Mentoring—what it is and how to make it work

Debra L. Fawcett

As with any profession, nursing has long been subject to change--titles change, practices change, and even verbiage changes. Perioperative nursing used to be known as OR nursing, and OR supervisors were in charge. Now perioperative directors are in charge of the OR. Not long ago, hospitals offered student nurse apprentice programs; now they offer student nurse intern and extern programs. Instead of problem-solving skills, the focus is on critical-thinking skills. In the past, nurses needed to be empowered through proactive behaviors instead of reactive behaviors. Now nurses need to be politically active to demonstrate professionalism and propel nursing practice into the future. Although many of the terms used in nursing imply the same meanings and outcomes, nursing adapts terms to fit trends. Currently, one buzzword commonly used in nursing is the term mentor. In the past, new nurses were assigned to preceptors, out now, because of changes in terminology trends, new nurses are assigned to mentors. The true question is whether a mentor really can be assigned. To answer this question, nurses need to understand the definition of mentor.

WHAT IS A MENTOR?

One author defines a nursing mentor as an experienced nurse who shares knowledge with less experienced nurses to help advance their careers and a preceptor as a nurse who assumes responsibility for teaching a novice. (1) Although the mentor may be a teacher, he or she has a much stronger impact on the mentee and affects all areas of the mentee's career. The definition of mentor implies a long-term relationship between people, whereas the definition of preceptor implies a teaching relationship. This teaching relationship ends when the novice is considered educated and able to perform independently. A mentoring relationship, however, extends over a longer period of time, and the length of the relationship is not predetermined. Growth of both parties should occur, as well as respect for the others' abilities and knowledge. The mentor possesses specific characteristics that allow him or her to facilitate the career development of others, and he or she must believe that the mentee is capable of growing and learning. Mentoring, by nature, is an extremely labor-intensive relationship that requires the constant attention of both parties. (2) It conveys a mutual respect, a common interest, and a desire to grow professionally. (3) A cornerstone of the mentor mentee relationship is the beliefs and values shared.

Mentors are role models. Showing a new nurse how to perform a specific task is not the same as explaining why the task is performed and modeling the behavior. A mentor understands that there are many right ways to perform a task and that the mentee will develop his or her own style based on knowledge provided by the mentor. Mentors are professional nurses who understand mentees, are cognizant of how they communicate, follow standards and policies, and are certain of the role of the professional nurse. Mentors have positive attitudes about the profession and are willing to work with others.

CAN A MENTOR BE ASSIGNED?

A new nurse may be assigned a mentor, but there is no guarantee that the assigned person will indeed be a mentor. A mentor is a professional who other nurses want to emulate. If the mentor is not a person the mentee wants to emulate, he or she may seek another experienced nurse for his or her knowledge, professionalism, and leadership. More often than not, mentors are selected by the mentee and not assigned. A mentor does not have to be someone the mentee works with but can be someone the mentee sees and connects with as a nurse or an individual. To have a successful relationship, there must be commitment by both parties to the professional growth of the mentee, and the relationship must be a nurturing one.

Does this mean that a person who is assigned to teach new nurses cannot become a mentor? Absolutely not! Many nurses assigned to teach exhibit the values and behaviors a mentor needs. The new nurse will form bonds based on what he or she values. If he or she values knowledge and professional growth, the new nurse will seek someone with the knowledge and ability to help him or her grow. If the new nurse is concerned only with having and keeping a job, he or she will seek someone with the same values. If the person assigned to the new nurse has the knowledge, behaviors, and values the new nurse desires, he or she will become a mentor, and a long-term relationship will develop that will benefit both parties.

MENTOR CHARACTERISTICS

Effective mentors should possess a wide variety of characteristics to facilitate a positive mentor-mentee relationship. These characteristics include

* patience,

* enthusiasm,

* knowledge,

* a sense of humor, and

* respect.

Patience. Ideally, a mentor should possess patience. If the mentor is not patient, it is difficult for the mentee to accomplish the task of learning. Mentees who are not given the opportunity to try new activities and make mistakes often feel intimidated. If the mentor is not patient, the mentee may become unwilling to demonstrate new skills. The mentor is encouraged to plan new experiences around the needs of the mentee and allow enough time so that the mentee feels successful in each new endeavor. The mentor should not take over an assigned task because it is easier for him or her to accomplish the given task. This does not help the mentee learn the task, adds to the mentor's frustration, and decreases the mentee's independence. (4)

Enthusiasm. A mentor also should possess enthusiasm. Without enthusiasm, the mentee comes to view the OR as drudgery. If the mentor is not excited about new experiences or roles, the mentee probably will not be either. Mentoring is an active process. A mentor should reach out to the mentee and guide him or her in a positive, productive manner. Mentoring requires work on the part of both parties--the mentor and mentee--and a substantial amount of energy, time, and thought on the part of the mentor. (5) With each success, the mentor should praise the mentee so that the behavior becomes one of pride, and enthusiasm for the OR remains intact.

