Team concepts
Breaking traditions with reciprocal mentoring By Gina Stephenson, RN
A
forecasted nursing shortage in combination with an aging workforce, a staff composed of different generational values, and the recent implementation of healthcare reform make maintaining a healthy work environment challenging for even the most experienced nurse leader. A study done by the American Association of Critical-Care Nurses (AACN) in 2005 showed a strong correlation between healthy work environments, patient safety, staff recruitment, retention, and an organization’s financial stability.1 However, there have never been four different generational cohorts—each with their own experiences, values, and beliefs—in the workforce at the same time.2 This presents nurse leaders with many new issues and challenges while trying to create a conflict-free, cohesive work environment. Nursing plays a critical role in healthcare delivery. Because of this, organizations are looking to nurse leaders to help sustain a healthy work environment where younger cohorts want to be hired and older cohorts want to remain employed. An area that has worked in the business world to encourage team building and bridge the generational gaps is reciprocal mentoring. Through relationship building and bilateral transfer of knowledge, reciprocal mentoring enhances team-building efforts, contributes to a healthy work environment, and, ultimately, provides safe, quality, efficient patientcentered care. Changing the game Generational cohorts typically span 15 to 20 years and include groups of people who share birth years, history, and a collective personality. Their values, work ethics, attitudes toward authority, 10 June 2014 • Nursing Management
and professional aspirations are shaped by the historical, political, and social events of their time.2 There are four distinct generational cohorts in the workforce today: traditionalists, baby boomers, generation X, and millennials. In 1996, the Institute of Medicine (IOM) published its Crossing the Quality Chasm report, which stated that safety and quality issues exist in part because working environments and employment conditions aren’t conducive to providing quality care. In response to the IOM’s report, the AACN conducted a national study on healthcare environments and employment conditions. The study revealed inextricable links between the quality of the work environment, nursing practice, and patient care outcomes.1 It discovered that unhealthy work environments contributed to medical errors, inefficient care, conflict, and stress among healthcare professionals.1 As a result of its study, the AACN identified six standards for a healthy work environment. The standards are evidence-based and support the development of interdisciplinary and intradisciplinary relationships.1 Skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership are the six standards essential to the development of a healthy work environment. Applying these standards and their corresponding elements in an organization creates an environment that empowers nurses from all four generational cohorts. Evolving from the start Empowered nurses are more likely to participate in cross-generational dialog. This form of communication and collaboration is essential to sustaining an environment where everyone feels valued for their contributions. With a rapidly changing healthcare environment and the continuous implementation of new technologies, cross-generational relationships can be further fostered through reciprocal mentoring. www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Team concepts There are three styles of mentoring: traditional, reverse, and reciprocal. Each centers on a relationship between a mentor and mentee, but differs in whether the transfer of knowledge is unilateral or bilateral. Traditional mentoring is a oneway relationship between an individual, typically older, with more experience and knowledge, who assists with the career development and psychosocial support of a younger, less-experienced colleague.3 Nursing utilizes traditional mentoring through clinical ladder programs, which focus predominantly on individual advancement within the organization.4 A typical pairing is a seasoned, older nurse in a leadership position with a younger, inexperienced nurse. However, this promotes a unilateral relationship where knowledge is transferred from mentor to mentee and misses the opportunity to capitalize on the different experiences, skills, and knowledge brought to the profession by the mentee. Traditional mentoring addresses the needs of one individual to be successful rather than promote the organization as a whole. This methodology is no longer effective in sustaining a healthy work environment. The younger generational cohorts often differ significantly in their view of job loyalty and satisfaction from their older cohorts. They want a forum for their ideas and opinions to be heard and if they don’t get that opportunity, they typically move on. Therefore, developing and retaining younger nurses is a serious issue currently facing the nursing profession. Utilizing a different approach to mentoring may help alleviate this dilemma and, in the process, create healthier work environments for all four generational cohorts. www.nursingmanagement.com
