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Policy Plus

Should all nurses be mentors?

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Becoming a mentor has long been regarded as an important step in a nurse’s career development and in many healthcare organisations is an essential criterion for promotion

Citation: Nursing Times (2014) Should all nurses be mentors?. Nursing Times; 110: 05, 23.

  • Scroll down to read the article or download a print-friendly PDF including any tables and figures
  • Policy+ was a publication from the National Nursing Research Unit at King’s College London. Its editors were Jill Maben, Sarah Robinson, Jane Ball and Caroline Nicholson. Some issues were published in Nursing Times to mark the 35th anniversary of the unit

Introduction

The support and guidance mentors provide for student nurses and the assessments they make of students’ progress and competence are at the heart of nursing education. But is it time to rethink the role of mentor in nurses’ careers and in nursing education and to consider alternatives to the present situation in which most nurses become mentors? This Policy Plus presents views of higher education institute (HEI) and service personnel on these questions, obtained as part of a recent project on mentorship (Robinson et al, 2012).

The “hinterland” to mentorship delivery

Debates on whether all nurses should become mentors (the generic position) or whether mentoring should be a separate career pathway for a few (the specialist position) have arisen mainly over the issue of mentors’ ability to assess student competence. In the past, mentors focused on guiding student learning while clinical assessors assessed competence. Gradually, assessment became part of the mentor’s role (Bray and Nettleton, 2007). In response to research indicating that mentors’ assessments were not always robust (Duffy, 2003; Phillips et al, 2000), the Nursing and Midwifery Council (2008) introduced sign-off mentorship, in which experienced mentors with additional training assess whether final placement students are fit for practice.

Our study on capacity to sustain delivery of mentorship explored whether all nurses should be mentors, and whether all mentors should be sign-off mentors. Capacity was defined as the roles, activities, resources and policies entailed in ensuring sufficient numbers of mentors, appropriate placements and providing education and support for mentors; this is described collectively as the “hinterland” to mentorship. Undertaken by the National Nursing Research Unit, in collaboration with Chelsea and Westminster Hospital Foundation Trust, the project was part of NHS London’s Readiness for Work programme.

Semi-structured interviews (n=37) were held with senior personnel in two London-based HEIs and in seven of the trusts with which they were partnered for nurse education (the sample included hospital, community and primary care trusts and encompassed adult, child and mental health services). Analysis, using the Framework method, revealed a diversity of experiences, perceptions and views on these questions (Robinson et al, 2012).

Why should all nurses become mentors?

Advantages of the generic position:

  • Sufficient capacity for student numbers depends on most nurses being mentors;
  • Mentoring students is integral to the role and professional responsibilities of all nurses;
  • Skills and attitudes required for teaching students are similar to those for educating patients about care;
  • Working with students encourages nurses to keep updated and maintain competency.

Disadvantages of the specialist position:

  • Students will lose benefits of learning from teams with diverse teaching styles and perspectives on practice;
  • A nurse’s ability to qualify as a mentor is used as an indicator of readiness to take further courses and suitability for promotion.

Why should only some nurses become mentors?

Advantages of the specialist position:

  • Assessing student competence is a complex and sometimes challenging task and requires substantial clinical experience and confidence;
  • A pathway of increasing seniority as a mentor will provide a career option for specialising in nurse education and retain experienced practitioners as mentors.

Disadvantages of the generic position:

  • The quality of mentorship suffers if undertaken by people without a genuine interest in student nurse education;
  • Being a mentor is not an integral part of the nurse’s role and staff can be excellent nurses without the aptitude or desire to be mentors;
  • Including the mentorship qualification as an essential criterion for promotion means that nurses may become mentors for reasons other than interest in nurse education.

Developing new models of mentorship

Some supported the current model of mentors progressing to sign-off mentors having consolidated sufficient experience to make judgements about “fitness for practice”. Others thought that all mentors should be sign-off mentors; otherwise, mentors might leave decisions about competence to sign-off mentors so problems would not be identified and managed early in the programme.

A different approach envisaged all nurses attending study days on student learning but only some taking the course that leads to a formally recognised position of mentor. Alternatively, teams of mentors could be linked to a senior mentor who has ultimate responsibility to make judgements about competence. The focus of new models was ensuring robustness of assessment of competence and, in a few instances, this had already been introduced. There was little support for reintroducing the role of clinical assessor.

Conclusions and implications

Diverse views

Considerable diversity of view existed as to whether all nurses should potentially become mentors. Key issues are: whether mentorship should be regarded as an inherent part of nursing; providing sufficient mentorship capacity for student numbers; and ensuring quality of mentorship and robustness of assessment.

Resource implications

The specialist position would require resources of some staff having dedicated time for the role and specialist educational preparation and perhaps additional pay. These costs might be offset by resources not being required for the majority of nurses to attend a mentorship course as at present.

Career implications

The specialist position would provide a new career pathway but would entail breaking the link between the mentorship qualification and promotion.

Alternative models

Questions were raised as to how the alternative models proposed might mesh with diverse practice settings and services and with the independent sector.

Key points for policy

  • Mentorship continues to be recognised as the cornerstone of student nurse education (Willis et al, 2012) but the profession and statutory bodies need to debate its future direction.
  • Is the education of student nurses best served by a system in which all nurses are potential mentors or should the role be taken up as a discrete pathway by fewer nurses with dedicated time to spend with students and develop confidence in assessment?
  • Can mentorship be decoupled from a system in which it is the gateway to career progress and new career pathways developed?
  • Is there a means of assessing the relative costs of different mentorship models? 
  • 2 Comments

Readers' comments (2)

  • As a student nurse I've had brilliant mentors, and, well, some not so brilliant mentors. The main factor (in my opinion) relating to whether a person will be a good mentor for students is enthusiasm - both towards students and their personal practice as a healthcare professional. If people are coersed into becoming mentors, it is quite likely some people will gain the additional training for the wrong reasons. In my opinion, only people who elect to become mentors should be allocated students.

    After all, a good mentor makes a good placement, and a good placement makes for better learning experiences.

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  • Having had the experiences of having an excellent mentor and the opposite, I've had the opportunity to reflect about what the differences were.
    In my limited experience, it would seem that both people had a wealth of clinical experience. The difference is one of personal values and character. I have said this applies to student nurses too. The ones who think that all the things we are taught about preserving dignity and good practice are just stuff from the books but it doesn't really matter too much "on the floor". Some think the words really mean something and have it in their nature to want to practice well. The same with mentors. some understand the need for us to be taught how things should be because the evidence base tells us it works. Others think the books are a hindrance and "just do it this way" because it suits them and not the patient. A good mentor wants you to pick up good habits. A poor one doesn't really mind what you pick up as you're just passing through. A good mentor wants to be part of a cultural shift towards improvement and excellence. A poor one doesn't see the value in it because they are so demoralised and fixed in their own ways. A good one will ensure you feel valued and included and wants to foster your potential. A poor one sees you as a hindrance on their time, potentially a threat and uses you as a stool to stand on to bolster their own faltering sense of power and position.
    No, I do not believe that all nurses should be mentors unless they can be evaluated closely themselves as having the commitment and values in place to provide us with a good learning experience. I believe they should all have the opportunity laid out for them but it should certainly not be taken for granted that they are suitable to teach or lead. After all, many of us can drive but does that mean we could all be driving instructors?

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