Being a mentor is an essential part of the nurse’s role. Qualitative research was undertaken to discover how successful mentoring relationships are developed
Teatheridge J (2010) Ensuring effective mentoring in mental health nursing. Nursing Times; 106: 48, early online publication
Background A research project was undertaken to explore what constitutes a successful mentor.
Aim To increase understanding within the profession as to what makes an effective mentor.
Method The study mainly used qualitative methods, initially involving interviews with eight third year mental health student nurses, and postal questionnaires sent to 270 qualified mentors.
Results A positive attitude and being highly motivated are important attributes for both the mentor and student if mentoring is to be effective. Mentors felt having formal supervision would ensure they were supported appropriately. They also suggested they needed protected time to mentor in order to develop effective working relationships.
Conclusion Effective mentoring produces effective students, who in turn become competent, confident registrants.
Keywords Mentor, Mentee, Protected time, Learning outcome
- This article has been double-blind peer reviewed
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“Mentors are guides, they lead us along a journey of our lives. We trust them because they have been there before. They embody our hopes, cast light on the way ahead, interpret arcane signs, warn us of lurking dangers, and point out unexpected delights along the way,” (Daloz, 1986).
Mentors are indeed guides, as well as advisors and companions. Being a mentor is a vital part of the nurse’s role and involves teaching, educating and supporting students to help them become confident and competent in their practice. However, being an effective mentor involves much more than simply fulfilling these requirements.
Over the years, much has been written about mentoring and what the main principals are in terms of encouraging nurses to be effective mentors. The Nursing and Midwifery Council’s Standards to Learning and Assessment in Practice (2008) presented the profession with a framework for mentors with identified outcomes to ensure: “there is clear accountability for making decisions that lead to entry to the register”
The framework has eight domains, each of which has identified outcomes at four developmental stages. The domains are:
- Establishing effective working relationships;
- Facilitation of learning;
- Assessment and accountability;
- Evaluation of learning;
- Creating an environment for learning;
- Context of practice;
- Evidence-based practice;
These domains give mentors clear instructions about their responsibilities. However, adhering to these requirements alone will not make a nurse a successful mentor.
According to Gopee (2008) effective mentoring encompasses “effective working relationships, relevant mentor-mentee communication, and includes generic and specialist communication skills. The characteristics… include the mentor as a role model for learners and ascertaining own mentorship potential.”
A good mentor then, is much more than someone who guides and supervises the learning experience and assesses the student’s competencies in the practice area. By empowering students, mentors can enable them to find their own answers and solve problems (Wallace and Gravells, 2007).
Downie and Basford (2003) stated that mentoring begins with the student nurse - or mentee - being in a state of anxiety, fostering dependence (Bowlby, 1997). Skilled mentors encourage their mentees to become more independent in terms of their learning. This involves mentees being self directed and taking responsibility for their learning needs in the practice area (Downie and Basford, 2003). Mentors can encourage this process by creating a secure base for their students, built on a trusting relationship (Rogers, 1983) in which students feel confident to begin to explore the world of nursing.
As students gain experience, accumulate skills, and assimilate some theory into their practice experiences, they will then be more confident about seeking out new experiences, demonstrating a keenness to learn while at the same time feeling comfortable about asking for help (Downie and Basford, 2003).
The person centered goal is for the mentee to move from being “subject-centered to performance-centered”, (Downie and Basford, 2003). Miller (2002) described this type of mentoring as “holistic” mentoring, which involves tutoring, counselling and coaching, and stated it is likely that: “Holistic mentors will be very experienced and well-trained individuals who are able to operate at a high level of skill.”
Achieving a holistic style of mentoring requires effective mentors. The mentee has embarked upon the journey of nurse training with a vision of becoming a qualified nurse (Levinson et al, 1978). It is through a reciprocal effective mentoring relationship that the mentee can make the transition from student nurse to registered practitioner. This relationship indicates effective communication, and a willingness to learn from each other, which can enhance the mentoring process.
The quality of their mentoring relationships can affect students’ achievement and progression (Foster-Turner, 2006). Mentees will expect their mentors to provide consistent support (Bowlby, 1997), so they can learn skills and experience the “craft work” (Barker, 2009) in the clinical environment (Foster-Turner, 2006). According to Foster-Turner (2006), students will also presume that in this safe environment they will be able to learn through experience, examine their mistakes without ridicule, share their lack of knowledge, and experiment in decision making and problem solving supported by their mentor. However, there are external issues that can influence the effectiveness of the mentoring relationship.