Benefitting from change The business world has recognized the technologic skills of the younger generation who utilize them to their advantage. In 1999, the former CEO of General Electric (GE), Jack Welch, emphasized GE’s need to keep up with technologic advancements and made a conscious effort to hire younger, technologically-savvy employees. This helped GE as an organization to better understand the latest technologies and gain insight into the younger generation
knowledge and experiences known as reciprocal mentoring.3 Reciprocal mentoring takes the process one step further than traditional and reverse mentoring and transforms mentoring into a two-way, or team building, relationship where information and experiences are exchanged on a regular basis between the participants.5 Literature suggests that mentoring may have potentially mutual positive effects for both participants and, in terms of learning, these
Reciprocal mentoring transforms mentoring into a two-way relationship where information and experiences are exchanged on a regular basis between the participants. and culture.3 The process became known as reverse mentoring. Other organizations paired senior management with technologicallyproficient junior colleagues through reverse mentoring models for the purpose of introducing social media to the older generational cohorts.3 Some companies took it a step further and recruited younger employees for the facilitation of knowledge transfer to keep senior employees up-to-date on technology, business, and social trends.3 Although a new approach to mentoring, it remained a unilateral transfer of knowledge between the mentor and mentee where only one participant predominantly benefits. Recognizing the success of these generational relationships, companies expanded this concept and began pairing seasoned, older employees with younger, inexperienced, tech-savvy employees to promote a bilateral transfer of
individuals are colearners.3 This two-way learning and teaching relationship empowers both participants and gives each a sense of value and worth within an organization. Creating an environment with multigenerational groupings can result in the development of unexpected and innovative ideas, providing organizations that utilize reciprocal mentoring with a competitive edge.3 Most important is that by incorporating the six standards and their corresponding elements, a healthy work environment is created. Give-and-take management Having four different cohorts in the workforce can be challenging for nurse leaders, but the diversity and richness may also add strength and cohesiveness to the healthcare team.2 The fusing of these generations brings a blend of clinical experiences, but also fosters conflict.2 To prevent unhealthy Nursing Management • June 2014 11
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Team concepts work environments, leaders should utilize the expertise of older nurses to assist the younger nurses with the transition from novice to expert. Nurse leaders need to acquire an understanding of the individual cohorts and vary their leadership approaches accordingly to promote healthy work environments. Nursing knowledge and practice can be enhanced by changing staff members’ focus from being different to having a common patient-centered purpose.6 According to Benner’s Novice to Expert theory, nurses develop skills and an understanding of patient care over time via a sound educational base, as well as a multitude of experiences.7 Benner describes nurses as passing through five different steps: novice, advanced beginner, competent, proficient, and expert.7 Organizations must utilize the expert level of nursing through mentoring to strengthen the new generation of nurses. Absent from literature is the difference between hands-on patient care provided by each generation and the impact it has on quality. Generational work ethics and social skills vary considerably. Pairing an expert nurse with a less-experienced nurse provides opportunities for role modeling patient care beyond the clinical skills. The Robert Wood John Foundation defines mentoring as “providing advice and guidance on a job path by a trusted counselor, advisor or teacher who does not seek personal gain.” It promotes mentoring using five core competencies: selfknowledge, strategic vision, risk taking, interpersonal and communication effectiveness, and inspiration. Typically, in nursing, mentoring occurs when an expert nurse helps a novice or less-experienced nurse adjust to a new environment and responsibilities, or to gain leadership 12 June 2014 • Nursing Management
skills. However, the current hierarchal approach to mentoring requires more thought and strategy from nurse leaders dealing with multigenerational staff to maximize the experience for both participants. The focus of mentoring should turn from the traditional goal of providing career advice and leadership advancement to a broader focus involving strategic planning relative to the viability and success of an organization. An opportunity to introduce reciprocal mentoring occurs during the process of integrating new technology. For example, pairing a baby boomer who feels threatened by technology, but has strong clinical skills, with a clinically inexperienced, technologically proficient millennial bridges the gap between these differences and promotes a mentoring relationship where both employees benefit. This relationship can continue to develop beyond the implementation of technology by establishing an environment where each cohort is encouraged to share other individual skills, knowledge, and opinions pertaining to nursing practice. These additional venues that further promote the development of a cohesive team will ultimately result in a healthy work environment. Reaching mutual consensus With four generational cohorts in the workforce, organizations are challenged to develop innovative ways to recruit and retain new and aging nurses. The development of healthy work environments has proven effective in sustaining a multigenerational staff.8 By identifying and capitalizing on the unique characteristics of each generational cohort, nurse leaders can have a significant impact on work environments. Generational differences are assets that should be
