Mentoring in the Career Development - Assignment Example

 Mentoring in the Career Development Mentoring is an interpersonal phenomenon and exists within a social context (Angelini, 1995). Being a complex and important activity it requires formal training (Andrews & Chilton, 2000). Mentoring includes supervision but focuses on building a professional relationship between the mentor and the mentee (Aston & Molassiotis, 2002) which is distinguished by the emotional commitment of both the parties (Morrison-Beedy, Aronowitz, Dyne & Mkandawire, 2001). A good mentor is one who possesses the professional attributes, knowledge, communication skills and the motivation to teach and support students. A mentor has to be an inspirer, investor and supporter (Angelini, 1995), has nurturing, educative and protective elements (Aston & Molassiotis, 2002), one who acknowledges that learning can be stressful but still assists the learner to develop the confidence and the skills (Nursing Standard, 2004). Hence mentoring is a multi-dimensional process that involves people, environment and events as mentoring influence. Nevertheless, there is lack of clarity about its definition and purpose (Aston & Molassiotis, 2002) as well as the facilitation and assessment in practice. The mentor’s responsibility does not start with teaching and end with assessment (Price, 2004). It involves creating an environment conducive to learning. Working in the medical assessment unit (MAU) I fully understand the problems that students face when they first arrive. It is the responsibility of the mentor to ensure that the students feel supported in the learning environment. We do offer the students a welcome pack which contains all details of who their mentor is and where they can approach if they need help but the student is likely to feel isolated and the mentor should ensure that when she is on duty the student is not left with unqualified staff (Burns & Paterson, 2004). The unit is at times so busy that we are unable to give sufficient time to the student. MAU is a good learning environment because of its acute setting and there are plenty of mentors available. Students also get an opportunity to work with multidisciplinary team. We try to demonstrate leadership, care, patience and loyalty (Hockenberry-Eaton & Kline (1995). Building trust is essential to create a nurturing environment for less experienced nurses. In the learning environment knowledge is acquired by “observing” as well as “doing”. Mentors that do not possess these qualities are labeled as promise breakers, lacking in expertise and knowledge, unapproachable and intimidating to students (Hughes, 2004). Students feel supported where the staff is motivated, satisfied and work together (Pulsford, Boit & Owen, 2002). In an environment of low morale, students are seen as imposition. Communication should be open and confidential and no information should be shared with others without the consent of the other party (Reeves, 2004). At MAU we try to ensure as far as possible to maintain such an environment. Obstacles to effective mentoring can occur when the mentor employs disabling strategies or when the relationship is not build on trust. It is known as ‘toxic’ mentoring when the learner is not allowed to develop as the student is overprotected (Darling, 1986). Students need to learn how to relate to patients and their friends and their family (Spouse, 2001) and this is possible when theory is linked to practice and learning is facilitated by the help of a mentor. To facilitate the learning environment it is also essential to develop the leadership skills in the ward managers which would also help to improve the standards of care (Webb & Shakespeare, 2008). At the MAU, we try to make the students feel comfortable, and introduce the student to the placement team. Jointly we agree on a time table for working together. This time line is drawn in consultation with the student but we also take into account that once the process starts the student may like to alter the pace of learning. Mentoring requires involvement and commitment and without these, the mentor will not be able to assume responsibility for the student (Andrews & Chilton, 2000). The relationship between the student and the mentor can be promoted by caring for patients (Angelini, 1995). Clinical supervision helps to boost the morale of the staff and provide quality care to the patients (Aston & Molassiotis, 2002). We try to ensure that students develop high quality practical skills, augment knowledge and clinical proficiency and receive support during and after stressful situations. Mentoring strategies enhance confidence building behaviors, including nurturing, providing positive verbal feedback and inculcate the qualities as a team player. Mastery comes from successful experience (Donaldson & Carter, 2005) and hence we emphasize that students must be able to convert what they observed into appropriate action. In other words, they must be able to link theory with practice. The mentors are often unaware of their role and responsibilities as a mentor due to lack of specific guidelines (Morrison-Beedy, Aronowitz, Dyne & Mkandawire, 2001). We make efforts to be personally interested in the students’ professional advancement and remain approachable at any time for any discussions. When we provide support to the junior students it helps to encourage reflective thinking process, fills them with enthusiasm and confidence and the transition from the student to a qualified nurse is smooth (Aston & Molassiotis, 2002). A mentor can support critical thinking, reflection on practice and provide alternative strategies for care (Burns & Paterson, 2004). A mentor’s role is thus demanding and requires proper education, training and ongoing facilitation. Since nursing is primarily a competency based profession, it is the responsibility of the mentor to assess the students’ skills and competencies. The mentor should be able to meet the NMC criteria and when the mentor has signed off proficiency, at least on three occasions, it should have been supervised by an existing practice teacher (Rutkowski, 2007). Mentorship in nursing faces several challenges due to inadequate staffing levels and heavy workloads. Other problems that practitioners face are insufficient continuing support and development, inexperience, irregular attendance of the students due to clashes with academic studies, lack of resources for training, and staff misconceptions (Aston & Molassiotis, 2002). A practice learning environment provides the opportunity to link theory with practice (Burns & Paterson, 2004). Assessing the competencies of the student along with their every day duties is a major challenge as at MAU nurses are usually engaged in assisting the families of the patients or assisting other professionals which results in a break in the supervision of their mentee as it is not given priority (Rutkowski, 2007). Mentors do have an instinctive feeling about failing students (Duffy & Hardicre 2007) but the ‘failure to fail’ those students who have not acquired the desired competency has prompted the government to recommend a stronger practical orientation in pre-registration education and training (Rutkowski, 2007). The mentors may be unwilling to fail a student because it could reflect their inability to create an appropriate learning environment. They also want to give the students the benefit of the doubt and more time to improve (Duffy, 2004a). Besides, because of their own workload, they feel guilty of not having given sufficient attention to the mentor (Duffy, 2004). Mentors are under tension when they have to fail a student and wonder whether they are doing the right thing (Duffy & Hardicre 2007). They need an acknowledgement of their feelings and want support for their action. They are also aware that their report would be scrutinized by another board and hence they are extra cautious and need support in the completion of the form. Because of this reason they give satisfactory assessment which is against the best interest in nursing and leads to concerns about competence. The NMC standards require that mentors should be able to make assessment/judgments about the students’ competency. This requires that they should have developed their own knowledge, skills and competence beyond registration (NMC, 2006). Failure to do so would demonstrate the inability of the mentor. They should be informed about the students’ stage of learning which would help the mentor to select the appropriate learning opportunity to meet individual needs. We certainly do not like to fail a student but if necessary we have to do so in the larger interest of the patients and the nursing profession. At the same time, at the MAU, we also try to analyze whether the failure has occurred as a result of our paying less attention to the students. We try to provide support to the student when the mentor is under work load. In case a student needs more support than average, we provide assistance and encourage self-assessment although we do find it stressful at times. We try to monitor the progress regularly and we also consider assessment by different supervisors which ensures reliability. Students assessment has been devolved to staff nurses because the students feel more comfortable relating to the staff nurses as they see themselves in that position in the future (Andrews & Roberts, 2003). At the MAU things can be very stressful at times due to work overload and staff shortage. Since the resources are less, it becomes difficult to devote attention to the student. A mentor should have the flair and desire to be a mentor and some at MAU feel ill-equipped to handle this role. Andrews and Roberts (2003) confirm that such mentors have concerns during the assessments because there is increasing emphasis on academics within the curriculum. The mentors are not familiar with the assessment documents which have been prepared by the educators (Rutkowski, 2007). They even fail to identify the language used in the assessment forms. The nursing program gets updated every five years and the mentors thus may be unfamiliar with certain terms in the form. Thus the gap between the educators and the practitioners has to be bridged, which reinforces the need for formal training of the mentors. Short-term mentorship courses have not been found inadequate to train the mentors. We understand that we need to encourage reflective practice and critical thinking (Nursing Standard, 2004) but this would mean challenging assumptions and mentors are not equipped for this. Trying to be critical during the investigation process may result in work overload and stress thereby affecting the outcome. Besides, the student may not be yet prepared for critical thinking. Mentors must have a grasp not only of clinical practice but also of reflection since reflective practice is an important part of learning (Hughes, 2004). Some mentors have also expressed that they would like extra pay to take on the mentoring role or else there should be dedicated time allotted for taking the mentoring activities (Pulsford, Boit & Owen, 2002). The role of a mentor is to facilitate learning and supervise in practice setting. Assessment and feedback should be an ongoing process and problems must not be ignored. The students must be made