AORK JOL'RFIAL
NOVEMBER 1992, VOL 56, NO 5
The Mentoring Relationship Vicki J. Fox, RN; Jane C. Rothrock, RN; Milha Skelton, RN
T
he historical roots of the word nieiitor originate in Greek mythology. In Homer's The OOyssey, Mentor was a guide. protector. tutor, and advisor to Telemachus, the son of Odysseus and Penelope. Mentor motivated Telemachus to achieve his life's tasks. History notes other mentoring relationships: Socrates and Plato.
Vicki J . Fox
Jane C . Rothrock
Vicki J . Fox, RN, MSN. CNOR. is a clinical nurse specialist ir7 iridepenclent practice as ail RN first ussistant in Tyler, Tex. She eatxed her hadieloi. of science degree in nirr.sing at Texas Woninn's Uniixeix'ry, Denton, and her muster r?fscienc,r in riirr:riiig at the Uiiiiiersiy of Texas, Tyler.. Jane C . Rothrock, RN. DNSc. CNOR. is projessor criicl i ~ i o ~ i c i ~ l icoordinator, rni Perioperolive Ce i -t i f i c ut r Progi.anis. at De1aw.ar.e Coun t j Coni n i I I ti i ty CoI1eg e , Media, Pa. She eartied her diploma in nursing from the Byrn 858
Lorenzo de Medici and Michelangelo, Verrocchio and Leonard0 da Vinci, Sigmund Freud and Carl Jung, Ruth Benedict and Margaret Mead, and Anne Sullivan and Helen Keller.' This article describes mentoring as applied to the nursing profession with specific reference to the RN first assistant (RNFA) role. We will review the research on mentoring relationships;
Milha Skelton
MUMY( P a ) School of Nursing, her bachelor arid muster of science degrees in nursing at the Unii'ersity of Pennsylvania, Philadelphia, arid h e r d o c t o r a t e irz n u r s i n g s c i e n c e a t Widener Unii*ersity,Chester, Pa. Milha Skelton, R N , CNOR, is perioperative nianager of ovthnpedics at Mother Frances Hospital. Tyler, T e x . She earxed her diploma i n nursing a t Herman Hospital, Houston, aiid her RN f i r s t assistant certific a t i o n a t Delaw8are C o u n t y C o m m u n i t y College, Media, P a .
AORN JOURNAL
describe the differences between mentoring, role modeling, and preceptoring; and analyze the relationship between a specific RNFA mentor and his or her protegee.
Mentoring De$ned, Described
M
entoring occurs when “an established professional takes an interest in a neophyte’s career and/or training, and actively advises, guides, and promotes the protege.”2 Surveys of contemporary nursing leaders confirm that a large majority benefited from mentoring relationships, which had significant impact on their professional growth and development. The mentoring relationship usually lasts from two to 10 years and involves two individuals who differ in age from eight to 15 years, with the mentor usually being older than the protege. The mentoring relationship is based on mutual desire and respect, with outcomes that are beneficial for both parties. The mentor’s behaviors typically include career advice and guidance. role modeling, boosting self-esteem, sharing dreams, instilling a vision, providing emotional support and encouragement, and giving feedback. The protege behaviors include taking advice and risks, using feedback, and being open and honest with the mentor. A crucial element for a successful relationship is the protege’s admiration, respect, and trust of the ment0r.j
Mentor, Protege Roles
P
ositive mentoring relationships are characterized b y mutuality, support, and encouragement on the part of the mentor. The mentor maintains high, but achievable, expectations of the protege. Mentors are usually respected for their clinical expertise and their personal traitss They are confident in their abilities and see themselves as successful. This confidence enables them to share their expertise and experiences with others. Mentors are willing to invest the time and energy required to build a relationship. An effective mentor 860
NOVEMBER 1992, VOL 56, NO 5
needs to be an open, perceptive, and successful person with high status in the organization and the ability to make the “right” contacts. The mentor should be skilled at encouraging growth and be open to both disagreement and risk taking. Highly rated mentor behaviors include knowledge and experience, competence, intelligence, and demonstration of skills.6 The mentor’s primary responsibilities are career strategy advising; individual development planning and counseling; sponsoring and mediating; monitoring and giving feedback; role modeling; providing upward career mobility; boosting self-esteem; sharing dreams; giving vision; explaining corporate structure; and imparting valuable information. The faith the mentor has in the potential contributions of the protege, as demonstrated by the mentor’s setting expectations for the individual’s performance, is another important component of mentoring relationships. Proteges share in the responsibility for the success of the relationship. The protege has the responsibilities of initiating (ie, seeking and asking for advice and assistance), sharing (ie, openly sharing needs and goals), and listening. The protege must be actively involved in the relationship and be open to learning and risk taking. The protege must take appropriate advantage of the opportunities provided by the mentor, know how to use feedback, and be willing to recognize and accept the limits of the relationship.’
