This course reviews relevant terminology and explores the current research on best practices related to mentorship in nursing. It also reviews the benefits, barriers, and current evidence-based best practices for mentoring nurses.
...purchase below to continue the course
entorship in nursing and medical education, a discussion of some of the traditional teaching-learning methods used is pertinent. The concept of “see one, do one, teach one” has been used for decades in medical and nursing education to teach psychomotor skills. The
McGraw-Hill Concise Dictionary of Modern Medicine (2012) defines “see one, do one, teach one” as "a traditional format for acquiring medical skills, based on a three-step process: visualize, perform, regurgitate" (para. 1). The “see one, do one, teach one” method aligns with the internship, residency, or apprenticeship model commonly used in health care education; however, a more comprehensive, long-term approach to career development for health care professionals is needed in today's fast-paced and ever-changing health care environment (Evans et al., 2020).
Patricia Benner's 1984 nursing theory, Stages of Clinical Competence, describes five stages of how mentorship can help nurses progress through the different clinical competence levels. Mentorship supports nurses as they move through the stages of Benner's theory. The stages of Benner's theory are novice, advanced beginner, competent, proficient, and expert. Benner defines each stage as:
- The novice is a beginner with little to no previous experience. Their behavior is inflexible and governed by rules. They understand general rules for performing assigned tasks and following instructions. A novice nurse with previous experience working in another nursing role will transition to the next stage quicker than a new graduate nurse with no experience.
- Advanced beginners have prior experience in real-life nursing situations from which they can draw. They show acceptable performance but may require cues or support to perform a task or skill.
- Competent nurses have at least 2 to 3 years of experience in their current role. As a result, these individuals have more perspective, efficiency, and organization. They are also more aware of long-term goals and the steps needed to achieve them. Competent nurses are able to develop a plan based on current and anticipated outcomes, and are able to accomplish tasks without cues.
- Proficient nurses can understand the larger picture and how interventions affect outcomes. They have learned from their experiences and know what to expect from situations. They are also adaptable and able to modify plans when needed. Proficient nurses should be encouraged to participate in a mentorship program as a mentor. In order to move from competent to proficient, the nurse must have a holistic understanding of nursing, improve the speed of decision-making, and demonstrate mental flexibility.
- Expert nurses no longer need to rely on rules or guidelines to determine which action to take in a particular situation. They are flexible and highly proficient in their role. Due to their extensive background and experience, they have a firm grasp of clinical situations. Expert nurses should be encouraged to participate in a mentorship program as a mentor(Mitchell et al., 2018; Nursing Theory, n.d.).
Mentorship Skills
For experienced nurses to be successful as mentors, there are mentorship skills that they must have to provide novice nurses with the support that they need. Nurse mentors must have extensive and comprehensive knowledge of nursing practice. This knowledge and experience are required to guide and educate the mentee. Mentees should choose a mentor with relevant knowledge and expertise in their chosen nursing practice environment. For example, a medical-surgical nurse would not necessarily make a good mentor for a new emergency room nurse. Nurse mentors must also have excellent communication skills. Communication must be direct, open, and honest to have a productive and successful mentor-mentee relationship. Both parties should feel comfortable communicating with each other about expectations and areas of improvement. Mentors must also have strong problem-solving and decision-making abilities. In addition, mentors are experienced nurses and, therefore, should have the ability to quickly problem-solve and implement decision-making techniques during time-sensitive patient-related events. These skills can be used in the mentorship relationship when developing training approaches to help the mentee understand the real-world demands on nurses. An effective nurse mentor should have patience and empathy. Due to the vulnerability that accompanies starting a new nursing role, mentors should be patient with their mentees as they develop the skills and knowledge needed to succeed in their new role. It is also helpful when a mentor can remember how they felt as a novice nurse to better understand their mentee's needs and feelings (ANA, 2023; Bell, 2024; Gupta et al., 2022; Patel et al., 2022).
Mentoring
Currently, there is a shortage of bedside nurses and nurse faculty in the United States. It is estimated that hospitals cannot fill 9.9% of their vacant nursing positions. As the nursing workforce ages, the U.S. Bureau of Labor Statistics predicts that by 2032, there will be over 193,100 open nursing positions. The shortage of nursing faculty compounds this shortage of nurses. The lack of qualified nursing faculty has negatively impacted the number of new nurses who are graduating and entering practice each year. According to the American Association of Colleges of Nursing (AACN), the national faculty vacancy rate was 7.8% in 2023. This contributed to over 65,766 qualified applicants being rejected from enrollment in nursing school due to the insufficient number of faculty and clinical instructors (AACN, 2024a, 2024b; Nursing Solutions, Inc., 2024).
