses and nursing students must be sensitive to their own values and assumptions about patients and colleagues to be able to create health care environments conducive to learning and healing. Nurse attitudes and nursing mentorship towards students within the construct of society is a relatively unknown issue. Professions have a tendency to be non-transparent unless exposed creating greater awareness. Since the framework for education is in place, it is difficult to expose instances where negative student experiences have compromised patient care. Society is generally unconcerned with interactions and attitudes within the profession unless in directly affects the delivery and quality of patient care (Hurley & Snowden, 2008). Since mentorship does take place in a variety of health care settings with a variety of nurses from diverse backgrounds, patients and their families may accept the approach of teaching by nursing staff as the standard even if in a less than desirable learning environment (Doherty & Mendenhall, 2006). As long as the quality and continuity of care is present the awareness of potential educational shortfalls with students will be masked and will remain an issue solely within the context of nursing without the important prevailing opinions of an informed public.

            From a political standpoint, mentorship and nurse relationships with students is an investment in health care. Having confident, educated, and competent nurses working within health care in all its aspects improves the health outcomes of patients and their families and subsequently reduces fiscal spending on redundant or repetitive re-admissions or treatments. Investment in nursing students and effective education and mentorship allows for greater critical thinking skills, health education competencies, and furthering of education increasing scope of practice (Shakespeare & Webb, 2008). Lack of mentorship and one on one teaching benefits nothing as students may develop autonomous strategies for self education that may not be founded in evidence. This decreases the viability of the profession as a whole and contributes to dangerous work environments for staff and patients. Recently in Ontario, the government instituted the nursing graduate guarantee initiative. This ensured guaranteed full time employment for all nursing graduates that signed up for the program in an area of their choice. For six months, new graduates are to receive mentored employment by senior nurses enhancing and nurturing the integration of new graduates into the professional workforce. This investment has proven to be a success, so much so, that problems have arisen from it. Staffs from various hospital units across the province are reporting a lack of senior nurses to mentor new graduates as they at times outnumber the qualified staff. This initiative mandates participating hospitals to pair new graduates with mentors as written in the policy manual. This is causing a backlash as new graduates are forced to look beyond their areas of interest or to relocate to work and gain the invaluable experience with paired mentors (Nursing Graduate Steering Committee, 2009). As these issues have been identified, ideas must be generated for recommendations in how to solve this issue. As the logical shift to evidence-based practice and approached becomes the norm in professional practice, mentorship is becoming the standard of clinical educators. The Ontario government and other health care stakeholders are aware of this hence the mandatory criteria of mentorship are to be met. The benefactors of mentorship are everyone. Government benefits with improved patient care with better outcomes. The profession of nursing benefits as continuity and quality care is ensured through sound practice founded through supportive and evidence-based learning. This promotes a better image and greater emphasis on trust, the building block of the nurse-client relationship. Also, the professions that interact with nursing also benefit as mentees are shown the value of collaboration broadening the inter-professional relationship with a patient-centered focus (Lockyer, Moule, Sales, & Wilford, 2008). Patients and their families benefit as the mentored nurse provides the best possible care and treatment ensuring the best possible outcomes within the framework of evidence-based practice. Safe, accountable, comprehensive and competent care is just a few of the many reliable benefits patients and their families will receive as smart, motivated, and inspired degree nurses bring improved practice and thinking to the bedside or wherever they may be.

            Taking in to consideration that the profession of nursing is female dominated, focusing on the distinctly unique female approach to leadership and education plays a major role in the acceptance and attitude towards the education of nursing students. Women have a unique understanding of women and this reflected in the nature of mentorship styles and adjustment to learning needs. This draws upon the fundamental basis of nursing which is caring and expression, traits traditionally not associated in the mainstream with males (Philips, 2008). Mentorship is not associated with either men or women but for students entering a complicated and challenging workforce. Sex does not determine competency or skill-set learned through mentorship but rather influences the perception of nursing by patients and their families. As the profession evolves, so does opinion and thought towards competent mentored nurses by the very people we treat and care for. Nursing is not a female profession; it is a female dominated profession that has provided a great foundation by many great persons. It is important to be cognizant of this fact as the dynamics of the profession slowly change as the image of nursing improves with modern thinking.

