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Nurses nurturing nurses
Nurses Nurturing Nurses: A Mentoring Program
Kathleen A. Reeves, MSN, RN, CNS
An increasing shortage of nurses, demanding work environment, and alarming statistics indicating that almost half of all new nurses leave their first professional nursing position within the first year motivated the Academy of MedicalSurgical Nurses (AMSN) to develop a mentoring program for new graduate nurses. Through the guidance and leadership of Marlene Roman, MSN, RN, APRN, past-president of AMSN, and the AMSN board of directors, the mentoring program Nurses Nurturing Nurses (N3) was initiated in 2002.
T
he N3 mentoring program is based on a framework for the passage of wisdom, caring, and confidence between graduate and experienced nurses. The program has been designed as a research project, with a targeted evaluation process measuring nurse confidence, job satisfaction, and intent to remain in the nursing profession. According to Perrotta,1 job dissatisfaction is the underlying issue in many cases of high turnover in health care organizations. The N3 program objectives are the following: • To develop supportive and encouraging relationships • To guide new nurses in their professional, personal, and interpersonal growth • To promote mutuality and sharing based on colleagues’ needs • To communicate information concerning expectations, learning opportunities, and stressors According to the American Heritage Dictionary,2 mentor can be used as a noun and refers to a wise and trusted teacher or counselor. Mentor can also be used as a verb to mean to serve as a trusted teacher or counselor. Nurture means to cultivate, foster, or nurse. The N3 program requires a 1-year commitment between a mentor and mentee. The pair agree to meet consistently throughout the period to assist the mentee’s transition into the role of a professional nurse. The program requires coordination by multiple individuals. National and regional contacts are provided by AMSN, and the board of directors appoints a program coordinator. I have been in this role since the program December 2004
began, and I am responsible for overseeing all site-based activities and providing support for the regional and site coordinators. The AMSN research coordinator is Cecelia Gatson Grindel, PhD, RN; her role is essential in evaluating the data collected from mentors and mentees. She directly receives all evaluation forms, analyzes the data, and provides reports to the board. At this point a very minimal number of pairs have completed the entire program, and thus data are not available for reporting purposes. Several institutions have wanted data specific to their site; she will be able to provide site-specific information without violating confidentiality as long as there are five pairs at the site. Regional coordinators are appointed by the AMSN board. They often work very closely with site coordinators within their respective regions of the country, providing consultation and advice for facilities implementing the N3 program. The site coordinator is critical to the program. Generally appointed by an institution’s administration, the site coordinator recruits mentors and mentees and pairs them into dyads. In the N3 program, the pairs work in the same facility but not on the same unit, so it is essential to have someone coordinate the efforts within the institution. To assist the coordinator, the program provides suggested criteria or mentors and mentees (Table 1). Identifying and supporting the site coordinator requires an institutional commitment to the program. The level of commitment has varied throughout implementation. Most site coordinators have had the role added to an Nurse Leader 47
already challenging workThe site coordinator is load. Institutional focus can responsible for orienting Nurses Nurturing Nurses change throughout a 1-year the mentors and mentees to time frame. Some coordinathe N3 program and obtainMission Statement tors have had other essening consent from both parAMSN’s goal is to contribute to the personal and tial responsibilities (such as ties to participate in the professional development of nurses through preparation for a survey by study. The coordinator the Joint Commission on serves as a resource person relationships that are nurturing and supportive. Accreditation of Healthcare for the dyads and provides The mentor/mentee relationship will support the Organizations) take higher reminders as needed to the mentee’s transition to professional nursing, thus priority than the mentoring mentors and mentees to fostering confidence in practice and retention of program. Although undersubmit various evaluation the new nurse. standable, this delay someforms throughout the 12times hindered the full month period. implementation of the proThe mentor/mentee gram, despite the desire to do so. dyads are encouraged to have face-to-face meetings every Similarly, in some cases site coordinators experienced other week for the first 6 months to establish the relationunplanned position changes within the organization that ship. After that point, they are encouraged to meet once a