Academia
Mentorship can occur in academic and clinical settings. Mentoring in academia is twofold. First, it is essential to mentor new nurse faculty as they transition to a very distinct area of nursing outside of direct patient care. This type of mentoring is critical to retaining new nurse faculty. The National League for Nursing highlights the importance of mentoring relationships among faculty and notes that mentorship is an indicator of excellence in nursing education. It is also important that faculty members prioritize the mentorship of students within the nursing department (Ephraim, 2021; Evans et al., 2020; Ross & Dunker, 2019).
Transitioning from being a proficient or expert clinician to a novice nurse educator can be stressful and overwhelming as the responsibilities for each role are very different. Nurse faculty and clinical instructors with graduate nursing degrees are often not trained on how to fulfill the role of nurse educator. Unfortunately, the orientation process for these roles is lacking or nonexistent at many institutions. Mentoring new faculty members in higher education has evolved over the last decade to become an integral part of the transition from practice to academia. Implementing a faculty-to-faculty mentorship program can support faculty members while they conduct research, advance professional development, maintain or improve their clinical skills, and improve teaching techniques. Strong mentorship programs may alleviate the nurse faculty shortage in colleges and universities (Ephraim, 2021; Evans et al., 2020; Ross & Dunker, 2019).
Transitioning from clinical practice to academia is difficult for many nurses, leading to high turnover rates for faculty. A mentorship program's training, guidance, and support may prevent promising new nurse faculty members from prematurely leaving academia. In addition to increased retention, other desired outcomes from a mentorship program include increased faculty research, engagement in scholarship activities, increased rank and tenure, and increased intradepartmental socialization and collaboration. Some institutions provide faculty mentors with development tools, such as workshops, to prepare them for their role as mentors. In the academic setting, administrative support for the mentorship program and faculty involvement are paramount to the program's success and longevity. This support is needed to offset the cost (money, time, and energy) of implementing and maintaining a mentorship program. These costs are associated with faculty training, implementing and monitoring the program, and measuring positive outcomes. The savings to the institution in recruiting and training new faculty members and the possible increase in grant funding when faculty support allows for more research and other scholarly activities should offset the cost of the mentorship program (Busby et al., 2022; Calaguas, 2023; Ephraim, 2021).
Nursing faculty are responsible for preparing nursing students to enter a health care setting that is ever-changing and increasingly complex. Through faculty-led mentorship programs, students are paired with faculty mentors. This allows students to experience educational opportunities and growth outside the classroom setting. Being involved in a mentoring relationship can increase students' self-esteem, confidence, comfort in their role, and skill competence. Some institutions have implemented group mentorship programs. These programs pair senior nursing students with nurses currently practicing in a health care setting to facilitate the transition from nursing student to practicing nurse. The nurse mentors are often alumni of the nursing program or nurses working for an affiliated health care organization. Research has found that nursing students often have an incomplete and unrealistic understanding of the daily work required of nurses in the clinical setting. This lack of awareness, the need to adapt to shift work (often night shift for new nurse graduates), heavy workloads, and a lack of professional development skills cause increased stress in new nurses. Having an experienced nurse fulfill the role of nurse mentor before graduation can prepare the nursing student for the realities of working in the clinical setting, provide needed support, and help new nurses navigate the nuances of their role within an organization (Donnelly, 2024; Evans et al., 2020; Gularte-Rinaldo et al., 2022).
Another form of mentorship in academia, peer mentoring, includes mentoring new nursing students entering the program by higher-level nursing students. This type of mentorship is effective in both undergraduate and graduate nursing programs. Due to the rigors of nursing school, nursing students often experience higher levels of stress and anxiety than their peers in other degree programs. Studies have shown that this increase in stress and anxiety is highest at the beginning of the nursing program and during the first clinical experience, which can manifest as psychological and physical ailments. A peer mentor who has already completed and passed a certain level of schooling can offer novice students support, guidance, and knowledge. Mentorship has been shown to decrease stress and anxiety in novice nursing students. Other benefits of peer mentoring include increased student retention, engagement, and skill competence (Kachaturoff et al., 2020).