            The economic benefits of applying a mentorship program within an academic and health care setting are enormous. Fostering growth in skills and confidence ensures mentees are comfortable with their identities and competencies contributing to retention of smart nurses who place great emphasis on maintaining nursing excellence in practice (Godfrey, Nelson, & Purdy, 2004). With low turnover of mentored nurse’s, health care settings save money on hiring incentives, training costs, resources, and patient lengths of stay. Mentored nurses strive for nursing excellence in practice and this is reflected in patient outcomes which in turn are reflected in fiscal patterns. It just makes economical sense to mentor nurses.

            Mentorship has reflected well with me, my learning style, and I am appreciative to the nurses who became attuned to my learning style early on. On the other hand, I have had some less than desirable experiences within the clinical setting, and this did have an effect on my attitude towards staff on units and my opinions of their competencies as compassionate caregivers. As a student who has felt the cold hand of un-acceptance in the midst of trying hard to fit in and prove myself to be a competent professional, the feeling of discouragement is enormous and without the proper supports such as intuitive clinical instructors and nursing faculty, it is difficult to sway my opinion and the negative views I have towards individuals in the profession. Having these proper support systems, or, mentors of a different kind, helps guide me through the problems that arise within my practice wherever it may take me. It is important for me to stay patient-centered and focused on my nursing excellence. Being the best that I can be is the only way to gain the respect of future colleagues, and this does involve mentorship. Also, making my clinical instructor aware of the kind of education I benefit from helps ensure the proper pairing to a nurse willing to mentor, allowing me the freedom to practice without stress or anxiety. In summary, the importance of mentorship with students and new grads is paramount in providing the surety of confidence in practice. It makes sense to invest in programs designed around the concept of mentorship in learning, as it fosters and nurtures the bright minds of nurses for tomorrow’s world. Without change and evolution, stagnation becomes the norm, decreasing the stability and viability of the people involved in any organization, professional or not. Continually moving forward and developing new strategies for education, such as mentorship, strengthens professions and empowers individuals to make just and ethical decisions based on the best available evidence.



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Key Qualities Of Mentors

This essay is going to focus on various key qualities of mentors known as enabling traits in mentoring. Morton-Cooper and Palmer (2000) described enabling as the ability to make things happen and it has become related with other positive development concept of facilitation and empowerment to those around him/her, responsive to students need, easy to trust, able to command mutual respect from others, role model, patience, confidence, commitment, being competent. This essay will further analyze on role modeling, as an enabling trait in mentoring, as well different theoretical aspects underpinning the facilitating and assessment of learning. It will also discus the different strategies that mentor use to develop.

According to Gopee (2008) a mentor is a registrant who takes time to facilitate learning, assess and supervise students during their progression years, towards developing their skills and achieving competencies on completion of their course. It has been made a formal role in nursing education to directly allow students to obtain clinical skills during their practice placement in the clinical environment. According to Parsloe and Leedham (2009), a mentor is someone who encourages and support students to manage their own learning in other to maximize their potentials, develop skills as well as improving their performance and become competent professionals.

Gopee (2008) explained some of the enabling traits of mentor as a supporter; they gives time to support students' learning, encourages as well as willing to listen to students and makes himself/herself available whenever needed. As an investor, mentors invest reasonable amount of time working with the student, sharing their own skills, knowledge and experience.

According to Morton-Cooper and Palmer (2000) a mentor should be competent, have appropriate knowledge and experience and be effective in their work within clinical area, have confidence to take risk and allowing student to develop within their own terms. Student should be inspired to take on new challenges and initiatives. It is also vital that he/she recognizes their own strengths and limitations thereby seeking assistance when necessary thus allowing personal growth and development. A mentor should be flexible, approachable, accessible, patient, have perseverance and a sense of humor, which is also important for effective mentoring. With these enabling qualities, mentors should be calm and adaptable and they can also be generous towards others as well as acts as an effective enabler and leader.