resulted in replacements. This change required additional month at a minimum and to use other methods of comorientation for the new coordinator and at times disrupted munication, such phone calls or email, to maintain the the timely submission of evaluation tools. relationship. Site coordinators have the challenging task of encouragIn the mentoring relationship, sharing between coling dyads to meet on a consistent basis. A few institutions leagues is essential for success. The focus is on the offered incentives, such as Starbucks gift cards and cafetementee—his or her needs are identified and addressed ria passes, to encourage meetings between the mentor throughout the relationship. To create an environment of and mentee. Despite the incentives, some dyads did not open communication, it is critical that both parties are meet as often as suggested. A few institutions required clear that conversations are confidential. No information is their own Internal Review Board approval in addition to shared with others without the consent of the both parthat provided in the N3 program. Again, this resulted in a ties. The two exceptions to confidentiality are if the delay in implementation within an organization. mentee discloses a violation of hospital policy or does not 48 Nurse Leader
December 2004
Table 1. Mentor and Mentee Criteria Mentor criteria
Mentee criteria
Has a positive attitude
Communicates effectively with mentor
Is a role model
Accepts constructive criticism and feedback and encouragement
Communicates well
Is committed to attending scheduled meeting with the mentor on a regular basis
Listens well
Agrees to commit to the N3 program for at least 1 year
Provides moral support, guidance, and advice
Agrees to complete all required evaluation forms in a timely manner
Performs well under stress Demonstrates interpersonal problem-solving skills Demonstrates proficient or expert practice Serves as an immediate resource person Encourages mentees Is successful in building caring relationships Is committed to attending scheduled meetings with the mentor on a regular basis Agrees to commit to the N3 program for at least 1 year Agrees to complete all required evaluation forms in a timely manner Mentee Criteria
Table 2. Benefits of Mentoring Mentor
Mentee
Intrinsic benefits of teaching1
Familiarization with organizational culture
Development of professional colleagues
Recipient of one-on-one nurturing
Development of
self-awareness1
Development of interpersonal relationships Professional
development2
Stimulation to question practice Improved political
skills3
Insight about unwritten rules and politics3 Assistance with career development Increased network of contacts Open communication without fear of repercussion Increased self-confidence Development of problem-solving skills1 Professional development
1. Perrotta P. Effective mentoring programs yield benefits for all. EndoNurse April/May 2004. Available at: www.endonurse.com/articles/441staffing.html. Accessed May 1, 2004. 2. Gandy J. Mentoring. Orthop Pract 1993;5:6-9. 3. Restifo V, Yoder L. Partnership: making the most of mentoring. Nursing Spectrum 2004. Available at: nsweb.nursingspectrum.com/ce/ce190.htm. Accessed May 1, 2004.
honor the commitment to keep appointments or participate in the mentoring program. In this event, the site coordinator is contacted. Mentoring results in benefits for both the mentors and mentees. Although not a complete list, some benefits to both individuals are listed in Table 2. Mentoring also has a few barriers, according to the site coordinators. The time commitment to meet throughout the year continues to be challenging for some dyads. This is particularly true if the mentor and mentee do not work December 2004
similar days or shifts. Another barrier to the mentoring program has been the need to submit evaluation forms on a quarterly basis. Again, according to the coordinators, the paperwork requires time that some dyads do not always want to spend in their busy schedules. The N3 program provides tools to assist the mentor and mentee. Separate information packets are included for
Continued on page 53
Nurse Leader 49
Nurses Nuturing Nurses Continued from page 49
both mentors and mentees. The mentor packet includes helpful hints for conducting meetings and preparing agendas. A self-assessment tool is provided, as well as tips for mentoring and helpful exercises to assist in the mentoring process. Guidelines for meetings also are included in the mentee packets, along with suggestions to help mentees develop interpersonal, management, and organizational skills. There are also suggestions for topics to discuss with the mentor. Worksheets are included to help facilitate the meetings. In addition, the mentor evaluates the relationship with the mentee, and the mentee evaluates the relationship with the mentor. Self-addressed, stamped envelopes are provided to facilitate the submission of materials directly to the researcher. The evaluation process includes the completion of various tools to measure the mentee’s level of confidence, intent to stay in the institution, and job satisfaction. These measures are suggestive of nurse retention.
