Nursing Mentorship Research Articles

Clinical nursing mentors’ motivation, attitude, and practice for mentoring and factors associated with them

ObjectiveTo investigate the motivation, attitude, and practice toward mentoring and related factors among clinical nursing mentors.MethodsThis cross-sectional study included clinical nursing mentors from 30 hospitals in Zhejiang Province between August and September 2023. Demographic information, motivation, attitude, and practice were collected through a self-administered questionnaire.ResultsA total of 495 valid questionnaires were collected, and most of the participants were 30–39 years old (68.7%). Average motivation, attitude, and practice scores were 29 [26, 32] (possible range: 8–40), 87 (82, 94) (possible range: 22–110), and 41 (38, 45) (possible range: 11–55), respectively. Correlation analyses showed that the motivation scores were positively correlated with attitude scores (r = 0.498, P < 0.001) and practice scores (r = 0.408, P = 0.001), while attitude scores were positively correlated with practice scores (r = 0.554, P < 0.001). Multivariate logistic regression showed that intermediate and senior nursing mentors (OR = 0.638, 95% CI: [0.426–0.956], P = 0.030) and different hospitals (OR = 1.627, 95% CI: [1.054–2.511], P = 0.028) were independently associated with motivation. The hospital’s frequency of psychological care was a significant factor associated with nursing mentoring motivation, attitude, and practice. Participation in training (OR = 2.908, 95% CI: [1.430, 5.913], P = 0.003) and lower frequency of job evaluation in hospital (“Often”: OR = 0.416, 95% CI: [0.244–0.709], P = 0.001 and “Sometimes”: OR = 0.346, 95% CI: [0.184–0.650], P = 0.001) were independently associated with practice.ConclusionClinical nursing mentors had adequate motivation, positive attitude, and proactive practice towards mentoring and associated factors. Clinical nursing mentorship should be enhanced by prioritizing mentor training, fostering a supportive environment with consistent psychological care, and promoting structured mentorship activities.

Exploring the Role of Nurses in Advance Care Planning Within Long-Term Care Homes: A Qualitative Study.

Residents in long-term care homes (LTCHs) are often diagnosed with chronic, life-limiting illnesses, and it is now a common site to provide high levels of care and eventual death. There is an urgent need to address communication gaps and uncertainties surrounding resident's end of life preferences. Nurses are well situated to be key facilitators of necessary advance care planning (ACP), ensuring residents have discussions with family, substitute decision-makers and healthcare providers regarding future health and personal care preferences. However, LTCHs present unique challenges for nurses due to not only complex comorbidities but also staffing dynamics. This study explored the experiences and perceptions of Registered Nurses (RNs) and Registered Practical Nurse (RPNs) in LTCHs regarding their role in engaging residents and families in ACP discussions. Qualitative interpretive descriptive methodology was used. Data were collected from two LTCHs in Southern Ontario with a sample of 15 nurses (7 RNs and 8 RPNs). Analysis involved review of semistructured interviews, field notes, and utilizing constant comparison within an inductive approach. Power and authority dynamics in LTCH's was an overarching theme in the data, with four subthemes: (1) Nurses lacking clarity about ACP, (2) nurses' uncertainty regarding their role in ACP, (3) nurses feeling uncomfortable engaging in ACP discussions, and (4) nurses struggling to support families in ACP discussions. Recommendations for nurses, healthcare providers, LTCH administrators, and policy makers include: (1) development of policies which support, from a systemic level, nurses to feel safe while engaging in ACP; (2) reassessing LTCH's hierarchical structure, and clarifying RN, RPN, and interdisciplinary team members roles in ACP; (3) developing culture change that allows a team and person-centered approach to ACP; and (4) providing ongoing education and mentorship for nurses to manage family dynamics and expand their understanding of ACP beyond a biomedical lens.

