Sharing the Journey in Nursing
Practice©
Partners in Nursing Practice
Designing Career Maps for Nurses in Transition
Elizabeth Campbell, MSN, RN
Thomas Gunning, BFA, ASN, RN
Ann Marchewka, PhD, RN
The Power of Context …
• Future Nurse Initiative
– Examine nursing workforce capacity to meet demand
– Include change in public policy at local, state and national level
• Carnegie Report
– Examine nursing education’s capacity to meet demand
– Address the structural / program inadequacies
• Affordable Care Act
– Demand for 32 million
– Design for Supply “Shortage”
• IOM Report
– Enhanced and Reconceptualized Role / Education
– Examine Innovative Solutions
Mentoring
Applying Evidence in Practice …
“Knowing is not enough; we must apply.
Willing is not enough; we must do”
- Goethe
The Value of Mentoring
• Mentoring provides
– Retention by means of a personal relationship
– Staff development and career guidance
– Job satisfaction, decreased horizontal violence
and a healthy workplace environment
– The opportunity for a seasoned nurse to pass
the torch in career development
Pathways to
Success for New Graduates
• Supportive preceptorship and clinical skills
acquisition
• Acceptance into the social network
• Orientation sets the stage, and mentoring should
foster inclusion into the social network
• The more people you know…more inclusion into
the work community and the greater probability
of retention
• Support for stress in the workplace
Mentoring the
Nurse in Transition
• Mentoring a colleague in transition provides:
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Professional and personal challenges
Chance to development leadership and teaching skills
Shared expertise
Opportunities for reflective practice
Opportunities to update practice with new technology,
knowledge and skills
– Creativity in thought
– Adaptation theory applied in the changing face of
nursing and navigating the twists and turns of a career
(Roy)
Desired Outcomes of Mentoring
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Recruitment of quality candidates
Retention of talent
Increase in professional competency
Reduction in turnover and orientation costs
Cost-effective staff development
Decreased horizontal violence or.. “nurses eating
their young”
• Job satisfaction produces patient satisfaction
and quality care
Mentors v. Preceptors
• Older than learner
• Possesses wisdom
and experience
• Career networking
• Facilitator
• Guide
• Advisor
• Role model
• Willingness to teach and
learn skills
• Experience
• Competent practitioner
• Teaching and support
• Orientation and
socialization
• Role model
Mentor v. Preceptor
Learner Outcomes
MENTOR
• Self-actualization
• Guide to establish own
place in the profession
• Enhanced problemsolving
• Generativity v. Stagnation
• Personal satisfaction in
sharing knowledge
Preceptor
• Bridge theory to practice
gap
• Achievement of planned
learning outcomes
• Skills and knowledge
• Anxiety reduction
• Professional role
enhancement (self)
Mentors v. Preceptors
MENTOR
• Chosen
• May have no formal
preparation
• Life, education, work
experience
• Type of relationship:
close, personal friendship
• Not an evaluator
PRECEPTOR
• Selected
• Assigned to learner
• Prepared for role
• Competent practitioner
• Support needed from
peers, educators,
manager
• Functional not intimate
relationship
• May evaluate
How Can a Mentor Help?
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Shifting Context (envision a positive outcome)
Listening
Identifying Feelings
Productive confrontation (critique of behaviors)
Providing appropriate information /solutions
Delegating authority
Encouraging exploration of options (thinking
outside the box)
Tools of Mentoring
• Sharing… knowledge and experience
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Insight
Observations
Suggestions
Giving the Big Picture
Sharing messages
• Challenging
– Asking questions
– Asking for plans
– Asking for decisions and ideas
Mentoring at Hallmark
• Purpose:
– To provide the newer nurse within our health care
system with a seasoned colleague who can provide
emotional support and professional guidance in
making career choices and transitioning to the
professional role
– To provide a vehicle for retention of talent within the
organization
– To create a network of professional relationships and
supports that optimize a welcoming and receptive
culture at HHS
Designing Our Questionnaires
• New Graduates in the Class of 2007
– Many second, third and more careers
– Some prior mentorship exposure
– Interest and expectation of the support that
could be provided
– Call to arms to design a program, rather than
purchase one off the shelf
What Should the Program Look Like?