Mentoring, Role Modeling, Preceptoring
M
entoring relationships differ from role modeling and preceptoring (Table Role models are the first and simplest type of relationship between a novice and an expert nurse, but the relationship is rather passive for both. The novice admires a teacher, a skilled nurse, or supervisor and models or copies his or her behavior. The novice may not understand the reasons for the behavior and is just as likely to copy ineffective as effective behaviors; the role model may not
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NOVEMBER 1992, VOL 56, NO 5
Table 1
Comparison of Role Model, Preceptor, Mentor Role model
Preceptor
Mentor
Relationship is passive for both parties; usually occurs as a novice observes a skilled nurse.
Relationship is more active; may be a formal orientation process.
Relationship is active, ongoing, intensely personal.
Novice may copy behavior without understanding reasons for it.
One member coaches, teachers, supervises, while the other member learns.
One member guides and counsels, while both members share personal, professional goals.
Relationship ends as novice becomes proficient.
Relationship may end when orientation is complete, or may develop into a mentoring relationship.
Relationship may last for years; terminates by mutual agreement.
even be aware of his or her role. The relationship usually ends when the novice becomes more proficient. Role modeling relationships are not actively sought or nurtured and may or may not be positive for the novice. Preceptor relationships actively involve both the novice and the experienced nurse.9 Preceptor relationships often are part of a formal orientation process to introduce a new graduate to the employment setting or an experienced nurse to a new practice setting. The preceptor teaches, supervises, and coaches the novice. Preceptorships are central to many orientation programs because they are extremely effective in socializing new nurses into a role.10 Preceptor programs also function as a potent recruitment and retention strategy. The preceptor-novice relationship usually ends with the formal orientation program but, if nurtured, can develop into a mentoring relationship. Preceptor relationships may be assigned rather than occurring as a matter of choice for either party. The outcomes of the preceptor relationship are usually positive for both mem-
bers, but can be fraught with conflict if the goals and philosophies of the preceptor and novice are different." Mentoring relationships are active relationships sought and nurtured by both parties. They are ongoing, endure for many years, and may occur at any time during a nurse's career.12 The mentoring relationship usually forms when the mentor and protege display and discuss weaknesses as well as strengths in the workplace, maintain loyalty to each other even in the face of disappointmeats, and at times, act selflessly to help meet the other person's needs." Mentoring relationships involve intimacy and trust because personal and professional goals of a confidential nature are shared. The relationship between the mentor and protege is based partly on personal chemistry, with both mentor and protege having a significant emotional investment in each other. The outcome of the relationship typically is positive for both. Peers or colleagues can fulfill some mentoring functions. The difference, however, is that peers usually have similar experience, power bases, seniority, and contacts, whereas mentors 861
AORN JOURNAL
NOVEMBER 1992, VOL 56, NO 5
Fig 1
Conceptual Model Costs, Beneflts to Mentor, and Protege
I
I
I
Phase Two
Phase One Protege benefit
:,tor
have a better established and broader power base.I4
Phases of Mentosship
T
he mentoring process has three phases, each having its own set of tasks, costs, and benefits for both the mentor and novice. A conceptual model (Fig 1) can be used to compare and contrast the costs and benefits of the mentoring process for the mentor and protege. The first phase is the recognition and development phase. The major tasks of this phase for both the mentor and protege are "sizing each other up," recognizing the need and desire for a mentoring relationship, making the commitment, and setting expectations. The 862
Phase Three
costs for the mentor in time and energy predominate during the initial phases of the relationship.15 The cost for the protege is relatively low. He or she temporarily must sacrifice some professional independence to adopt the role of the impressionable novice. The benefits to the protege are high, as he or she can practice new technical skills in a safe environment, while receiving emotional support and encouragement. The second phase is one of emerging independence for the protege. The mentor's tasks involve using power and status to facilitate the learning process and foster independence. For example, the mentor can use his or her formal and informal power bases to help the protege obtain clinical privileges, to assist the protege
AORN JOURNAL
in developing clinical skills, to educate the bureaucracy on the role of the protege, and to help the novice find ways to deal with resistance. The protege’s tasks are to meet the objectives outlined in the learning contract. The costs for the protege rise with the investment of time and energy to meet specific goals and to deal with his or her changing role. The benefits remain consistently high: the protege experiences self-discovery, becomes competent in new skills, and enjoys the mentor’s emotional support and encouragement. The costs for the mentor in the second phase involve the physical, mental, and emotional work of assisting the protege to accomplish his or her goals. Even though the costs for the mentor remain high, they decrease as the protege becomes more independent. In addition, the benefits of gratification, stimulation, and satisfaction begin to exceed the mentor’s investment. The major task of the third phase of mentoring is either termination or realignment of the relationship. The cost for the mentor is the emotional work required to “let go,” a relatively low cost because the goal from the outset is the protege’s independence. The benefits continue to increase as the mentor gains a colleague and peer. The cost for the protege begins to decrease, and his or her primary effort focuses on setting up an independent practice. The benefits for the protege are great and continue to increase as he or she develops a new set of skills, a broader knowledge base, greater professional opportunities, and the reestablished independence that was temporarily sacrificed in the first phase of mentorship.
