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Category: Research

Teaching and Learning Forum 2011 [ Refereed papers ]
Cultivating care: Nurturing nurses for a new tomorrow

Caroline J Vafeas, Melanie Lauva and Tania Beament
Edith Cowan University
c.vafeas@ecu.edu.au, m.lauva@ecu.edu.au, t.beament@ecu.edu.au

In large academic institutions, students often feel very lost, confused, lonely, and anxious or even a fraud at being there. At Edith Cowan University in Western Australia, researchers identified a gap in provision for Nursing Students which addresses these concerns. This study used a qualitative case study utilising rich narrative and aesthetic expression to explore and describe the experiences of both student mentees and academic mentors over the trajectory of the student's Bachelor Degree programme. Findings emerging show students both want and need academic mentorship but the form upon which that takes is highly individual and changeable as the individuals professional competence and confidence increases; and as a positive and mutually accountable relationship is formed between the parties. While there is overwhelming empirical evidence to support mentorship for students in academic institutions and mentorship for newly Registered Nurses, a paucity of literature exploring academic mentorship of student nurses exists. This research aims to contribute to an emerging yet vital body of knowledge surrounding the notions of support and nurturing of health professionals of the future. A philosophical model proposed by the researchers has been identified as the foundation for this research and will also be explored within this paper.


Introduction

Mentoring is an alliance, that creates a space for dialogue, that results in reflection, action and learning (Rolfe, 2003).
The term mentor has its foundations in Greek mythology and refers to the role modelling, nurturing and trusted advisory relationship a knowledgeable individual takes on with a less experienced person (Roberts, 1999). Mentoring within nursing education appears to have various meanings and interpretations. Watson (1999) suggests that the term mentor must be clearly defined to ensure roles and relationships are understood by all parties; these including mentees, mentors and educators.

The concept of the mentor suggests that the role of the nurse preceptor in this regard is simply "what one defines it to be" (Barnum, 2006, p.1) though Barnum (2006) highlights that there is a difference between precepting and mentoring. Oliver & Enderby (1994) observed that the terms mentoring and preceptorship have been used interchangeably within the nursing literature and do have common features. Olive & Enderby go on to assert that while preceptorship is part of the mentor role, mentorship is not inherent in the nurse preceptor role.

While literature certainly suggests mentors embody desirable leadership qualities such as empowerment, importance of interpersonal relationships (Morton-Cooper, 1993) helping, guidance and counsel (Watson, 1999), mentorship is not possible in the undergraduate nursing education context due to the limited continuous time spent in clinical placements and the role of the nurse preceptor and mentor being fundamentally different (Mills, Francis, & Bonner, 2005). Research by Billay & Yonge (2004) explored the concept of preceptorship from the perspective of the nurse preceptor through the analysis of interdisciplinary literature. The findings showed that preceptorship was distinct from mentorship although a positive consequence of a preceptored relationship may involve the evolution of that relationship into a mentorship.

This research aimed to explore the form and function of the mentor-mentee relationship when implemented among first year undergraduate nursing students. During the proposal phase of this study, the researchers identified six concepts (see Figure 1- The Stairway to Success) which were felt to be important functions of both the mentor and mentee in ensuring positive outcomes for both parties. These concepts identify the underlying philosophical model for this project and are explored in more depth below.

Figure 1

Figure 1: The Stairway to success

Engage (engagement)

The concept of engagement refers to making real 'contact' with a student. It also addresses meeting them as people rather than as numbers (which unfortunately is often the case with large student cohorts). Through mutual commitment to the mentoring relationship, a rapport is built. The initial engagement period allowed the mentee to develop a feel for the mentoring programme and allow them opportunity to withdraw if they chose to. This initial period is also a time for defining boundaries. This concept is a complex one with regard to the mentoring context and warrants much more in-depth exploration, but for the purposes of this paper, setting boundaries began in this phase and continues over the lifetime of the relationships as various issues arise.

Nurture (nurturing)

Nurturing has been highlighted as an essential component as neophyte practitioners become socialised to the nursing profession. One of the goals of the mentoring programme was to create an environment of care and genuine concern. This was not forced and was a natural result of building relationships with the mentees and having a genuine interest in their fate. Trust has become a slowly emerging element of the mentee/mentor relationships, and through this trust, open and honest disclosure has resulted in the mentors being able to provide an empathetic ear and fulfil the nurturing role.

Explore (exploration)

The scope of a mentoring relationship allows both mentee and mentor to gain a broader knowledge of self through identifying their strengths and weaknesses. In terms of the mentee experience, guidance from an experienced and supportive mentor enables safe opportunities for the student to take chances experiencing both success and failure. Through exploration and taking chances, mentees discover a direction and are better placed to commit to it.

