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Mentorship in Nursing

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This assignment will evaluate and explore the experience of mentoring a student in practice,

critically analysing topics that will reflect on the role of the mentor, within the context of the

nursing profession. The placement area concerned is a 14 bedded acute elderly assessment ward,

which caters for both male and female patients.

Several students have been placed on our ward over the years, it is the mentors responsibility to

provide students with appropriate support, guidance and supervision within the clinical

environment, Myall 2008.

One of the key issues that need to be considered in preparation for an effective learning

environment would be making sure the student is aware of the situations that could arise on the

ward, discussing typical events that could happen on a daily basis. clinical experience can be a

stressful part of the nursing program, working in a unfamiliar area, working with difficult patients

and the fear of making mistakes. Hutchinson (2003) believes that a teacher should aim to provide an

environment in which learners feel safe to experiment, voice their concerns, identify their lack of

knowledge and stretch their limits.

One of the major factors affecting learning is the environment in which it takes place. It is the

responsibility of professional staff to create and develop an environment conductive to learning

(Price, 2004). This implies that the environment should be continually monitored to ensure it

provides appropriate support and experience for students and responds to the changes that take

place. The mentor could undertake this as part of their daily routine prior to the student

commencing their shift, ensuring that the appropriate environment is in place, thus aiding the

teaching process.

When discussing the topics involved within this assignment, SWOT analysis was used in order to

analyse the Strengths, Weaknesses, Opportunities and Threats that the placement could offer.

The opportunities that the student could experience are very valuable to their learning, actively

engaging with patients, their families and working along side the multidisciplinary team within the

clinical environment. Students are allocated to work with all members of the nursing team

including health care support workers, consultants, occupational therapist, physiotherapists etc.

Discussions about interprofessional interaction and interprofessional relationships should be had

when working with/meeting your students, and support should be offered for opportunities for

students to work with or shadow other professionals, or to spend time with students from different

professions. Ward rounds are held on a weekly basis so students can have the chance to get actively

involved in them.

Pollard K,et al (2008) suggests students benefit from being mentored from different professionals.

This in turn will contribute greatly to feedback given to the student, communicating with different

health professionals on the students progress, can rule out bias opinions and discuss different

approaches to the students learning process.

(Boud et al, 1985) proposed a model of reflection based on their experiences, attending to their

feelings, and re valuation of the experience leading to new learning.Reflection is also one of the

many original teaching approaches and models for nursing education.

Ireland (2008) believes that helping students use reflection helps to create an environment where

students are free to make decisions and can seek solutions to complex problems. She suggests the

use of reflection as it offers strategies to help students pose searchable and answerable, clinical

questions. Gibbs (1988) model of reflection was also used throughout my teaching and feedback

sessions with my student as the six phases of the model are essential to the reflection process.

Analysing on the above, working with a multidisciplinary team provides great personal benefits

for the student as they get to explore several areas of the team, experience different outlooks and

opinions within the professionals area of expertise, therefore expanding the students

knowledge base and increasing their opportunities, as part of the SWOT analysis.

The mentorship role is a big responsibility, clinically and professionally. The mentor needs to

ensure that working relationships are formed and maintained to have a successful impact on their

learning. The mentor needs to be aware of what is required to maintain an effective relationship

with the student and create a partnership. This was achieved by myself at the initial stage of

meeting my student, as I wanted to make sure all questions and topics where covered to ensure our

partnership had good grounding for the weeks ahead.

Neary (2000) suggests that setting ground rules could be undertaken as part of the learning contract,

both parties need to be precise about the degree of autonomy expected to allow the student to

achieve their required learning outcomes. An effective mentor/student relationship should help

motivate the student, improve confidence and self-esteem, it can help them adjust to the clinical

environment, enhance their career development and help them reach their goals.

Price, (2002) suggests that it can be useful to have a disagreement because it can help each party to

reflect on situations. Anger, boredom or sympathy can lead to a more honest, strengthened

relationship, however this does not work for everyone and ( Charnock,1993) suggests that if

conflict is unresolved the student should be allowed to change to another mentor.