Haven discussed the key concepts of enabling traits; this essay is going to analyze role modeling. A good role model is someone who exhibits a very high quality of skills and practices high standard, using evidence based research and working in accordance to policies as well as conducting him/herself ina a professional way (Brown 2002). A role model should also be an organizer of care, a researcher, and teacher within the limitation of their position (Gopee 2008). Rogers (2002) refers to role a model as being natural instead of presenting with false role and pretending to be some sort of perfect one. He/she does not act as they know everything or they are perfect. He/she will display warmth, genuineness and interest in student recognizing them, allowing time for questions and willingness to listen students' responses and replying in an appropriate and caring way. Thereby creating a trustful atmosphere where students can freely ask question without feeling foolish (Ellis and Hartley 2000). They look at themselves as someone who is still learning but are willing to share their knowledge. They are well respected and regarded by their colleagues and students look up to them (Walsh 2010).
bles student to develop more interest in professional development than any other learning experience (Spouse 1998). Bahn (2001) suggests that role modeling is consistent with social learning
According to Donaldson and Cater (2005) students' emphasize on the importance of a good role model whose expertise they could observe and practice. It ena theory, a great deal of socialization occur in clinical environment as well as student learning. According to Bandura (1977) cited in McLeod (2011) behaviors are learnt from clinical environment, through observational learning. However, professional socialization is not mainly a reactive process, it depends on past experiences of the student and the reflective nature of the process and the values promoted in the course (Hawkins and Ewen 1999).howe (2002) states that students put theory into practice during placement in clinical environment; professional roles and values are learned from role models. Hichcliff (2009) states that social learning is a very important useful tool that allows individual to measure outcomes and effect of others' behavior and as a result of this, individuals are able to gain understanding of consequences of their own action. Having the knowledge of the above theory will enable mentors to structure their teaching to facilitate effective learning (Murray and Main 2005). As a good role model, mentors should have positive attitude to work and be comfortable with carrying out their roles. Mentors should give student positive and constructive feedback to enable them to know how they are progressing, what they need to improve on and also guiding them on how to go about it. This will enhance their competence and also motive students as well as make them feel valued as part of the team. It will help to build their confidence and increase students' performance while incorporating it into their behavior and skills (Spouse 2002). Ali and Panther (2008) argued that for feedback to be positive, supportive and unbiased, observed behavior, experience and competence should be put into consideration and should no be based on presumptions and personality.

According to Rogers (1983) role modeling consists of social and humanistic theory considering that learning takes place in clinical environment where students work alongside their mentors; emulate their skills, knowledge and practice. However, precautions should be taken as students in these ways can also copy some harmful behavior and attitudes. Faugier (2005a) suggests that mentors should be aware of their effect as role models on students' learning of skills and professional attitudes. Allen (2001) suggested that, for role modeling to be successful, mentors should try as much as possible to engage student in professional activity by encouraging, motivating and inspiring students; this is because students are unlikely to repeat an observed response unless they are motivated to do so (Bandura 1977).

Further analyzing on being responsive to student's needs. According to Walsh (2010) acknowledging students as an individual and being aware that they have other social lives as well as commitments outside their practice placement and putting this into consideration, will make student feel respected , recognized and motivated. A good mentor is non-judgmental about his/her student and being so, will enable them develop a good relationship based on trust and acceptance. Mentors, who understand his/her student needs, will exhibit a degree of empathic awareness, which will make the student feel relieved. By disclosing that they were once like them and reassuring students that they will also become competent, will help to develop students' confidence and student can believe that they can achieve the same professionalism as their mentors.

Quinn (2000) believes that it is good that mentor should be knowledgeable of student's programme, competencies and learning objectives in order to guarantee effective learning. According to Nursing and Mindwifery Council (NMC 2008) mentors should empower students to identify learning opportunities, needs and experiences that are appropriate to level of learning as well as motivate them to be self-directed learners. As adult learner students may have their objectives and competencies that they want to achieve in additional to practice competencies. Using more of anagogical teaching approach, which is student centered, and it help learning on occur as a result of the student's effect, and it helps learner to learn what they want to learn (Knowles 1990).