aware of their shortcomings or attitude which could even make them change and bring about satisfactory performance (Duffy & Hardicre 2007). At MAU we try to have regular meetings which give the students time to reflect on their performance. Discussions with the students are done on a one-to-one basis and the students are apprised of the criteria against which the assessment has been done. Judgment of student competence is made on a relatively subjective basis, and personality clashes lead to negative outcomes (Webb & Shakespeare, 2008). NMC advises that assessment of competence should be through direct observation in practice (NMC, 2006). It should also include patient’s comments and peer evaluation. Students should also be encouraged for self-assessment and reflective learning. As a role model, the mentor should be familiar with the learning objectives relevant to the practice setting. This would help to make the assessment realistic and a rapport with the link teacher would enhance the professional education of the student (Wilkinson, 1998). As a role model, it would not be wise to start assessing a new student very early into the practice setting. Sufficient time should be allowed to the student to settle down. The student has shifted to a new environment and settling down can take a while. Feedback should be taken as soon as possible after the event and written feedback is preferable as the student can then reflect over it. A role model would clarify and explain the comments to the student who can then take corrective action. It is necessary that the students derive the most out of their practice placement and derive the best practice. Feedback should be accurate, meaningful and presented in a way that will help the student to reduce anxiety and enhance motivation. The mentor should prepare what and how to convey to the student in advance. The judgments should be supported with evidence. Feedback also includes that the mentor should be able to accept the students’ reaction in the right manner and hence should possess good listening skills. The mentor will understand the student’s experiences and opinions and offer better guidance in reflective learning. At MAU, these are some of the practices that we try to enforce and make attempts to be a role model to our students. Nevertheless, we do realize that mentoring should be optional and formal training is essential. References: Andrews, M. & Chilton, F. (2000). Student and mentor perceptions of mentoring effectiveness. Nurse Education Today (2000) 20, 555–562 Andrews, M. & Roberts, D. (2003). Supporting student nurses learning in and through clinical practice: the role of the clinical guide. Nurse Education Today (2003) 23, 474–481 Angelini, D. J. (1995). Mentoring in the Career Development of Hospital Staff Nurses: Models and Strategies. Journal of Professional Nursing, Vol 11, No 2 (March-April), 1995: pp 89-97 Aston, L. & Molassiotis, A. (2002). Supervising and supporting student nurses in clinical placements: the peer support initiative. Nurse Education Today (2003) 23, 202–210 Burns, I. & Paterson, I. M. (2004). Clinical practice and placement support: supporting learning in practice. Nurse Education in Practice (2005) 5, 3–9 DARLING, L., 1986. What to do about toxic mentors. Nurse Educator, 11 (2), 29-30. [online] Available at: http://www.bournemouth.ac.uk/hsc/pdf/ments1.pdf [accessed 07 October 2008] Donaldson, J. H. & Carter, D. (2005). The value of role modelling: Perceptions of undergraduate and diploma nursing (adult) students. Nurse Education in Practice (2005) 5, 353–359 Duffy, K. & Hardicre, J. (2007). Supporting Failing Students in Practice 2: Management. Nursing Times. 103/48. pp. 28-29 Duffy, K. (2004). Mentors need more support to fail incompetent students. British Journal of Nursing. 13/10 Duffy, K. (2004a). Failing Students - should you give the benefit of the doubt? NMC News July 2004 Hockenberry-Eaton, M. & Kline, N. (1995). Who is Mentoring the Nurse Practitioner? JOURNAL OF PEDIATRIC HEALTH CARE/March-April 1995 Hughes, S. J. (2004). The mentoring role of the personal tutor in the ‘Fitness for practice’ curriculum: an all Wales approach. Nurse Education in Practice (2004) 4, 271–278 Morrison-Beedy, D. Aronowitz, T. Dyne, J. & Mkandawire, L. (2001). Mentoring Students and Junior Faculty in Faculty Research: A Win-Win Scenario. Journal of Professional Nursing, Vol 17, No 6 (November–December), 2001: pp 291-296 NMC (2006). Standards to support learning and assessment: NMC standards for mentors, Practice teachers and teachers. NMC:UK. [Online] Available at: http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=4368 [accessed 07 October 2008] Nursing Standard (2004). Mentoring. 18/4. pp. 11-15 Price, B. (2004). Mentoring Learners in Practice. Nursing Standard October 13/vol19/no5/2004 Pulsford, D. Boit, K. & Owen, S. (2002). Are mentors ready to make a difference? A survey of mentors' attitudes towards nurse education. Nurse Education Today (2002) 22, 439±446 439 Reeves, K. A. (2004). Nurses Nurturing Nurses: A Mentoring Program. Nurse Leader. December 2004 pp. 47-53 Rutkowski, K. (2007). Failure to fail: assessing nursing students' competence during practice placements. Nursing Standard. 22/13. pp. 35-40 Spouse, J. (2001). Workplace learning: pre-registration nursing students’ perspectives. Nurse Education in Practice (2001) 1, 149–156 Webb, C. & Shakespeare, P. (2008). Judgements about mentoring relationships in nurse education. Nurse Education Today (2008) 28, 563–571 Wilkinson, J. (1998). A practical guide to assessing nursing students in clinical practice. British Journal of Nursing. 8/4. pp. 218-221 Read More