Changing Practice Through Nursing Leadership: A Pediatric Oncology Unit in Delhi, India

The pediatric oncology unit at the Rajiv Gandhi Cancer Institute and Research Center (RGCI &amp; RC), a nonprofit medical facility and research institute based in Delhi, India, sought to improve clinical nursing practice through nurse leadership training supported by international nursing mentorship. A nursing team leadership program with a goal to strengthen practice was designed in collaboration with the RGCI &amp; RC nurse education department and pediatric oncology physicians on the unit. Two expert oncology nurses from the United States made multiple visits from 2017 to 2019 to support the development of the leadership program and the resulting practice changes. Specific areas of nursing addressed through these efforts included attention to education, practice, and leadership. Selected processes were improved by the following: (a) development of a pediatric oncology nursing orientation program to follow general onboarding by the nursing education department, (b) strengthening and updating standard operating procedures for nursing, and (c) development of a nursing Team Leads program. Four team leads completed training, and staff nurses are now active members in the care of patients and opining themselves when decision-making occurs during rounds. RGCI &amp; RC nurses have written abstracts and posters accepted at national and international conferences, which further strengthens their profile in the larger pediatric oncology professional community.

Every breath counts: Lessons learned in developing a training NICU in Northern Tanzania.

IntroductionNeonatal mortality rates in resource-limited hospitals of Sub-Saharan Africa (SSA) remain disproportionately high and are likely underestimated due to misclassification of extremely preterm births as “stillbirths” or “abortions”, incomplete death registries, fear of repercussions from hospital and governmental authorities, unrecorded village deaths, and cultural beliefs surrounding the viability of premature newborns. While neonatology partnerships exist between high income countries and hospitals in SSA, efforts have largely been directed toward improving newborn survival through neonatal resuscitation training and provision of equipment to nascent neonatal intensive care units (NICUs). These measures are incomplete and fail to address the challenges which NICUs routinely face in low-resource settings. We draw on lessons learned in the development of a low-technology referral NICU in Tanzania that achieved an overall 92% survival rate among infants.Lessons learnedAchieving high survival rates among critically ill and preterm neonates in SSA is possible without use of expensive, advanced-skill technologies like mechanical ventilators. Evidence-based protocols adapted to low-resource hospitals, mentorship of nurses and physicians, changes in hierarchal culture, improved nurse-infant staffing ratios, involvement of mothers, improved procurement of consumables and medications, and bedside diagnostics are necessary steps to achieving high survival rates. Our NICU experience indicates that low-technology solutions of thermoregulation, respiratory support via continuous positive airway pressure, feeding protocols and infection control measures can ensure that infants not only survive, but thrive.ConclusionsNeonatal mortality and survival of preterm newborns can be improved through a long-term commitment to training NICU staff, strengthening basic neonatal care practices, contextually appropriate protocols, and limited technology.

Mentorship ReSPeCT Study: A Nurse Mentorship Program’s Impact on Transition to Practice and Decision to Remain in Nursing for Newly Graduated Nurses

The COVID-19 pandemic has worsened a pre-existing US nursing shortage, leaving newly graduated nurses vulnerable in their early career. This study analyzed the effectiveness of a mentorship program offering individualized mentorship through culturally congruent, customized pairing for 96 mentees. Key findings of this study show that this nursing mentorship was beneficial for the majority of mentees on their decision to remain in nursing, and on their self-confidence, problem-solving, professional communication, and transition to practice, with perceived benefits steadily increasing for mentees up to 2 years. These findings have valuable implications for innovative recruitment and retention interventions to address the nursing shortage.

Nurse Mentorship to Support Healthy Growth of Adolescent Girls.

Adolescent girls from many urban communities are a vulnerable population, with high rates of school dropout, pregnancy, sexually transmitted infections, and substance use disorders. Mentorship programs can support the growth and development of this at-risk population. We report on the content of a pilot girls' empowerment program created by nurse faculty to promote health and self-awareness among underserved adolescent girls. Pre/post program scores of 15 participants using the Harter Self-Perception Profile for Adolescents found positive changes in seven of eight domains: scholastic (p = 0.001), social (p = 0.001), appearance (p = 0.001), job competence (p = 0.003), conduct (p = 0.02), close friendship (p = 0.006), and self-worth (p = 0.001). Nurse faculty and students might consider the development of similar mentorship programs for adolescent girls. [Journal of Psychosocial Nursing and Mental Health Services, 60(5), 15-18.].