Mentor-ing in Academic, Clinicd Settings
C
ollege and university administrators identify three phases in the development of mentoring relationships: recognition of talent. testing, and recruitment. The mentor recognizes the potential talent in the protege, “tests” that potential, and then recruits the protege to work with the mentor. In the academic 864
NOVEMBER 1992, VOL 56, NO 5
setting, mentoring can emphasize role-specific modeling and teaching and predict career activities of research, book publishing, and professional service.I 6 Research-oriented productivity benefits significantly from collaboration and coparticipation between academic mentors and proteges.” Studies of mentorship in clinical settings have been inconclusive. Three separate research projects studied the effects of mentorships during the orientation of new graduate nurses. One small pilot project studied the effects of the presence of a master’s-prepared nurse mentor on the experience of two neophytes on an oncology unit. The researchers examined the role responsibilities of counseling on a one-to-one basis, introductions to the unit, and collaboration on patient care assignments. The mentor gave assurance and guidance, intervening where necessary. The neophyte who received only traditional orientation during the six weeks experienced a period of discouragement, but the mentored neophyte experienced no such period of discouragement. The researchers concluded the difference was the presence or absence of the mentoring relationship.ls In a larger study of a mentorship program for new graduates, an 11-week program appeared to yield positive results for both mentors and their proteges. The mentors felt challenged, reporting perceived boosts in self-esteem and job satisfaction. The mentored nurses indicated that the mentorship was both helpful and practical. They continued, however, to report feelings of difficulty in making the transition from new graduate to staff nurse.I9 In a study of nurse-tonurse mentorships for new graduates, mentored nurses reported more confidence, competence, and feelings of independence following a threemonth “internship” program. Mentors in this program were selected for their clinical competence, communication and leadership skills, participation in health care and professional activities, ability to work at conflict resolution, and willingness to serve as a mentor.*O The beginning research on mentoring of clinical nurses seems to indicate its utility for both
AORN JOURNAL
introduction and orientation to the nursing role. Mentors provide guidance and direction during periods of acclimatization to a nursing unit. In addition, the humanizing quality of sharing and nurturing in the work environment affects job and role transition. Mentoring, nonetheless, is thought of as more than an activity which occurs during orientation, and is more active and broad in scope than preceptoring. Further nursing research is needed which uses theoretical frameworks, reliable and valid measurement tools, and larger samples to quantify what mentoring relationships mean, how they are defined, characteristics of the relationship, and positive and negative outcomes.
Problems Mith Mentoring Relationships
M
entoring is not without problems. One researcher studied mentorship and influence in nursing. Nearly half the nursing leaders surveyed reported an unfavorable incident with their mentor: confrontation with the mentor. feeling let down by the mentor. feeling overpressured by the mentor, or enduring physical separation from the mentor.?‘ Mentoring relationships can breed conflict. The goal of the mentor should be to help the protege toward professional independence. The overprotective mentor may not encourage risk taking behaviors, such as suggesting that the protege expand clinical skills o r seek a promising job opportunity, and the protege can thus become too dependent. Both the mentor and protege must have the maturity to accept each other’s personal and professional priorities.’?
