Nurse mentors still 'failing to fail' students

27 April 2010 | By Sally Gainsbury

Unpublished research from the University of Hertfordshire shows that nurse mentors are still “failing to fail” poor students, seven years after the issue was first raised.

In 2003 the Nursing and Midwifery Council published research by Kathleen Duffy entitled Failing to Fail, which showed mentors were passing students they thought actually should have failed. That research eventually led to the NMC issuing revised guidance on mentoring in July 2008.

Many felt they should give students the ‘benefit of the doubt’

But seven years on from the original research, a study lead by University of Hertfordshire senior lecturer Louise Lawson shows the problem has not gone away.

Ms Lawson spoke exclusively to Nursing Times about the findings from her research which corroborates Nursing Times’ own survey results.

The research was based on interviews with over 300 nurse mentors. A quarter said they did not feel confident in managing challenging behaviour and poor performance by students. This figure tallies with the 37 per cent of Nursing Times readers who said they had passed poor students and 31 per cent who said they did this because they knew the university would only overturn a fail.

Ms Lawson told Nursing Times: “Many of the mentors I interviewed told me it was difficult to fail a student. Doing so is both time-consuming in terms of the paperwork but also emotionally difficult.”

“Many felt they should give students the ‘benefit of the doubt’. But doing that cannot be in the best interests of patients.”

Mentors also found it difficult to create and maintain professional boundaries between themselves as mentors and their students, she said. “They have a relationship with the student and they are often counted as a part of the team and they might socialise with them, which makes it difficult to fail them,” she added.

Through her research Ms Lawson found that mentors commonly had problems knowing how to deal with personality clashes, emotional blackmail, poor personal hygiene, aggression, punctuality and learning difficulties such as dyslexia from their students.

Why mentors pass poor students

“Sometimes I have only observed or assessed a competency once before signing it off – [it’s] impossible then to say [they are] ‘consistently able’”

“I have witnessed a ward manager passing someone who was, quite frankly, dangerous, because she didn’t want to deal with the paperwork”

“The university applies huge pressure to staff who fail a student [and they] tend to pass the failed student on mitigating circumstances, so [failing them] is generally seen as pointless”

“It is far easier to pass a student than it is to fail them. I felt I was the failure”

“I was bullied into signing off learning outcomes and then my comments about attitude and competence were ignored by the university”

Readers' comments (15)

Anonymous | 27-Apr-2010 10:50 pm
I have noticed that students in my class are sitting on very low grades on placement, D's and C's. these are students that are about to qualify, I think mentors feel bad about failing people so they just give them a low grade. I don't understand how a mediocer nurse can qualify and progress if they are sitting with D and C grades on clinical placement, as at the end of the day this is how they are on the job, the future nurses. I don't understand why a mentor can allow a student to scrape by like that when they are about to become nurse in charge of peoples care. its irresponsible and action must be taken with students who sit at D and C grades.
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Anonymous | 28-Apr-2010 0:57 am
^

D - Satisfactory
C - Good.

I dont see C as a low grade.

Some people get A's because they get along with their mentors, have good chats.

In our very first placement, some 1st years students got A's. Now they are only 1st year students, some dont even have any healthcare experiece and theres no way a first year student will know everything. getting A does not means that their performance is excellent with flashy stars. Doing as you are told, being nice and getting along with mentors automatically get you an A!

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Anonymous | 28-Apr-2010 7:30 pm
Ironically I have discussed this issue with senior mentors and academics today at University, and we agree that there are several factors that influence the pass rate of students on placement.
As I wrote on this subject 2 weeks ago, it can be very traumatic, on a personal level, to fail a student who does not achieve the required standard. Nonetheless, it has to be understood that not all students thrive and enjoy particular placements; this should not, in my opinion, be cause to fail their competencies. As mentors, we are most likely to be working in a specialism that suits us as professionals, however, my personal mantra has always been my experience of the individual student, inasmuch as "would I want this nurse caring for me or my family?" If a student can demonstrate the necessary qualities - many and various - then the student will pass. If they demonstrate lack of interest, caring, compassion, empathy or clinical skills for my client base, they will fail.
For those of us who are now a bit "long in the tooth", we have had many years of different curriculum changes, competencies, attainment standards to work with / adapt to, but none of my wider team would ever predjudice a student because my specialism is not of their choosing.
The University I work closely with, in structuring a good community learning experience for all students, strive to encourage students to voice any concerns early in placement; we can then make adjustments for them if required - this may necessitate change of mentor, additional time to understand the philosophy, or address their worries. This approach is paramount in enabling each student to gain the best from their placement whether or not they choose to follow that path on qualifying. My NMC code of conduct as a registered nurse requires me to fulfill this role willingly and to the best of my ability.
I would just add that the 3rd year students on elective placement now are some of the best we have ever had. OSCE's loom for June, not too sure how some students will react when they see their mentors in a different role! Will be interesting........
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Anonymous | 28-Apr-2010 9:02 pm
do patients want 'satisfactory' nurses when they could have 'excellent' nurses??
I agree with the first comment that students with low grades on placement should have to do extra things to pull their grades up.
In a time where litigation is rife we need to be confident all our nurses are sitting at A and B level in the clinical area. who have knowledge and confidence in their nursing. I disagree that the only reason mentors give A's is because the student is smiley and nice, it proves they have a readiness to learn and the way they have integrated into the team has demonstrated the ability to adapt to new environments and staff, also it shows their manner with patients. no-one like a grumpy nurse!!
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Anonymous | 29-Apr-2010 5:22 pm
ha ha ha ha ha but us 'failing' students are good enough to be counted in the numbers when it suits!!!!
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Anonymous | 30-Apr-2010 9:37 am
Are we talking diploma students here or degree or nurse practitioners?
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Anonymous | 30-Apr-2010 2:19 pm
Reply: Anonymous | 28-Apr-2010 9:02 pm

