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Mentorship system only ‘just holding together’

The mentorship system, seen as the cornerstone of nurse education, is under “considerable pressure” and “facing a diverse range of challenges”, warn researchers.   

Mentors have a “sense of the system just holding together”, according to a study by the National Nursing Research Unit at King’s College London and Chelsea and Westminster Hospital Foundation Trust. 

Researchers carried out in-depth interviews with 22 staff from two higher education institutes and 15 from seven trusts, all of whom had key roles in providing mentorship.

They were asked about their current ability to provide mentorship, the challenges they faced and their views on its future direction, which the authors noted were a “subject of ongoing debate”.

Mentors identified a wide range of challenges. For example, trust mergers and changes in education contracts had the potential to disrupt long-established and productive relationships between nurses in higher education institutes and their trust-based colleagues, they noted.

In addition, placements and the number of students that could be supported were under pressure from service and team reconfigurations, and a reduction in the number of qualified nurses.

Conflicting demands on time were also becoming “increasingly acute” for link lecturers, who said they regretted the reduction in time they were able to spend in practice settings.

Meanwhile, mentors reported often having to use their own time to meet mentorship standards set by the Nursing Midwifery Council.  

The majority of those interviewed thought that the NMC’s standard of students spending 40% of their time working with a mentor was met for “most” students.

But this was only achieved with “difficulty” in some of the busiest settings and could “depend on mentors using their own time to fulfil all the requirements of their mentoring role”.

More challenging still was meeting the NMC standard of sign-off mentors having one hour a week protected time to spend with final destination placement students. This could also depend on mentors using their own time, especially in acute adult and mental health settings.

The authors highlighted that interviewees often had “diverse views” on potential solutions to the challenges and on how the system work in future.

For example, views were split on whether all nurses should be mentors or whether the role should be filled by a smaller group of nurses who had been trained in mentorship as a specialist career pathway and could spend more time with students.

Sarah Robinson, lead researcher and visiting senior research fellow at the NNRU, said: “Our research showed that delivering mentorship in practice depends on a range of trust and HEI personnel involved in a complex network of inter-related activities.

“Although much is being achieved, the staff we spoke to highlighted numerous challenges facing mentorship,” she said.

“Given the centrality of mentorship to the preparation of the next generation of nurses, the challenges it faces and the very diverse views held about future directions – the next stage is for the profession and the statutory body to discuss and debate the findings and develop a blueprint for the future,” she added.

The study is one of a four-part research programme, called “Readiness for Work”, which was commissioned by the strategic health authority NHS London to look into the factors affecting newly qualified nurses in the capital.

As revealed by Nursing Times, another arm of the programme found that ethnicity affected job chances for new nurses.

Readers' comments (57)

  • michael stone

    were a “subject of ongoing debate”.

    Isn't almost everything ?

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  • Michael Fowler

    From a students perspective there are some extremely good mentors out there who help train and prepare you, and then mentors who couldn't be any less interested. I think from my experience there is a strong argument that not All nurses should be mentors.

    Having only nurses with specialist training mentoring students would have resolved many problems I have come a cross in my nursing studies and does seem a logical step forward.

    What I can not understand from this research though, is when debating whether the mentoring system needs to be overhauled why have students themselves not be question to give ideas, thoughts on feeling on what they would like to see improved to benefit their learning... After all that is that mentoring is about

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  • michael stone

    Michael Fowler | 8-Jan-2013 12:06 pm

    Michael, asking perceptive questions, such as 'why were the students not asked', will get you treated as 'a troublemaker' in all probability. But not by those other people, who bother to think (not necessarily the majority).

    Keep it up !

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  • tinkerbell

    my student asked me today

    'Do you get paid extra for being a mentor'

    I answered 'no'

    she said 'well you should do'.

    'Good idea' i replied.

    Although i enjoy mentoring and sharing the knowledge and skills and the thought has never crossed my mind before that we should be paid it did make me think.

    She also told me that most of her cohort are planning on going to Saudi when they qualify as the pay is so much better.