• Discussion at new graduate internship
program
• Focus groups
• Marketing materials
• Literature Review
• Work-group to devise materials
The Questionnaires
• For the mentor and mentee
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Strengths and weaknesses
Career goals
Expectations of the program
Personal hobbies and interests
Past careers, past experiences if any with
mentoring
– Commitment level and meeting schedule
The Matching Process
• Reviewing the questionnaires
• Allowing a mentee to pick a mentor if
desired
• Some ground rules
– The developmental plan
– On or off the unit matches
– “No-fault divorce” clause
Objectives of Each Mentor Pair
• To facilitate the professional development of new
nurses and ease their transition into practice
• To foster a supportive, caring environment that
encourages professional growth and guidance
• To provide the seasoned nurse with an
opportunity to contribute to the growth of a
colleague (Generativity v. Stagnation)
• To provide a supportive environment within the
Hallmark community and a healthy workplace
environment for nursing
Expectations of Each Mentor Pair
• Attend program orientation
• Complete questionnaires for matching according
to common interests, personality and style
• Together, establish a development plan for the
newer nurse
• Mentors should encourage the networking of
their colleague in order to facilitate career
growth
• Maintain contact on a mutually agreed upon basis
• Complete evaluation tools as requested
Creating a Mentoring Agreement
• Objectives for a mutual effort
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Tentative and subject to change
Defines how the pair works together
Sets a tone, and expectations for achievement
Mutual and agreeable to both parties
Suggest written format, even if informal, to
revisit progress towards goals
Key Points of the Agreement
• Frequency of meetings
• Frequency of self-evaluation of progress
• Frequency of contact with the coordinator as a
check-in
• Attendance at meetings if scheduled
• Seeking out educational programs to attend
together
• Crafting a developmental plan
• Problem-solving strategies
What Does an
Agreement Look Like?
• List your expectations
• List how often, when and where you will meet
• Modes of communication; phone, face to face or
e-mail
• Potential obstacles to meeting: schedules, family
lives, etc.
• Some discussion about how to give and receive
constructive feedback
• Reminders about confidentiality
• Other players, and other concerns
Sample Focuses
In a Newer Nurse’s Plan
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Time management and organizational skills
Conflict management with co-workers
Teambuilding and communications skills
Clinical skill development (not necessarily by the mentor)
Confidence building bother personally and professionally
Exposure to cross-training or observational experiences
Brainstorming about continued educational plans
Leadership skills
Settling into the organization and the larger nsg
community
Focuses of the
Seasoned Nurse as a Mentee
• Where do I go from here?
• How do I get there? (Roadmap)
• Letting go of the familiar and embracing a new
role, fear of change
• Educational avenues
• Developing as a professional in organizations and
certifications
• What even are my options?
• Analyzing strengths and weaknesses
• Developing leadership skills
Philosophical
Framework of Mentoring
• Synergy Model
– Matching competencies of staff to care delivery and
matching competencies of colleagues in professional
support
• Benner’s Novice to Expert model
– Focus and philosophical framework of our preceptor
and professional development program
• Generativity v. Stagnation (Erickson)
– Seasoned nurse sees the value in passing the torch,
and learning new skills in the process to remain
actively engaged in his/her own career development
Getting Started
• Do staff want to be mentored?
• Do staff want to mentor?
• What is the view of new graduate support
and support for nurses in transition?
• Administrative support
• Budget (or lack thereof…)
• Inviting staff to join the merry band
Sustainability
• The mentored should want to mentor
• The mentored should invite their friends
• Structure vs. non-structure and a place for
each
• Building a cohort
• Planning an educational schedule to
introduce new ideas
Bibliography
• Benner, P. (1984). From Novice to Expert.
Excellence and power in clinical nursing practice.
Menlo Park, CA: Addison Wesley.
• Campbell, E., Gunning, T. “ Sharing the Journey ©
Hallmark Health Nurse Mentorship Program, 2008,
unpublished materials.
• Erickson, E.H. (1963). Childhood and Society.
• New York, NY: Norton.
Bibliography
• National League for Nursing.(2006) Mentoring of nurse
faculty. Position statement. New York: NLN. Available at:
httpp://www.nln.org/aboutnln/Positionstatements/ment
oring
• Scott, E. and Smith, S. Group Mentoring: a Transition to
Work Strategy (2008), Journal for Nurses in Staff
Development . 24 (5), 232-238.
• Shea, G. (2002) Mentoring: How to Develop Successful
Mentor Behaviors. New York, NY. Skillsoft Corp.
• Vance, C., & Olson, R.K.,(1998) The Mentor Connection in
Nursing. New York, NY: Springer Publishing.
Bibliography
• Younge, O., Billay, D., Myrick, F., Luhanga, F.
“Preceptorship and Mentorship: Not Merely
a Matter of Semantics”,(2007) International
Journal of Nursing Education Scholarship, 4
(1), 1-13.