Mentorship


The student failed the placement because she failed to engage. She never once came to me to ask how she was doing, even when it was obvious she was failing. She objected to us using her a couple times as an HCA when we were short staffed, and after that I figured if she wasn’t going to pitch in to help us, well, she could be on her own … (Staff nurse, during a disciplinary resulting from a complaint made by a student nurse who was failed but who alleged she had received inadequate mentorship)



WHAT DOES THE NMC SAY ABOUT MENTORS AND MENTORSHIP?




Nurses and midwives who take on the role of mentor must have current registration with the NMC. They will have completed at least twelve months full-time experience (or equivalent part-time). Mentors will require preparation for, and support in, their role. This should include access to a lecturer and/or practice educator as well as support from their line manager. (Standards for the preparation of teachers of nursing and midwifery:Nursing and Midwifery Council 2002)




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The reality is that new nurses are often asked to be ‘assistant’ or ‘co-’ mentors because there is a real shortage of available nurses. If you are asked to be a mentor, you must be prepared to offer support – you already know that part. But remember, you also have the right to receive support and preparation for the mentor role. Appendix 1 at the end of this chapter comprises a factsheet from the Nursing and Midwifery Council (NMC) about the preparation of mentors. It can guide you to ask for the development you need to be able to fulfil this crucial role as a qualified mentor.

The NMC also makes a strong statement, through research done on its behalf, that students must prove their competency in order to pass their clinical placements. In summary, the report found that:


• Students are passed on clinical placements even when mentors have doubts about their performance.


• ‘Benefit of the doubt’ or consideration for ‘personal problems’ led mentors to pass students who had not clearly demonstrated competence in the clinical area.


• Mentors should contact tutors/appropriate university staff, in writing, as soon as concerns are raised over a student’s performance.


• Mentor preparation needs to be improved.

In response, the NMC put out a statement that said mentors need to be prepared to fail students who have not proven their competency, but that mentors are responsible for working with the student and with university staff to help students succeed in placement areas.



DEFINITIONS


Before you start, here are some definitions to the different words you may hear associated with mentorship.


Mentor: a trusted counsellor and advisor, a role model, one who helps another to reach a level that they themselves have already reached.


Assessor: one who measures and assures that an individual has reached a certain level based on certain criteria and expectations.


Preceptor: a teacher or advisor, especially in an academic sense.


Supervisor: one who has authority over another.

In reality, the words mentor, assessor, preceptor and supervisor are often used interchangeably. For the purposes of this chapter, I will use the word ‘mentor’ to identify the nurse who is expected to take primary responsibility for the development, assessment and support of a student nurse.


WHY MENTOR?


Student nurses spend roughly 50% of their course, about 2300 hours, on clinical placements. This is all the time they have to develop the basic skills, knowledge and nursing judgement they need for the foundation of their nursing career. They also need to learn our special language, our nursing hierarchies and the special tricks and tools experienced nurses have developed over time.

It can be difficult and stressful to be a mentor but few roles are more rewarding. Try to remember that mentorship is more than just showing a student how to document or give an injection. You are helping to mould that student into a nurse, a potential colleague and someone who will one day care for patients just as you do. This student might be your nurse in a few years. If you as a mentor don’t invest in that student, you will fail not just that one individual but other nurses, patients and their families as well. Being a mentor is not just a huge responsibility to one student but to the entire health service and profession as well. The NMC recognises the importance of the mentorship role. The Code of professional conduct (NMC 2002) states:

6.4 You have a duty to facilitate students of nursing, midwifery and specialist community public health nursing and others to develop their competence.


Although it is yet to occur at the time of writing this, there is always the possibility that a student nurse will raise an NMC complaint against a nurse who fails in his or her role as a mentor.

As a former student yourself, you know the frustration and stress that the lack of a good mentor brings. It’s actually not that difficult to mentor – you already know the job and you care about nursing. All you need is to manage your time to include your student and the time they need. That can be a tall order at times, but it is possible. By knowing more about setting goals for your students, helping them plan their learning opportunities and understanding how people learn it will be easier. That these skills are also helpful when delivering patient education is a bonus that perhaps you hadn’t considered!


Mentorship can be time consuming and challenging. After all, as a nurse you have many responsibilities and having a fledgling nurse following you around, asking questions and taking twice as long to do things as it would take you to do them alone, can be a real burden. So why bother?


The NMC Code of professional conduct: as discussed above, you have an obligation to teach and support student nurses.


Someone mentored you: remember how much a good mentor did for you as a student, and how stressful it was to deal with a difficult mentor.


You are a patient advocate: adequately preparing tomorrow’s nurses is essential to ensuring that patients continue to receive good care.


