Mentorship in Professional Practice - Essay Example

Mentorship in Professional Practice The role of mentors in professional clinical practice has been taking on a more critical role in the past few years. In the 2001 paper released by the Department of Health on the Preparation of Mentors and Teachers, the Government was quoted to have committed to ensuring that health care students are taught by those with practical and recent experience of their professions (ENB, 2001, p.3). Mentoring is the chosen approach to be used in pre-registration programmes to ensure that the next generation of nurses, midwives and health visitors are able to competently carry out their tasks. This is especially true in today's clinical setting as more and more nurses are needed to care for an aging population. But what exactly does the term mentorship mean and how does it impact the clinical learning environment Mentorship Defined In order to fully understand the impact of mentoring, it must first be defined. Wilson (2001) understood the complexity of the mentorship concept when she rightly stated that it usually conjured images of an older person mentoring a younger person but that it also meant many things to different people. The ENB (2000) uses it to denote the role of the nurse, midwife or health visitor who facilitates learning and supervises and assesses students in the practice setting and often uses it in lieu of assessor (ENB, Preparation of Mentors and Teachers (2001) p6). Wilson (2001) defines this further to refer to "holistic process that facilitates the personal and professional development of an individual. It is the opportunity to learn from someone more experienced and respected who plays a significant role in guiding one in both personal and professional decision-making." In effect, a mentor is someone who goes beyond teaching the mentee by inspiring them to go beyond the boundaries of what they believe they are capable of doing. In the clinical environment, the role of the mentor thus takes on a more critical role in that they are responsible for shaping pre-registration healthcare personnel and preparing them for contact with the individuals, who more often than not, need high quality and competent health care. Mentorship Traits and Roles Rowley (2005) provided five key qualities of the good mentor. He states that a good mentor is: committed to the role of mentorship a model of continuous learning accepting of the beginning mentee communicates hope and optimism Darling (cited in HCCSHS, 2001) further identified the following characteristics students look for in a mentor: An envisioner who gives a picture of what nursing can be, is enthusiastic about opportunities or possibilities and inspires interest; An energiser who makes nursing fascinating, and is enthusiastic and dynamic; A model the student can look up to, values and admires and may wish to emulate. An investor who spends a lot of time with the student, spots potential and capabilities, and who can hand over responsibility. A supporter who is willing to listen, is warm and caring and is available in times of need. An eye-opener who inspires interest in research and is able to facilitate understanding of wider issues, such as hospital politics and the total impact of departmental initiatives on the unit as a whole. A door-opener who included the student in discussions, asks the student to be a representative on committees and delegates a range of tasks to the learner. A problem-solver who helps the student to figure out and try out new ideas, and who can analyse strengths and create ways to use them for the benefit of nursing. A career counselor who gives guidance and support in career planning No more are these descriptions more apt as in the clinical environment where the mentor is both teacher, advocate and friend to her charges. Mentorship as applied to the clinical environment In the a pre-registration set-up such as the ward, a majority of the student nurses usually come to the unit with only theoretical concepts of nursing. It is always a challenge for them to integrate theory within the practical scopes of nursing in action. One key area where most of the students in the unit have difficulty is in formulating a comprehensive care plan where not only are the immediate needs of the patient in the ward are taken cared of but also that of his specific long term goals. In this area, most students are hindered by the fact that they are bombarded with the conflicting situations that need to be addressed. The difficulty is further enhanced by the fact that there is often not enough time to go into books and review a patient's case in order to formulate an adequate care or discharge plan. With the demands on a student's time, she becomes preoccupied with how little time they have to do what they know best and how many demands there are to do things they do not know well. This issue was solved with ongoing dialogues between the students and the mentors regarding their progress and the difficulties they encounter in the ward. It was determined that prior to assigning each patient to one particular student, a review of his case file prior to the assignment gave the student more confidence in creating a working care plan of that particular individual. In addition, an end - of - duty conference whereby both review the care plan for possible flaws was instituted whereby the mentor provides a helpful critique of the student's implementation of the plan and where she may assist the student in realising any errors