Mentorship as a Teaching Strategy

Mentorship as a Teaching Strategy

0899-5885/01 $15.00 + .00 Critical Care Education Mentorship as a Teaching Strategy Susan Flewelling Goran, MSN, RN Mentors give us the magic that ...

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0899-5885/01 $15.00 + .00

Critical Care Education

Mentorship as a Teaching Strategy Susan Flewelling Goran, MSN, RN

Mentors give us the magic that allows us to enter the darkness; a talisman to protect us from evil spells, a gem of wise advice, a map, and sometimes simply courage. LAURENT A. DALOZ

word "mentor" has been synonymous with wise and trusted adviser.

Understanding the Mentor Role The Myths

Many know the story of Mentor as depicted in Homer's Odyssey. While Odysseus journeyed to fight in the Trojan War, Mentor his wise and trusted friend, was left in ch~rge of keeping the household safe and to raise Odysseus' son, Telemachus. After the war, Odysseus could not get home because an angry Poseidon kept him journeying another 1O years, from one adventure to another. Telemachus wanted desperately to find his father; and because it takes a god to defeat a god, Athena, goddess of wisdom, who was distressed at Odysseus's suffering, came to his defense and descended to earth to embolden young Telemachus.9 · 14· 23• 38 Because Mentor was a man of integrity, Athena assumed his shape to provide counsel. When she entered his body, the male and female persons merged, combining the traditional feminine and masculine qualities.14 • 23 Mentor/Athena guided Telemachus in the quest to find his father and served as parent substitute , teacher, friend, guide, protector, and guru. 9 · 14· 23• 38 Since Homer's Odyssey, the From the Maine Medical Center, Portland, Maine

Mentor figures can be found in fairy tales (fairy godmother), in popular literature (Merlin, Morrie), and in the movies (Yoda). Daloz9 describes the role as "designed to fill a psychic space somewhere between a lover and parent." He continues, "... they [mentors] are suffused with magic and play a key part in our transformation, reminding us that we can indeed survive the terror of the coming journey and undergo the transformation by moving through, not around, our fear. "9 The mentor figure is viewed as all knowing and often appears in the nick of time to assist the protege in his or her task. 14 · 23 The mentor relationship has been the subject of significant investigation and discussion during the past 25 years, both in industry and academia. 38 The virtues of mentors appear such that without these benevolent figures, success cannot be attained easily. The Realities

Mentor is both a noun and a verb. There is considerable debate and frustration in the literature about the accurate definition

CRITICAL CARE NURSING CLINICS OF NORTH AMERICA I Volume 13 I Number 1 I March 2001

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of mentor, mentorship, and mentoring.2· 6, 12, 14, 19, 21, 33, 38 The inability to define the role consistently makes mentoring research especially challenging. 39 Although role model, teacher, coach, sponsor, guide, and advisor all describe components of the mentor role, they are not synonymous with mentor. Vance and Olsen38 agree that mentoring is "difficult to define and measure," but they offer their own description: "It cannot be seen, but is a powerful, enriching phenomenon that can be described by those who experience it." Alleman1 defined mentoring as "a relationship between two people in which one person with greater rank, experience, and/ or expertise teaches, counsels, guides and helps the other develop both professionally and personally." The classic traditional mentor, or life mentor, based on a male relationship model, speaks of a "close, intense, mutually beneficial relationship between someone who is older, wiser, more experienced, and more powerful with someone younger or less experienced."23 The male model focuses on issues of power, and the relationship is contrived as one that can enhance or provide increased power to both the mentor and the protege. 23 This hierarchical relationship incorporates both career functions and psychosocial functions, with the mentor acting as teacher, guide, and adviser. 14· 23 Mentoring/mentorship is an interactive, interpersonal process, either formal or informal, between a dyad of expert and newcomer that assists the protege's role socialization and helps to develop self-efficacy in performing new roles. 21 · 38 Informal mentorship tends to occur because of a current relationship between the mentor and protege. It is a voluntary, spontaneous relationship between two people w ho make either a spoken or unspoken commitment to the relationship and each other. 23· 38 The relationship develops based on mutual attraction and respect and occurs in an organizational or professional context. 14· 23· 38 The relationship changes and evolves. Initially, the protege tries to learn from the mentor, then wants to equal him or her, and eventually, surpass him or her. 9· 23 During that time, the mentor advises, helps, and teaches and then must let go so the protege can become his or her own professional. 9· 23 For many,