Mentorship in nursing education: A concept analysis

Background and objective: There is a lack of consensus on the definition of mentoring, and a lack of agreement on the role and functions of mentors in nursing education. It is critical to clarify the concept of mentorship in nursing education for mentoring to be used effectively in mentorship programs. The aim of this paper is to provide an in-depth concept analysis on formal faculty-to-faculty mentorship in nursing education.Methods: This study used the Walker and Avant concept analysis model. Results: The analysis identified five defining attributes, three antecedents, and six consequences of mentorship in nursing education.Conclusions: The concept of mentorship in nursing education was clarified and can be applied to nursing mentorship programs. Further research on mentorship’s empirical referents is required to properly evaluate the mentorship relationship, avoid failed mentorship, and consider how the role of age, gender, class, ethnocentric background, and race in shaping the nursing mentorship relationship.

Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care

BackgroundEvidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited.ObjectiveThe objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses’ experience and thus enhancing patient experience in a tertiary care hospital in Pakistan.MethodsDesigned as an intervention development study, it was completed between January 2018–December 2019. The programme was developed by a team composed of service and nursing leadership, director patient experience of care and a compassion specialist using a theory of change model. The package followed a series of steps, a) identification of a framework, b) creation of working group c) needs assessment and d) multiple meetings to frame the model followed by implementing the preconditions for roll-out of the programme with the frontline staff.ResultsThe eventual outcome was improving the patient’s experience of compassion while the intermediate outcome was to have nurses demonstrate compassionate care. The pre-conditions were identified as: recruitment of staff with appropriate skills for pediatric care, provision of compassionate experience to the frontline nurses by addressing their specific pain points, development of competent head nurses as supervisors and creation of a compassionate culture. To ensure the pre-conditions, various interventions were planned with some implemented through the course of the study while others are in the process of being rolled out. These involved, inclusion of pediatric compassion specific module during orientation of new hires, creation of space to talk about compassionate skills with staff, provision of trainings and mentorship to create competent head nurses, and creating a culture that promoted and recognized compassionate care values.ConclusionThe approach helped to delineate feasible pathways for an on-job compassionate mentorship programme enhancing routine supervisors' role as facilitators of compassionate care.

The Structure, Process, and Outcome of Mentorship on Survivor with Schizophrenia: A Case Study

The personal recovery paradigm in schizophrenia patients require a change of service. One of the changes that can be made to support the schizophrenia recovery process is a change in the concept of the relationship between patients and nurses. Nurse mentorship for schizophrenia patients is a new terminology of innovation in a supportive relationship between health workers and patients. At present, it is not known how the structure, process, and outcome of mentorship to schizophrenia survivors. This study aimed to explain how the structure, process, and outcome of mentoring nurses to schizophrenia survivors. This research is qualitative research using the case study method involving three cases of mentorship conducted in Banyumas Regional Hospital. A total of nine participants were involved in this study which consisted of three nurses as mentors, three schizophrenia survivors, and three caregivers. Data were collected by semi-structured interview techniques, observation, and document review. After in-depth analysis seven research themes were found. Participants' perception about the structure of mentorship include the theme mentorship requires a variety of abilities of nurses and conditions of survivors who can participate in mentorship. While the mentorship process includes the theme requires patience in mentorship, giving guidance for the recovery of survivors, and facing the recurrence of survivors due to treatment factors. Participants revealed the outcome of mentorship in the theme mentors feel inner satisfaction, and survivors feel more enthusiastic about life. The results of this study provide the view that mentorship has the potential to be developed into quality nursing interventions to support the recovery process of schizophrenia survivors.