RNFA Men toring Espei-ience
T
he following is a personal account of the mentoring relationship between two of the a u t h o r s . Vicki F o x , RN, MSN. CNOR. and Milha Skelton. RN, CNOR. Fox: I wanted to be able to pass on the skills. knowledge. and rewards of first assisting, but had found no one who was willing to invest the 866
NOVEMBER 1992, VOL 56, NO 5
time and effort to pursue the role of the RNFA protege until an acquaintance asked m e to be one of her mentors. My expectations of the mentoring role were high. From the beginning I made it clear that I wanted more than a preceptor role. I copied articles on mentoring for my protegee and included mentoring activities in my personal learning objectives for a graduate school course. In the early stages, I perceived my role as providing support for my protegee’s willingness to implement a new role. We discussed w h a t we thought this relationship s h o u l d involve. My protegee gave me frequent feedback as she secured clinical privileges at the two hospitals where she would be doing her internship. During this time, I offered emotional support when the bureaucracy delayed the granting of privileges. I facilitated her getting privileges at a hospital at which she was not known but where 1 worked regularly. I also gave my protegee practical instruction on suturing and knot tying. W e spent hours in her kitchen suturing pigs’ feet. As my protegee worked through her intemship, one of the major difficulties she encountered was resistance from other nurses and physicians as her role began to change and expand. I provided biweekly evaluations of her clinical skills to fulfill the learning objectives. I watched her change from a novice RNFA with little experience to an advanced beginner who could demonstrate marginally acceptable levels of performance. In time, she became a competent RNFA who had a feeling of mastery and demonstrated the ability to cope with and manage most patient care situations.2’ I found myself enjoying her successes as much as she did. My investment of time was well rewarded, because the role of the RNFA was advanced in our community and my protegee gained confidence and skill. Skelton: I met my clinical mentor when she spoke on certification to my AORN chapter in Longview, Tex. As I oriented to the OR in which she functioned as an RNFA, I gradually realized that her role was different than that of a “private scrub.” I detected feelings of jeal-
NOVEMBER 1992, VOL 56, NO 5
ousy and displays of passive-aggressive behavior from the other nurses. I respected my ment o r because s h e dared to be different a n d always maintained a professional demeanor despite this undercurrent. When I made the decision to take the postgraduate course in first assisting at Delaware County Community College, Media, Pa, I asked her to be one of my clinical mentors. My responsibilities as protegee were to be open and honest in sharing experiences; to be receptive to guidance, advice, and criticism; and to fulfill the RNFA course requirements. From my mentor, I expected support, guidance, advice, and encouragement. I had no idea at the beginning of the internship the difficulties I would encounter as I changed roles. I vacillated between euphoria (“I can d o anything”) and abject despair (“Everyone’s watching and my fingers won’t work”). My personal and professional respect for my mentor grew through this relationship. Andysis. In this case, the mentor was actually younger than the protegee, a not uncommon situation today when nurses may change specialties and a younger person with more experience and expertise is their teacher.24 Both the mentor and protegee invested a great deal of time and emotional energy in nurturing the relationship, a characteristic that distinguishes mentoring from preceptorships. The protegee’s learning contract provided objectives that the mentor and protegee agreed upon, thereby avoiding major differences in philosophy or goals.
Conclusion
M
entors can shape a positive environment that allows career development, satisfaction, and leadership to blossom. Mentoring opportunities do not just happen. They are sought after and created by quality interaction b e t w e e n talented nurses. Mentoring relationships used wisely and often can rejuvenate the profe~sion.2~
AORN JOURNAL
Nursing Administration Quarterly 15 (Fall 1990) 9; C 0 Prestholdt, “Modern mentoring: Strategies for developing contemporary nursing leadership,” Nursing Administration Quarterly 15 (Fall 1990) 20. 2. C Vance, “Is there a mentor in your future?” Imprint 36 (December 1989/January 1990) 41-42. 3. D C Kinsey, “Mentorship and influence in nursing,” Nursing Management 21 (May 1990) 4546. 4. L T Jowers, K Herr, “A review of literature on mentor-protegee relationships,” in Review of Research in Nursing Education, ed G M Clayton, P A Baj (New York City: National League for Nursing, 1990) 49-77. 5. B E Puetz, “Learn the roles from a mentor,” Nursing Success Today 2 (June 1985) 11-13. 6. Kinsey, “Mentorship and influence in nursing,” 45-46. 7 Ibid. 8. Puetz, “Learn the ropes from a mentor,” 1113. 9. Ibid. 10. P Benner, “From novice to expert: Experience and power,” in Clinical Nursing Practice (Menlo Park, Calif Addison-Wesley Publishing Company, 1984) 278. 11. K O’Conner, “For want of a mentor ...” Nursing Outlook 36 (Januarypebruary 1988) 38-39. 12. Puetz, “Learn the ropes from a mentor,” 1113. 13. Yoder, “Mentoring: A concept analysis,” 11. 14. Vance, “Is there a mentor in your future?” 4142. 15. B Amoldussen, “The mentoring experience: The mentor perspective,” Nursing Administration Quarterly 15 (Fall 1990) 28-31. 16. S M Rawl, L M Peterson, “Nursing education administrators: Level of career development and mentoring,” Journal of Professional Nursing 8 (MXch-April 1992) 161-169. 17. Amoldussen, “The mentoring experience,” 2831. 18. Ibid. 19. Ibid. 20. Ibid. 21. Ibid. 22. Puetz, “Learn the ropes from a mentor,’’ 1 1 13. 23. Benner, “From novice to expert,” 20-27. 24. Yoder, “Mentoring: A concept analysis,” 11. 25. C Boyle, S K James, “Nursing leaders as mentors: How are we doing?” Nursing Administration Quarterly 15 (Fall 1990) 44-48.