You are an ambassador for nursing and nursing practice: by sharing your knowledge and skill, you are promoting and advancing good nursing practice.


You have an obligation to stay up to date: students have a habit of challenging nurses and nursing practice, and this can help you reflect on your practice. Because they are actively in education, they might have new and more up-to-date information than you do. They also have ‘fresh eyes’ and their perspective might help you see your work area and your own practice differently.

Just a note: personally I have found that what I have received by supporting students has far outweighed the efforts I put into providing that support. Let me share part of a letter I received not too long ago from a student who had been in our team: ‘After my last placement and all the grief I got, I was ready to give up, but you helped me realise where I was going wrong and now I know I’m going to be a good nurse …’ . Think about that the next time you work three weekends in a row because you are short staffed. Potential nurses are a resource we can’t afford to waste!


‘Amnesia studentia’ is an illness that can affect experienced staff. It is characterised by a marked inability to relate to the problems and experiences common to pre-registration nursing students. It is of concern because it is contagious …



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All kidding aside, it’s important as a mentor to remember when you were a student, how you felt, how you were worried and how difficult it was when your mentor wasn’t as supportive as you needed.


In addition, you must remember that you and your student are part of a team of people and you have obligations to the team and the clinical environment.


BEING A MENTOR: WHERE DO YOU START?


First, get familiar with the paperwork and assessment documents used for student nurses in your area. Other mentors, placement educators/placement facilitators, link tutors, etc. should all have these documents, and there should be a student resource folder in your clinical area.

Second, think about what your area can offer student nurses. Some common areas are:


Essential patient needs: communication, hygiene, etc.


Documentation.


Understanding different team roles and responsibilities.


Processes: how do lab results get to the clinical area? How are X-rays ordered? Where are the admission forms? Where do our patients come from?


The routine: what do we do, and when do we do it?


Clinical skills: learning how to carry out the daily skills needed to provide nursing care. Obs, nursing assessments, injections, etc.


Specialty: what are the kinds of problems that your patients have, and how do nurses meet their special needs?

Some other areas that might not seem as obvious but are very important to students are:


• How to cope with the stresses of the clinical area.


• How to interact with other professionals and carers.


• How to solve problems creatively.


• How to delegate.


• What professional resources are important for a nurse in your specialist area: journals, texts, professional organisations, etc.


Finally … knowing what you need to offer, think about how well the area supports students:


• Is there currently a morale problem in your clinical area? How will that affect your student?


• Is the area adequately staffed to allow you time to mentor?


• Is there currently such a staffing problem that you foresee the student being used to augment staffing?


• Are there teaching and learning resources?


• Are there any specific health and safety concerns for students?


• Do you have a ward philosophy?


• Does that philosophy include students?


• Is there a place for students to change into their uniform?


• Is there a secure place for students to store valuables?


• Where can they eat? Where can they park? Where is the bus stop?


• Is the role of students respected or are they seen as a burden or free HCAs?


• Is there anyone who has a negative attitude about nursing students?

If the ward environment is lacking in its ability to support students, you as a mentor (or potential mentor) should raise them with your ward management. Think back: would you have wanted to be a student on a ward like yours? If the answer is no, then improving the area for students will improve it for you and your colleagues as well: we are all students, no matter where we are in our career, aren’t we?

Note: the NMC Code of professional conduct states that you have a duty to facilitate students’ learning. This means highlighting possible problems in the clinical area that might obstruct their ability to learn, or yours to teach.


THE PROCESS OF LEARNING IN PRACTICE


The first thing to remember is that students will be placed in your clinical environment during different stages of their education. Newer students will probably need more help and guidance than more experienced students. It is important for you to balance your expectations against the student’s experience and level. Because each student is an individual, don’t just assume that a student at a particular stage in his or her course has a certain level of understanding or skill: you must discuss your expectations with the student.



Phase 1: introduction


The student shows up, might or might not have experience, might or might not understand what kind of nursing goes on.


Student needs





• To be oriented to the environment.


• To have an initial interview (part of assessment process).


• A plan to get learning needs met.


• Reassurance about being wanted and welcome in the clinical area.


How to


Have a handout available. This will ensure that all students get the same information. Include: parking, shift times, contact numbers, location of necessary equipment/map of the clinical area, fire/health and safety information, where the off-duty area is located, general information about the type of clinical area and any essential terms the student must know. It is also a good idea to include a copy of the clinical area’s philosophy.


Why is it important?


You know students need to know this stuff and it’s easier to have it ready and hand it to them than it is to repeat it every time there is a new student. If students feel welcome and wanted, it will help their transition into the placement area. It would be useful for new staff as well.

Feb 15, 2017 | Posted by in NURSING | Comments Off on Mentorship

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