Mentorship in Nursing - Essay Example

?Mentorship in Nursing Introduction Nurses play a variety of roles. These roles involve activities in both the clinical and the academic setting. Regardless of the roles these nurses play, playing the role of mentor is an important element and requirement which all nurses have to master in order to ensure the continuity of quality nursing care. Aside from being a mentor, nurses also function as assessors. As assessors, they assist and evaluate activities of nursing students in the field. This paper shall provide a reflection on my role as a mentor-assessor. It shall incorporate a critical analysis and evaluation of the assessment skill. One element shall be highlighted – infection control – in order to gain depth of analysis required at the academic level. Reflection on the infection control for these students will be evaluated in terms of policy, professional literature, and theoretical concepts that relate to my role as an assessor. I would also identify what I have learned as a result of this process and make the recommendations for my future practice as a mentor. Gibbs Reflection Description As an assessor I had the opportunity to observe other students and even myself in terms of how infection control measures were being undertaken and fulfilled. During my observation, I have discovered that many students were not complying with infection control measures. Some were not washing their hands before and after each nursing intervention, and some were not practicing aseptic techniques during the implementation of interventions. As such, the risk of transferring bacteria from one patient to another increased. At one point, I observed a student I was mentoring (student A) coming from a patient with pneumonia and as she was about to administer medication to another patient without washing her hands, I called her attention. At which point, she went to wash her hands. As an assessor, I noted the infection control techniques being carried out (or not being carried out) by the students, and the common errors in infection control practices. At some point, I had to call the student’s attention, reminding her of her hand washing as well as infection control strategies. After which, the student became more aware and vigilant of her actions. I also assessed some of the student’s hand washing techniques and found out that some of them did not practice hand washing correctly. I then called their attention on proper techniques in hand washing. Feelings I felt that in making my assessment of infection control practices that nurses need to be more aware of their actions, and I felt that with lesser experience as is often the case for students, infection control can be simply forgotten. I felt however that with a greater awareness and with continued practice and experience, it is possible for students to eventually hone their skills in infection control and to eventually make it an unconscious part of their clinical practice. I felt anxious about my mentee’s actions because I was concerned about her causing more harm than good to her patients, especially when she comes from a patient with a contagious disease. I felt that it would not be healthy and fair to the patient to experience hospital-acquired infection because of her incompetence, lack of vigilance and awareness, or because of her limited knowledge and skills. In calling the student’s attention on proper hand washing techniques, I felt nervous about correcting her and I also did not feel very confident in reminding her of the proper techniques in hand washing. However, I felt more confident in carrying out this responsibility when I was armed with the appropriate knowledge on infection control. At times, my mentee was not too receptive to the criticism and correction but she eventually understood the importance of the correction. I felt good about how the event turned out and how I was able to provide guidance to my mentee and I felt more confident as a future mentor after I carried out the task. Evaluation In assessing the incident, I found out that the transition for students into clinical practice can prove to be a challenge. Although, infection control practices have been grilled on students in the academe, actually applying these practices in the clinical setting is a different matter. I found out that as a mentor, it is important to assist students in making the transition from student to clinical nurse (Kneafsey, 2007). Moreover, playing the role of an assessor can help provide the necessary guidance to the students in order to allow them to make a smooth transition into practice – to help them retain their academic knowledge and theories as well as to pick up practical skills in the clinical setting (Hutchings, et.al., 2005). Assessors evaluate the learning attainment in relation to the stated practice competences, mostly in relation to the Code of Professional Practice as prescribed by the Nursing and Midwifery Council (Royal College of Nursing, 2009). There is strong support for assessing infection control practices of student nurses. By making this assessment, I