Empower (empowerment)

The mentoring relationship (when functioning reciprocally and optimally) creates an atmosphere of empowerment. When a student feels positive about their potential for success they become more confident. In the nursing context, feeling positive and empowered brings about feelings of professional pride and personal pride with respect to achievement and performance.

Reflect (reflection)

Reflection is an acquired skill which allows an individual to think about and critically examine events of the past in order to plan for a better future. In reflecting on performance and experiences, mentees are well placed to identify new and achievable goals and the humility to recognise the difference. It may be necessary for reflection to be encouraged by the mentor in order for the mentee to be able to view progress and success.

Succeed (success)

Success is the desired ultimate result of the mentoring relationship. Successes may be big or small but facilitating the student towards this goal creates a sense of satisfaction and confidence to further succeed in the nursing journey.

Methodology

This study adopted a qualitative methodology utilising a case study approach and aesthetic methods of data collection to explore the experiences of a cohort of first year, stage two undergraduate nursing students completing a three-year Bachelor of Science (Nursing) programme within the largest nursing school in Western Australia and their faculty mentors. The study commenced with the first cohort of mentees joining the programme in July of 2009. Since this time an additional two cohorts of mentees and one other faculty mentor has joined the programme.

Sample

Students invited to participate within the research were a purposive sample of students enrolled in the first year (second semester) of the undergraduate course. These students were selected as they were entering the second semester of their first year of study and had time to adjust to the procedures and processes within the university. Of the 50 students, 49 were female and ages ranged from 17 - 51 with an average of 34 years.

Procedure

Students were invited to self nominate for involvement within the study following a presentation by the researchers during an orientation lecture. An information letter and consent document was provided to interested students detailing the extent of involvement within the study. Students were asked to return the consent document to the researchers in a sealed envelope via nursing reception. Approximately 50 students were randomly selected and recruited from 94 expressions of interest. For the purposes of clarity within this paper the term 'mentors' also refers to 'the researchers'.

Setting

The study is being carried out within a Western Australian university which accommodates a large nursing school with approximately 1600 undergraduate nursing students enrolled across six semesters of the three year pre-registration programme. The site was selected as it is where the researchers are currently employed and therefore have a familiarity with the staff, procedures and layout of the university. Researching the target population in their own environment is more convenient for the sample in terms of time and effort required to attend meetings and/or interviews with their assigned mentor.

Data collection

Each mentor was allocated 25 students (mentees) for the purposes of the study. Each individual student was offered one-on-one time (30 minute sessions) twice per semester to meet with their mentor to discuss any issues arising in relation to course progress and generalities around the choice of nursing as a career. During one-on-one sessions, the mentor took notes which formed a record of the meeting.

In addition to the one-on-one sessions, the group of mentees were offered two meetings as a large group with the mentors during the semester. These sessions were facilitated as focus groups and tape recorded.

Each mentee was given a diary in order to record reflections as often as they chose. The researchers review entries with the students at planned meetings. Diary entries are photocopied, de-identified, coded and analysed.

The mentors add contextual notes and engage in peer debrief and reflection throughout each semester. These notes and discussions form part of the data being continuously analysed.

The researchers additionally set up a web site housed within the university online management system (BlackBoard). The site is accessible only to mentee students and the assigned mentors. Over the course of the semester and in response to mentee requests, various information and resources were added. The site also housed a blog and discussion board where mentees could collaborate and discuss.

Over the first week, four participants withdrew from the study and an additional two were recruited after emailing the researchers directly expressing interest in participation.

Instrumentation

Since no previously developed instrument was available for use in this study, a questionnaire titled "Mentoring New Nurses Survey" was specifically developed to in order to obtain baseline and demographic information to serve as a starting point. It comprised items relating to expectations of the programme and concept of mentorship and present challenges and highlights of the nursing course. Additionally information relating to age, gender and course details was sought. The survey was distributed at the first group meeting in August 2009. All attending participants completed and returned the survey (n=48), resulting in a 100% response rate.

Findings

Initial findings from the study identified that the mentees want someone to talk to; someone who wanted to listen to their story. Mentees wanted to feel that they were not simply a number, but an individual who brings to their nursing training a variety of life experiences. Academic mentoring seemed to create these opportunities for fostering students through their early and undeniably impressionable student days.

Responses from an initial questionnaire revealed what the students expected from the Academic Mentor and included;

Assistance with areas of my study which I may be finding difficult as well as being someone to talk to about other issues which may affect my academic performance.

I tend to keep to myself a lot so don't have anyone to throw around ideas with - say regarding assignments. An academic mentor may just give me the edge I need.

I think you can offer me someone to turn to about all the unknowns about the health industry which will make it easier or a little less scary as a student nurse.

Previously studied nursing in the UK and had a mentor there. Could not imagine anyone surviving without one.

