1. Patten, Constance S. EdD, RN

Article Content

Mentoring can have a considerable impact on the direction of a new nurse's career.1 A mentorship relationship can emerge from the precepting process. This article explores the relationship of a mentor and protege and features practical tips to make it rewarding for both.


Building the foundation

A new nurse makes the transition into practice initially by completing an orientation program. Typically, the new nurse is assigned a preceptor who provides support and guidance. Once the precepting experience is complete, the opportunity to mentor may emerge as a continuation of the relationship.


Precepting and mentoring have distinct differences: Precepting is a time-limited process that focuses on the new nurse developing clinical skills and becoming oriented to the unit. In contrast, mentoring is a long-term sharing relationship that benefits both participants.2


Mentoring can strengthen the novice's transition into nursing after orientation. But for the process to work, both new and experienced nurses need to understand the mentoring process and how it differs from precepting.


Room for growth

A nurse with many years of experience has established clinical proficiency and time-tested interpersonal skills. The new graduate isn't at this level of functioning. Being new to the practice setting, new nurses may feel insecure for a while after completing orientation. For instance, they may feel unsure of themselves when working with a team of experienced nurses and observing their proficiency. A sense of vulnerability may surface when new nurses worry that they're taking too long to complete patient care assignments, or when they need to ask several questions. In view of their limited clinical experience, new nurses may begin to doubt or criticize themselves. They may also think others on the team are impatient with them. This is where a mentor takes the opportunity to reassure and support a new nurse, emphasizing the time required to become proficient.


The nurse new to the hospital setting may also be challenged by many nonclinical realities of the workplace, such as the organization's unique culture. New nurses may find themselves working in a highly structured culture that's more formal than the culture of their clinical experiences while in school. In this instance, new nurses must learn to understand and navigate another type of practice culture. New nurses may also be caring for a group of patients from a much different ethnic culture than their own. Here the mentor would suggest resources that a protege can use to learn about other cultures.


In addition, new nurses may face situations that cause workplace conflict, such as understaffing, budget limitations, and other cost constraints.3 Staffing issues in particular can create turmoil for new nurses. They may be asked early in their experience to take on more responsibilities when staff members call out sick. Here, the mentor can support a new nurse in re-evaluating the plan of care and setting new priorities in light of a change in patient assignments.


Mentoring has legs

A mentoring relationship has longevity, usually lasting beyond a year but typically much longer. Because of the long-term nature of mentoring, barriers such as ego issues, dependency, and lack of time can surface.4 Such issues can be minimized by clarifying expectations for the protege.


As time goes on in the mentor/-protege relationship, there may be instances when one party becomes disappointed in the other. For example, due to other demands, the mentor may not be as available to the protege as in earlier stages of the relationship. To deal with this, the mentor should make it clear that he or she is still committed to mentoring and confer with the protege to reset expectations of when they can meet.


Fulfilling the mentor role

By sharing knowledge, the mentor helps the protege learn to manage conflicts and responsibilities effectively. Here are a few practical examples:


* A new nurse may feel awkward delegating responsibility when making team assignments, especially if he or she is delegating to a much older person or to someone from a different culture or ethnic background. Based on knowledge and past experiences, a mentor can provide feedback on further developing the protege's leadership skills in a constructive but sensitive way. The key here is to communicate in a style and tone that doesn't make the protege feel defensive. In providing feedback, the mentor should focus on the behavior or the facts of the issues and not criticize the person.


* A protege may feel confident about basic clinical skills but feel challenged if the patient's condition dramatically changes. The mentor can guide the protege's response to unexpected complications by offering specific information to address the situation along with a steadying tone to reassure the protege.


* The new nurse may feel unsure about questioning or clarifying the patient's overall treatment plan. In this situation, the mentor may provide a safe haven where the new nurse can express concerns without being judged. The mentor can offer suggestions on how to enhance collaboration with other healthcare professionals and how to express differing opinions to another professional such as a pharmacist or a social worker.


* The protege may be interested in an aspect of patient care that's too advanced for a new graduate, such as complex wound care for a stage IV pressure ulcer. Rather than discourage the new nurse from pursuing such information, the mentor can take an aspect of this interest and make it a manageable experience. In the case of complex wound care, for example, the mentor can review basic standards of care, including pressure ulcer assessment, turn and position protocols, nutritional considerations, and documentation. The mentor can also invite the new nurse to observe the mentor providing complex wound care.


* At times, the new nurse may be surprised about an aspect of practicing nursing, such as the physical demands of working a 12-hour shift or lifestyle changes required to work night shifts. An effective mentor can be supportive by explaining the different phases of a career and how to make these career transitions.



The mentor could share Marlene Kramer's landmark work on reality shock, which is generated by the contrast between the anticipated experience and the reality. The protege works through this in four phases: honeymoon, shock, recovery, and resolution.5 Also, the mentor could introduce the protege to Benner's model, which outlines the career stages of novice, advanced beginner, competent, proficient, and expert nurse.6


Responsibilities of a protege

The protege supports the mentoring process by showing initiative, being motivated to learn, and developing career goals.7 Following these guidelines helps the protege get the most out of the experience.


* A protege needs to be responsive and follow up on the mentor's advice. If the mentor suggests taking part in an update of a policy, for example, the new nurse should be eager to participate. Here's an opportunity for the mentor to illustrate how the mentoring process benefits the mentor and the entire organization. The mentor may say, for example, "Let's work on this together-it will help you learn and, in the process, it will help me update this policy."


* The protege needs to know when to ask for help and when to express interest in topics for learning experiences. The protege should tell the mentor what he or she hopes to achieve as career goals. A simply written goal list is a tremendous aid to a mentor when identifying relevant learning experiences.


* Throughout the mentoring process, the protege should be encouraged to ask questions and be affirmed for being inquisitive. Such questions as, "Why is this done this way?" may prompt senior staff to reconsider long-standing policies. Such a review conducted in response to questions may generate needed changes.


* As the protege continues to progress, opportunities to advance in other areas of professional development may arise. These can include working with the mentor at a beginning level in making unit-based presentations or getting involved in committee work.



Mutual rewards

As the relationship develops, the mentor takes satisfaction in the growing confidence of a protege; the protege enjoys an increasing comfort level while developing clinical expertise. On a professional level, the mentor fosters pride for the nursing profession and contributes to the retention of a new nurse. The protege may be inspired to become a mentor in the future. The mentor's careful preparation for this role ensures that both parties benefit.




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