Knowledge. Another characteristic important in a mentor is knowledge. If the mentor is not knowledgeable, the mentee cannot foster respect for the mentor or the profession. The mentee who wishes to be successful may look elsewhere for the knowledge necessary to be successful in his or her new role. A mentor's knowledge should encompass a wide variety of areas. If the mentee is new to the institution, the mentor should be prepared to discuss issues such as where to park when called in at 2 AM, who to talk to about insurance, and the personalities of the physicians. Although not as important as teaching the mentee skills, the mentor also should help the mentee obtain a sense of belonging and being in control. When the mentee feels like an outsider, performance level drops, attitude becomes morose, and the mentee may seek other places to work.

Sense of humor. A mentor's primary role is to teach the mentee by example. (6) To be effective, the mentor should possess a sense of humor and be able to laugh at himself or herself and find humor in the learning process. The mentee will make mistakes, and whether the mentor laughs at him or her or the situation makes a difference in the mentee's self-esteem and willingness to learn more complicated tasks. Humor can provide relief from a stressful situation, but it must be used appropriately. If the mentee believes the mentor is laughing at him or her, feelings may be hurt and the relationship damaged. The mentor must remember that at one time, he or she too was just learning. The OR may have changed dramatically since the mentor's orientation, but the anxiety of the mentee has not. Humor helps decrease anxiety, thus decreasing stress levels and allowing the mentor-mentee relationship to grow. (7)

Respect. Respect of peers is a characteristic many mentors share. Peers recognize the mentor's knowledge, enthusiasm, willingness to share, and success in the perioperative environment. New and experienced nurses seek mentors who are respected. (8) Respect is given freely because of the mentor's competency, knowledge of the OR, and willingness to learn and change. Respect also is given because of the mentor's ability to be flexible and open-minded and because of his or her ability to use resources.

ADVOCATE FOR THE MENTEE

The mentor must be an advocate for the mentee. Learning is hard work for both the mentor and mentee. The mentor should support the mentee while he or she is learning. Often surgeons want more nurses but do not want to be inconvenienced (eg, experience delays, not have the right equipment at the right time) while new nurses are learning. The mentor is encouraged to provide surgeons with explanations of the learning process and assure them that the mentee is well supervised during new procedures. The mentor should plan experiences that allow the mentee to be successful and grow in competency and self-esteem.

To be an effective mentor, one must learn to be nonthreatening, nonjudgmental, and cognizant of personal weaknesses. Each person possesses weaknesses, and the mentor needs to identify his or her weaknesses and try to overcome or work around them. For example, if the mentor has little knowledge of cardiac procedures, he or she should learn more or identify someone to teach the mentee about cardiac procedures.

Another potential weakness is if the mentor does not like a particular physician but must work with him or her. The mentor should overcome this weakness so that the mentee does not acquire the same feelings. The mentee should have the opportunity to form his or her opinions without the mentor's influence. If the mentor is lazy, the mentee may pick up the mentor's lazy habits. If the mentor has the attitude of "this is the way we have always done it, and I am not going to change," the mentee may acquire the same attitude. A nurse with this attitude will not be an effective mentor and often deprives the entire OR of the ability to develop and retain new nurses. When an OR is stagnant, people become unhappy and look elsewhere for employment, leaving the OR short staffed.

Each person in the OR possesses a multitude of characteristics that allow him or her to be an effective perioperative nurse. Perioperative nurses who use these characteristics in a positive and confident manner have a positive effect on the retention of new nurses into the OR.

MENTOR RESPONSIBILITIES

The mentor should get to know the mentee. (9) Getting to know the mentee allows him or her to succeed. Take the opportunity to see how the mentee learns, understand his or her background, and see how much sterile technique he or she really knows. Has he or she applied aseptic technique before? Was it in a laboratory or clinical setting? Getting to know the mentee can be achieved in a formal atmosphere, such as a classroom or an interview. The mentor should provide the mentee with the opportunity to demonstrate skills before entering the OR, if possible. Let the mentee know this is an assessment period and that time should not be wasted repeating unnecessary information. This allows the mentor-mentee relationship to grow, trust to be formed, and a better plan of learning to be developed. The mentor and mentee then can work together to set goals so that success can be achieved in a timely manner.

Getting to know the mentee also may be accomplished in an informal arena. The mentor can invite the mentee to eat with him or her, meet with the rest of the group after work, or attend a meeting. He or she then should take time to observe the mentee, see how he or she reacts, and identify the mentee's personality traits. Is the mentee shy, or does he or she open up and let the mentor glimpse his or her true personality in a less stressful environment? Many people are totally different outside of the work environment, and if the mentor can blend both the social and professional, the OR will be an exciting challenge and a positive environment for all.

Communication is a big key in the mentor-mentee relationship. How do both parties communicate? Does the mentee appear to be stoic? Does he or she cry easily? Is he or she assertive or overly aggressive? The mentor needs to recognize these qualities and direct them appropriately. Explain to the mentee the role of the staff nurse. Every institution has different expectations of the staff nurse. The mentor should know his or her institution's policies and impart that knowledge to the mentee. If the mentee does not have knowledge of the expectations, his or her potential for success is diminished, as is the success of the mentor-mentee relationship.