When asked what they thought the mentor does, responses included the words;
Guiding, encouraging, genuine, motivate, feedback, listen, advice, honesty and support.
Excerpts taken from the student journals during the first 12 months included;
I was very excited to be chosen for the mentoring programme. I think it will help me with my studies and improve my learning.

I like the idea of going to speak to our Mentor on a one to one basis. It speaks volumes to me. It shows that someone is willing to get to know more about me and my journey as a nursing student.

I absolutely know that I have made the right decision to do nursing - I just need to arrange my time better. The staff at ECU are very committed to supporting the students to achieve their goals.

Everything is just so hard being a student nurse. I am having to be mum, partner and often counsellor to my fellow students. Sometimes I feel that there is just not enough of me to go around.

I have two assignments due and a debate to prepare. So much pressure. Pressure to keep up. Pressure to pass. Pressure to get assignment in. Pressure from work. Pressure from family. Don't want to fail anything.

I am pleased that I have found the motivation and courage to follow my dream to become a nurse.

Have just finished my first week of prac and feel tired. I loved being on the wards, being of service to patients. I feel that I contributed significantly to my patients, but also received a lot in return from them.

Comments from the academic mentors also demonstrate the mentor/mentee relationship as a positive experience;
For me, being a mentor is about giving something back. I came through a system where I was nurtured by some wonderful nurse educators who taught me about the value of people and what it really meant to be a nurse. I want to give my students that opportunity; to involve them in a process that creates a meaningful connection and takes us a place where they feel comfortable to ask the questions and share the experiences that sometimes can change the course of the careers.

I feel that being a mentor is a fundamental role of the lecturer. The lecturer has been a nurse and has experienced the highs and lows that go with the journey. The student needs to know that they are a person and not just a student number and that someone will listen when things are hard. For me, being a mentor means I can offer some clarity and direction when things look or feel blurred.

For me, being a mentor gives me the opportunity to make a difference to the support and education that our undergraduates receive. I think often there is a perceived barrier between academics and students and I would like to bring down these barriers and make academics more assessable to students. I was very thankful for to receive wonderful support and guidance during my nursing training, and I feel very fortunate to be in a position where I am able to o provide my students with the same opportunities.

The students and academics associated with the mentoring programme have reflected positively of their involvement with the programme and intent to continue. While there are undeniably challenges associated with the role of mentor, the benefits as reported in these early stages appear to far outweigh the difficulties.

Key points

Conclusion

Although well-explored across many disciplines and in a practice context, mentorship as it applies to academics mentoring nursing students has been all but neglected in the contemporary literature. This paper represents the experiences of a cohort of Student Nurses and three faculty mentors as they both travel and define the mentoring path as it applies to new nurses learning the profession through academic study. Academic mentoring has been demonstrated through this study to represent a valuable activity which is professionally rewarding for all parties.

References

Billay, D. B., & Yonge, O. (2004). Contributing to the theory development of preceptorship. Nurse Education Today, 24(7), 566-574.

Mills, J. E., Francis, K. L., & Bonner, A. (2005). Mentoring, clinical supervision and preceptoring: clarifying the conceptual definitions for Australian rural nurses. A review of the literature. The International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy, 5(410), 1-10. http://www.rrh.org.au/articles/subviewnew.asp?ArticleID=410

Morton-Cooper, A., & Palmer, A. (1993). Mentoring and preceptorship: A guide to support roles in clinical practice. London: Blackwell Scientific Publications.

Oliver, R., & Enderby, C. (1994). Teaching and Assessing Nurses: A Guide for Preceptors. London: Balliere Tindall.

Roberts, A. (1999). Homer's mentor: Duties fulfilled or misconstrued? Retrieved 21/11/2006, from http://www.nickols.us/homers_mentor.pdf

Rolfe, A. (2003). Core concepts of mentoring. Retrieved 07/05/2009, from http://mentoring-works.com/definitions_of_mentoring.html

Watson, N. A. (1999). Mentoring today - the students' views. An investigative case study of pre-registration nursing students' experiences and perceptions of mentoring in one theory/practice module of the common foundation programme on a project 2000 course. Journal of Advanced Nursing, 29(1), 254-262.

Please cite as: Vafeas, C.J., Lauva, M. & Beament, T. (2011). Cultivating care: Nurturing nurses for a new tomorrow. In Developing student skills for the next decade. Proceedings of the 20th Annual Teaching Learning Forum, 1-2 February 2011. Perth: Edith Cowan University. http://otl.curtin.edu.au/tlf/tlf2011/refereed/vafeas2.html

Copyright 2011 Caroline J Vafeas, Melanie Lauva and Tania Beament. The authors assign to the TL Forum and not for profit educational institutions a non-exclusive licence to reproduce this article for personal use or for institutional teaching and learning purposes, in any format, provided that the article is used and cited in accordance with the usual academic conventions.


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