The application and relevance of

mentorship in nursing practice

during the orientation of a new
employee.
SFU Spring 2015 EDUC class 816

Kasia Kozlowska

Many of us can think back and remember a person that

played a significant role in our lives. It could be a parent, child,
teacher, coach, friend, a co-worker or even a fictional character.
Someone, whose actions, behaviours or words positively
influenced our way of being. Could any of these individuals be
considered a mentor? Were their behaviours/actions similar to the
ones of mentoring? There are many definitions of mentoring in the
literature. The one that could be applied to work, career or
professional development is quoted by Eric Parsloe (2008) who
states that "Mentoring is to support and encourage people to
manage their own learning in order that they may maximize their
potential, develop their skills, improve their performance and
become the person they want to be. It is a partnership between
two people (mentor and mentee) normally working in a similar
field or sharing similar experiences (MentorSet website, 2008).
Regardless of ones profession or occupation, whether they are a
new graduate or experienced worker, starting a new job has its
benefits and challenges. In general, it requires transition from
being a new employee to the one that is competent and trained in
their duties. This transition is not only reflected in time but in the
acquisition of competencies, building relationships and gaining
experiences. To support new hires many organizations offer a
mentorship program as part of the orientation phase for a new
employee. In health care sector mentorship programs are used to
provide education, leadership skills and improve quality of work
for nurses (DeCicco, 2008). Julie DeCicco (2008) in her article
states that the introduction of mentoring process during
orientation is hoped to bring success of the individual and the
agency. The literature review reveals that there are numerous
benefits of mentorship programs not only for mentees and

mentors, but also for the organizations. In this paper I would like
to introduce some of the theories that could be applied while
mentoring a new employee, review the literature related to
mentorship process and its principles. Lastly, describe the
relevance and application of mentorship programs in the nursing
practice as a new hire transitions from a novice to more
competent and independent nurse.
When I think of a newly hired nurse I would likely consider
her as an adult learner. Knowles (1980) points out that adults are
very different learners than children. In his book about adult
education, he differentiates children learning from adult learning.
He refers to children learning as more of the transfer of
knowledge from the teacher directly to the children (Knowles,
1980). Opposite to that, in adults learning the role of the
educators is to recognize the knowledge and experiences that
adults already have, and to see how this influences their learning
needs and abilities. Malcolm Knowles (1980) calls this process
andragogy, which he defined as "the art and science of helping
adults learn," and further contrast this with pedagogy, which in
turn is the art and science of helping children learn (p.44-45).
Furthermore, Knowles describes the adult learner as someone
who (1) has an independent self-concept and who can direct his
or her own learning, (2) has accumulated a reservoir of life
experiences that is a rich resource for learning, (3) has learning
needs closely related to changing social roles. (4) is problemcentered and interested in immediate application of knowledge,
and (5) is motivated to learn by internal rather than external
factors (Merriam, 2001, p.5). Having the past learning
experiences allows adult learners to use their own preferred
learning style and to apply it to the new learning environment.

The individual preference of learning has to be considered during

the mentorship interactions to account for diversity of ways adults
learn. For example, some of us learn by hearing the content,
others by writing things down, some people like doing things;
more hands on learning, while others would prefer to learn by
reading or seeing (Fraser Health Authority 2011, p.36). The
different learning styles can be chosen in isolation or a
combination of ways. This may vary depending on the content or
environment of the learning experience. For example, to learn a
new address, one can view a map or perhaps get written
instructions or just listen to directions. Therefore, mentors should
be aware of the mentees learning style and try to meet the
learners style to facilitate learning and acquisition of new
knowledge. Moreover, a learning environment that includes good
rapport and mutual trust will enhance ones learning (Boettcher,
2007).
In the nursing profession, as in many others, the above adult
learning principles are very important to consider during the
mentorship process. When developing mentor/mentee
relationship there are some characteristics of adult learners that
require special attention for successful learnings to occur. Within
my eighteen years of nursing experience, I have observed that
nurses change workplaces frequently. It is generally viewed as a
contributing factor for professional/clinical growth and
development. Nursing is a profession with a wide range of
competencies, skills, concepts, and responsibilities. It gives
opportunities to practice in diverse care settings while caring for
different age-group of patients in various populations. Many
nurses can gain experience and nursing knowledge by working in
variety of settings. Thus, nurses who change jobs may need to