that she had inadvertently committed. This exercise has often worked to my advantage as a mentor in that the hands-on and personal approach to a student's learning often provides one with a clearer picture of the strengths and weaknesses of that particular learner. In that way, as a mentor, I can effectively analyze and devise a plan of learning that would improve learning and retention as well development of the student's requisite nursing skills. As mentioned previously by Darling, a good mentor is someone who, "who spends a lot of time with the student, spots potential and capabilities, and who can hand over responsibility" and, " who is willing to listen, is warm and caring and is available in times of need" (HCCSHS, 2001). Furthermore, it is a method in line with what the HCCSHS (2001) stated as part of the responsibilities of a mentor, which is to work alongside the student to help him meet his individual learning needs. Inasmuch as the student is concerned, this personalized approach to learning works to his advantage as well, in that his confidence is developed in the sense that he feels he is given adequate time, support and encouragement to really put his knowledge into practice. Having someone to turn to as a guide, enhances the learning experience. A mentor who can tune into and understand what the mentee is experiencing is critical in that it fosters a sense of independent confidence in the student. Wilson (2001) notes in her interview of one of the AWID staff, Joanna who stated that her mentor 'threw her to the sharks' with the knowledge that she would be able to cope. This style worked for her because, the mentor gave support but also set goals beyond what she would have set for herself. One can correctly postulate that it is the mentor's comprehensive knowledge of her mentee's capabilities and limitations that made her challenge her charge with a situation that at that time seemed beyond what Joana taught she could handle. A student who feels that she is supported in her learning processes is helped by alleviation of any self-doubt she may seem to experience when she first enters the workplace (Wilson 2001). Having a mentor one can approach helps to creates a learning environment in which a student feels safe to ask questions. Showing an interest in individuals and recognizing their wish to understand and deliver patient care helps them quickly integrate in to their teams and their role within the nursing community. A mentor becomes a role model through which a student turns as his guide to determine how he or she should act as a nurse. At this moment, with the issue of the importance of developing a more personal yet oddly professional approach to mentoring, the only difficulty becomes related to time. Coetze (2005) realized this when he said that people need to be given enough time to pursue their learning, if they want personal development and learning itself to take place. Oftentimes, he says, there are not enough resources to allow individuals to spend time on learning and that to encourage learning this capacity has to be created by the addition of more resources or by eliminating or streamlining time-wasting activities. Inasmuch as the growth rigors of a modern nursing education demand more of the student in terms of his theoretical foundation and practical knowledge, and the fact that a mentor is often assigned not one but several mentees, the mentor oftentimes becomes hard pressed to find the time to attend to all of his mentee's learning needs. This coupled with the difficulty of a people's reluctance to assume mentorship roles in the first place considering the intricacy of the transition from teacher to mentor, is where the difficulty often lie. After all, as Smith and Zeegers (2002) so aptly described, "The original Mentor was charged by Odysseus to look after and nurture the kingly qualities of his son, Telemachus, while he himself was absent at Troy. It was then, and still is, a role that transcends transmission of technical expertise. It goes into the realm of those things that Schn (1987, p. 6) might see as indeterminate zones of professional practice" (Smith and Zeegers, From Supervisor to Mentor: Suggestive Possibilities, 2002). Mentors and assessors - delineating the differences It is understandable that one often confuses the role of a mentor with that of an assessor. Both function in relative similar manners with the assessor often assuming aspects of mentorship. The English National Board defines an assessor as: "An appropriately qualified and experienced first level nurse who has undertaken preparation to develop skills in facilitating student learning, supervising practice and assessing the student's level of attainment related to the stated outcomes of the programme." An assessor is someone who assumes the responsibility of judging the outcomes of the learning process (HCCSHS 2001). However, with the roles of the assessor and mentor overlapping, one can agree with the authors that judgement is sometimes difficult and becomes clouded as the mentoring aspects of one's relationship with the student progresses. On the one hand, as a mentor, one feels that one should be an advocate but then again, one must maintain the objectivity to be able to see the student's performance in an objective light because it is also the role of an assessor to pass or fail a student based on judgements according to his performance. This is an especially difficult aspect of mentoring, especially during one's fist days as a mentor/assessor. When