Notes 1. L Yoder, “Mentoring: A concept analysis,” 867
NOVEMBER 1992, VOL 56, NO 5
The Mentoring Relationship Vicki J. Fox, RN; Jane C. Rothrock, RN; Milha Skelton, RN
T
he historical roots of the word nieiitor originate in Greek mythology. In Homer's The OOyssey, Mentor was a guide. protector. tutor, and advisor to Telemachus, the son of Odysseus and Penelope. Mentor motivated Telemachus to achieve his life's tasks. History notes other mentoring relationships: Socrates and Plato.
Vicki J . Fox
Jane C . Rothrock
Vicki J . Fox, RN, MSN. CNOR. is a clinical nurse specialist ir7 iridepenclent practice as ail RN first ussistant in Tyler, Tex. She eatxed her hadieloi. of science degree in nirr.sing at Texas Woninn's Uniixeix'ry, Denton, and her muster r?fscienc,r in riirr:riiig at the Uiiiiiersiy of Texas, Tyler.. Jane C . Rothrock, RN. DNSc. CNOR. is projessor criicl i ~ i o ~ i c i ~ l icoordinator, rni Perioperolive Ce i -t i f i c ut r Progi.anis. at De1aw.ar.e Coun t j Coni n i I I ti i ty CoI1eg e , Media, Pa. She eartied her diploma in nursing from the Byrn 858
Lorenzo de Medici and Michelangelo, Verrocchio and Leonard0 da Vinci, Sigmund Freud and Carl Jung, Ruth Benedict and Margaret Mead, and Anne Sullivan and Helen Keller.' This article describes mentoring as applied to the nursing profession with specific reference to the RN first assistant (RNFA) role. We will review the research on mentoring relationships;
Milha Skelton
MUMY( P a ) School of Nursing, her bachelor arid muster of science degrees in nursing at the Unii'ersity of Pennsylvania, Philadelphia, arid h e r d o c t o r a t e irz n u r s i n g s c i e n c e a t Widener Unii*ersity,Chester, Pa. Milha Skelton, R N , CNOR, is perioperative nianager of ovthnpedics at Mother Frances Hospital. Tyler, T e x . She earxed her diploma i n nursing a t Herman Hospital, Houston, aiid her RN f i r s t assistant certific a t i o n a t Delaw8are C o u n t y C o m m u n i t y College, Media, P a .
AORN JOURNAL
describe the differences between mentoring, role modeling, and preceptoring; and analyze the relationship between a specific RNFA mentor and his or her protegee.
Mentoring De$ned, Described
M
entoring occurs when “an established professional takes an interest in a neophyte’s career and/or training, and actively advises, guides, and promotes the protege.”2 Surveys of contemporary nursing leaders confirm that a large majority benefited from mentoring relationships, which had significant impact on their professional growth and development. The mentoring relationship usually lasts from two to 10 years and involves two individuals who differ in age from eight to 15 years, with the mentor usually being older than the protege. The mentoring relationship is based on mutual desire and respect, with outcomes that are beneficial for both parties. The mentor’s behaviors typically include career advice and guidance. role modeling, boosting self-esteem, sharing dreams, instilling a vision, providing emotional support and encouragement, and giving feedback. The protege behaviors include taking advice and risks, using feedback, and being open and honest with the mentor. A crucial element for a successful relationship is the protege’s admiration, respect, and trust of the ment0r.j
Mentor, Protege Roles
P
ositive mentoring relationships are characterized b y mutuality, support, and encouragement on the part of the mentor. The mentor maintains high, but achievable, expectations of the protege. Mentors are usually respected for their clinical expertise and their personal traitss They are confident in their abilities and see themselves as successful. This confidence enables them to share their expertise and experiences with others. Mentors are willing to invest the time and energy required to build a relationship. An effective mentor 860
NOVEMBER 1992, VOL 56, NO 5
needs to be an open, perceptive, and successful person with high status in the organization and the ability to make the “right” contacts. The mentor should be skilled at encouraging growth and be open to both disagreement and risk taking. Highly rated mentor behaviors include knowledge and experience, competence, intelligence, and demonstration of skills.6 The mentor’s primary responsibilities are career strategy advising; individual development planning and counseling; sponsoring and mediating; monitoring and giving feedback; role modeling; providing upward career mobility; boosting self-esteem; sharing dreams; giving vision; explaining corporate structure; and imparting valuable information. The faith the mentor has in the potential contributions of the protege, as demonstrated by the mentor’s setting expectations for the individual’s performance, is another important component of mentoring relationships. Proteges share in the responsibility for the success of the relationship. The protege has the responsibilities of initiating (ie, seeking and asking for advice and assistance), sharing (ie, openly sharing needs and goals), and listening. The protege must be actively involved in the relationship and be open to learning and risk taking. The protege must take appropriate advantage of the opportunities provided by the mentor, know how to use feedback, and be willing to recognize and accept the limits of the relationship.’