FUTURE DIRECTIONS As several dyads are expected to complete the program at the end of 2004 and early 2005, AMSN expects to share the results. Many of the institutions expressing interest in the program have requested the materials to use with foreign nurses being introduced to the U.S. workforce. In addition, some institutions are requesting to use the program for refresher nurses re-entering the workforce or experienced nurses transitioning into new specialty units. There are also plans to have the mentoring program available electronically to nurses who may not work in institutions with the resources to support a formal mentoring program. AMSN is hoping N3 will be a useful tool to assist nurses in various facilities to implement a program to nurture and retain nurses. References 1. Perrotta P. Effective mentoring programs yield benefits for all. EndoNurse April/May 2004. Available at: www.endonurse.com/articles/441staffing.html. 2. The American heritage dictionary of the English language. 3rd ed. New York: Houghton Mifflin; 1996. 3. Restifo V, Yoder L. Partnership: making the most of mentoring. Nursing Spectrum 2004. Available at: nsweb.nursingspectrum.com/ce/ce190.htm. 4. Gandy J. Mentoring. Orthop Pract 1993;5:6-9.
Kathleen A. Reeves, MSN, RN, CNS, is an assistant clinical professor at the University of Texas Health Sciences Center in San Antonio. She can be reached at [email protected]. 1541-4612/2004/$ see front matter Copyright 2004 by Elsevier Inc. doi:10.1016/j.mnl.2004.09.011
December 2004
Nurse Leader 53
Kathleen A. Reeves, MSN, RN, CNS
An increasing shortage of nurses, demanding work environment, and alarming statistics indicating that almost half of all new nurses leave their first professional nursing position within the first year motivated the Academy of MedicalSurgical Nurses (AMSN) to develop a mentoring program for new graduate nurses. Through the guidance and leadership of Marlene Roman, MSN, RN, APRN, past-president of AMSN, and the AMSN board of directors, the mentoring program Nurses Nurturing Nurses (N3) was initiated in 2002.
T
he N3 mentoring program is based on a framework for the passage of wisdom, caring, and confidence between graduate and experienced nurses. The program has been designed as a research project, with a targeted evaluation process measuring nurse confidence, job satisfaction, and intent to remain in the nursing profession. According to Perrotta,1 job dissatisfaction is the underlying issue in many cases of high turnover in health care organizations. The N3 program objectives are the following: • To develop supportive and encouraging relationships • To guide new nurses in their professional, personal, and interpersonal growth • To promote mutuality and sharing based on colleagues’ needs • To communicate information concerning expectations, learning opportunities, and stressors According to the American Heritage Dictionary,2 mentor can be used as a noun and refers to a wise and trusted teacher or counselor. Mentor can also be used as a verb to mean to serve as a trusted teacher or counselor. Nurture means to cultivate, foster, or nurse. The N3 program requires a 1-year commitment between a mentor and mentee. The pair agree to meet consistently throughout the period to assist the mentee’s transition into the role of a professional nurse. The program requires coordination by multiple individuals. National and regional contacts are provided by AMSN, and the board of directors appoints a program coordinator. I have been in this role since the program December 2004
began, and I am responsible for overseeing all site-based activities and providing support for the regional and site coordinators. The AMSN research coordinator is Cecelia Gatson Grindel, PhD, RN; her role is essential in evaluating the data collected from mentors and mentees. She directly receives all evaluation forms, analyzes the data, and provides reports to the board. At this point a very minimal number of pairs have completed the entire program, and thus data are not available for reporting purposes. Several institutions have wanted data specific to their site; she will be able to provide site-specific information without violating confidentiality as long as there are five pairs at the site. Regional coordinators are appointed by the AMSN board. They often work very closely with site coordinators within their respective regions of the country, providing consultation and advice for facilities implementing the N3 program. The site coordinator is critical to the program. Generally appointed by an institution’s administration, the site coordinator recruits mentors and mentees and pairs them into dyads. In the N3 program, the pairs work in the same facility but not on the same unit, so it is essential to have someone coordinate the efforts within the institution. To assist the coordinator, the program provides suggested criteria or mentors and mentees (Table 1). Identifying and supporting the site coordinator requires an institutional commitment to the program. The level of commitment has varied throughout implementation. Most site coordinators have had the role added to an Nurse Leader 47