was able to discover lapses in infection control practices and how my mentee in the clinical setting can sometimes forget some of the basic principles of the practice. Assessing student behaviour can reveal the failure of compliance with standards within the practice (Field, 2004). And assessment also allows early detection of these failures and gaps to eventually ensure effective early management. As I was able to assess my mentee early, I was able to ensure early reminders, and therefore prevented any risks from befalling the patient. Unfortunately, in playing the role as an assessor, I made the student nervous and anxious. In some instances, the more I observed the student in her activities, the more I made her nervous and the more she manifested errors in her actions and activities. Being consciously observed by another person for assessment purposes can make for an uncomfortable relationship between the student nurses and the mentor-assessors (Gillespie, 2005). Nevertheless, what’s good about the experience was that I had to make the necessary adjustments in my assessment process in order to be a less intrusive presence in the student’s daily nursing activities and instead be a welcome guide in her daily nursing practice. Analysis The assessment carried out by the assessor is part of the bigger collective in the overall mentor function of nurses. As an assessor however, the process itself must be valid and must include strategies recommended by the Nursing and Midwifery Code (RCN, 2009). A total assessment must include an assessment via direct care, simulation, and observed structured clinical examinations and similar strategies including observation, testimony of others, student self-assessment, active participation, guided study, interviews, interviews, patient comments, case studies, and mentorship (RCN, 2009). All mentors may assess specific competences and establish achievements, which may include those achieved based on various progression points (Marsh, 2004). The assessment would be based on achievements within the standard proficiencies according to certain activities within the field (Marsh, 2004). Specifically, these competencies include hand washing and infection control practices. These proficiencies demonstrate student’s fitness for practice and they help establish whether students have complied with the standards of proficiency for actual entry into practice (Nursing and Midwifery Council, 2008). The assessment practice is a necessary part of the developmental or formative assessment where the students would now gain deeper experiences (RCN, 2009). The continued assessment of the student within the placement is crucial because it helps ensure that the student is progressing based on her level of knowledge within the various stages of their training (NMC, 2008). The student’s performance has to be assessed by the assessor in order to ensure that the she is complying with the standards of care, and that she is safely administering the various interventions. The process of assessment can be an informal or a formal process (NMC, 2008). I was able to apply an informal assessment and I tried my best to be surreptitious in my assessment. As an assessor, I was also able to review the knowledge and understanding of my mentee, including her ability to apply theories learned in the actual practice (Stuart, 2007). I observed her professional attitude and behaviour, her ability to work with other nurses, her caring skills, and her general motivation. Making these observations during the assessment process ensured that the student’s own goals for each action plan were being fulfilled (Stuart, 2007) Mentors are an important part of education programmes because they help provide assistance, guidance, and direction to the students. They serve as easy access persons for the students who may find the actual clinical setting a different world from what they are used to (Skingley, 2007). They can easily answer questions from students and give them tips on how to make their jobs in the hospital easier. Moreover, specific hospital practices can also be gained in the hospital setting by these students (Skingley, 2007). Nurse mentor roles are crucial because they provide support for the student nurses in eventually gaining their nursing registration (Gobet, 2008). These mentors also seek to ensure that mentees can function effectively in practice, can accomplish and fill in the needs of registration, and that they have the depth and breadth towards gaining awarded a diploma or a higher degree (RCN, 2009). Mentors are also considered role models; they are knowledgeable and skilled. These mentors also help students in developing skills and confidence. These mentors are also obligated to establish a professional relationship with their students (RCN, 2009). They are also there to supervise, to assist in planning the different learning experiences, and finally to provide honest, as well as constructive feedback (RCN, 2009). Nurse-mentors also have a significant degree of accountability in facilitating students in the development of their competence (RCN, 