I had first entered the field of professional mentorship, it was easy to come to terms with the role of teacher, advocate and friend. Being able to shape the mind of a budding protg has always been a source of fascination and it was this that had helped me adapt to the role of mentor rapidly. Needless to say, one develops a plan of action where one meets with the students and consults with them regarding the particular difficulties they face in their respective areas. A relationship develops, where one has an idea of the difficulty and ease with which each student takes to his learning environment. One particular student Linda, was a likeable and eager student who had always been very open to feedback. She would attend to the mentorship dialogues with a very open attitude and one can see that she tried her best in putting to practice what she has learned. However, has struggled considerably to achieve the required standard in three of the competencies. She had been made aware of her deficiencies and it was resolved that a way must be found to improve her performance but in the end, it was still not up to par. Having reviewing progress with her weekly, still at the end of her placement she had not achieved the required standard and should therefore be failed.. As a mentor, one appreciated the fact that she was an eager student but when it came time to finally assessing her performance and giving her a pass-fail mark, the task became daunting. Personal feelings on what the student was like had a tendency to cloud the judgement when one needed to objectively assess performance. It was also difficult to eventually tell that student, with whom one has had numerous conferences, that she had failed to pass the mark. It became even more difficult when a fellow assessor who is also a registered nurse questioned the decision to fail Linda, arguing that her practice was up to standard. The problem was a difficult one because the decision to fail a student is never an easy task. Complications arise when a colleague disagrees with the decision made. Appreciating the gravity of the dilemma and turning to a more experienced individual for guidance, a conference between all concerned was established where we discussed the points of concern of Linda's performance. By comparing the standards by which we had individually assessed her performance and what our individual expectations were, we were able to come up with an idea of how we had come to our own conclusions regarding Linda's performance. The other assessor had seen that we had been looking at Linda's assessment from different viewpoints and eventually conceded that as the primary assessor for the student, the evaluation done was fair in all counts. It was acknowledged that as the named assessor the responsibility for making the final assessment decision and the accountability for the grade at the end of the period of practice placement belonged solely to me. In analyzing the above situation, it can be said that the situation may well have gotten out of hand had one let personal biases obscure judgement. In Placements in Focus, an article published by the ENB (2001), it is stated that: "All organisations and professionals must share a responsibility to support and educate the next generation of health care professionals. Students also have a responsibility to be active participants in their own learning and make the best use of the learning opportunities in their practice areasThis responsibility is shared in partnership with those responsible for service provision, education commissioning and workforce planning and development, and is carried out in conjunction with appropriate approval mechanisms. The approval mechanisms incorporate the relevant standards of the statutory and professional bodies. Service providers are responsible for the quality of the practice learning environment." As an assessor, it is one's responsibility to ensure that the next generation of nursing professionals to become qualified practitioners of their field. By objectively assessing the performance of the aforementioned student, comparing this with set evaluative standards, the issue of personal biases is thereby negated. However, had adequate preparation for the differences in the role of assessor and mentor been understood better, the situation whereby the task of failing a student should not have been as difficult as it had been. The following description of the roles of an assessor from by the Homerton College's Clinical Practice Supervisor and Mentorship Guidelines (2001) states the role of the assessor quite clearly: It is understandable that no amount of preparation can actually prepare one for the fact that assuming the role of named assessor has personal consequences for the assessor herself. As in the days where we ourselves had been the one in need of placement, we were unprepared for the difficulty of transitioning from student to an accountable individual, the role that faces an assessor upon assumption of the fact is daunting. Where does one draw the line between personal bias and the need to evaluate objectively How does one find the equanimity to switch between roles of mentor and assessor How does one decide what comprises a formative judgement of the performance of a student How does one identify what evidence is necessary to denote competence of the mentee These are questions that cannot be answered before the fact. To be an objective assessor and competent mentor one must rely on the lessons taught by experience and through