fostered and valued for their contributions to nursing practice. Through reciprocal mentoring, nurse leaders can promote the strengths of each cohort and, at the same time, enhance cross-generational relationships. As a result, a healthy work environment is sustained and the ultimate goal is achieved—the provision of safe, quality, and efficient patient-centered care. NM
REFERENCES 1. The American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: a journey to excellence. http://www.aacn. org/WD/HWE/Docs/HWEStandards.pdf. 2. Sherman RO. Leading a multigenerational nursing workforce: issues, challenges and strategies. Online J Issues Nurs. 2006;11 (2):3. 3. Harvey M, McIntyre N, Heames J, Moeller M. Mentoring global female managers in the global marketplace: traditional, reverse, and reciprocal mentoring. The International Journal of Human Resource Management. 2009;20(6):1344-1361. 4. Weng RH, Huang CY, Tsai WC, Chang LY, Lin SE, Lee MY. Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses. BMC Health Serv Res. 2010;10:240.. 5. Lenhoff A. How reciprocal mentoring can help you bridge generational gaps. http:// www.sbnonline.com/component/k2/26Columnist/26512. 6. Hendricks JM, Cope VC. Generational diversity: what nurse managers need to know. J Adv Nurs. 2013;69(3):717-725. 7. Dracup K, Bryan-Brown CW. From novice to expert to mentor: shaping the future. Am J Crit Care. 2004;13(6):448-450. 8. Sherman R, Pross E. Growing future nurse leaders to build and sustain healthy work environments at the unit level. http:// nursingworld.org/MainMenuCategories/ ANAMarketplace/ANAPeriodicals/OJIN/ TableofContents/Vol152010/No1Jan2010/ Growing-Nurse-Leaders.html. Gina Stephenson is a graduate student at Regis College is Weston, Mass. The author has disclosed that she has no financial relationships related to this article. DOI-10.1097/01.NUMA.0000449766.91747.77
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Breaking traditions with reciprocal mentoring By Gina Stephenson, RN
A
forecasted nursing shortage in combination with an aging workforce, a staff composed of different generational values, and the recent implementation of healthcare reform make maintaining a healthy work environment challenging for even the most experienced nurse leader. A study done by the American Association of Critical-Care Nurses (AACN) in 2005 showed a strong correlation between healthy work environments, patient safety, staff recruitment, retention, and an organization’s financial stability.1 However, there have never been four different generational cohorts—each with their own experiences, values, and beliefs—in the workforce at the same time.2 This presents nurse leaders with many new issues and challenges while trying to create a conflict-free, cohesive work environment. Nursing plays a critical role in healthcare delivery. Because of this, organizations are looking to nurse leaders to help sustain a healthy work environment where younger cohorts want to be hired and older cohorts want to remain employed. An area that has worked in the business world to encourage team building and bridge the generational gaps is reciprocal mentoring. Through relationship building and bilateral transfer of knowledge, reciprocal mentoring enhances team-building efforts, contributes to a healthy work environment, and, ultimately, provides safe, quality, efficient patientcentered care. Changing the game Generational cohorts typically span 15 to 20 years and include groups of people who share birth years, history, and a collective personality. Their values, work ethics, attitudes toward authority, 10 June 2014 • Nursing Management
and professional aspirations are shaped by the historical, political, and social events of their time.2 There are four distinct generational cohorts in the workforce today: traditionalists, baby boomers, generation X, and millennials. In 1996, the Institute of Medicine (IOM) published its Crossing the Quality Chasm report, which stated that safety and quality issues exist in part because working environments and employment conditions aren’t conducive to providing quality care. In response to the IOM’s report, the AACN conducted a national study on healthcare environments and employment conditions. The study revealed inextricable links between the quality of the work environment, nursing practice, and patient care outcomes.1 It discovered that unhealthy work environments contributed to medical errors, inefficient care, conflict, and stress among healthcare professionals.1 As a result of its study, the AACN identified six standards for a healthy work environment. The standards are evidence-based and support the development of interdisciplinary and intradisciplinary relationships.1 Skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition, and authentic leadership are the six standards essential to the development of a healthy work environment. Applying these standards and their corresponding elements in an organization creates an environment that empowers nurses from all four generational cohorts. Evolving from the start Empowered nurses are more likely to participate in cross-generational dialog. This form of communication and collaboration is essential to sustaining an environment where everyone feels valued for their contributions. With a rapidly changing healthcare environment and the continuous implementation of new technologies, cross-generational relationships can be further fostered through reciprocal mentoring. www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Team concepts There are three styles of mentoring: traditional, reverse, and reciprocal. Each centers on a relationship between a mentor and mentee, but differs in whether the transfer of knowledge is unilateral or bilateral. Traditional mentoring is a oneway relationship between an individual, typically older, with more experience and knowledge, who assists with the career development and psychosocial support of a younger, less-experienced colleague.3 Nursing utilizes traditional mentoring through clinical ladder programs, which focus predominantly on individual advancement within the organization.4 A typical pairing is a seasoned, older nurse in a leadership position with a younger, inexperienced nurse. However, this promotes a unilateral relationship where knowledge is transferred from mentor to mentee and misses the opportunity to capitalize on the different experiences, skills, and knowledge brought to the profession by the mentee. Traditional mentoring addresses the needs of one individual to be successful rather than promote the organization as a whole. This methodology is no longer effective in sustaining a healthy work environment. The younger generational cohorts often differ significantly in their view of job loyalty and satisfaction from their older cohorts. They want a forum for their ideas and opinions to be heard and if they don’t get that opportunity, they typically move on. Therefore, developing and retaining younger nurses is a serious issue currently facing the nursing profession. Utilizing a different approach to mentoring may help alleviate this dilemma and, in the process, create healthier work environments for all four generational cohorts. www.nursingmanagement.com
Benefitting from change The business world has recognized the technologic skills of the younger generation who utilize them to their advantage. In 1999, the former CEO of General Electric (GE), Jack Welch, emphasized GE’s need to keep up with technologic advancements and made a conscious effort to hire younger, technologically-savvy employees. This helped GE as an organization to better understand the latest technologies and gain insight into the younger generation
knowledge and experiences known as reciprocal mentoring.3 Reciprocal mentoring takes the process one step further than traditional and reverse mentoring and transforms mentoring into a two-way, or team building, relationship where information and experiences are exchanged on a regular basis between the participants.5 Literature suggests that mentoring may have potentially mutual positive effects for both participants and, in terms of learning, these
Reciprocal mentoring transforms mentoring into a two-way relationship where information and experiences are exchanged on a regular basis between the participants. and culture.3 The process became known as reverse mentoring. Other organizations paired senior management with technologicallyproficient junior colleagues through reverse mentoring models for the purpose of introducing social media to the older generational cohorts.3 Some companies took it a step further and recruited younger employees for the facilitation of knowledge transfer to keep senior employees up-to-date on technology, business, and social trends.3 Although a new approach to mentoring, it remained a unilateral transfer of knowledge between the mentor and mentee where only one participant predominantly benefits. Recognizing the success of these generational relationships, companies expanded this concept and began pairing seasoned, older employees with younger, inexperienced, tech-savvy employees to promote a bilateral transfer of
individuals are colearners.3 This two-way learning and teaching relationship empowers both participants and gives each a sense of value and worth within an organization. Creating an environment with multigenerational groupings can result in the development of unexpected and innovative ideas, providing organizations that utilize reciprocal mentoring with a competitive edge.3 Most important is that by incorporating the six standards and their corresponding elements, a healthy work environment is created. Give-and-take management Having four different cohorts in the workforce can be challenging for nurse leaders, but the diversity and richness may also add strength and cohesiveness to the healthcare team.2 The fusing of these generations brings a blend of clinical experiences, but also fosters conflict.2 To prevent unhealthy Nursing Management • June 2014 11
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