Acquaint the mentee with the appropriate standards and ways to access them. Standards ensure safe, effective practice; allow the perioperative nurse to provide quality care to patients; and describe the responsibilities for which nursing practitioners are accountable. (10) By knowing and communicating standards of practice, the mentor can validate, through evaluation, the mentee's level of competence. It is imperative that standards be followed to prevent the possibility of litigation and to allow the perioperative nurse's active participation in shaping professional practice. (11) The mentor also should be aware of new standards and inform the mentee of changes in practice standards.

Mentors must assist in the socialization of new perioperative nurses. (12) No one wants to work in a place where they have no friends or believe that they do not know the underlying ambience. A feeling of belonging goes a long way to retain a new nurse. Take the mentee to lunch. Introduce the mentee to others in the OR. If OR staff members are planning an event outside of work, invite the mentee, offer to pick him or her up, and explain the associations he or she may. observe. Encourage the mentee to take breaks with others from the OR and introduce himself or herself. A mentor should be a friend as well as a teacher, advocate, and confidant. As a friend, the mentor should guide the mentee. If the mentee is not making friends or others shun him or her, talk to the mentee. Very often people do not see how small behaviors can be offensive to others.

CHARACTERISTICS EFFECTIVE ENVIRONMENT

Why do some ORs seem to keep every new nurse and others always seem to be orientating new nurses? One group of researchers believes the characteristics of an effective mentoring environment include providing leadership, showing patience, demonstrating caring, and maintaining loyalty. (13) Retaining nurses new to the OR takes the entire perioperative team. Every nurse in the OR is responsible for the success of a new nurse, whether it be by accepting him or her as part of the team or teaching a new skill. New nurses often feel the difference between an OR that really cares for new nurses and one that does not. Even though an OR may be short staffed, experienced nurses may have many excuses for why new nurses do not stay after orientation. Excuses include "They won't stay anyway," "I just had a new nurse, and I don't want another," "They really don't want to learn," or "I don't have the time." These are just excuses. If the mentee is assigned to someone else, the nurse should ask the mentee how he or she is doing or forgo sitting with friends at lunch and sit with the mentee. If the nurse sees the mentee looking lost, he or she should ask if the mentee needs help. When passing the mentee in the hall, the nurse should smile. When the mentee is introduced, the nurse should take the time to ask about him or her and be interested. If the mentee enters the room to observe, the nurse should talk with him or her. If the nurse is busy, he or she should explain why he or she cannot talk but not be unkind. If the nurse has promised to explain something, he or she should follow through, even if it is days later.

New nurses can feel whether they are accepted. If they do not feel accepted, they are more likely to leave and go to a more accepting unit. It is imperative that perioperative nurses look closely at how the perioperative team treats new nurses. This often is a difficult and frustrating job. Perioperative nurses must demonstrate leadership through values, ethics, trust, and application of standards. Building trust in the OR is an essential component of creating a nurturing environment. (14)

NOTES

(1.) K K Chitty, Professional Nursing: Concepts and Challenges, third ed (Philadelphia: W B Saunders Co, 2001).

(2.) S P Redmond, "Mentoring and cultural diversity in academic settings. Additional info: The inclusive university: Making cultural diversity happen," American Behavioral Scientist 34 (November 1990) 188.

(3.) C Vance, R K Olsen, The Mentor Connection in Nursing (New York: Springer Publishing Co, 1998).

(4.) S Young, J Theriault, D Collins, "The nurse preceptor: Preparation and needs," Journal of Nursing Staff Development 5 (May/June 1989) 127-131.

(5.) Vance, Olsen, The Mentor Connection in Nursing.

(6.) N Busen, J Engebretson, "Mentoring in advanced practice nursing: The use of metaphor in concept exploration," The Internet Journal of Advanced Nursing Practice 2 no 2 (1999).

(7.) F L Bower, Nurses Taking the Lead: Personal Qualities of Effective Leadership (Philadelphia: W B Saunders Co, 2000).

(8.) Busen, Engebretson, "Mentoring in advanced practice nursing: The use of metaphor in concept exploration."

(9.) B Shaffer, B Tallarica, J Walsh, "Win-win mentoring," Nursing Management 31 (January 200O) 32-34.

(10.) Standards, Recommended Practices, and Guidelines (Denver: AORN, Inc, 2002).

(11.) Ibid.

(12.) Bower, Nurses Taking the Lead' Personal Qualities of Effective Leadership.

(13.) M Hockenberry-Eaton, N E Kline, "Who is mentoring the nurse practitioner?" Journal of Pediatric Health Care 9 (March/April 1995) 94-95.

(14.) Bower, Nurses Taking the Lead: Personal Qualities of Effective Leadership.

Debra L. Fawcett, RN, MS, is an assistant professor of nursing, Indiana University at Kokomo.

COPYRIGHT 2002 Association of Operating Room Nurses, Inc.
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