this one-on-one relationship is the ideal, but in reality it is often difficult to establish or maintain. One-on-one relationships are time consuming and require commitment. They are options often not available to women or minorities in the workplace. 14· 23 Many organizations offer an alternative to the more traditional mentoring model with formalized mentoring programs. 9· 23· 38 Participation for both the protege and mentor may or may not be voluntary. Typically, the program has a structured set of goals or objectives, is time limited, and assigns the match between mentors and their proteges. In many programs, the mentor is a peer with limited power advantage but has the knowledge or skills the protege needs to acquire.9· 23· 38 Peer mentors and preceptors are examples of formal mentoring relationships. 38 Formal mentoring programs exist in government agencies, universities, professional organizations, corporations, and often, in nursing. Both mentors and proteges espouse numerous benefits in mentoring relationships, including career success and advancement, personal and professional satisfaction, enhanced self-esteem and confidence, preparation for leadership roles and succession, and, in nursing, strengthening of the profession.9· 14· 23· 38 "Mentors and proteges report a sense of renewal as they are mutually stimulated to expand their skills and knowledge by each other's questions, specific challenges, and belief in one another." 38 Women and the Mentoring Model

In learning their role in the business world, women have been mentored by men, in the male tradition, producing results that reflect and perpetuate the existing system. Many women have been encouraged to assimilate, to adapt to a way of being and a reward structure that perpetuate male expectations and values. This allowed a generation of women to survive and succeed in a career. For many, however, the malestructured workplace did not feel like home, a place where they could be their genuine, w hole selves. 14• 23 New models were needed. Jeruchim and Shapiro23 selected eight professions, including nursing, and interviewed

MENTORSHIP AS A TEACHING STRATEGY

106 proteges, scores of mentors, and several mentoring experts. Their research focused on mentoring from four perspectives: as a woman's issue, as a developmental issue, as a relationship, and finally as a success/power issue. In the female-dominated occupations, such as nursing, social work, and education, mentoring as a career-advancement tool was underused. Nurses were perceived as having vague career goals and lacking powerful role models. "While nurses serve as models for younger nurses, they are not in position to help newcomers politically because they do not hold the power within the hospital. Thus the traditional business model of a mentor as a powerful political adviser does not hold in nursing. The nursing mentor is more of a teacher and role model."23 ]eruchim and Shapiro23 found significant differences in the use of the mentor model with women. They concluded, "That women must redefine the mentoring relationship in their own terms to meet their unique needs is a bold, new idea. Rather than struggle to make the male model fit, women must create a new model if they are to fulfill their own potential. "23 They suggest a new mentoring model based on women's world view, 23 "a web of relationships," 9· 38 suggesting that a woman probably will not have one traditional male mentor for her lifetime, but instead several mentoring relationships throughout her career. 23 Women need other women as role models to "teach them how to live their lives as professionals, wives, and mothers." 14

The Mentor Link in Learning Most would agree that it is impossible to learn any profession just from books, curricula, or programs. Although these can teach us important topics, only other persons can teach us who we are. When a nurse is asked about her occupation, the answer is not "I do nursing," rather, it is "I am a nurse." It is the element of being a person in community (nursing) that is the essence of the mentoring relationshipn So, how does one learn to be a nurse?