view themselves, despite previous work experiences, as a novice

practitioner, when they enter a new area of work. In the new
workplace, the nurses past experience could be utilized to
support subsequent learnings, and build on past competencies
and knowledge. However, this existing expertise can pose
challenges in the unfamiliar environment. In general, adult
learners are very cautious in the new situations and one can
assume that they strive to perform well. The fear of making
mistake during this transition is heighten and nurses who dont
feel supported may get discourage or perceive themselves as a
failure (Fraser Health Authority, 2011). Even for newly graduated
nurses who have just started a career in nursing, the support
through mentorship program is critical in their professional growth
and development. Race and Skees (2010) highly support
mentorship programs and view them as a valuable tool in
recruiting and retaining nurses as well as improving their sense of
job satisfaction. They claim that if we dont foster growth and
development of nurses they may flounder, become extremely
frustrated and seek out new alternative employment settings
(Race & Skees, 2010).
The nursing profession poses many challenges. In my
practice, it is expected that dedicated, well-educated and critically
thinking nurses are required to show practical capabilities to
perform nursing duties. Nurses have to provide safe quality care
to patients and follow best nursing practice that is well informed
and evidenced based. Newly graduated nurses or even
experienced nurses need time to fully transition into a new role.
Boychuk-Duchschers (2001) study demonstrates that it takes
twelve months for a new learner to become competent and a
confident nurse. She proposes a model that shows the transition

process starting with the orientation phase and the journey that is
lasting a year before a nurse can feel proficient. BoychukDuchscher refers to this three stage model as the Transitional
Shock Theory. In her article, Boychuk-Duchscher (2001)
describes the model as follows: 1) The Doing phase (0-3 months)
consists of task-oriented activities that lead to building confidence
by learning, performing and adjusting. 2)The Being phase (3-6
months) is the phase usually post orientation and consists of the
time when the nurse starts questioning, examining and searching
for answers, sometimes even doubting herself as the
responsibilities and expectations are increased and fatigue from
continuous learning is more prominent. 3) The last phase is the
Knowing phase (6-12 months).During this time a nurse is able to
see the bigger picture and express her own feelings of successes
as well as disappointments. In the last phase, the ability to
critically think and explore is more visible. In my role of Clinical
Nurse Educator, I often see the value of this model as I coach and
support nurses in their daily nursing practice. Especially during
the first three months of the orientation period when the main
focus is on tasks, skills and translation of the new knowledge into
practice. Over the years, I have had opportunities to work with
newly hired nurses and to watch their journey as they become
more competent and proficient in their practice. This journey can
be illustrated not only in stages but also in an experiential
acquisition of knowledge and skills.
Another often citied framework of how nurses learn and
develop competencies is seen in Patricia Benners (1982) model
called Novice to Expert. Benner (1982) in her model illustrates
how the theoretical knowledge and learned skills evolve and
develop as one transition from novice to expert. Benner

recognized five levels of skill acquisition and the competencies

involved as a nurse moves along the continuum starting from
novice, to advanced beginner, moving towards competent then
proficient and ultimately expert practitioner (Benner, 1984). The
transition from novice to expert is characterized by evidence of
specific behaviours. However, in my opinion, this progression
from novice to expert is not guaranteed; not every nurse becomes
an expert in every area of the nursing practice. It is valuable to
recognize and build on the learners previous life and work
experiences when applying this model in mentorship programs.
As said earlier, experienced nurses may be proficient or experts in
their previous roles; but a new position with new roles and
responsibilities defaults them into being a novice again. Thus, the
mentor needs to assess mentees current knowledge and
competencies and facilitate its application into the new situations.
Benners model Novice to Expert provides a distinct framework
that supports learning for nurses and it is applicable to nursing
practice, research and education (Altmann, 2007).
A different explanation of adult learning and relevant to
mentorship programs is portrait in Gardners Multiple Intelligences
Theory. Howard Gardner in 1983 presented multiple learning
intelligences to account for a wide range of human potential
(Armstrong, 2013). In his theory Gardner identified eight learning
styles: 1) linguistic- word smart; 2) logical/mathematical- number
smart; 3) visual/spatial-picture smart; 4) bodily/kinesthetic-body
smart; 5) interpersonal-people smart; 6) intrapersonal-self smart;
7) musical/rhythmic-rhythm smart, and 8) naturalistic-nature smart
(Armstrong, 2013). This theory claims that different people have
different preferences of learning, or in other words learning styles.
Multiple Intelligences Theory has strong implication in adult