(Darling, 1986) discusses the term “Toxic Mentors” which include, dumpers, blockers and

destroyers/criticizers, which students should try to avoid at all costs. According to Gray (2000, cited

in Pulsford et al 2002) all students have normally experienced a poor mentor, they tend to break

promises, lack knowledge and expertise, have poor teaching skills have no structure in their

teaching and consequently change their minds about things. Bearing all this in mind I am able to

ensure that as a mentor I provide safe, effective, evidence based care in the clinical area.

Furthermore poor mentors tend either to over protect their student by allowing them to observe only

or were unclear on the students capabilities and threw them in at the deep end, hoping they will

swim in the process. To enable a good mentor student relationship, the use of ground rules, and

awareness of student handbooks is important.

It is frequently mentioned that mentors find assessment documentation confusing, obscure and full

of educational jargon (Duffy & Watson 2001). Valuing the student as a learner, being aware of

personal strengths and weaknesses and thier effect on others can all promote a genuine, long

lasting, non threatening relationship. Hence by reflecting on all of the above as a mentor I will

ensure I communicate effectively to provide a safe, effective, evidence based environment for my

student to work in.

Reflecting on the challenges experienced when facilitating learning in practice, can be viewed very

widely, both student and mentor can be influenced by a variety of circumstances. A mentor

working for the NHS involves an extensive workload, not only am accountable for myself but also

staff, patients and students. Looking back on previous experience I recognise the importance of

good prioritisation and appropriate delegation thus enabling me to spend quality time with my

student.

I recognise that students have outside commitments which could potentially disrupt teaching

sessions i.e working part time or having dependents. This could be seen as a threat as part of the

SWOT analysis, so working and communicating effectively in a mentor/student partnership could

reduce these factors.

(Honey & Mumford,1989) developed a learning style questionnaire they evaluated four learning

styles which include: Reflectors; who learn by listening, observing and reflecting on experiences.

Activists; who learn and thrive on new experiences and learns by active experimentation, theorists;

who analyze and synthesizes observations into theories. Pragmatist; prefer to experiment with new

ideas, theories and techniques and is interested in the application of information.

By analysing my students learning style will enable me as a mentor to approach situations and

teaching sessions around the students chosen style of learning.

As clinical settings and professional practice require many different skills from clinicians. Ward

environments are busy, task focused places, things often need to be done by yesterday. Meeting and

interacting with patients sometimes requires the ability to think on ones feet, to make decisions

quickly or expediently, sometimes with much thought and reflection, so different mentors and

students will rise to these tasks differently depending on their own unique style of learning.

The mentors role and accountability within the assessment process in practice is well documented

in literature which prompted investigations, as a result the ( NMC,2008) published a report

“Standards to support learning and assessment in practice” to ensure that qualifying students

are fit for practice, the mentor in the clinical environment is responsible and accountable for student

assessment, insuring safe practice and must-demonstrate their knowledge, skills and competence on

an ongoing basis.

This includes the mentors role as the “sign off “ mentor this is mandatory for confirming that on

completion of the final clinical placement, the student will have had met all the requirements of the

pre registration clinical assessment criteria, this insures the student can now register as a qualified

nurse with the NMC, this is generally carried out by more experienced nurses, junior mentors can

sign off documents from previous placements but not the final one until they have undertook and

supported an experienced mentor three times.

Therefore this can put added pressure on the mentor, along with the day to day tasks and

responsibilities they have to undertake in their profession. It is their accountability and experience

to acknowledge if the student is competent to become a fully qualified nurse.

As the (NMC,2008) states students are responsible for their actions but not accountable, they are

assessed throughout their pre-registration program and, if there are ever concerns, these will be

investigated and addressed by the university, long before the final placement is due to commence.

When students are learning new skills in practice, its important to evaluate and give feedback on the

processes and strategies that have contributed to their development, with their assigned mentor. It is

unrealistic to reflect on every moment of every working shift, but to understand the purpose of

feedback and to learn to give positive and negative feedback to receive positive and negative

feedback about their clinical practice.

Mann, K, et all (2009) states deep learning will occur as students reflect on their feelings about the

feedback experience. Self appraisal provides a structured format for the giving and receiving of

feedback between students and mentors, the aim of the discussion is for the student to generate a list

of goals for themselves, it is important for the student to have the opportunity to express concerns

and fears they may have about the placement Whilst on the ward students will have a ‘buddy’

mentor that they can work with as well as the main allocated mentor this works well as due to time

constraints and shift patterns, as the allocated mentor is not always available.