External influences on the effectiveness of mentoring
Organisations responsible for training student nurses also have a responsibility to promote a positive learning environment (Foster-Turner, 2006). This can have a beneficial effect on the mentoring process, and the nature of the mentoring relationship (Downie and Basford, 2003). Daloz (1986) suggested students’ development is not just influenced by the organisation, but also by the environment in which their development is being supported.
It may be that the organisation where students undertake their practice placement promotes an atmosphere where learning is encouraged. However, the dynamics and cultural inferences of the team, and the individuals who work within that team can also affect and influence the mentoring experience, and ultimately the mentoring relationship. Daloz (1986) suggested that individuals working within the same organisation may not have identical views and beliefs, while Stuart (2007) noted they may have different expectations of themselves and others. These complex issues will influence the effectiveness of the mentoring experience and students’ development. As a result, the mentoring experience is highly variable in different clinical environments (Taylor, 2008).
Aim and method
Hoping to increase understanding within the profession as to what makes an effective mentor, we conducted a study examining mentors’ and mentees’ views on the subject. The study is part of larger piece of research carried out by Anglia Ruskin University into shifting perceptions of mentoring in mental health nursing. The overall study is based on findings from a longitudinal survey, which looks at the changing attitudes of a group of nurses from being students to eventually working in professional practice. It aimed to understand the essential meaning of the everyday reality of being a mentee and a mentor in mental health practice.
The study mainly used qualitative methods, initially interviewing eight third year mental health student nurses, and sending postal questionnaires to 270 qualified mentors. There was a 23% response rate to the questionnaire and the final data for the overall study will be based on interviews with the students once they have qualified as nurse mentors.
Data from the eight interviews with students was selected from transcriptions validated by interviewees, and from the seven qualitative questions in the mentor’s anonymous piloted questionnaire. The latter proved valuable in that many respondents provided detailed responses to these questions. This research was designed to explore students’ and nurse mentors’ perceptions as trainees and trainers operating in relation to the world of mental health nursing. Ethical approval was obtained from theNational Research Ethics Service (www.nres.npsa.nhs.uk).
The analysis of the data from the students and mentors clearly indicates that effective mentoring is dependent on a secure, productive relationship and that both parties have a responsibility to commit to this process.
One student respondent believed that mentoring was about “a mentor passing their experience to you as a student, and preparing you for what you’re going to encounter, once you’re actually a qualified nurse yourself”.
The mentors revealed that effective mentoring depends on the attitude, motivation, experience and quality of the mentor. The students also acknowledged that some mentors are not as good as others, and said one of the reasons for this is that nurses sometimes have no choice but to become mentors. One student stated: “Some do it reluctantly… you need to have a passion for mentoring”. Another pointed out: “Everyone cannot be a mentor… it’s like nurses - everybody cannot be a nurse.” Some mentors agreed with this student’s view that nurses should be given the option of becoming a mentor.
Mentors believed that effective mentoring was also dependent on the students’ ability, skills, motivation and attitude. Mentoring they stated, was more beneficial to willing students. One student respondent agreed that the experience of the placement is affected by the student’s attitude, perception and willingness to learn, pointing out that “some students are more willing to learn than others.”
Effective mentoring from a student perspective is about having a mentor who is able to calm their anxiety, especially in a new placement; this then helps them to settle, focus, learn and understand how the unit works. It is also good to have a mentor as a source of practice knowledge. “If I need to know something, if I haven’t been taught something, it’s the support I suppose,” one student said.
The mentors generally stated that effective mentors guide, supervise and teach their students. They act as role models, ensuring students know what to expect. Mentors felt they also needed to be committed to the role and be aware of individual students’ strengths and weaknesses. Students made similar comments and said that mentors should point out their weaknesses at the earliest stage possible in the placement so they can address the issues promptly.
The mentoring relationship
One student believed that mentoring is about the relationship between the mentor and mentee, and also “the interest of the mentor in imparting knowledge to you”. This knowledge is important because not everything is learned at university, and often in practice students are not aware of what they should know.
Many of the mentor respondents believed that effective mentoring allows for a professional relationship or partnership to develop, where the student is able to observe, learn new skills, ask questions and be supported. Student and mentor can then promote good standards, get results and ensure good practice is safely delivered. One student respondent described a good mentor who was able to admit they did not know something. “They said, ‘can you find out the research and we’ll look at it together and I’ll learn from it as well, so we’ve both learnt something’”.
According to one mentor respondent, effective mentoring is “enabling and facilitating students to practise their theoretical knowledge and skills in clinical areas and enhancing their practice through reflection in and on practice”. Some of the student respondents agreed with this mentor’s comments, and felt they learned most from those who were supportive, but also encouraging.
