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OPINION EXTRA

Why I'm giving up mentorship: an update

  • 15 Comments

Brian’s article in NT about giving up mentorship caused a stir among readers. Has he rethought his decision?

Last year, I attended my mandatory mentors’ update session, and came away feeling that perhaps my time and experience would be used better if spent on direct patient care, instead of working with some students who did not want to learn, based in establishments which did not understand the realities of life on the ward.

I wrote this up, and submitted it to NT many months later, where it was published with commendable speed.

The online responses, on the whole, supported my view and stance; if you are a mentor, please try to find the time to read at least some of them. If you are a student, please try and read the lot. I never use this adjective in a blasé fashion, but in terms of nurse education today: there are profound insights there.

When I raised the matter of mentorship in my appraisal, a couple of days ago, I learned that I’m not the only nurse in my organisation to be thinking the same way. So I believe that an update might be worth the effort; but then, that is for you to judge.

Cutting to the chase: I am giving mentorship up.

This is not an easy choice – there’s little more pleasing to me than a session with a student where you see the light bulb go on. Even better is when the student says “Aaah… so that’s why….” and extrapolates to other conditions.

Those are the days when I clock off as a happy lad.

But over the time since that mentorship update, I’ve become more and more aware of students wanting ‘teaching’ over ‘education’ (see The Prime of Miss Jean Brodie by Muriel Spark). An example: revising neurological observations, I always ask “if intracranial pressure is rising, what happens with blood pressure and pulse, and why?” Once the student understands the concept of a system enclosed in a non-elastic case, they usually work it out.

But if I get the response: “it’s frustrating, you’re just not telling me”, then either I’m a rubbish teacher, or they don’t want to put the effort in (or both, of course).

This has not been an easy decision, and I am going to have to deal with guilty feelings for (probably) years. However, I will still be able to teach/educate; I just won’t have to spend hours filling in forms which may never be read, or deal with people who want ineffectual students to continue with their course, irrespective of their abilities, without ever coming and assessing them in the workplace.

Any fool can highlight problems, but suggesting solutions is harder. Anyway, here goes: bring back the RCNT. Younger nurses can Google it; older nurses will know what I mean.

 

Brian Booth is as staff nurse in a community hospital

  • 15 Comments

Readers' comments (15)

  • On re-reading this properly for the first time since submitting it, I wondered whether some nursing colleagues might think my implicit definition of 'mentorship' is rather narrow. To me, the first and most important part of mentorship and preceptorship is acting as a role model; but what I am writing about here (as in the previous article) firstly concerns what is being taught in the lecture hall and seminar room, from the basics of A&P to the very privileged position you attain when allowed to nurse someone, and the mismatch I - and many respondents to the first piece - currently perceive in the workplace; and secondly, the willingness to learn.

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  • I am an older nurse and have no idea what RCNT is and neither apparently does Google.
    Please could somebody explain?

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  • This applies to nurses of my vintage (I started in 1979:) When nurse training was mostly based in hospitals, classroom teaching was delivered by registered nurse tutors, or RNTs. Their province was theory.

    Alongside them was a group of people who had the title registered clinical nurse tutors, or RCNTs. Their remit was the teaching of clinical skills (note - most nurses probably know that the word 'clinical' is derived from 'bedside', but just in case...). In our first six weeks, before we were let loose on real live patients, they taught us how to make beds, feed a helpless person (we fed each other jelly and ice cream), inject oranges and then each other (yes, we did stick needles in our classmates),pass a nasogastric tube (only one victim this time - me) get a patient comfortable on a bedpan, which meant inserting one under each other - fully clothed, but I know that some RCNTs would have liked to have done it for real, for educative purposes - blah blah blah.

    Once student/pupil nurses hit the wards, the RCNTs would appear (often unannounced) to work with us (usual reaction from the regular staff: 'Oh ****, that's three hours to do a drug round/an hour to do that bedbath', etc).

    I hope that answers your question, and I know other people may have a contrary view of the RCNT role.

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  • brian booth | 30-May-2014 1:17 pm

    Many thanks for your explanation.

    My experiences were very similar to yours having qualified in 1978. I was assigned a clinical tutor who as you said made an appearance on the ward often unannounced. She also carried out my clinical assessments in my final year which led to my SRN qualifications. There were often complaints about the theory practice gap and it was sometimes quite difficult for us learners as they always insisted that everything was followed to the letter in the book but on the ward there was less time for this, as you say. Unfortunately I adopted some of the time saving habits I picked up on the wards and got severely reprimanded once on my finals drug round but fortunately she still passed me.