In conclusion my critical review has enabled me to discuss my clinical area as a learning

environment and reflect on it. Hence showing that mentorship is an integral part of

the nurses role, either formally when mentoring nursing students on clinical placement, or

informally when helping less experienced colleges to develop their practice. Nurses have increased

responsibility for assessing students and therefore it is essential that nurses who are considering

becoming mentors appreciate the expectations, responsibilities and accountability involved in this

role.

They need to recognize that once they take on the role of mentor, they will need managerial

support and relevant training to equip themselves with up to date knowledge, however the need to

support students who are the nurses of the future cannot be consistently considered a secondary

priority in clinical practice if these nurses are to be fully prepared to undertake their clinical roles.

Furthermore by using a SWOT analysis throughout the mentorship process it enable me as a

mentor to see how i can improve on strengths and weakness, formulated throughout my

development plan for my student.

I would also recommend that the student visit the clinical area before placement is due to start to

find out the type of patients, type of risks involved within this specialised field of nursing, this

would be beneficial for both student and mentor involved.

Whether nurses actively seek out the role of the mentor, or find themselves in the position of

supervising, managing and helping less experienced colleagues, knowledge of the roles and

responsibilities, and competence in the skills and abilities required, enables professional

development on an individual and professional basis. Mentor and student need to have an

appreciation and acceptance of each others individual characteristics and learning styles, with good

communication, honesty and trust, mentorship relationships can be successful, healthy and strong.

REFERENCES

Boud, D., Keogh, R. & Walker, D. (1985) Promoting reflection in learning: A model. In D. Boud, R. Keogh & D. Walker (Eds), Reflection : Turning experience into learning, pp 18-40. London Kogan Page.

Charnock, A (1993) The personal tutor: a teachers view. Nursing Standard. 7, 30 pp 28-31

Curzon, L, B. (1990) Teaching in further education: an outline of principles and practice, 5th Edn. London: cassell

Darling, L. A. W (1985) What to do about toxic mentors: Journal of nursing administration, 15 pp 43-44

Duffy, K., Watson, H.E. (2001) An interpretive study of the nurse teacher’s role in practice placement areas. Nurse Education Today. Vol. 21, pp.551-558.

Gibbs, G. (1988) Learning by doing : A guide to teaching and learning methods. London : Further Education Unit.

Honey P, Mumford A (1989) The manual of learning styles. Peter Honey Publications, Maidenhead.
Hutchinson (2003)

Ireland, M. (2008)Assisting students to use evidence as a part of reflection on practice. Nursing education perspectives,29 (2) pp 90-93.

Lincoln, M. & Mc Allister, L (1993) Facilitating peer learning in clinical education. Medical Teacher, 15, pp 17-25

Mann, K., J Gordon, & Macleod, A (2009)Reflection and reflective practice in health professions education: a systematic review

Myall, M., Levett-Jones, T. and Lathlean, J. (2008), Mentorship in contemporary practice: the experiences of nursing students and practice mentors. Journal of Clinical Nursing, 17: 1834–1842.

Neary, M (2000) Teaching, assessing and evaluation for clinical competence: A practical guide for practitioners and teachers. Nelson Thornes, Cheltenham.

NMC, (2008) Professional code of conduct, Protecting the public through professional standards NMC, London

Nursing and Midwifery Council (NMC 2008) Standards to support learning and assessment in practice, London: Nursing and Midwifery Council.

Pollard K, Rickaby C and Miers M (2008) Evaluating student learning in an interprofessional curriculum: the relevance of pre-qualifying interprofessional Education for future professional practice is available from: http://www.health.heacademy.ac.uk/projects/miniprojects/completeproj.htm

Price B, (2004) Mentoring learners in practice. Number 2, Evaluating your learning environment. Nursing Standard, 19, 5

Pulsford, D., Boit, K., Owen, S. (2002) Nurse Education Today:Are mentors ready to make a difference ? A survey of mentors attitudes towards nurse education. 22, pp 439-446

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