Mentoring, Role Modeling, Preceptoring
M
entoring relationships differ from role modeling and preceptoring (Table Role models are the first and simplest type of relationship between a novice and an expert nurse, but the relationship is rather passive for both. The novice admires a teacher, a skilled nurse, or supervisor and models or copies his or her behavior. The novice may not understand the reasons for the behavior and is just as likely to copy ineffective as effective behaviors; the role model may not
AORN JOURNAL
NOVEMBER 1992, VOL 56, NO 5
Table 1
Comparison of Role Model, Preceptor, Mentor Role model
Preceptor
Mentor
Relationship is passive for both parties; usually occurs as a novice observes a skilled nurse.
Relationship is more active; may be a formal orientation process.
Relationship is active, ongoing, intensely personal.
Novice may copy behavior without understanding reasons for it.
One member coaches, teachers, supervises, while the other member learns.
One member guides and counsels, while both members share personal, professional goals.
Relationship ends as novice becomes proficient.
Relationship may end when orientation is complete, or may develop into a mentoring relationship.
Relationship may last for years; terminates by mutual agreement.
even be aware of his or her role. The relationship usually ends when the novice becomes more proficient. Role modeling relationships are not actively sought or nurtured and may or may not be positive for the novice. Preceptor relationships actively involve both the novice and the experienced nurse.9 Preceptor relationships often are part of a formal orientation process to introduce a new graduate to the employment setting or an experienced nurse to a new practice setting. The preceptor teaches, supervises, and coaches the novice. Preceptorships are central to many orientation programs because they are extremely effective in socializing new nurses into a role.10 Preceptor programs also function as a potent recruitment and retention strategy. The preceptor-novice relationship usually ends with the formal orientation program but, if nurtured, can develop into a mentoring relationship. Preceptor relationships may be assigned rather than occurring as a matter of choice for either party. The outcomes of the preceptor relationship are usually positive for both mem-
bers, but can be fraught with conflict if the goals and philosophies of the preceptor and novice are different." Mentoring relationships are active relationships sought and nurtured by both parties. They are ongoing, endure for many years, and may occur at any time during a nurse's career.12 The mentoring relationship usually forms when the mentor and protege display and discuss weaknesses as well as strengths in the workplace, maintain loyalty to each other even in the face of disappointmeats, and at times, act selflessly to help meet the other person's needs." Mentoring relationships involve intimacy and trust because personal and professional goals of a confidential nature are shared. The relationship between the mentor and protege is based partly on personal chemistry, with both mentor and protege having a significant emotional investment in each other. The outcome of the relationship typically is positive for both. Peers or colleagues can fulfill some mentoring functions. The difference, however, is that peers usually have similar experience, power bases, seniority, and contacts, whereas mentors 861
AORN JOURNAL
NOVEMBER 1992, VOL 56, NO 5
Fig 1
Conceptual Model Costs, Beneflts to Mentor, and Protege
I
I
I
Phase Two
Phase One Protege benefit
:,tor
have a better established and broader power base.I4
Phases of Mentosship
T
he mentoring process has three phases, each having its own set of tasks, costs, and benefits for both the mentor and novice. A conceptual model (Fig 1) can be used to compare and contrast the costs and benefits of the mentoring process for the mentor and protege. The first phase is the recognition and development phase. The major tasks of this phase for both the mentor and protege are "sizing each other up," recognizing the need and desire for a mentoring relationship, making the commitment, and setting expectations. The 862
Phase Three
costs for the mentor in time and energy predominate during the initial phases of the relationship.15 The cost for the protege is relatively low. He or she temporarily must sacrifice some professional independence to adopt the role of the impressionable novice. The benefits to the protege are high, as he or she can practice new technical skills in a safe environment, while receiving emotional support and encouragement. The second phase is one of emerging independence for the protege. The mentor's tasks involve using power and status to facilitate the learning process and foster independence. For example, the mentor can use his or her formal and informal power bases to help the protege obtain clinical privileges, to assist the protege
AORN JOURNAL
in developing clinical skills, to educate the bureaucracy on the role of the protege, and to help the novice find ways to deal with resistance. The protege’s tasks are to meet the objectives outlined in the learning contract. The costs for the protege rise with the investment of time and energy to meet specific goals and to deal with his or her changing role. The benefits remain consistently high: the protege experiences self-discovery, becomes competent in new skills, and enjoys the mentor’s emotional support and encouragement. The costs for the mentor in the second phase involve the physical, mental, and emotional work of assisting the protege to accomplish his or her goals. Even though the costs for the mentor remain high, they decrease as the protege becomes more independent. In addition, the benefits of gratification, stimulation, and satisfaction begin to exceed the mentor’s investment. The major task of the third phase of mentoring is either termination or realignment of the relationship. The cost for the mentor is the emotional work required to “let go,” a relatively low cost because the goal from the outset is the protege’s independence. The benefits continue to increase as the mentor gains a colleague and peer. The cost for the protege begins to decrease, and his or her primary effort focuses on setting up an independent practice. The benefits for the protege are great and continue to increase as he or she develops a new set of skills, a broader knowledge base, greater professional opportunities, and the reestablished independence that was temporarily sacrificed in the first phase of mentorship.
