Sharing the Journey in Nursing Practice© Partners in Nursing Practice Designing Career Maps for Nurses in Transition Elizabeth Campbell, MSN, RN Thomas.

Sharing the Journey in Nursing Practice©

Partners in Nursing PracticeDesigning Career Maps for Nurses in Transition

Elizabeth Campbell, MSN, RNThomas 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. “Knowing is not enough; we must apply.

Willing is not enough; we must do”Willing is not enough; we must do”- Goethe- 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:

– 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• 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. PreceptorLearner Outcomes MENTOR• Self-actualization• Guide to establish

own place in the profession

• Enhanced problem-solving

• 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?

• 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– 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– 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

– 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• 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/mentoring

• 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.