Clinical Practice
New nurses have reported feeling overwhelmed and undersupported when transitioning to a new nursing role. These feelings are exacerbated in areas of high stress, such as the intensive care unit (ICU), intermediate care unit, progressive care unit, emergency room (ER), or operating room (OR). This transitional period and the accompanying stress have been termed reality shock or transition shock. Reality shock is commonly experienced by nurses transitioning from student to practicing nurse, changing roles or departments, or re-entering the clinical setting after holding a nonclinical nursing position or having taken a hiatus from health care. Reality shock usually occurs within the first 2 years of a transition period. It can diminish the ability of nurses to effectively care for their patients, leading to a higher incidence of missed nursing care. Strategies such as mentorship can help to facilitate a smooth transition for these nurses to ultimately prevent poor clinical care and patient outcomes (Ko & Kim, 2022; Labrague, 2024).
Barriers to mentorship in the clinical practice setting include increased workloads, decreased job satisfaction, incivility, and unprofessionalism, resulting in increased turnover rates. Due to increased turnover rates, fewer suitable mentors are available, hindering mentorship opportunities. However, there are numerous benefits to employing a nurse mentorship program in the clinical practice setting. Studies have shown that novice nurses who participate in a mentorship program experience decreased stress levels and increased job satisfaction in the hospital setting. Institutions that have mentorship programs in place report reduced turnover rates of new nurses by 2% to 15%. Improved retention decreases the institutional costs of recruitment, onboarding, and orientation, which are estimated to be $80,000 per nurse. The benefits of increased retention rates include increased department stability, teamwork, and increased patient satisfaction. Mentoring also has benefits for the mentor. Being involved in a mentorship program as an experienced nurse improves leadership skills, builds professional relationships, enhances problem-solving and decision-making skills, and increases job satisfaction. Due to the positive impact mentorship has on nursing departments in the clinical setting, the Magnet Recognition Program supports and encourages mentorship in all areas of nursing (Dirks, 2021; Gill-Bonanco, 2024; Horner, 2020; Olaolorunpo, 2019).
As the population ages, many nurses are leaving the profession for retirement. Unfortunately, this is occurring while the growing older adult population needs more nursing care. A strong mentorship program can retain nurses, especially those who work in specialty or high-risk departments. Working in a critical care environment requires a solid knowledge base and the ability to act on informed clinical decisions quickly. Individuals able to function successfully in these environments are a precious commodity in health care. The need to retain specialty-trained nursing staff with the knowledge and skill to work in critical care was demonstrated during the COVID-19 pandemic (Dirks, 2021).
Finding a Mentor
For some nurses, it can be challenging to navigate the process of finding the right mentor. Nurses can take the following steps to ensure that they find the right mentor:
- A new or transitioning nurse should identify their needs. Nurses should reflect on their career goals and what kind of mentors they would like to support them and help them achieve their goals.
- The nurse should do their research and think about their ideal mentor's traits or career achievements, and who would fit their criteria for a mentor.
- The nurse should talk to their preceptor to determine if they would be a good fit as a mentor and if that is a role that they are comfortable taking on. If not, they can be a good resource for finding a mentor within the department or institution.
- Observing nurses while at work can be instructive. Whether a new nurse on the unit or a student nurse, it can be helpful to observe other nurses to determine who has a similar approach to nursing. It can also be valuable to identify which nurses effectively deal with stress and who is an instrumental part of the health care team.
- Institution-based mentorship programs may not be highly publicized; therefore, new employees may not be aware of their existence. It is advantageous to determine what resources are available to ensure future success in the workplace. If the institution has a mentoring program already established, it is beneficial to join and choose a mentor involved with the program.
- If an institution does not have an established mentoring program available, there are virtual options through different nursing organizations. Alternatively, leadership may be able to suggest which employees would make good mentors. These additional resources are discussed below (Maryville University, 2023; Miller, 2020).
Additional Resources
There are many professional resources available related to mentorship. These resources offer support and education to make the relationship successful, implement a mentorship program within the workplace, and connect with a mentor or mentee.
- Sigma Theta Tau offers an online mentoring program for members, resources on hot topics in mentorship, and instructions to initiate a mentoring program (Sigma Global Nursing Excellence, n.d.).
- The National League for Nursing (2022) has articles, guides, webinars, and continuing education courses related to mentoring in the academic setting.
- The ANA (n.d.) has online continuing education courses and articles about implementing mentorship programs.
- The AACN (2017) has a tool kit for implementing a mentoring program in an academic setting.
- The National Mentoring Resource Center (n.d.) provides handbooks, manuals, and curricula for mentors to develop their skills or implement a mentoring program at their institution.