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Learning as Transformation It is clear that the role of the mentor en-

compasses that of teacher. One assumes that the mentor is the teacher and the protege is the learner, although mentors clearly identify mutual learning as part of the relationship. Mentors teaching in the workplace often focus on building competence and career rather than on developing awareness and emotional maturity. 23 Although the development of competence, particularly in a practice discipline such as nursing, is necessary, other types of learning must occur for the profession to grow. 26· 38 Is learning only the acquisition of knowledge, or is it the development of the whole person? Learning, like the mentoring relationship, can be viewed as transformative.9 As we learn, we need to let go of old ways of seeing. "Letting go" speaks of loss and fear. Growth means transformation, and transformation means yielding old structures of meaning and making new ones. 9 Often this process of transformation is enhanced by the use of a guide/teacher/preceptor/mentor, "someone to hold onto until we regain our balance."9 Two key factors in the learning process are the learner's readiness to learn and the motivation for learning. 9 Incidental Learning

Jeruchim and Shapiro23 specifically identified the importance of role modeling in nursing. Modeling causes incidental learning. Incidental learning speaks to "medium is the message"; we learn as much or more from the way we are taught as from the content itself. 9 Modeling is an inherent part of the mentor process. The protege identifies with the mentor, admires his or her expertise, takes in his or her professional values, and models his or her behavior. 38 We have all said, "I want to be just like her" at some point in our career. Teaching by example speaks of the leadership component of mentoring. Multidimensional elements of learning that are contingent upon role modeling include expectations of self and others, situational conditional factors, situational anxiety, application of theoretic knowledge to practice, and experiential knowledge. 24 Unfortunately, learning via role modeling is passive behavior. The role model can be totally

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unaware that someone is learning from his or her behavior of the moment. In a profession known for "horizontal violence" and "eating our young," nurses must make a concerted effort to recognize the power, positive and negative, of modeling. 26,3 8

Mentorship in the Academic Setting

The Mentor Versus the Teacher

The "Adult" Student and the Mentor

What is the difference between mentoring and other forms of teaching, learning, and sharing? Most agree it is mainly a difference of intensity and commitment. The role of the teacher traditionally has been to transmit knowledge. 9 Unfortunately, teaching does not necessarily assure learning. "We know the quality of learning is high when students show intellectual, emotional, and ethical growth; we know that teaching is excellent when it fosters such growth, when we have teachers who are willing to care-both about their subjects and/or their students." 9 Teaching is more than asking questions, giving answers, and then asking the same questions again. In describing his philosophic view about teaching, Daloz9 argues, "education is something we neither 'give' nor 'do' to students. Rather, it is a way we stand in relation to them. The nature of that relationship is best grasped through the metaphor of a journey in which the teacher serves as guide." 9 In his book, Mentor: Guiding the journey of Adult Learners, Daloz9 eloquently introduces the concept of the mentor as master teacher, guiding the student on a transformational journey. He gently chides, "Whether you teach accounting to classes of three hundred or psychological anthropology to a seminary of six, whether you are semesterly swamped with a river of advisees or meet individually as tutor for a dozen, the material here is pertinent. For although students do indeed learn differently in groups than alone, and although it may seem that when we enter the lecture hall we are 'teaching a class,' always it is individuals who are learning." 9 The teacher is the catalyst for development. Mentors provide support, challenge, and vision for their protege. The mentor teaches the technical skills of the profession and helps the protege learn the values and standards of the profession while he or she develops a professional identity.38 In nursing, it is clear that teaching is provided not only by the teacher

but from all who come in contact with the novice and provide teaching moments.