Many of the other student respondents said they had mentors who would not sign the practice document until they were certain their students had a clear comprehension of the learning outcomes - even asking the students to research certain concepts first. One student said in areas that were not so busy the mentors took the time to question their students before signing the book. “They actually sat there and questioned you about medication and planning of care, and things like that, instead of it being ‘quick, quick, come and we can do your book now for half an hour’.”
However, this was not always the case. One student respondent said there was not always enough time to go through the documents and look at everything. “Sometimes it’s all done in a rush, all the document signing and the assessment”. The mentors did ask questions but as one noted: “Sometimes we did not have time to discuss it in depth… in hospital time is precious”.
Time to mentor
Both the mentors and the students made similar frequent comments on the paucity of time. Students felt this was more of an issue in busy inpatient units. One commented on how busy nurses are in the acute inpatient settings, and that sometimes it is hard to find time to mentor. “I had a very good mentor, but a lot of the time she was very busy, rushed off her feet, trying to keep up with the workload. At times she would be the nurse in charge and would have a lot of things to attend to.”
Many of the mentors who responded said that the practice areas are often too busy, crowded and noisy, that there is no time for students to get their needs met, and that this is not conducive to learning. One mentor stated: “Mentors should be given protected time away from regular duties to devote to teaching and assessing students”. Mentors also felt that they should be allocated time for formal supervision to enhance effective mentoring. Another organisational issue for the students was that they felt much more secure and less anxious if the mentor had been allocated before they arrived in a new clinical environment.
Some students considered that having good and consistent mentors makes them keen to become mentors themselves. “I think it’s helped that I have a good mentor and a consistent mentor… it’s made me enthusiastic about becoming a mentor and I am looking forward to the day I start my mentorship course”.
It is important these results are explored in relation to the NMC’s (2008) framework for mentoring; this can then be reviewed in regards to future implications for practice.
Mentors and students agreed that a positive attitude and being highly motivated are important attributes that both mentor and mentee should have if mentoring is to be effective. According to Gopee (2008) these characteristics will also form the basis of an effective working relationship, in which both parties learn from the experience. One student taking part in the survey was encouraged by the mentor to research, and then share the findings and learn together – an approach which links with the NMC (2008) framework in terms of “establishing effective working relationships”.
The students in this study also acknowledged differing levels of anxiety (Downie and Basford, 2003). A skilled mentor can reduce this anxiety by ensuring the student feels secure (Bowlby, 1997) - especially if the mentor makes the student feel welcome when starting on a new placement. If the mentor is able to reduce the student’s anxiety (Bowlby, 1997) the student is then able to explore the craft of caring (Barker 2009). As the students in this study said, they are then more able to settle and focus on learning - thus facilitation of learning has begun (domain 2, NMC, 2008).
The committed mentor guides, supervises and teaches the student, acting as a role model, ensuring students are safe in the practice area, and that good practice is safely delivered. These effective mentoring relationships will help students develop (Foster-Turner, 2006) encourage them to become performance-centered (Downie and Basford 2003), and feel more confident in learning new skills and asking questions, thus enhancing the learning environment (domain 5, NMC, 2008).
However, these results highlighted that the effective working relationship that encourages learning in the environment (NMC, 2008) is affected by external factors, including time.
Allocation of time is essential for these mentoring relationships to be developed. However, both mentors and students referred to the lack of time available to mentor effectively. Foster-Turner (2006) suggested that the mental health trust has an obligation to ensure each practice placement fosters a positive learning environment, for their future workforce to become competent in the craft of caring. Therefore although the organisation may not always be able to monitor the effectiveness of each individual mentor (Daloz, 1986), it could take some responsibility in ensuring some time is protected for mentoring. As one student said: “I think mentorship can be really good when done properly, as with everything within nursing and life.”
While this preliminary report only refers to a small section of the results for this study, effective mentoring featured strongly throughout the data. Effective mentoring produces effective students, who in turn become competent, confident registrants who will have mastered the art and craft of caring for patients with mental health needs.
Recommendations for practice
- For mentoring to be effective nurse mentors need to be motivated, have a positive attitude, take an interest in their students’ learning and encourage them to reach their full potential.
- Students need to show a willingness to learn.
- Both the mentor and mentee are responsible for fostering a positive effective working relationship.
- Mentors have a responsibility to reduce students’ anxiety and promote independence during the learning process.
- Mentors need protected time to develop effective, committed working relationships, which support learning that is evidence based and promote accurate assessment processes.
- As part of their responsibility to educate students, mental health trusts should provide protected time and formal support for mentors.
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