2009). As work is delegated to students, these nurses must also ensure that the individual carrying out the work knows what to do, is being supervised, and is given adequate support (Stuart, 2007). In supervising and assessing these students, the mentor is accountable for ensuring compliance with the personal standards of practice, and the standards of care by learners (Stuart, 2007). These mentors are also accountable for what is taught, learned, and assessed by the student, and for the professional judgments in student performance (Stuart, 2007). It is mandatory for all students under educational programmes to have mentors as the mentors support the learning and perform the assessments in practice; moreover, they also make judgments on how the students would fit into the practice (RCN, 2009). These mentors are responsible to the NMC for their judgments on student capability; and they are also responsible for informing the staff about any major concerns on the performances of the students, as well as the progress that the students are making in the field (NMC, 2008). In order to enhance learning and assessment in practice, the mentor must update his knowledge with the latest developments in teaching, learning, and assessment of students (Smith, 2010). In order to ensure these developments, the mentor must attend mentor conferences in order to gain new updates and new developments in mentoring. Local updates can also be attended in order to provide the appropriate competences and developments in the practice (Smith, 2010). Mentors have to have a valid and fully supported position as mentors, therefore, they need be equipped with the proper information as well as the skills in guiding the students towards the correct standards in the practice (Ali and Panther, 2008). Evidence suggests that the more experienced mentors are those who are able to guide students better and are able to anticipate the student’s actions, and more importantly, they are able to build a good and strong rapport with students (Gillespie, 2010). Strong rapport with students also helps ensure that the students would not hesitate to approach their mentors for any problems and for any clarifications and questions (Gillespie, 2010) The effective relationship with learners and other health professionals can be improved through frequent interactions and communication. Communication is a significant key in any mentor-mentee relationship (Lindgren, et.al., 2005). Where the channels of communication are open, the mentee can easily learn from the mentor, and the mentor can easily guide the mentee towards the acceptable standards of practice (Latham, 2008). Communication was applied well in this interaction with the mentee as I was able to interact and communicate well with the mentee. I made myself available and approachable for questions, clarifications, and assistance. I also made sure that my gestures were welcoming and accommodating (Cassidy, 2009). My mentee claimed that they found it difficult to communicate with mentors and other staff nurses who had an unapproachable air, and rather than risk being reprimanded in the practice, they often preferred not to say anything or seek clarifications for their interventions. The problem in these instances is that by closing the doors or communication, medical errors can sometimes occur (Latham, 2008). It was difficult at times to demonstrate confidence and competence in giving feedback to my mentee. I had to establish an authoritative yet still very supportive attitude in order to be effective in my role as mentor (Duffy and Hardicre, 2007). Confidence in giving feedback must always come from logical and well supported observations and assessments. It cannot come from unfounded assessments of the mentee behaviour. With each assessment and feedback I gave to the mentee, I also explained why such feedback was being given (O’Connor, 2007). As the mentee understood each feedback, she was also able to adapt her attitudes, her interventions, and skills. Confidence in delivering the feedback also involved the process of being firm in delivering the assessment (O’Connor, 2007). As soon as each feedback was given, suggestions for improvement were also immediately given. These suggestions were discussed in detail with the mentee, capitalizing on the rationale for each recommendations and self improvement. Under this set-up, I was able to exhibit leadership skills (O’Connor, 2007). I had to make the decisions based on my assessment, and to relay my decisions to the mentee in a specific, effective, and supportive manner. At times, I also had to lead by example, by applying the same principles I was teaching my mentee. Conclusion The role of mentor-assessor is one which is filled with various competencies. Nurses playing this role must be equipped with knowledge and skills, not just in the nursing practice, but also with teaching, guiding, supportive, as well as observations skills. In assessing my mentee, I noted issues in complying with infection control practices. Considering that infection control is a major part of effective health care delivery, it was