Development of a Nurse Mentorship Program

Retention of graduate nurses within a health care system is a problem that negatively effects patient care and health care outcomes. A novice nurse requires the guidance of others to learn how to apply theoretical knowledge to real-life clinical situations. Mentoring is an intervention to foster support and socialization of the new nurse. For this reason, a 1-year nurse mentor program was developed to increase job satisfaction and retention. In reviewing retention rates, it was noted that the greatest opportunity for improvement resides within the novice nurse during the 1st year of employment. A mentorship program was created that outlined the steps to transition from being a novice to being experienced by providing a successful transition in the workplace. The newly created mentorship program paired the novice nurse with an experienced nurse. On hire, surveys were disseminated to all novice nurses, who then were paired with volunteers eager to be involved in the program. Each month, a 1-hour support session was held offsite for the new employee and the mentor to have an open-ended discussion regarding their progression as a new employee. Quarterly surveys were distributed to the mentee to assess job satisfaction and involvement in the unit. After 1 year, a final survey was collected that evaluated the success of the mentorship program. For the development of the mentorship program, we used Benner’s theory from novice to expert. Educational sessions discussing Benner’s theory as well as templates were provided to roll out a standardized process for mentors. With administrative support and staff involvement, novice nurses have been successfully acculturated and retained. Results from surveys show an increase in teamwork, staff satisfaction, and involvement in the unit. Historically, the tough and demanding transition from nursing school to the workplace has proven difficult. For this reason, retention rates of novice nurses are declining. Using experienced nurses to support novice nurses in the mentorship program and eliciting ongoing novice nurse feedback are imperative for a successful mentorship program. Implementing a mentorship program helps to facilitate a successful transition to employment through provision of technical and emotional support.

Implementation of a Pediatric Early Warning Score to Improve Communication and Nursing Empowerment in a Rural District Hospital in Rwanda.

Pediatric early warning (PEW) scores represent a "track-and-trigger system" that identifies clinical deterioration in a patient's condition in the hours preceding a sentinel event. Before implementation, nurses reported feeling unprepared to identify and advocate for acutely ill patients owing to a lack of skills, vocabulary, and agency. We implemented a Pediatric Early Warning Score for Resource-Limited Settings (PEWS-RL) with nurses in a rural district hospital in Rwanda. Although PEW scores can improve clinical outcomes, empowering nurses in resource-limited settings to discuss patient acuity with physicians is a critical first step. Our primary aims were to train nurses to obtain more accurate vital signs and assess their importance as early warning signs of clinical deterioration and use PEW scores to improve communication between nurses and physicians. The PEWS-RL tool implementation began with a training program that was created through discussions with nurses, physicians, and the medical director of the hospital. The program included lectures and application of learned skills through direct clinical mentorship of nurses, as well as training of physicians regarding PEWS-RL as a communication tool. The PEWS-RL protocol was evaluated based on pre- and post-tests to assess improvement in nurses' knowledge and skill, as well as skills assessments of accurate recognition of clinical deterioration. All 6 nurses passed skill testing with >80% accuracy. Nurses' feelings of empowerment to advocate for patients and to escalate care were assessed through pre- and post-training interviews. Nurses described increased confidence in calling for physician support. Implementation of PEW scores increased nurses' technical skills and feelings of confidence and empowerment; however, the low-resource setting presented major challenges. Barriers to sustainable implementation include the rapid ward staff turnover as well as limited physician buy-in. Nevertheless, the PEWS-RL tool has the potential to empower nurses and improve patient outcomes if fully embraced by staff.

OUTCOME OF MENTORSHIP PROGRAMS BASED ON SIX SPECIFIC CRITERIA OF REGISTERED NURSES IN MALAYSIA

Background: Mentoring of new staff nurses is frequently performed. Internationally researches have reported that this exercise helped the new staff to retain information better, adopt a professional conduct, and be more satisfied with their jobs. Mentoring programmes are usually conducted to encourage cooperation as well as socialisation among the new registered nurses (RNs) in specific units or organisations. Aim: This research aims to evaluate the outcome of mentorship programs based on six specific criteria and nurses' willingness to stay in the profession in hospital settings. Method: A comparative cross-sectional study designed via convenience sampling was conducted in nine hospitals using the self-administered mentorship for nurses (MNMSN) questionnaire. Findings: A total of 593 respondents were recruited, mostly female (87.6%), under 25 years old (84.7%), from Malay (71%) and highest nursing education of diploma level (99.2%). The predisposing factors that influence performance for pre- and post-program are 'patients assessment' (mean=4.763, S.D.=0.52 and mean=4.733, S.D.=0.536); 'clinical decision' (mean =4.722, S.D=0.527 and mean=4.73, S.D.=0.54); 'cultural competencies' (mean=4.42, S.D.=0.443 as well as mean=4.354, S.D=0.442); and 'professionalism' (mean=4.764, S.D.=0.533 and mean=4.698, S.D.=0.563) respectively. Each predisposing factor showed a significant correlation (strong and moderately positive). Overall result for 'willingness to stay' is significant [F, (5,585)=556.308, p<0.05] pre-program compared to post-program (willingness to stay is significantly correlated [F (5,585)=544.907, p<0.05]). Discussion: The mentorship program showed a positive transition among new nurses to start their nursing career. They somewhat agree with all statements regarding patient's assessment skill, clinical decision making, professionalism, positive feeling and willingness to continue working as a nurse. However, according to several nurses admitted, their cultural competency and sensitivity were somewhat low and challenging. Conclusion: Mentor-mentee programmes can improve new RNs' willingness to stay and increase retention. Nurses were able to face greater challenges to provide cultural and linguistically appropriate healthcare services. Therefore, guidance by the mentor should be given highest emphasis.