Team concepts work environments, leaders should utilize the expertise of older nurses to assist the younger nurses with the transition from novice to expert. Nurse leaders need to acquire an understanding of the individual cohorts and vary their leadership approaches accordingly to promote healthy work environments. Nursing knowledge and practice can be enhanced by changing staff members’ focus from being different to having a common patient-centered purpose.6 According to Benner’s Novice to Expert theory, nurses develop skills and an understanding of patient care over time via a sound educational base, as well as a multitude of experiences.7 Benner describes nurses as passing through five different steps: novice, advanced beginner, competent, proficient, and expert.7 Organizations must utilize the expert level of nursing through mentoring to strengthen the new generation of nurses. Absent from literature is the difference between hands-on patient care provided by each generation and the impact it has on quality. Generational work ethics and social skills vary considerably. Pairing an expert nurse with a less-experienced nurse provides opportunities for role modeling patient care beyond the clinical skills. The Robert Wood John Foundation defines mentoring as “providing advice and guidance on a job path by a trusted counselor, advisor or teacher who does not seek personal gain.” It promotes mentoring using five core competencies: selfknowledge, strategic vision, risk taking, interpersonal and communication effectiveness, and inspiration. Typically, in nursing, mentoring occurs when an expert nurse helps a novice or less-experienced nurse adjust to a new environment and responsibilities, or to gain leadership 12 June 2014 • Nursing Management
skills. However, the current hierarchal approach to mentoring requires more thought and strategy from nurse leaders dealing with multigenerational staff to maximize the experience for both participants. The focus of mentoring should turn from the traditional goal of providing career advice and leadership advancement to a broader focus involving strategic planning relative to the viability and success of an organization. An opportunity to introduce reciprocal mentoring occurs during the process of integrating new technology. For example, pairing a baby boomer who feels threatened by technology, but has strong clinical skills, with a clinically inexperienced, technologically proficient millennial bridges the gap between these differences and promotes a mentoring relationship where both employees benefit. This relationship can continue to develop beyond the implementation of technology by establishing an environment where each cohort is encouraged to share other individual skills, knowledge, and opinions pertaining to nursing practice. These additional venues that further promote the development of a cohesive team will ultimately result in a healthy work environment. Reaching mutual consensus With four generational cohorts in the workforce, organizations are challenged to develop innovative ways to recruit and retain new and aging nurses. The development of healthy work environments has proven effective in sustaining a multigenerational staff.8 By identifying and capitalizing on the unique characteristics of each generational cohort, nurse leaders can have a significant impact on work environments. Generational differences are assets that should be
fostered and valued for their contributions to nursing practice. Through reciprocal mentoring, nurse leaders can promote the strengths of each cohort and, at the same time, enhance cross-generational relationships. As a result, a healthy work environment is sustained and the ultimate goal is achieved—the provision of safe, quality, and efficient patient-centered care. NM
REFERENCES 1. The American Association of Critical-Care Nurses. AACN standards for establishing and sustaining healthy work environments: a journey to excellence. http://www.aacn. org/WD/HWE/Docs/HWEStandards.pdf. 2. Sherman RO. Leading a multigenerational nursing workforce: issues, challenges and strategies. Online J Issues Nurs. 2006;11 (2):3. 3. Harvey M, McIntyre N, Heames J, Moeller M. Mentoring global female managers in the global marketplace: traditional, reverse, and reciprocal mentoring. The International Journal of Human Resource Management. 2009;20(6):1344-1361. 4. Weng RH, Huang CY, Tsai WC, Chang LY, Lin SE, Lee MY. Exploring the impact of mentoring functions on job satisfaction and organizational commitment of new staff nurses. BMC Health Serv Res. 2010;10:240.. 5. Lenhoff A. How reciprocal mentoring can help you bridge generational gaps. http:// www.sbnonline.com/component/k2/26Columnist/26512. 6. Hendricks JM, Cope VC. Generational diversity: what nurse managers need to know. J Adv Nurs. 2013;69(3):717-725. 7. Dracup K, Bryan-Brown CW. From novice to expert to mentor: shaping the future. Am J Crit Care. 2004;13(6):448-450. 8. Sherman R, Pross E. Growing future nurse leaders to build and sustain healthy work environments at the unit level. http:// nursingworld.org/MainMenuCategories/ ANAMarketplace/ANAPeriodicals/OJIN/ TableofContents/Vol152010/No1Jan2010/ Growing-Nurse-Leaders.html. Gina Stephenson is a graduate student at Regis College is Weston, Mass. The author has disclosed that she has no financial relationships related to this article. DOI-10.1097/01.NUMA.0000449766.91747.77
www.nursingmanagement.com
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
