Professional Documents
Culture Documents
Mentoring in The Career Continuum of A Nurse: Clarifying Purpose and Timing
Mentoring in The Career Continuum of A Nurse: Clarifying Purpose and Timing
Introduction to Mentoring and the Career tional socialization process, new employees transition from
organizational outsiders to organizational insiders. The pur-
Trajectory of a Nurse pose of onboarding is organizational socialization. It
Mentoring is a term that evokes many different views involves processes such as environmental orientation (i.e.,
on what it is and where it fits in the career lifespan of a tours of the unit, locker room, and employee lounge), and
nurse. Ask five people to define mentoring and you will required employee procedures and processes (e.g., employ-
receive just as many different answers. Mentoring is often ee badges, pass codes, and associate training). Onboarding
confused with preceptor-facilitated orientation and nurse can begin before or on the employee’s date of hire, and gen-
residency programs. To dispel the myths and confusion erally lasts for weeks or months (Bauer & Erdogan, 2011;
about mentoring in the career trajectory of a nurse, this col- Jakubik, Eliades, & Weese, 2016; NMI, 2016).
umn will provide definitions of mentoring and related def-
initions, including the timing and purpose of mentoring Orientation
and related career developmental phenomenon encoun-
tered on the unique trajectory each nurse takes on the Orientation is a semi-structured to structured program
career continuum (see Figure 1) (Nurse Mentoring Institute using a blend of formal classroom, self-paced learning, and
[NMI], 2016). At the conclusion, we provide case scenarios preceptor-directed learning designed to transfer job skills
depicting how mentoring can be applied to practice in the and knowledge needed to become a competent profession-
beginning, middle, and later stages of a nurse’s career tra- al. The purpose is to train an employee who functions safe-
jectory. ly and independently in a specific work setting at the com-
pletion of orientation (American Nurses Association [ANA],
2010). Timing for orientation can range from days to
Onboarding months, depending on the employee’s experience level and
Onboarding is the mechanism through which a new the complexity of the patient population (NMI, 2016). For
employee acquires knowledge, skills, and behaviors to instance, an experienced pediatric medical-surgical nurse
become an organizational insider. Through this organiza- who has transferred from another hospital may only
require a few days of orientation followed by a few weeks of
Louise D. Jakubik, PhD, RN-BC, CSP, is President and Chief
resourcing, while a new graduate nurse hired into the same
Mentoring Officer, Nurse Mentoring Institute; and President and Chief
pediatric medical-surgical unit may require an 8- to 10-
Learning Officer, Nurse Builders, Philadelphia, PA. week orientation. In contrast, a new graduate nurse hired
Mentoring has been proposed as a solution for retention and succession planning in nursing; however, there is a lack of information about
“how to” mentor based on evidence. This Leadership Series takes a deep dive into evidence-based mentoring for staff nurses and the
organizations in which they work.
Transition into Practice Program (TIP)/ is retention and role transition in the beginning phase of a
new nursing role, these programs are designed to either over-
Nurse Residency lap or follow unit-based orientation and continue through
A Nurse Residency program is a formal, structured pro- the first one-year to 18-months of practice. Research shows
gram/curriculum aimed at role transition, workplace accul- that nurses who are retained through the first 18 months of
turation, and retention with an assigned “preceptor or employment are much more likely to be retained long-term
mentor.” The program begins during or after orientation once they have successfully transitioned through this high-
and extends throughout the first 12 to 18 months of risk period of “reality shock” (Kramer et al., 2013).
employment (NMI, 2016). Research from Marlene Kramer
(1974) on the term she coined “reality shock” documents Mentoring
the difficulty nurses have transitioning from the nursing
student’s protected, utopia of the classroom environment Mentoring is an intentional, long-term career develop-
to the challenges of the less-protected, complex, and fast- mental relationship among an experienced nurse, a less-
paced environment of being a nurse in clinical practice. experienced nurse, and their workplace involving six men-
Although Kramer documented this phenomenon in the toring practices (facilitated by the mentor and the work-
1970s, it was not until the 1990s that hospital administra- place) that are associated with six mentoring benefits (for
tors began to see the link between reality shock and the protégé, mentor, and workplace). The purpose of men-
turnover of nurses within the first 18 months of hire toring is lifelong learning, professional advancement,
(Kramer, Brewer, & Maguire, 2013). Due to the high cost of engagement, and succession planning. Mentoring is associ-
a single RN’s turnover, estimated between 75% to 125% of ated with employee engagement, increased employee satis-
the RN’s annual salary (Beecroft, Kunzman, & Krozek, faction, and succession planning (Greene & Puetzer, 2002;
2001), coupled with the negative impact on safe care deliv- Tourigny & Pulich, 2005). Robust mentoring cultures afford
ery and the workplace environment, it is no surprise that nurses retained by transition into practice/residency pro-
administrators, clinicians, and educators alike sought solu- grams to be engaged and developed within the workforce,
tions to quelling the impact of reality shock. Studies and thus creating an improved work environment.