    I don't think Cameron can rely on taking the next lot of qualified nurses for granted.

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  • this was an extremely small 'study' - only 27 participants.

    why can't we have ward based clinical facilitators like we did in the good old days. why can't we have enough staff nurses to work alongside student nurses like we did in the good old days.

    answers on a post-card please Mr C.

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  • "Do you get paid extra for being a mentor'"

    poor reflection on our culture that everybody now expects extra just for doing their salaried job. aren't all the bonuses and incentives what have drained our economy in the first place and helped to lead to the degradation of care.

    I support the priest who said on the tv news that everybody seems to be forgetting that the economy is there to serve the people and not the other way round.

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  • May I add to the debate by saying that this a only a part of the UK and we should be careful not to generalise these findings too widely without looking at the research methodolgy and methods more closely. I recently carried out an exploratory survey with nearly 1800 qualified mentors and did not find this to be the case at all. This survey revealed quite postive aspects about the mentor role and particulary that mentors rated the support they recieved as beeing good/very good and that this perceived support was the lynchpin for them continuing as a mentor and making the difficult decsions mentors have to make from time to time.
    thanks for reading
    Lynn Brown

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  • Mentors are paid! See NHS band 5/6/7 job descriptions and the KSF!

    How many 'mentors' complete mentor modules yet never mentor! Just collecting academic credits for CPD!

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  • Again as a current student, I find a certain sense of disappointment that students are not part of this study, particularly given that this seems it will be quite influential when it comes to the future of education delivery. I do not think a separate central group of mentors is a good idea, the best experiences I have had as a student were actually spent not with my mentor, but with those who really got stuck in and spent time with patients etc, which due to the pressures of being one of the few qualified on shift and thus very Admin. orientated, my mentor was unable to do. I am a mental health student too, and wonder if this has been taken into account when discussing the future of mentorship.

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  • hear hear. Mentoring and supporting students and other colleagues is part of your job and not an additional extra. you have the wrong attitude to be a mentor.

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  • I would definitely agree with Michael Fowler, not also nurses should be mentors. A good mentor is worth their weight in gold. Most of us will remember a mentor who made a real difference to us in our training. In my current job I am the lead and sign off mentor and its a role I adore, there is a real sense of pride seeing a student learn and grow in confidence, knowing you've helped them. It can be stressful and time consuming though, I seldom get a chance to do reading/ paperwork during work hours, opting instead to do it at home. I don't mind this though as it's a part of my job that is so rewarding. I do get annoyed though when I see other staff who don't mentor and don't have to put the extra work in, get paid the same as me. But I suppose as nurses we're not really in the job for the money.

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  • tinkerbell

    *Troll alert*

    Watch out, think the trolls about.

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  • I don't feel Band 5 nurses are paid enough to mentor. Ban 6, 7 and above yes they are.

    I agree with the idea of specialist mentors. Personally I really enjoy working with students especially those who appreciate the input you give and the advice.

    Not all students treat a mentor with respect. One experience I had was working with a student and wound cleansing and infection control. This student had no idea about aseptic technique and when I pointed out that they had performed the process incorrectly they went mad at me. They were very rude and made some appalling comments about my level of experience.

    I had another student who was about to qualify and I asked her to perform a blood suga'sr on a diabetic patient as I was busy dealing with a resuscitation. When we completed the resus I went into the room to find this patient in a diabetic coma and none of the blood sugars done. Of course it was another emergency and which thankfully the outcome was ok. When I approached this student to ask what had happened and find out if she required further training in this area I was told I was the qualified nurse and she was just a student and not responsible even though she was due qualify that week. Needless to say I documented this on her final report and she was refused a job in the hospital I was working in at the time.

    You can be an approachable mentor to students but they don't always respond. In fact sometimes the more approachable the ruder they can be.