imperative for me to immediately call her attention and to ask her to make the necessary adjustments in her actions and interventions in order to prevent transmitting any infection to the other patients. In carrying out my functions, I noted that it can be difficult to play this role because it can go wrong in different ways, especially with improper and inadequate communication between the parties. I believe that I was able to adequately comply with my role as a mentor-assessor. I believe however that I could have done things differently in terms of establishing a more authoritative demeanour as a leader. At times, I did not have much confidence, especially in delivering constructive criticism, and this is something I need to work on in the future. Action Plans In encountering this incident in the future, I would not change much in the actions I applied as a mentor-assessor. I would be communicative with my mentees, I would observe them properly in the clinical setting and make sure that they do not commit any errors and that they comply with the standards of the clinical practice. In order to further improve my mentorship, I would also conduct demonstrations for various interventions which are not being properly carried out. As I observed that my mentee did not practice hand washing or did not adequately practice hand washing, I would conduct demonstrations with my mentee in order to remind her of these important skills and nursing practices. Conclusion Being a mentor-assessor is a very demanding activity and role because it calls on almost all skills and nurse competencies. It requires knowledge, skills, leadership abilities, communication abilities, vigilance, and observation skills. These elements are needed in order to ensure that mentees are properly observed in their activities in the clinical setting, and are then properly guided by their mentors. There is also an enormous amount of responsibility and accountability attached to mentorship. Such a responsibility must be adequately carried out by the mentor in order to improve mentee outcomes, and ensure the effective transition of these students into the clinical setting. References Ali P. and Panther, W., 2008. Professional development and the role of mentorship. Nursing Standard, 22(42), 35-39. Cassidy, S., 2009. Subjectivity and the valid assessment of pre-registration student nurse clinical learning outcomes: Implications for mentors. Nurse Education Today, 29, pp. 33–39 Duffy, K. and Hardicre, J., 2007. Supporting failing students in practice 1: assessment. Nursing Times, 103(47), 28–29. Field, D., 2004. Moving from novice to expert – the value of learning in clinical practice. A literature review. Nurse Education Today, 24, 250–265. Gillespie, T.M., 2005. Student–teacher connection: a place of possibility. Journal of Advanced Nursing 52 (2), 211–219. Gobet, M.F., P.Cassy, 2008. Towards an alternative to Benner’s theory of expert intuition in nursing: a discussion paper. International Journal of Nursing Studies 45, 129–139. Hutchings, A., Williamson, G.R., Humphries, A., 2005. Supporting learners in practice: capacity issues. Journal of Clinical Nursing 14, 945–955. Kneafsey, R., 2007. Developing skills in safe patient handling: mentors’ views about their role in supporting student nurses. Nurse Education in Practice 7, 365–372. Latham, C., Hogan, M., and Ringl, K., 2008. Nurses supporting nurses: creating a mentoring program for staff nurses to improve the workforce environment. Nursing Administration Quarterly, 32(1), 27-39 Lindgren, B., Brulin, C., Holmlund, K., Athlin, E., 2005. Nursing students’ perception of group supervision during clinical training. Journal of Clinical Nursing 14, 822–829. Marsh, S., 2004. Assessment of students in health and social care: managing failing students in practice. Practice-based Learning [online] Available at: http://www.science.ulster.ac.uk/nursing/mentorship/docs/learning/Failing_students_final_version_22%20Nov.pdf [Accessed 21 May 2012]. Nursing and Midwifery Council, 2008. Standards to support learning and assessment in practice [online] Available at: http://www.nmc-uk.org/Documents/Standards/nmcStandardsToSupportLearningAndAssessmentInPractice.pdf [Accessed 21 May 2012]. O’Connor, S.J., 2007. Developing professional habitus: a Bernsteinian analysis of the modern nurse apprenticeship. Nurse Education Today 27, 748–754. Royal College of Nursing, 2009. Guidance for mentors of nursing students and midwives: An RCN toolkit [online] Available at: http://www.rcn.org.uk/__data/assets/pdf_file/0008/78677/002797.pdf [Accessed 21 May 2012]. Smith, B., 2010. Information for mentors of nursing students: a toolkit for mentors. Facilitators of Coventry and Warwickshire [online] Available at: wwwm.coventry.ac.uk/HealthcareMentors/.../... [Accessed 21 May 2012]. Skingley, A., 2007. Supporting practice teachers to identify failing students. British Journal of Community Nursing, 12(1), 28–32. Stuart, C., 2007. Assessment, supervision and support in clinical practice: a guide for nurses, midwives and other health professionals. London: Churchill Livingstone. Read More