interaction and seeking guidance from those who have been filling those roles for longer periods. The psychological impact of failing a student is immense. In a study by the NMC (2004), it was found that mentors in their capacity as assessors failed to 'fail' students for reasons ranging from deficient assessment documentation (because the mentors found the documentation confusing and obscure), insufficient time to let the student gain sufficiency or enough time to work with the students, or simply the distinct feeling that failing a student 'opens up a hornet's nest' or even that in failing a student, it reflects on one's efficiency as a mentor. Having had the experience of being given this dubious task of failing a student, I find myself in sympathy with those who tell of having regretted the decision (NMC, 'A grounded theory investigation of factors which influence the assessment of students' competence to practice', p. 4). After all, how does one tell the parents of a third year student that their child will no longer be allowed to continue because her performance in placement was not satisfactory However, it was a task that needed to be done. I recalled and discussed with an older and more experienced assessor/mentor, how I had gone over many of the supporting documentation as well as the action plans I had formulated with Linda in the hopes that she would improve performance. It was agreed that considering all things, I had done all that one could do in the matter and as 'it was claimed by students that it was up to individuals to take responsibility for their own learning (Neary, 2000, p 2). After having gone through the somewhat emotional experience of informing Linda and her family of her failure and of dealing with the anger that accompanied the decision and eventually surviving the situation, it can be said that one grows in maturity, if not resolve. As mentors and assessors, I now realize that the responsibility assessors and mentors should look at is not at the immediate responsibility of the mentor/assessor to the student but of the greater responsibility we have as professional practitioners of our profession to the general public. At no such time have I felt my Hippocratic oath as when faced by the anger of parents questioning my qualifications and competence as an assessor. In this I fall back on the recommendation made by the NMC (2004) when it stated that 'it is recommended that mentorship programmes address the issue of accountability and that mentors are made aware of the potential professional consequences of 'failing to fail' students. Too often do we fail to assume accountability for our actions for the sake of convenience. Mentorship in Professional Practice - a difficult mantle to wear The roles of mentor and assessor are difficult mantles to wear. On the one hand, there is the thrill and excitement of interacting and shaping eager young minds, training them and teaching them to practise a profession one learns to love so well. On the other hand, there is also the biting reality that as mentors and assessors, we have a responsibility to the greater community to ensure that the future nurses who will care for them are competent, compassionate and caring professionals. As mentors, we have a duty to instill in this future community of carers the same sense of responsibility that we would like to be accorded with should we one day need to be cared for. One of the best tenets that I believe tells it best is 'do unto others as you would like others to do unto you'. In the case of mentors, teaching and developing the next generation to the best of their abilities and to the assessor, recognizing when something or someone is not good enough. We may after all find ourselves in the position of 'patient' to these future nurses. References: Coetze, F 2005, Change and Learning, Xpdian.com, viewed 30th July, 2005, English National Board for Nursing and Midwifery Visiting 2001, Preparation of Mentors and Teachers: A new framework of guidance (2001), English National Board for Nursing and Midwifery Visiting, London See reference ENB - see English National Board for Nursing and Midwifery Visiting Main entry under full name as above English National Board for Nursing and Midwifery Visiting 2001, Placements In Focus (2001), English National Board for Nursing and Midwifery Visiting, London See reference ENB - see English National Board for Nursing and Midwifery Visiting Main entry under full name as above Homerton College, Cambridge School of Health Studies 2001, Clinical Practice Supervisor and Mentorship Guidelines, Homerton College, Cambridge School of Health Studies, viewed 27th July, 2005, < www.health-homerton.ac.uk> Neary, M 2000, Responsive assessment of clinical competence, November 2000.vol.15, no.9, Nursing Standard, viewed 30th July 2005, Nursing and Midwifery Council, 2004, A grounded theory investigation of factors which influence the assessment of students' competence to practice, Nursing and Midwifery Council, London, viewed 27th July 2005, See reference NMC - see Nursing and Midwifery Council Main entry under full name as above Rowley, J 1999, The Good Mentor, Educational Leadership, May 1999, Volume 56, No. 8, Association for Supervision and Curriculum Development, The George Lucas Educational Foundation, USA Smith, P & Zeegers, M 2002, From Supervisor to Mentor: Suggestive Possibilities, AARE Conference, University of Queesnland, viewed 30th July, 2005, Wilson, S 2001, What is Mentorship, AWID.org, viewed 27th July, 2005, Read More