Pediatric Palliative Physician and Nurse Mentorship Training Program: A Personalized Didactic and Experiential Training Curriculum Developed to Enhance Access to Care in Non-Metropolitan Communities

Pediatric Palliative Physician and Nurse Mentorship Training Program: A Personalized Didactic and Experiential Training Curriculum Developed to Enhance Access to Care in Non-Metropolitan Communities

657 - Poised Partnership: Enhanced Professional Development Through a Nurse Mentorship Program

657 - Poised Partnership: Enhanced Professional Development Through a Nurse Mentorship Program

Resources for Educating, Training, and Mentoring Nurses and Unregulated Nursing Care Providers in Palliative Care: A Review and Expert Consultation.

Nurses and nursing care providers provide the most direct care to patients at end of life. Yet, evidence indicates that many feel ill-prepared for the complexity of palliative care. To review the resources required to ensure adequate education, training, and mentorship for nurses and nursing care providers who care for Canadians experiencing life-limiting illness and their families. This is a systematic search and narrative review in the Canadian context. Six previous reviews and 26 primary studies were identified. Studies focusing on regulated nurses indicated that even amid variability in content, delivery methods, and duration, palliative education improves nurses' knowledge, confidence, attitudes, and communication abilities, and decreases nurses' stress. Results from palliative education in undergraduate curriculum were less definitive. However, studies on palliative simulation in undergraduate education suggest that it improves knowledge and confidence. Studies focusing on educating nursing care providers, either alone or in collaboration with regulated nurses, indicated positive outcomes in knowledge, confidence, communication, identification of clients who are dying, abilities to interact with patients and families, and a better understanding of their own contributions to care. Curricular resources in Canada have been developed. However, there is no dedicated and funded capacity-building strategy. Resources exist to support palliative education for nurses and nursing care providers. Furthermore, the evidence suggests good outcomes from this education. However, there is no dedicated strategy for implementing those resources. Furthermore, there is little evidence of the critical role of knowledge translation in preparing nurses and nursing care providers for evidence-informed palliative practice.

Clinical Coaching and Transitioning Into the Professional Role Using Nurse Mentors

The New York University Langone Medical Center Obstetric Nursing Mentorship Program was initiated to assist newly hired staff to transition to their professional roles. Conversations between the 25 newly hired staff and more senior nurses suggested a need for clinical coaching. Novice nurses historically lack confidence, efficiency of time management, and competency in performing with high acuity. The program includes nurses from labor and delivery and mother–baby units. Staff nurses with four or more years of obstetric experience were encouraged to enlist as mentors. The mentees were given a list of the volunteering mentors, were asked to rank their top three choices, and matched accordingly. The purpose of ranking is to encourage a mentee to choose someone they feel comfortable with, who may or not have been a preceptor. Mentor–mentee dyad interactions were promoted through professional formal and informal meetings and personal communication. A kick-off event, including night and day shift staff, was held to promote communication and a team-building environment. Based on mentee feedback through a presurvey and Likert scale, the program was considered beneficial in the areas of work experience, support system, self-confidence, teamwork, knowledge and skills, and intraprofessional communication. The survey will be distributed at 3-month intervals, concluding at 1 year of participation. A handbook was developed to assist in the framework of the program and guide mentorship pairs throughout the process. Goals include enhancing team building, staff engagement, shared leadership, healthy work environment, and professional development.