Education is not the .filling of a pail, but the lighting of a .fire. W.B. YEATS

The enrollment of traditional students has decreased significantly over the past several decades. Since the early 1970s, nontraditional or "adult" student enrollment has risen rapidly. Estimates acknowledge that adult students constitute 50% of the student body today. 9 For the more mature student, the campus is not the center of social and intellectual life that it is for the younger student. Instead, adult learners come to college complete with jobs, spouses, children, and well-developed community roles. They already have extensive life experience in both love and work. Women often return to school because of some transition in their lives (e.g., divorce , empty nest) , whereas men typically return to school to enhance their work life. The emotion described by most adults returning to school is fear. 9 The adult student looks to the teacher not only for knowledge, but for providing a context for the new learning. New knowledge without context is unsettling to say the least and terrifying at worst. 9 Nursing also is seeing a resurgence of students entering the nursing profession as a second career. Although a novice to nursing, these adult students challenge old ways of knowing while looking for context. They expect to be respected for their life's experience and are anxious to lose the sense of the unfamiliar and return to a previous comfort zone. 38 They need a guide/teacher/mentor who can provide support and reassurance but also challenge and stimulate new learning. Mentorship in Nursing Education

The most important day I remember in all of my life is the one in which my teacher came to me. HELEN KELLER

MENTORSHIP AS A TEACHING STRATEGY

The Undergraduate Nursing Student

How do we grow a nurse? Learning to nurse is identified as a "complex interaction of affective, practical, and cognitive factors." 33 Traditionally, nursing has been taught through an apprentice model, with the novice learning from the experienced nurse. By working alongside practitioners, students learn from experts in a safe, supportive, and educationally adjusted environment. 34 Schools of Nursing provide clinical faculty to supervise and evaluate student performance in the clinical experience, but the staff RN plays a significant role in "teaching" nursing to students. For most, this is an expectation of the role, assigned without any special preparation or compensation. This model has its challenges, especially today, when the workload of the nurse allows little time for teaching students. It is a short-term relationship, and in reality the student can be placed with a different RN for each clinical experience. 34 Furthermore, even given enough time, not all staff has adequate teaching skills. "People who are experts in their field are not always experts at communicating that expertise." 23 Spouse33 concluded that staffs were more likely to expose students to technical procedures than to help them put those skills in the broader context of patient care. By their actions, the RN staff teaches more than skills. Indeed, they often provide socialization, which is the process of the neophyte moving closer to the accepted norms of the group he or she enters. 7 As they come closer to the end of their program, student perceptions of nursing move closer to that held by their teachers, or the clinical nurses with whom the students work. 24 Two nursing students, Cude and Edwards, 8 emphasize that to be a positive model, clinical mentors "should be enthusiastic and genuinely interested in students." Spouse's33 research agrees: "Levels of stress experienced by students were inversely proportional to the friendliness offered by both the mentor and ward environment.'' 33 Recognizing that learning and socialization is enhanced with a more intense one-onone relationship, many schools are developing opportunities for students to learn with selected preceptors/mentors in longer-term relationships. 5• 20 • 39 Currently the educational

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preparation for nursing in Great Britain is being evaluated and redesigned in a project known as Project 2000. 20.33 As part of the evaluation, a longitudinal qualitative study reviewed the use of mentors in the socialization of students to the profession of nursing. Two important points were indicated: students identify the mentor as the "linchpin" of their experiences, and some students with mentors develop intuition earlier than previous work has stated. 20 This study also clearly identified the need of students to feel as though they are "fitting in," as they are anxious to lose the "outsider role.'' 2° Certainly, the same principles can apply to nurses entering new employment opportunities. Many programs in the United States are also trying innovative methods for pairing students with staff nurses in longerterm relationships to enhance the learning relationship. 2• 25 The Graduate Nursing Student

The needs of the graduate nursing student are often similar to those of the adult student. Frequently, the graduate student already has been socialized and integrated as a professional nurse. The clinical skills already have been obtained, and now the professional is returning to school to prepare for an expanded role in nursing. The literature offers considerable discussion about the importance of the preceptor in the preparation of the advanced practice nurse (APN). 4 • 21• 32• 38 There is no debate that the education of the APN requires both didactic study and clinical experience. 32 Although programs provide faculty, the practice sites must rely on expert practitioners as the teachers of the next generation.32 The preceptorship experience allows students to acquire clinical skills and socialization into the role. The preceptor is assigned a student for a short-term, one-on-one clinical learning experience, often with little guidance. As is often the case in the orientation of new employees or precepting students, the preceptor must add the teaching responsibilities to patient care responsibilities. Nurse practitioner (NP) students learn their roles as primary caregivers and how to relate to patients through this preceptor/student relationship. It provides a model for the