Mentor-ing in Academic, Clinicd Settings
C
ollege and university administrators identify three phases in the development of mentoring relationships: recognition of talent. testing, and recruitment. The mentor recognizes the potential talent in the protege, “tests” that potential, and then recruits the protege to work with the mentor. In the academic 864
NOVEMBER 1992, VOL 56, NO 5
setting, mentoring can emphasize role-specific modeling and teaching and predict career activities of research, book publishing, and professional service.I 6 Research-oriented productivity benefits significantly from collaboration and coparticipation between academic mentors and proteges.” Studies of mentorship in clinical settings have been inconclusive. Three separate research projects studied the effects of mentorships during the orientation of new graduate nurses. One small pilot project studied the effects of the presence of a master’s-prepared nurse mentor on the experience of two neophytes on an oncology unit. The researchers examined the role responsibilities of counseling on a one-to-one basis, introductions to the unit, and collaboration on patient care assignments. The mentor gave assurance and guidance, intervening where necessary. The neophyte who received only traditional orientation during the six weeks experienced a period of discouragement, but the mentored neophyte experienced no such period of discouragement. The researchers concluded the difference was the presence or absence of the mentoring relationship.ls In a larger study of a mentorship program for new graduates, an 11-week program appeared to yield positive results for both mentors and their proteges. The mentors felt challenged, reporting perceived boosts in self-esteem and job satisfaction. The mentored nurses indicated that the mentorship was both helpful and practical. They continued, however, to report feelings of difficulty in making the transition from new graduate to staff nurse.I9 In a study of nurse-tonurse mentorships for new graduates, mentored nurses reported more confidence, competence, and feelings of independence following a threemonth “internship” program. Mentors in this program were selected for their clinical competence, communication and leadership skills, participation in health care and professional activities, ability to work at conflict resolution, and willingness to serve as a mentor.*O The beginning research on mentoring of clinical nurses seems to indicate its utility for both
AORN JOURNAL
introduction and orientation to the nursing role. Mentors provide guidance and direction during periods of acclimatization to a nursing unit. In addition, the humanizing quality of sharing and nurturing in the work environment affects job and role transition. Mentoring, nonetheless, is thought of as more than an activity which occurs during orientation, and is more active and broad in scope than preceptoring. Further nursing research is needed which uses theoretical frameworks, reliable and valid measurement tools, and larger samples to quantify what mentoring relationships mean, how they are defined, characteristics of the relationship, and positive and negative outcomes.
Problems Mith Mentoring Relationships
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entoring is not without problems. One researcher studied mentorship and influence in nursing. Nearly half the nursing leaders surveyed reported an unfavorable incident with their mentor: confrontation with the mentor. feeling let down by the mentor. feeling overpressured by the mentor, or enduring physical separation from the mentor.?‘ Mentoring relationships can breed conflict. The goal of the mentor should be to help the protege toward professional independence. The overprotective mentor may not encourage risk taking behaviors, such as suggesting that the protege expand clinical skills o r seek a promising job opportunity, and the protege can thus become too dependent. Both the mentor and protege must have the maturity to accept each other’s personal and professional priorities.’?