already challenging workThe site coordinator is load. Institutional focus can responsible for orienting Nurses Nurturing Nurses change throughout a 1-year the mentors and mentees to time frame. Some coordinathe N3 program and obtainMission Statement tors have had other essening consent from both parAMSN’s goal is to contribute to the personal and tial responsibilities (such as ties to participate in the professional development of nurses through preparation for a survey by study. The coordinator the Joint Commission on serves as a resource person relationships that are nurturing and supportive. Accreditation of Healthcare for the dyads and provides The mentor/mentee relationship will support the Organizations) take higher reminders as needed to the mentee’s transition to professional nursing, thus priority than the mentoring mentors and mentees to fostering confidence in practice and retention of program. Although undersubmit various evaluation the new nurse. standable, this delay someforms throughout the 12times hindered the full month period. implementation of the proThe mentor/mentee gram, despite the desire to do so. dyads are encouraged to have face-to-face meetings every Similarly, in some cases site coordinators experienced other week for the first 6 months to establish the relationunplanned position changes within the organization that ship. After that point, they are encouraged to meet once a resulted in replacements. This change required additional month at a minimum and to use other methods of comorientation for the new coordinator and at times disrupted munication, such phone calls or email, to maintain the the timely submission of evaluation tools. relationship. Site coordinators have the challenging task of encouragIn the mentoring relationship, sharing between coling dyads to meet on a consistent basis. A few institutions leagues is essential for success. The focus is on the offered incentives, such as Starbucks gift cards and cafetementee—his or her needs are identified and addressed ria passes, to encourage meetings between the mentor throughout the relationship. To create an environment of and mentee. Despite the incentives, some dyads did not open communication, it is critical that both parties are meet as often as suggested. A few institutions required clear that conversations are confidential. No information is their own Internal Review Board approval in addition to shared with others without the consent of the both parthat provided in the N3 program. Again, this resulted in a ties. The two exceptions to confidentiality are if the delay in implementation within an organization. mentee discloses a violation of hospital policy or does not 48 Nurse Leader
December 2004
Table 1. Mentor and Mentee Criteria Mentor criteria
Mentee criteria
Has a positive attitude
Communicates effectively with mentor
Is a role model
Accepts constructive criticism and feedback and encouragement
Communicates well
Is committed to attending scheduled meeting with the mentor on a regular basis
Listens well
Agrees to commit to the N3 program for at least 1 year
Provides moral support, guidance, and advice
Agrees to complete all required evaluation forms in a timely manner
Performs well under stress Demonstrates interpersonal problem-solving skills Demonstrates proficient or expert practice Serves as an immediate resource person Encourages mentees Is successful in building caring relationships Is committed to attending scheduled meetings with the mentor on a regular basis Agrees to commit to the N3 program for at least 1 year Agrees to complete all required evaluation forms in a timely manner Mentee Criteria
Table 2. Benefits of Mentoring Mentor
Mentee
Intrinsic benefits of teaching1
Familiarization with organizational culture
Development of professional colleagues
Recipient of one-on-one nurturing
Development of
self-awareness1
Development of interpersonal relationships Professional
development2
Stimulation to question practice Improved political
skills3
Insight about unwritten rules and politics3 Assistance with career development Increased network of contacts Open communication without fear of repercussion Increased self-confidence Development of problem-solving skills1 Professional development
1. Perrotta P. Effective mentoring programs yield benefits for all. EndoNurse April/May 2004. Available at: www.endonurse.com/articles/441staffing.html. Accessed May 1, 2004. 2. Gandy J. Mentoring. Orthop Pract 1993;5:6-9. 3. Restifo V, Yoder L. Partnership: making the most of mentoring. Nursing Spectrum 2004. Available at: nsweb.nursingspectrum.com/ce/ce190.htm. Accessed May 1, 2004.