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nurse/ patient relationship, with the student learning how to care for patients as the preceptor cares for both patient and student. 32 As with most transitions, the role of the APN begins with letting go of the past. Most APN students come to their programs as experienced nurses with a particular expertise. Also, many NP students today are former clinical nurse specialists (CNS) now returning for practitioner skills. Preceptors must be sensitive to the mix of confidence and insecurity displayed by the student. 32 The preceptor has the challenge of teaching, encouraging, and correcting. He or she must be a "wise time manager, and excellent clinician, an understanding teacher, a gracious hostess, and a caring professional. "32 Hayes 21 suggests this short-term relationship is not adequate for the NP to develop self-efficacy. She argues that self-efficacy (i.e., the personal belief or conviction in one's ability to carry out a behavior that will produce a particular outcome, a sense of confidence that one can organize and complete a behavior competently) can be better assured by taking the preceptor relationship one step further into a mentoring relationship. Hayes studied the effects of an assigned preceptor versus a self-selected mentor on student NP self-efficacy. Her research concluded "positive correlation between mentoring and student self-efficacy, and significant differences in mentoring scores between students who chose their preceptors themselves, particularly preceptors with whom they already had a relationship, and those students who accepted faculty assignments." 21 Hayes 21 advocates that by using Eastern Taoist principles that emphasize empathy, compassion, nurturing, mutual respect, and learning, the mentor can teach the student to appreciate the patient's lived experience. She summarizes, "... it is the mentoring experience that may ultimately provide for the development of more efficacious providers who will make significant contributions, particularly in primary care." 21 Mentoring the Teachers

For some of the same reasons that we are currently experiencing a significant nursing shortage, nursing faculty are also in short supply. Estimates warn that by the year 2006, half of all nursing faculty are expected to

retiren Unfortunately, fewer nurses are prepared for or desire to teach. Many blame this on the inadequate or noncompetitive salaries.11 Whatever the reason, it is clear that linking education and practice will continue to be a challenge for the students in both graduate and undergraduate nursing programs. As new faculty members assume positions, they too will need an opportunity to learn the job and be socialized into academia. Vance 37 studied the characteristics of mentoring and its relationship with role socialization functions among academic nurse administrators. The results supported the importance of mentoring in academic settings, and the mentor was perceived as a positive, pivotal figure who facilitated role socialization. Brown6 describes the mentoring program for new faculty at the University of North Carolina at Greensboro School of Nursing. Current faculty members are asked to serve as a mentor to new faculty for 1 year. The purpose of the program is to assist the protege in becoming oriented, knowledgeable, and comfortable in the School of Nursing culture and environment. Evaluations of the program clearly indicate this is a positive experience for both the proteges and mentors. Participants identify both psychosocial and career benefits (e.g., teaching tips , grant writing, and preparation for promotion and tenure).

Mentorship in the Workplace: Continued Learning Mentorship for Women in Business

As women take their place in banking, the media, the law, accounting, academia, and certainly the business world, they are assuming more positions of power. 40 Books, articles, Internet sites, and programs are dedicated to helping women learn to find balance and make a maximum contribution (Box 1). Many of these supports tout the importance of mentoring as a strategy for success. Networking, ethnic circles, friends with a similar focus, affinity groups, and defined action groups all can evolve into mentoring opportunities. When women come together for the purpose of connecting as women and sharing who they are with one another, we create an