RNFA Men toring Espei-ience
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he following is a personal account of the mentoring relationship between two of the a u t h o r s . Vicki F o x , RN, MSN. CNOR. and Milha Skelton. RN, CNOR. Fox: I wanted to be able to pass on the skills. knowledge. and rewards of first assisting, but had found no one who was willing to invest the 866
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time and effort to pursue the role of the RNFA protege until an acquaintance asked m e to be one of her mentors. My expectations of the mentoring role were high. From the beginning I made it clear that I wanted more than a preceptor role. I copied articles on mentoring for my protegee and included mentoring activities in my personal learning objectives for a graduate school course. In the early stages, I perceived my role as providing support for my protegee’s willingness to implement a new role. We discussed w h a t we thought this relationship s h o u l d involve. My protegee gave me frequent feedback as she secured clinical privileges at the two hospitals where she would be doing her internship. During this time, I offered emotional support when the bureaucracy delayed the granting of privileges. I facilitated her getting privileges at a hospital at which she was not known but where 1 worked regularly. I also gave my protegee practical instruction on suturing and knot tying. W e spent hours in her kitchen suturing pigs’ feet. As my protegee worked through her intemship, one of the major difficulties she encountered was resistance from other nurses and physicians as her role began to change and expand. I provided biweekly evaluations of her clinical skills to fulfill the learning objectives. I watched her change from a novice RNFA with little experience to an advanced beginner who could demonstrate marginally acceptable levels of performance. In time, she became a competent RNFA who had a feeling of mastery and demonstrated the ability to cope with and manage most patient care situations.2’ I found myself enjoying her successes as much as she did. My investment of time was well rewarded, because the role of the RNFA was advanced in our community and my protegee gained confidence and skill. Skelton: I met my clinical mentor when she spoke on certification to my AORN chapter in Longview, Tex. As I oriented to the OR in which she functioned as an RNFA, I gradually realized that her role was different than that of a “private scrub.” I detected feelings of jeal-
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ousy and displays of passive-aggressive behavior from the other nurses. I respected my ment o r because s h e dared to be different a n d always maintained a professional demeanor despite this undercurrent. When I made the decision to take the postgraduate course in first assisting at Delaware County Community College, Media, Pa, I asked her to be one of my clinical mentors. My responsibilities as protegee were to be open and honest in sharing experiences; to be receptive to guidance, advice, and criticism; and to fulfill the RNFA course requirements. From my mentor, I expected support, guidance, advice, and encouragement. I had no idea at the beginning of the internship the difficulties I would encounter as I changed roles. I vacillated between euphoria (“I can d o anything”) and abject despair (“Everyone’s watching and my fingers won’t work”). My personal and professional respect for my mentor grew through this relationship. Andysis. In this case, the mentor was actually younger than the protegee, a not uncommon situation today when nurses may change specialties and a younger person with more experience and expertise is their teacher.24 Both the mentor and protegee invested a great deal of time and emotional energy in nurturing the relationship, a characteristic that distinguishes mentoring from preceptorships. The protegee’s learning contract provided objectives that the mentor and protegee agreed upon, thereby avoiding major differences in philosophy or goals.
Conclusion
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entors can shape a positive environment that allows career development, satisfaction, and leadership to blossom. Mentoring opportunities do not just happen. They are sought after and created by quality interaction b e t w e e n talented nurses. Mentoring relationships used wisely and often can rejuvenate the profe~sion.2~
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Nursing Administration Quarterly 15 (Fall 1990) 9; C 0 Prestholdt, “Modern mentoring: Strategies for developing contemporary nursing leadership,” Nursing Administration Quarterly 15 (Fall 1990) 20. 2. C Vance, “Is there a mentor in your future?” Imprint 36 (December 1989/January 1990) 41-42. 3. D C Kinsey, “Mentorship and influence in nursing,” Nursing Management 21 (May 1990) 4546. 4. L T Jowers, K Herr, “A review of literature on mentor-protegee relationships,” in Review of Research in Nursing Education, ed G M Clayton, P A Baj (New York City: National League for Nursing, 1990) 49-77. 5. B E Puetz, “Learn the roles from a mentor,” Nursing Success Today 2 (June 1985) 11-13. 6. Kinsey, “Mentorship and influence in nursing,” 45-46. 7 Ibid. 8. Puetz, “Learn the ropes from a mentor,” 1113. 9. Ibid. 10. P Benner, “From novice to expert: Experience and power,” in Clinical Nursing Practice (Menlo Park, Calif Addison-Wesley Publishing Company, 1984) 278. 11. K O’Conner, “For want of a mentor ...” Nursing Outlook 36 (Januarypebruary 1988) 38-39. 12. Puetz, “Learn the ropes from a mentor,” 1113. 13. Yoder, “Mentoring: A concept analysis,” 11. 14. Vance, “Is there a mentor in your future?” 4142. 15. B Amoldussen, “The mentoring experience: The mentor perspective,” Nursing Administration Quarterly 15 (Fall 1990) 28-31. 16. S M Rawl, L M Peterson, “Nursing education administrators: Level of career development and mentoring,” Journal of Professional Nursing 8 (MXch-April 1992) 161-169. 17. Amoldussen, “The mentoring experience,” 2831. 18. Ibid. 19. Ibid. 20. Ibid. 21. Ibid. 22. Puetz, “Learn the ropes from a mentor,’’ 1 1 13. 23. Benner, “From novice to expert,” 20-27. 24. Yoder, “Mentoring: A concept analysis,” 11. 25. C Boyle, S K James, “Nursing leaders as mentors: How are we doing?” Nursing Administration Quarterly 15 (Fall 1990) 44-48.
Notes 1. L Yoder, “Mentoring: A concept analysis,” 867