- Campaign for Action (n.d.), funded by the American Association of Retired Persons (AARP), has videos, articles, and educational activities on its website that address mentorship in health care.
Although this is not an inclusive list, it provides a good starting point for understanding mentorship and how nurses can incorporate the process into their practice.
References
American Association of Colleges of Nursing. (2017). Mentorship: A student success strategy mentoring program toolkit. https://campaignforaction.org/wp-content/uploads/2020/04/Mentoring-Toolkit-2017.pdf
American Association of Colleges of Nursing. (2024a). Nursing faculty shortage fact sheet. https://www.aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage
American Association of Colleges of Nursing. (2024b). Nursing shortage fact sheet. https://www.aacnnursing.org/news-data/fact-sheets/nursing-shortage
American Nurses Association. (n.d.). Welcome to ANA’s mentoring program. Retrieved February 25, 2025, from https://community.ana.org/pages/mentorprogram?ssopc=1
American Nurses Association. (2023). Benefits of mentorship in nursing: Why it’s essential. https://www.nursingworld.org/content-hub/resources/nursing-resources/benefits-of-mentorship-in-nursing
American Nurses Association Massachusetts. (n.d.). Mentoring definitions. Retrieved February 22, 2025, from https://www.anamass.org/page/61
Angelilli, S. (2024). The four primary roles of the preceptor. Association of periOperative Registered Nurses. https://www.aorn.org/article/the-four-primary-roles-of-the-preceptor
Bell, F. (2024). The importance of mentoring and coaching in nursing. https://www.myamericannurse.com/the-importance-of-mentoring-and-coaching-in-nursing
Busby, K. R., Draucker, C. B., & Reising, D. L. (2022). Exploring mentoring and nurse faculty: An integrative review. Journal of Professional Nursing, 38, 26-39. https://doi.org/10.1016/j.profnurs.2021.11.006
Calaguas, N. P. (2023). Mentoring novice nurse educators: Goals, principles, models, and key practices. Journal of Professional Nursing, 44, 8-11. https://doi.org/10.1016/j.profnurs.2022.11.002
Campaign for Action. (n.d.). Mentoring for success, diversity, and health equity. American Association of Retired Persons. Retrieved February 23, 2025, from https://campaignforaction.org/mentor-training
Dale-Tam, J., & Thompson, K. (2021). Nursing orientation during the COVID-19 pandemic. Journal for Nurses in Professional Development, 37(4), 216-219. https://doi.org/10.1097/NND.0000000000000754
Dirks, J. L. (2021). Alternative approaches to mentoring. Critical Care Nurse, 41(1), e9-e16. https://doi.org/10.4037/ccn2021789
Donnelly, L. (2024). Group mentoring: A viable alternative. American Association of Critical Care Nurses. https://www.aacn.org/blog/group-mentoring-a-viable-alternative
Ephraim, N. (2021). Mentoring in nursing education: An essential element in the retention of new nurse faculty. Journal of Professional Nursing, 37(2), 306-319. https://doi.org/10.1016/j.profnurs.2020.12.001
Ernawaty, E., Hariati, S., & Saleh, A. (2024). Program components, impact, and duration of implementing a new nurse orientation program in hospital contexts: A scoping review. International Journal of Nursing Studies Advances, 7, 100214. https://doi.org/10.1016/j.ijnsa.2024.100214
Evans, M. M., Kowalchik, K., Riley, K., & Adams, L. (2020). Developing nurses through mentoring: It starts in nursing education. Nursing Clinics of North America, 55(1), 61-69. https://doi.org/10.1016/j.cnur.2019.10.006
Gill-Bonanca, K. (2024). Mentorship: A strategy for nursing retention. American Nurse Journal, 19(8). https://doi.org/10.51256/ANJ082406
Gularte-Rinaldo, J., Baumgardner, R., Tilton, T., & Brailoff, V. (2022). Mentorship ReSPeCT study: A nurse mentorship program’s impact on transition to practice and decision to remain in nursing for newly graduated nurses. Nurse Leader, 21(2), 262-267. https://doi.org/10.1016/j.mnl.2022.07.003
Gupta, Y., Patel, K., & Patel, A. (2022). Key communication skills for mentees. Journal of the American College of Radiology, 19(7), 901-902. https://doi.org/10.1016/j.jacr.2022.03.002