MENTORSHIP AS A TEACH ING STRATEGY

Box 1 EXAMPLES OF WOMEN 'S MENTOR ING GROUPS 14, 23, 4o

Mentoring circles are typically groups of 6 to 10 women with a mentor; relationships and commitment develop among all members of the circle. • NYNEX Mentoring Circles • WOW'M : The Mentoring Company, Denver • Coors Brewing Company Mentoring Circle • Hewlett-Packard Mentoring Circles • Institute for Women and Leadership at Colorado State University Mentoring Circle Weekend mentoring workshops bring women together for 1 or 2 days to meet with mentors and hear featured speakers . Private coaches consultant for hire are business coaches who help you set the personal and professional goals that will give you the life you really want; consultants help you take an objective look at yourself, assess your assets and your weaknesses, and get the coach ing you need to develop your strengths and ach ieve a successful and fu lfill ing life. Internet sites assist you in finding connections. • www.coach.com (Coach University) • www.womensresourcentr.org/mentor (Woman to Woman Mentoring Program) • www.mentor.electra.com/electra (Electra Mentoring Connection) • www.advancing-women.com/wk mentornet. html ("MentorNet," The National Electronic Industrial Mentoring Network for Women in Engineering and Science) • www.menttium .com (Menttium 100; an innovative project designed to help fast-track women hook up with mentors outside their own companies) • www.mentorusa.com (Mentor Networks USA) Corporate networks and forums give women exposure to new responsibilities; forums address issues that affect women in the workplace and present seminars and speakers that offer member new ski lls and ideas . • Kodak's Women's Forum • Beichtel Women's Initiative • Corning International Women's Forum • Hewlett-Packard Women's Information Network (WIN) Professional organizations offer mentoring based on shared professional fields. • National Organization of Business Women • American Women's Society of CPAs

opportunity to discover ourselves and who we can become. 14 Nursing, a profession still 95% female, needs to take opportunities to partner with or learn strategies for professional development from our counterparts in the business world.

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Transitioning into the Nursing World

Who should assume the respo nsibility for the career development of the individual nurse? Vance and Olson38 suggest, "This is a shared responsibility of the partnership among the nurse , peers, and advanced colleagues, the profession, and the organization." New nurses should be "proactive" in their own growth and "actively seeking the help of peers and experienced professionals. "38 Seasoned professionals should be on the "lookout for promising persons who desire to grow" and "assume an active helping role in their development. "38 Indifference can be highly destructive to career development. Unfortunately, we have anecdotal evidence of professional hazing, a phenomenon in which neophytes are made to prove themselves and their competency in a hostile, unsupportive environment. "By contrast, when involved, caring mentors are available for beginning nurses, a foundation of work satisfaction and success, self-confidence, and professional commitment is established." 38 Recognizing the significant cost of traditional orientation, the current high rate of turnover, and the conclusions of the research on new graduate transition, one organization developed a new model for the training and retention of the new graduate. 3 In their excellent article , Beeman, Jernigan, and Hensley3 describe their goal-driven program designed to prepare new nursing graduates. They suggest focusing first on their security and affiliative needs and subsequently on their professional skill and knowledge acquisition. 3 The attention devoted to assimilating to the culture cannot be undervalued. Culture is a powerful force that gives meaning to people's lives, reduces uncertainty, and creates stability. Groups and organizations develop a culture that affects how people think, feel, and act. 9 In the Beeman, Jernigan, and Hensley3 model, RN mentors play a vital role. The mentor is chosen based on essential skills that include the desire and willingness to help, highly refined interpersonal skills, competency, and a supportive attitude. Mentors must complete required training with a focus on role modeling, documentation, confrontation, coaching, and other teaching skills. Managers coordinate and facilitate the overall process. Unlike the traditional

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orientation model, the mentoring relationship is not severed after 12 weeks but continues, albeit less intensively, for 2 years. Results demonstrate an increase in morale, an increase in retention, and a cost savings realized over the traditional orientation model.3 Other models also suggest the impact of a mentoring relationship on the smooth transition of novice nurses. Barmentoring, a relationship built on personal encouragement, is the basis for another concept of the mentor/ protege interrelational process. 12 Conceptualized from the Greek word Barnabus, meaning son of encouragement, and mentoring, the purpose is to use encouragement to promote constructive professional relationships, security in role transition, and progression in clinical nursing practice.12 The DiVitoThomas12 study of novice nurses in clinical practice demonstrated a positive correlation between the level of achievement rating of critical care skills (basic psychomotor skills) and the level of encouragement.