reports focused on incorporating the Quality and Safety Mentoring is a career developmental phenomenon
Education for Nurses (QSEN) competencies to improve that should begin at one year of experience and continue
quality and safety practices of graduate nurses, while throughout the career of a nurse until retirement. Formal
increasing job satisfaction, reducing work stress, and and informal mentoring programs and initiatives should
decreasing turnover began to emerge (American Nurses begin where nurse residency concludes. As the transition
Credentialing Center [ANCC], 2016; Institute of Medicine into practice is complete through TIP/Residency programs,
[IOM], 2011; Sherwood & Barnsteiner, 2012; Spector et al., the process of ongoing career and role development should
2015). Transition into practice/residency programs were be facilitated by mentoring. Mentoring can be used to
created in response (Beecroft, Dorey, & Wenten, 2008; develop horizontally within or across a role and vertically
Krugman et al., 2006). into more advanced roles.
It is worth noting that the timing of transition into prac-
tice/residency programs is very specific. Because the purpose
Certification
nurse as it is for the mid-career and executive nurse.
improvement projects
Association of Critical-Care Nurses (AACN), the profession-
al organization for their specialty. She seeks out Sandy, an
Leadership role
as a mentor to meet her goals. Sandy sees potential in Alexa
and readily agrees to help her pursue these goals. She sug-
Publications
course, online study resources, study groups, test taking
strategies). Sandy encourages Alexa to join AACN and
Project management
she found to be valuable. She also mentors Alexa to
advance on the career ladder, join the unit-based council,
Interprofessional collaboration
and be an informal unit leader in influencing positive unit
Precepting
mentorship from Julie, the director of Ambulatory Services,
to guide him in developing the knowledge and skills
Advocacy required to advance to the next level. Julie recognizes Adam
Leading change/innovation
has what it takes to be an effective leader and mentors him
to foster leadership development. Their mentoring relation-
Entrepreneurship ship focuses on pursuing formal education, taking advan-
Business savvy
tage of leadership development opportunities, fostering
interprofessional collaboration, and leading systematic
Technology improvements in practice through Lean Six Sigma method-
Simulation
develop his leadership skills and asks Julie to let him know
of any organizational development courses she thinks
Advanced practice role would be of value for him. Julie sponsors him for the orga-
Beecroft, P.C., Dorey, F., & Wenten, M. ments on new graduate nurses’ environ-
and state level professional organiza-
(2008). Turnover intention in new grad- mental reality shock. Western Journal of
tion for nurse executives. Nancy
uate nurses: A multivariate analysis. Nursing Research, 35(3), 348-383.
becomes involved in advocating for
nursing and health care at the state Journal of Advanced Nursing, 62(1), 41- Krugman, M., Bretschneider, J., Horn, P.B.,
52. Krsek, C.A., Moutafis, R.A., & Smith,
Beecroft, P.C., Kunzman, L., & Krozek, C. M.O. (2006). The national post-bac-
and national level through the profes-
63-70. Career%20Continuum%20Flyer.pdf
ning session to design and optimize
Institute of Medicine (IOM). (2011). The Sherwood, G., & Barnsteiner, J. (2012).
the new space to meet patient, staff,
and organizational needs. future of nursing: Leading change, Quality and safety in nursing: A compe-
advancing health. Washington DC: The tency approach to improving outcomes.
National Academies Press. John Wiley & Sons.
References Jakubik, L.D., Eliades, A.B., & Weese, M.M. Spector, N., Blegen, M.A., Silvestre, J.,
American Nurses Association (ANA). (2010). (2016). Part 1: An overview of mentor- Barnsteiner, J., Lynn, M.R., Ulrich, B., ...
Scope and standards of practice for ing practices and benefits. Pediatric Alexander, M. (2015). Transition to prac-
nursing professional development. New Nursing, 42(1), 37-38. tice study in hospital settings. Journal of
York, NY: Author. Jakubik, L., Eliades, A., Weese, M., & Huth, Nursing Regulation, 5(4), 24-38.
American Nurses Credentialing Center J. (2016). Leadership series: ‘How to’ Tourigny, L., & Pulich, M. (2005). A critical
(ANCC). (2016). Practice transition for mentoring: Mentoring practice and examination of formal and informal men-
accreditation program manual. Silver benefit 2: Mapping the future and career toring among nurses. Health Care
Spring, MD: Author. optimism – An overview and application Management, 24(1), 68-76.