learning and development (Armstrong, 2013). Being aware of

ones own learning style can facilitate the learning experience.
Earlier in the paper I gave an example of learning a new address
to a specific location, so again, people who like the linguistic style
will prefer written instruction, but people who prefer spatial style,
would appreciate a map or a drawing. Because each person has
a preferred style, it is important to incorporate this awareness to
mentorship practice. The goal of a mentor is to be sensitive to a
mentees learning style and adapt as much as possible for optimal
learning experience (Fraser Health Authority, 2011).
In summary there is no one theory that is exclusive in
application to nursing practice. The Adult Learning Theory,
Transitional Shock Theory, Benners Novice to Expert Theory or
Gardners Multiple Intelligences Theory, are just a few examples
that could benefit organizations in the mentorship programs. High
quality, effective mentorship can be a valuable tool provided that
both mentors and mentees work together towards mutually
agreed professional and personal goals.
As a Clinical Nurse Educator (CNE) I have had many
opportunities to mentor newly hired nurses as well as support the
implementation of the mentorship program within my organization.
It is within my responsibility as a CNE to mentor, teach, coach,
and evaluate new nurses and to lead them to become successful
practitioners. I believe that besides the application of the learning
theories into nursing practice, mentorship should focus on the
establishment of a relationship between mentor and mentee. This
relationship, in my opinion, should be based on mutual trust,
respect and should occur within a supportive environment that
fosters optimal learning for both mentors and mentees.

A successful orientation involves the mentor and mentee to

collaborate together in setting goals, expectations, to explore
learning styles, to respect ones values and beliefs, and to
consider the application of past experiences and knowledge
(Fraser Health Authority, 2011). In addition to building a
collaborative relationship, learning experiences occurs within an
environment that involves the interaction between mentor,
mentee, content, skill, and knowledge. This observation is echoed
in Schwabs (1973) work, where he talks about supportive
learning environment by creating commonplaces in which the
teacher (mentor), students (mentee), subject matters (context)
and milieu (social and cultural context) are important and
essential components in education planning. Consequently,
establishing a supportive relationship and environment in
mentorship programs can lead to many benefits and successes.
Wolak, McCann, Queen, Madigan, & Levak (2009) examined the
experiences of mentees and mentors in a structured mentorship
program and agreed that mentorship programs create a unique
environment that facilitates the educational opportunities for both
the novice and the expert clinician.
However, despite the established, collaborative relationship
and supportive environment the evolution from a novice nurse to
a competent practitioner can be challenging and difficult (Jewell,
2013).Transitioning from novice to expert takes time to develop
critical thinking skills in order to apply the new knowledge into
nursing practice. Making informed decisions can pose challenges
and requires some expertise to respond appropriately in different
situations (Jewell, 2013). Learning is a life long journey, learners
and mentors could benefit from the use of a framework that
guides them to evaluate their mentorship experiences and