Building nursing and midwifery leadership capacity in the Pacific.

The Australian Award Fellowship Program aimed to strengthen nursing and midwifery leadership and capacity in developing countries in the Pacific. It is necessary to build an optimal global health workforce, and leadership and mentorship are central to this need. This is especially important in small island states such as the Pacific who have limited capacity and resources. This health system strengthening program addressed quality improvement in education, through the mentorship of potential nursing and midwifery leaders in the South Pacific Region. Program participants between 2013 and 2015 were interviewed. Data were audio-taped, transcribed and analysed thematically using an inductive process. Thirty-four nurses and midwives from 12 countries participated. There were four main themes arising from the data which were: having a country-wide objective, learning how to be a leader, negotiating barriers and having effective mentorship. Our study showed that participants deemed their mentorship from country leaders highly valuable in relation to completing their projects, networking and role modelling. Similar projects are described. The limitation of this study was its small size. There is a need to continue to build the momentum of the program and Fellows in each country in order to build regional networks. The Program has provided beneficial leadership education and mentorship for nurses and midwives from Pacific countries. It has provided a platform to develop quality improvement projects in line with national priorities. Global aid programs and the recipients of the program would benefit from comparable health strengthening approaches to nursing and midwifery in similar developing countries.

Implementation Process of a Canadian Community-based Nurse Mentorship Intervention in HIV Care

We describe salient individual and organizational factors that influenced engagement of registered nurses in a 12-month clinical mentorship intervention on HIV care in Canada. The intervention included 48 nurses and 8 people living with HIV (PLWH) who were involved in group-based and one-on-one informal mentorship informed by transformative learning theory. We evaluated the process of implementing the mentorship intervention using qualitative content analysis. The inclusion of PLWH as mentors, the opportunities for reciprocal learning, and the long-term commitment of individual nurses and partner organizations in HIV care were major strengths. Challenges included the need for multiple ethical approvals, the lack of organizational support at some clinical sites, and the time commitment required by participants. We recommend that clinical mentorship interventions in HIV care consider organizational support, adhere to the Greater Involvement of People Living with HIV/AIDS principles, and explore questions of professional obligations.

Public Health Nurse Mentorship of Pregnant and Parenting Adolescents

This study explored the experience of the mentoring relationship for public health nurses (PHNs) and teen parents. PHNs and teen parents who participated in the Parenting and Teen Program provided qualitative data about mentorship provided by PHNs. The participants were asked open-ended questions that addressed interactions; meaning of success for the teen; and support, information given, and decisions made in the context of the mentoring relationship. Data analysis of the PHN (n=7) data revealed eight mentorship themes: (1) being nonjudgmental, (2) working with strengths, (3) meeting the teens where they were, (4) sticking with the teen, (5) honoring persons, (6) giving information, (7) making referrals, and (8) facilitating decisions. Analysis of the teen data (n=11) resulted in four mentorship themes: (1) trustworthiness of the PHN, (2) the PHN as part of their support network, (3) independence building, and (4) help with decision making. Parenting teens viewed PHNs as contributing to their success in managing their lives and becoming successful parents. They viewed PHNs as trustworthy, supportive, encouraging their independence, and facilitating positive decision making.

Implementing an Organization-Wide Quality Improvement Initiative

With the movement to advance quality care and improve health care outcomes, organizations have increasingly implemented quality improvement (QI) initiatives to meet these requirements. Key to implementation success is the multilevel involvement of frontline clinicians and leadership. To explore the perceptions and experiences of frontline nurses, project leads, and managers associated with an organization-wide initiative aimed at engaging nurses in quality improvement work. To address the aims of this study, a qualitative research approach was used. Two focus groups were conducted with a total of 13 nurse participants, and individual interviews were done with 10 managers and 6 project leads. Emergent themes from the interview data included the following: improving care in a networked approach; driving QI and having a sense of pride; and overcoming challenges. Specifically, our findings elucidate the value of communities of practice and ongoing mentorship for nurses as key strategies to acquire and apply QI knowledge to a QI project on their respective units. Key challenges emerged including workload and time constraints, as well as resistance to change from staff. Our study findings suggest that leaders need to provide learning opportunities and protected time for frontline nurses to participate in QI projects.