    It was a very formal relationship and rather embarrassing when I visited the flat of my boyfriend, at that time, for dinner only to discover she had helped cook it and was the girlfriend of one of his flat mates - all medical students!

    We called them clinical tutors and I had never heard them referred to as RCNTs. I think it was a very good system and am eternally grateful for what I consider the excellent all round training I received which stood me in good stead for an excellent, challenging and very enjoyable career abroad.

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  • Im working as an HCA, and I was shocked when one student told me 'I dont like nursing, but I like the money'. I admire her honesty.

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  • I know exactly where youre coming from as a nurse trained in the 80's, mentorship now is just about signing forms, and universities don't listen when you voice concerns infact 2 students I have failed their placements have gone on to qualify despite my worries at their suitability to become qualified nurses I certainly wouldn't want them looking after me or any member of my family. I worry where nursing is going because at some point Im going to experience care delivered by unsuitable indviduals

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  • I'd like to comment on the responses above, noting sadly that they're anonymous - the reasons for which, in themselves, could be the subject of a separate article:

    Anon, May 30, no 1: your comments about 'time saving' made me think. As a first year student, I was pulled aside by a kindly/concerned enrolled nurse and told that the ward sister would find it unacceptable for a member of her staff to spend a full ten minutes admitting a patient to an acute medical ward.

    The second thought is, I didn't appreciate at the time that the clinical tutors made us do it by the book because only when you know a procedure backwards, can you find shortcuts that are safe. I only realised this too late to be able to thank them for enabling me to be at least part way competent in my job, thirty-odd years later.

    Second anon, May 30 - from an HCA - what I've found much more shocking is students who have no problem in admitting that they are getting a 'free' degree, and have no intention of practising after graduation.

    Anon, June 2nd: Again, material for another, separate article. When learner nurses were part of the hospital workforce, expected to 'pay back' a year to our employer after qualification, there was a vested interest in ward staff to ensure underperforming pupils and students were a) brought to the attention of their teachers (who could be found in the same building), and b) helped to get back on track in the workplace. If you let a bad one through, they might come back to work alongside you...Now, the inadequate student is an SEP - 'somebody else's problem'. Yet another article crying out to be written: 'what does it take to fail a student nowadays?'

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  • brian booth

    hopefully I will have more time to respond to your post later. but thanks, I don't need to be questioned on my motives for choosing to post anonymously. everybody is free to make their own decision and I am old enough to make mine after a long, highly satisfying and successful career!

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  • brian booth | 2-Jun-2014 8:31 pm

    from anon 30 may no. 1

    Now have time to get back to you again.

    I hope you don't think i was criticising learning from the book which I also believe is essential. However, it was also difficult on the wards where as a novice one is anxious to do things the way they have been taught, practice getting that right and give the best to the patients, but where speed and the patience and tolerance of trained staff was the essence and one often had to eventually cede to some of their ways of doing things(for better or for worse and sometimes under duress) , it was easy to get confused or out of the habit of what one had learned correctly, only to have an unannounced visit from the clinical tutor to be reprimanded for doing it differently from the way being taught. I found at this stage one could end up feeling pulled in every direction. I also learned throughout my training and career that there is not always only one right way and one wrong but most importantly one had to learn to distinguish between them and what was good and safe practice (trained staff were not always a guarantee of this or necessarily good role models) by watching, listening, reading and constantly questioning before deciding for oneself if no official guidelines beyond the textbooks were available, the best, safest and most efficient way to proceed. that is what working in an open and honest learning environment, evidence-based and best practice from an autonomic professional practitioner is all about.

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  • I am really upset to have caused offence - I obviously was unclear.

    Looking at other threads on this site, I am always struck by the number of anonymous posts. Each person has their reasons, of course; but my comment was about the way organisations would like to censor staff comments in public forums. I asked NT not to publish details of my place of work, because otherwise I would have had to submit these two pieces to our communications department, who would then have raised queries about my tarnishing relations with the universities with whom we work. My wife recently wrote an article about an innovation which showed her employers in a very good light indeed; she sent it to comms, from where it was sent all around the houses, and she finally received an email from the people she initially sent it to, asking for a copy. A final line like 'The views expressed are personal and do not reflect the opinions of his/her employer' is not acceptable anymore, it seems.

    On the second point: I couldn't agree more, that is pretty much what I obviously failed to say clearly.

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