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  • Mentorship is incredibly important, however the experience of many trainee nurses and assistant practitioners is that their mentors often have other priorities and struggle to meet with them. As a member of a research group interested in mentorship, we have found that mentors often lack an understanding of their role, particularly in the signing off of competencies, but also do not always appreciate the (non-financial) rewards such as being kept up to date with changes to policy, theory and practice as their students learn.

    As registered professionals in an often apprenticeship-style learning environment, shouldn't all nurses consider themselves mentors? Perhaps this would take some of the pressure off the current system whilst we rethink a new approach?

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  • Interesting thread and provoking thoughts.
    To some degree, Anonymous is right that all nurse should be willing to mentor. By that same logic, I should be equally proficient in OB/GYN as I am in critical care, but that is not the case. I believe we all gravitate towards our passsions and interests and that is what we excell in. All nurses are leaders per our education, but not all nurses make good leaders. Good leaders receive extra training and also extra compensation. And so it should be for mentors. Most good mentors are very generous of spirit and would mentor without additional pay because they are global thinkers and looking long term for the best interest of the patient and our profession. No matter how much one enjoys mentoring, it can be draining and to some degree creates extra work. When a nurse is identified as a good mentor, she can have an unending string of students while others only have to do their jobs. I think historically, nurses take on many uncompensated extra functions and administrations (nursing and executive) come to expect it. It is not wrong to invest in good mentors (training and compensation) and is actually overdue. Good mentors ensure the holistic quality of the art of nursing is there from generation to generation.

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  • tinkerbell

    Update: it’s working! The petition demanding an investigation into lives put at risk by private health companies is growing fast with over 90,000 signatures so far. Thanks so much for being part of it.

    If we can get the petition to 100,000, we will deliver it by hand to a powerful committee of MPs. There’s a great chance that it will convince them to launch a high-profile investigation into private health companies, just like they recently did for tax-dodgers.

    Can you help by spreading the word to your friends and family? Please forward this email and ask friends to sign the petition here:

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  • I have the priviledge of being a sign off mentor and have had tremendous feedback from students I have mentored. The only downside is I or other mentors I work with ever get the reflection time , where we can work one to one for feedback. I do get a bit peeved that colleagues a higher band than me are not mentors. At the time I trained for mentorship I was told it was compulsory. Obviously not for everyone. Although I think of myself as "old school" I have to work harder to keep up with changes in nurses education. Most of it in my own time, but to be able to pass on my knowledge and skills to a new generation of nurses will be my legacy. Am I sad or what?

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  • I am a student nurse and have just had a very bad experience with a mentor who couldn't of cared less about me or my learning experience. I feel that qualified nurses should be given the choice to decide whether or not they wish to mentor and be given an incentive to do a good job, they should also receive adequate training in people management and understand the goals/expectations of the placement. Those who do not wish to do it only make poor mentors. Also as a student we should be given the opportunity to grade/comment on our mentors performance, however as I and my cohort have discovered the opinion of a student nurse counts for nothing and as the previous comment says, we would be classed as trouble makers so keep our mouths shut in order to preserve our future career. I have learn't one very valuable lesson from my placement and will ensure that when I do qualify and am able to mentor I will do this with enthusiasm and pride.

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  • tinkerbell

    Marina Broom | 9-Jan-2013 9:11 pm

    Well said Marina. We need quality mentors who are keen but sadly i don't see much enthusiasm sometimes amongst my fellow mentors, it is as though they are taking on some chore. So for those who don't wish to be mentors i do not think it should be forced upon them, better mentors do it because they want to rather than be forced to.

    It is a joint enterprise between mentor and student and both should be keen.

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  • bill whitehead

    It should be no surprise that mentorship is under strain. Mentorship of student nurses has mainly been run on a shoestring by nurses whose main priority has to be their clinical responsibilities as a nurse. Moments of sensibleness have prevailed at times such as the employment of ward based clinical teachers, clinical facilitators etc. However, whenever finances get tight the first casualty is always professional clinical education. My PhD studies (and lots of other other research ) illuminated the need for clinical facilitators and that they are a cost effective addition to the team as well as being a useful quality improvement tool.

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