learnings. One of such frameworks proposed by Koch, Mann,

Kralik & Van Loon (2005) is called Action Learning Cycle. The
three stages of Action Learning Cycle (look/listen, think/reflect
and learn/act) support reflection process in learning (Koch et al.
2005).The use of reflection is a good way of providing feedback to
each other and fosters critical thinking to achieve deeper meaning
and understanding of the experience. Mentee can share her/his
story or practice experience with a mentor by telling what
happened, how it happened and where. Together they would
think/reflect on the situation and identify contributing factors to
ones actions. Finally, they would learn together from the
experience and be able to provide feedback to each other or think
of other solutions applicable to a specified situation. The Learning
Action Cycle framework can be used to reflect on positive and
negative experiences and is helpful in debriefing or re-thinking a
learning situation by fostering judgement and sharing wisdom
(Fraser Health Authority, 2011). In my nursing practice the
reflective model is used commonly with new and experienced
nurses to evaluate their practice and to promote safe, quality care
to patient.
Establishing mentorship programs for newly hired nurses
involve many principles and concepts that need to be considered
for a successful and effective initiative. The phenomena of how
adults learn, analyse and reflect together and the drive to grow
and become proficient critical thinker should be an integral part of
each nurse. In my opinion, mentorship opportunities and the
interaction between mentor and mentee are not linear or
directional. I see them as constant interaction and partnership
between a mentor, a mentee, a patient, particular content and the
environment. These fluid interactions require multiple

10

assessments and reassessments of ones knowledge/skills

related to a specific situation. The application of critical reasoning
and reflection of ones practice is needed for the learnings to be
optimized. When I look closely at this quite complex process, I
see some analogy of the mentorship phenomena to the concept
of reflective practicum in the education model referenced by Allan
MacKinnon in his article Conceptualizing a Hall of Mirrors in a
science teaching practicum (MacKinnon, 1989). The model
described by MacKinnon (1989) proposes a framework that
represents triangular arrangement between supervising teacher
(in nursing mentorship that would refer to a mentor), a student
teacher (mentee) and practicum phenomena (I would compare
this to the content and context of the nursing practice as well as
specific patients care needs). This dynamic process of reflective
practicum is very complex and I think simplifying it to the mere
interactions between the three components of the model could
exclude many important elements that may influence the
learnings. The reflective practicum model, if applied in the nursing
practice, can provide a framework that enables the new nurse to
gain necessary insight for developing competencies and gaining
deeper understanding of the phenomenon in question.
Experienced or expert nurses (mentors), similar to supervising
teachers have a greater repertoire of skills to use in critical
thinking and in application of their knowledge. Whereas mentees
like student teachers need time and support to learn necessary
skills/knowledge to help them develop competencies. Mentors
help mentees to learn or even imitate mentors behaviours or
actions by modeling and demonstrating required skills. The
reason I chose the analogy of the reflective practicum model to
the mentorship process is to illustrate universality of the model

11

used in the education discipline and its relevance in knowledge

translation between mentor and mentee in the nursing practice.
In summary, even though mentorship program is a very
complex phenomena, its applicability to nursing practice can bring
a lot of benefits providing that those who mentor others have the
necessary competencies and understanding of mentorship
principles and concepts. The literature reveals many models and
frameworks for mentoring activities. The few models introduced in
this paper tend to outline the stages of the mentoring process and
the relationship between mentor and mentee. No one model is
more appropriate than another and its choice usually depends
upon the mentors familiarity with a particular framework. I would
agree that in my nursing practice, mentoring has showed to be a
powerful personal development and empowerment tool. It is an
effective way of helping people to progress in their careers and it
is documented in the literature as a valuable tool in recruiting and
retaining nurses as well as improving their sense of job
satisfaction Race & Skees (2010). Beside decreasing nursing
turnover and contribution to retention of nurses , formalized
mentoring programs facilitate the transition of a new employee to
professional practice and prepares them to be able to provide
competent and safe patient care (Hayes, 2007).Furthermore, it
has been suggested that both mentors and mentees have an
opportunity to evaluate mentorship experience and benefit from
having more accountability and responsibility that could help them
advance within the organization (DeCicco, 2008). In addition,
mentors enjoy what they do and take great pride when a new
hire becomes an asset to the team (DeCicco, 2008) In sum, the
various research studies support mentorship programs and reveal
the numerous benefits of them not only for mentors and mentees

12

but also for organizations and the nursing profession. Thus, for
mentorship programs to be effective and successful it is important
to consider: different adult learning theories, establishment of
collaborative relationship between mentor and mentee, provision
of supportive environment as well as evaluation of the mentorship
experiences and learnings in the form of feedback or reflection.
Mentorship is a dynamic and complex process that has its value
in the nursing profession.

13

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