Box 2 VANCE AND OLSON 38 NURSING CAREER STAGES AND RELATIONSHIP NEEDS Career Stage 1

• • • •

First 2 years of nursing Frequently fraught with stress and ambiguity Novice nurse serves as an apprentice Learns from observation and trial and correction • Focus is on learning to work with supervision , fol lowing directions, and getting help from more experienced colleagues • Advanced nurses and peers are mentors who serve as intellectual guides and sociocultural role models Career Stage 2

• 3 to 10 years in nursing • Focus on increasing competence; works independently • Specialization occurs through advanced study and work training • Becomes increasingly visible in the organization • Peer mentoring common; provides encouragement, guidance, inspiration , and belief in the nurse's growing competence Career Stage 3

Lifelong Learning and the Mentor Obviously the learning process does not, nor certainly should not, end once one has attained the skills required for the role . Continued learning and development is vital to the individual and to the nursing profession.26 · 38 Dalton, Thompson, and Price 10 developed a model that relates primary relationships to career development. Using this model and the data from a review of 81 nursing research studies about mentoring, Vance and Olsen38 describe the types of mentoring relationships formulated in a nursing career. Box 2 summarizes their descriptions. Initially, the research on mentoring relationships in nursing used the more traditional definition of mentor and focused on nurses in positions of responsibility, thus assuming power, such as nurse executives and academic administrators. 2· 19· 31 · 35- 38 Studies indicate that for many in such positions of authority, the use of a mentor had been a significant factor in their success and survival. 19 Not only do many respondents express deep satisfaction with their mentors , but a high percentage are actively mentoring others. 2• l9, 3l, 35-38

• 10 to 20 years in nursing • Focus on increased responsibility • Have broadened capabilities both inside and outside organization • Work is complex, requiring high degree of interpersonal skills • Often responsible for influencing, guiding, directing, and developing others • Provides more traditional mentoring for those early in their careers, peer mentoring for their colleagues, and still may receive mentoring from those in more advanced positions Career Stage 4

• Greater than 20 years in nursing • Exerts a wide sphere of influence • Shapes the direction of the organization in which she or he works • Significant influence on external organizations and the profession • Promoters of human growth and professional development • Serves as mentor/sponsor to individuals, professional groups, and organizations

All nurses , regardless of role, have opportunities available for new learning, both in and outside of the clinical arena. Teaching and supportive relationships contribute to the success of the individual in any practice

MENTORSHIP AS A TEACHING STRATEGY

setting. Ecklund15 surveyed and examined the relationship between mentoring and job satisfaction of 76 members of a critical care nursing organization's clinical practice network. Scores were higher in the mentored group, and the subjects were able to identify positive characteristics of a mentor. Some of us return to the academic setting looking for new knowledge and opportunities for advancement. Others combine their professional and personal roles to provide mentoring to the community (e.g., as Girl Scout leaders, school board members, or in formal mentoring programs with schools). "Mentoring moments" 38 occur daily. They happen between the manager and the staff nurse, between the advanced practice nurse and the bedside clinician, between two staff nurses, and between a physician and an advanced practice nurse. They happen when teaching and support are provided around a specific encounter. The mentor can be fully aware of the opportunity, such as when the CNS or NP is asked a question about a patient condition, an intervention, or a skill by a staff nurse. To provide this informal teaching, Neuher et al1 8 • 28 have developed a five-step model designed to keep a teaching encounter to 5 minutes or less, as summarized below: 1. Getting a diagnostic commitment from

the student encourages the student to process data from the student's database. The student's failure to commit can indicate either a knowledge deficit or a dependence on the thinking of others. Preceptors are encouraged to ask the following questions: • What do you think is going on with this patient? • What laboratory tests do you feel are indicated? • What would you like to accomplish on this visit? 2. Probing for supporting evidence helps both the preceptor and student recognize what the student does and does not know. 3. Teaching general rules from what the student has disclosed allows the preceptor to teach from the apparent gaps or mistakes in data. 4. Reinforcing what was done right targets the specific behaviors the student did right and can repeat consciously, praise