honor the commitment to keep appointments or participate in the mentoring program. In this event, the site coordinator is contacted. Mentoring results in benefits for both the mentors and mentees. Although not a complete list, some benefits to both individuals are listed in Table 2. Mentoring also has a few barriers, according to the site coordinators. The time commitment to meet throughout the year continues to be challenging for some dyads. This is particularly true if the mentor and mentee do not work December 2004
similar days or shifts. Another barrier to the mentoring program has been the need to submit evaluation forms on a quarterly basis. Again, according to the coordinators, the paperwork requires time that some dyads do not always want to spend in their busy schedules. The N3 program provides tools to assist the mentor and mentee. Separate information packets are included for
Continued on page 53
Nurse Leader 49
Nurses Nuturing Nurses Continued from page 49
both mentors and mentees. The mentor packet includes helpful hints for conducting meetings and preparing agendas. A self-assessment tool is provided, as well as tips for mentoring and helpful exercises to assist in the mentoring process. Guidelines for meetings also are included in the mentee packets, along with suggestions to help mentees develop interpersonal, management, and organizational skills. There are also suggestions for topics to discuss with the mentor. Worksheets are included to help facilitate the meetings. In addition, the mentor evaluates the relationship with the mentee, and the mentee evaluates the relationship with the mentor. Self-addressed, stamped envelopes are provided to facilitate the submission of materials directly to the researcher. The evaluation process includes the completion of various tools to measure the mentee’s level of confidence, intent to stay in the institution, and job satisfaction. These measures are suggestive of nurse retention.
FUTURE DIRECTIONS As several dyads are expected to complete the program at the end of 2004 and early 2005, AMSN expects to share the results. Many of the institutions expressing interest in the program have requested the materials to use with foreign nurses being introduced to the U.S. workforce. In addition, some institutions are requesting to use the program for refresher nurses re-entering the workforce or experienced nurses transitioning into new specialty units. There are also plans to have the mentoring program available electronically to nurses who may not work in institutions with the resources to support a formal mentoring program. AMSN is hoping N3 will be a useful tool to assist nurses in various facilities to implement a program to nurture and retain nurses. References 1. Perrotta P. Effective mentoring programs yield benefits for all. EndoNurse April/May 2004. Available at: www.endonurse.com/articles/441staffing.html. 2. The American heritage dictionary of the English language. 3rd ed. New York: Houghton Mifflin; 1996. 3. Restifo V, Yoder L. Partnership: making the most of mentoring. Nursing Spectrum 2004. Available at: nsweb.nursingspectrum.com/ce/ce190.htm. 4. Gandy J. Mentoring. Orthop Pract 1993;5:6-9.
Kathleen A. Reeves, MSN, RN, CNS, is an assistant clinical professor at the University of Texas Health Sciences Center in San Antonio. She can be reached at [email protected]. 1541-4612/2004/$ see front matter Copyright 2004 by Elsevier Inc. doi:10.1016/j.mnl.2004.09.011
December 2004
Nurse Leader 53