According to Burnard (1992) communication acts ad a therapeutic intervention to meet learning needs. It plays an important role in facilitating learning. How mentors communicate and the type of relationship they build with student plays a significant role in empowering or disempowering students (Brown 1997). In order to facilitate learning, mentors should provide an appropriate conducive clinical learning environment suitable for individual students. Rogers and Freiberg (1994) state that one of the mentors' key functions is to welcome student to the team as well as helping them settle down into their clinical environment, which includes managing practice placement and conducting assessment and evaluation throughout the practice placement. It is vial that mentors work alongside students in order to be able to assess and make judgment about the level of student's not withstanding their stage in training.

Rogers and Freiberg (1994) identified that learning contract will give student some freedom to learn about areas they wish to learn as well as areas they wish to achieve which they find particularly interesting. A learner contract is used to identify areas students need to improve on, it clearly identifies how, when and also signed by the both parties. It motivates and helps to reinforce student learning through achieving the objectives. Mazhindu (1990) argues that they are effective but Neary (2000) suggested that they are not. NMC (2009) have emphasized that attitude of mentors, towards record keeping and the use of written records as evidence of actions taken as well as omitted. It advised that for learning contracts to be effective they have to be clearly written and well-constructed.

Mentors should structure teaching and present it in a way that makes it easy to understand. By using a range of learning skills to meet individual student needs, mentors should establish student's learning styles to enable them determine how to facilitate individual learning. It should also be structures in a way that it includes different learning style as described (Walsh 2010). Students are more likely to learn successfully if teaching is planned in a way that addresses individual student's need and interest that is within their ability as suggested by humanistic approach (Hinchliff 2009).

Behaviorist learning theorist recommended that learning through acknowledgement of a certain reaction, resulting in operant condition (Skinner, 1971). Mentor praising student when they perform certain clinical skills or partly completed skills towards their desired competency can easily motivate the student to learning new skills, thus enabling positive reinforcement. According to social learning theory, students learn by working along mentor, observing competent behavior or skill performed. He/she learn and practices it and if the attempt is positively reinforced, students will likely imitate and adopt the behavior and attitude. Mentors should take into account the student's previous knowledge and competence, such as skills already acquired on previous placement in other to maximize learning (Ausuble et al, 1978, cited in Gopee 2008).

According NMC (2008) mentor can develop his/her mentoring qualities by attending mentor's update and also suggested that it should be ongoing instead of annual event. It gives an opportunity to discuss issues with other mentor. It is also required that mentor keep their knowledge and skills up to date throughout their practicing period. Aston and Hallam (2011) states that mentor can receive evaluation and constructive feedback from students regarding their performance to enable them reflect on their aspect of mentoring, thus developing their mentoring skills and improving quality and promoting best practice. According to Anderson (2011) the reason for evaluation is to improve teaching process and learning outcome. However, Kilgallon and Thompson (2012) states that mentors should be careful when requesting for comprehensive feedback from students, unless they are prepared to deal with it in a positive way.

Others strategies mentor can develop their mentoring qualities is by attending organizational training, receiving institutional support and undertaking professional development by attending courses and further educational training as well as receiving support from manager whenever they are available (Wikes 2006). Mentor can update and improve their skills and qualities by using strength, weakness, opportunities and threats (SWOT) analysis to examining his/her roles as a mentor; it is also efficient way of reflection.

In conclusion, having discussed enabling trait/characteristics of mentors and using appropriate educational theories to analyzed role modeling and being responsive to student's needs. This essay has discussed the ways that mentor can exploit to develop his/her mentoring qualities. To enable a successful mentoring, mentor should provide an appropriate conductive clinical learning environment suitable for individual students and also identifying their learning needs as well as opportunities. Self-reflection will improve skills and qualities of mentor as well as improving teaching process and learning outcome.


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