Horner, D. K. (2020). Mentoring: Positively influencing job satisfaction and retention of new hire nurse practitioners. Plastic and Aesthetic Nursing, 40(3), 150-165. https://doi.org/10.1097/PSN.0000000000000333
Jakubik, L. D., Weese. M. M., Eliades, A. B., & Huth. J. J. (2017). Mentoring in the career continuum of a nurse: Clarifying purpose and timing. Pediatric Nursing, 43(3), 149-152. https://doi.org/10.1016/j.nepr.2017.09.014
The Joint Commission. (2022). Competency assessment vs. orientation. https://www.jointcommission.org/standards/standard-faqs/nursing-care-center/human-resources-hr/000002152
Kachaturoff, M., Caboral-Stevens, M., Gee, M., & Lan, V. M. (2020). Effects of peer-mentoring on stress and anxiety levels of undergraduate nursing students: An integrative review. Journal of Professional Nursing, 36, 223-228. https://doi.org/10.1016/j.profnurs.2019.12.007
Ko, Y-J., & Kim, S-Y. (2022). Transition shock experience of nursing students in clinical practice: A phenomenological approach. Healthcare (Basel), 10(4), 613. https://doi.org/10.3390/healthcare10040613
Labrague, L. J. (2024). Reality shock in newly graduated critical care nurses and its association with missed nursing care: The mediating role of caring ability. Intensive and Critical Care Nursing, 80, 103554. https://doi.org/10.1016/j.iccn.2023.103554
Maryville University. (2023). How to find a mentor in nursing. Retrieved February 23, 2025, from https://online.maryville.edu/blog/mentorship-in-nursing
McGraw-Hill Concise Dictionary of Modern Medicine. (2012). See one, do one, teach one. https://medical-dictionary.thefreedictionary.com/see+one%2c+do+one%2c+teach+one
Miller, R. (2020). How to find the right nurse mentor. https://www.aspen.edu/altitude/how-to-find-nurse-mentor
Miller, C. M., Meyer, K., Riemann, L. A., Carter, B. T., & Brant, J. M. (2023). Transition into practice: Outcomes of a nurse residency program. The Journal of Continuing Education in Nursing, 54(1), 32-39. https://doi.org/10.3928/00220124-20221207-08
Mitchell, A., Lucas, C., Cisar, P., Wilson, K., & Bowe, J. (2018). Mentoring novice nurses in healthcare organizations. International Journal of Medical Science and Health Research. 2(1). 91-96. https://ijmshr.com/uploads/pdf/archivepdf/2020/IJMSHR_02_24.pdf
Moreno, I. M., Gonzalez de la Cuesta, D., Narvio, M. J. B., Esteban, M. A., & Cantalejo, M. G. (2023). Nurse mentoring: A scoping review. Healthcare (Basel), 11(16), 2302. https://doi.org/10.3390/healthcare11162302
National League for Nursing. (2022). Mentoring. https://www.nln.org/search-results?keywords=mentoring
National Mentoring Resource Center. (n.d.). Resources for mentoring programs. Retrieved February 23, 2025, from https://nationalmentoringresourcecenter.org
Nursing Solutions, Inc. (2024). 2024 NSI national health care retention & RN staffing report. https://www.nsinursingsolutions.com/documents/library/nsi_national_health_care_retention_report.pdf
Nursing Theory. (n.d.). Dr. Patricia Benner novice to expert: Nursing theorist. Retrieved February 22, 2025, from https://nursing-theory.org/nursing-theorists/Patricia-Benner
Olaolorunpo, O. (2019). Mentoring in nursing: A concept analysis. International Journal of Caring Sciences, 12(1), 142–148. http://www.internationaljournalofcaringsciences.org/docs/16_olorufremi_12_1.pdf
Patel, K., Gupta, Y., & Patel, A. (2022). Key communication skills for mentors. Journal of the American College of Radiology, 19(7), 903-904. https://doi.org/10.1016/j.jacr.2022.03.001
Ross, J. G., & Dunker, K. S. (2019). New clinical nurse faculty orientation: A review of the literature. Nursing Education Perspectives, 40(4), 210-215. https://doi.org/10.1097/01.nep.0000000000000470
Sigma Global Nursing Excellence. (n.d.). Mentoring cohort. Retrieved February 23, 2025, from https://www.sigmanursing.org/advance-elevate/careers/sigma-mentoring-cohort
WordSense Online Dictionary. (n.d.) Orientee. Retrieved February 22, 2025, from https://www.wordsense.eu/orientee
Zaremba, R. (2024). What is a nurse residency program? NurseJournal. https://nursejournal.org/resources/nursing-residency-programs