in that case, a lot of staff nurses would have to go! My ex-mentor was terrible, had compliants from patients, some were even scared of her. Had her own favouriate patients, I as a student witnessed myself: she wipes down the table thoroughly for patients she likes and then take the same old cloth and wipe tables of patients she dislike in a 'cant be bothered attitude'. cough cough infection control excuse me! Patient complained to me regarding infection control when she left and i was so embarassed to tell her that was my mentor, yeah the one that would be teaching me things and grading me!

and regarding the students with A pass, o yeah a few passed with A, B and Cs in the first few placements and then failed others, also failed the exmination. skipped almost all classes and had to repeat whole year. Now now what does that tell you? grade does not necessary mean everything, its what you have learned and your willingness to learn. I got B in my rheumatology placement, and i must say it was the most boring placment after health visitin i have been in (!). These grades are not accurate, it also depends on who your mentor is. some students are just obsessed with straight A and Bs! it ceratinly does make look nicer.

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Anonymous | 3-May-2010 9:47 am
I believe that the hospital I work in has excellent links and support with the local university. All the mentors have recently completed their annual updates and therefore are mindful of issues surrounding 'failure to fail nursing students'. We always work towards the NMC professional standards for nurses/student nurses and have actually 'failed' 2 students (in different ward areas) this year. We were completely supported by the ULL and the personal tutors for the respective students.
The hospital as a whole is always evaluated very well from students, stating that they receive lots of support and guidance from their mentors and the team
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Anonymous | 4-May-2010 4:42 pm
I work as a specialist nurse practitioner in Primary Care, and, at present we do not have student nurses on placement with us. However, this is something I am trying to change to be able to take our service forward!

I have mentored students in some of my past lives as a nurse, and have, and will do again, fail someone if they fail to meet up to the desired criteria to warrant a pass grade.

I feel that if I were to pass someone who should fail then I am failing patients, and also failing other nurses. If someone is not fit, safe, or whatever as a student and that they have been given sufficient opportunity to improve and pass then they should not be allowed to become a qualified nurse.

To hear that some mentors pass students to avoid paper work or fear of "having a bad name" is just not acceptable and this needs addressing as much as the students failing itself.

It is a 2 way street though and if mentorship is poor due to staffing issues etc. then this should be flagged with management as well.

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Anonymous | 9-May-2010 10:33 pm
Its amazing the number of 'mentors' who never spare the time of day for their protegees, in some instances its like a personal vendetta against the student nurse,fellow workmates are recruited to make life a living hell for some students.A thorough inquiry should be conducted before failing a student on placement,destroying someones dream and ambition should never be taken lightly.
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Anonymous | 5-Jul-2010 9:11 am
I have 4 placement so far, and 3 have been excellent, but one wasn't so good. I do not think it would be fair to fail a student due to one placement. I did pass it with no problems in the end, but I now know which section of my branch I would never want to work in!!
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Anonymous | 15-Jul-2010 11:14 am
I am on the final placement of my 2nd year as a nursing student with 2 others and understand how difficult some mentors may find failing students. However, my current placement has mentors that are happy to fail students and actually laugh about it infront of us. The staff have a really poor attitude to students in general and we are often blanked by the nurses and rarely taught anything other than HCA work. If I fail this placement, it will be because I have had no input or guidance. The uni's attitiude is that we should not complain as the ward will lose some of their funding if students are banned. Maybe it's time students were able to fail mentors
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Anonymous | 27-Dec-2011 8:45 pm
Wow, as an access student who is hoping to start my Adult Nursing degree next year, the horror stories I and my fellow students have heard about mentoring and the impact that having a 'good' or 'bad' mentor will have are scary to say the least! Is the reality that we could work really hard and excel academically but if we don't bond with our mentor - we could fail?! I understand that good interpersonal skills are essential, but that has to work both ways surely? If I find myself working with a less-than-helpful mentor, I would prefer to know that my university is on my side and will work to further my studies not just prolong a route of funding.
So much about training to be a nurse if off-putting. Is it any wonder that less are joining the profession? I have given up a very well-paid job to follow my heart into this job but I am seriously starting reconsidering.
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Anonymous | 27-Dec-2011 8:57 pm
Anonymous | 27-Dec-2011 8:45 pm

my advice would be to think also about after training and what you want to do in the longer term in the light of the current situation with the cutting of posts, higher risks of working conditions and what sort of pension you will need. although the job itself has very many rewards if you are left in peace to use you autonomy and initiative to practice and look after patients they way you think fit but it can also have very many frustrations much to do with poor management of services. it is worth considering very seriously whether it would really be practical and beneficial to give up a a well paid and possibly more stable career with good prospects when there are factors such as mortgages to pay and family to look after, etc.
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Anonymous | 29-Dec-2011 5:18 am
whilst i was a student i failed on 1 placement and was upset to say the least but i say it was a learning curve. now i am a confident conscientious staff nurse who manages her workload, just! i have mentored students who have been both brilliant and some not so.i have always tried to put myself in their shoes as after all we were all students once.i have no problem failing students who don't pass required competencies and explain my reasons why. i have to think of the patients in their care and also would i want to be nursed by them.
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