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and criticism need to be as specific as possible. 5. Correcting mistakes requires tact and the appropriate time and place. Mentoring moments are different from grilling, which implies judgment and criticism. 21 The emphasis in mentoring is on support and caring. It is important to remember, however, that mentoring moments also occur without the mentor' knowledge, via role modeling. The role model component of the advanced practice role or a formal leadership role cannot be emphasized enough. 21

Unique Mentoring Opportunities in Nursing Long-Distance Relationships

With today's communication innovations, distance is not a barrier for developing a mentoring relationship. Using a written inventory process, a formal mentorship program was started by the Southern Council on Collegiate Education in Nursing. 29 The authors of this article describe the success of the relationship despite the challenge of distance. 29 Internet mentoring sites, list servers, and chat rooms are readily available to link the "haves" and "have nots" of experience. These connections can be especially helpful for the nurse entrepreneur. 41 Professional Organizations

Many professional organizations offer opportunities to link their members in mentoring relationships. The networks provided in belonging to a professional organization are one of the many advantages of membership. When attending national conferences, most organizations take special care to provide opportunities for networking. By listening and talking with others, you have the chance to identify those with whom you would like to develop a further relationship. The American Association of Critical Care Nurses (AACN) provides several mentoring opportunities, or Learning Connections, to its members. AACN co-sponsors with Mallinckrodt, Inc., a $10,000 grant, which provides research support for a novice with limited or no research experience working

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under the direction of a mentor with expertise in the area of proposed investigation. Wyeth-Ayerst Laboratories, the American journal of Nursing, and AACN sponsor a 9-month fellowship. Through the program, acute and critical care nurses participate as either mentors or fellows. Guided by the mentor, each fellow prepares an individualized fellowship project, which is published in a supplement to the American journal of Nursing. Mentors are experienced acute and critical care professionals who help guide the fellows in further developing their clinical leadership potential, including professional writing that is directly related to clinical practice. These are just two examples of

AACN's commitment to learning through mentorships. Further information can be found on their Web site, www.aacn.org. Many other professional organizations provide similar programs.

But before we speak too much of magicians and mentors, teachers, healers and guides, I want to make it clear as sunlight that there is nothing here that does not meet the eye willing to see or the ear ready to hear. Magic, as all true wizards know, is available to anyone willing to stand in the right place. LAURENT DALOZ, 1999

Nursing is facing challenges perhaps unparalleled in its history. As we face the opportunities of the future, mentors play a more important role than ever. Mentors have "provided inspiration, support, and encouragement during high and low points of my development," 22 "have forever changed the course of our practice," 16 taught through "her commitment to the advancement of her students and colleagues, her gentle but persistent encouragement to grow, and her generosity in providing pivotal opportunities," 27 "taught me three lessons: caring gets results, family comes first, and passionate commitment is contagious," 17 offers a potential buoy in the sea of change in health care, 15 and possibly enhances clinical outcomes. 42 Mentors can be found in your boss, teacher, spouse, friend, colleague, or peer. Mentorship is a gift between two people and must be given and accepted as such. 9 • 14 ' 38 Not everyone should act as a mentor; the relationship cannot occur and develop when there is no desire to share. 21 Nursing is about learning and teaching. "The spirit of the nursing profession dies when it is reduced to a set of abstract theories, legal requirements, and expert skills. These are the results, not the goals, of scholarship and leadership. Scholarly endeavors always occur amidst communities of learners engaged in being better practitioners of their discipline." 13 Mentors are the leaders amidst the community of nursing.

REFERENCES 1. Alleman E: Alleman Mentoring Scales Questionnaire,

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