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FOSTERING LEADERSHIP THROUGH COLLABORATION

Theresa A. Granger

Mentoring: Leading the way toward positive change

by Theresa A. Granger

Since the time of Florence Nightingale, the nursing profession has earned a reputation for eating its young. Unsupportive health care environments and unrealistic expectations of nurses by other nurses drive new and potential nurses away. Neophytes are often subjected to harsh words of criticism or indifference, or receive inadequate patient-care support. Self-doubt, accompanied by unhappiness, burnout and depression, often results. Many nurses abandon their dreams and leave the profession.

If we fail to address these damaging dynamics, the desire to leave nursing will surpass the call to serve, and the present nursing-shortage crisis will be exacerbated. Nurses are leaving the profession at an alarming rate. Between 1992 and 2000, the number of registered nurses not employed in nursing increased about 28 percent (U.S. Department of Health and Human Services, 2000). In a March 2000 study, the National Sample Survey of Registered Nurses stated that 44.9 percent of RNs having a profession other than nursing find their non-nursing position more rewarding (U.S. Department of Health and Human Services, 2000).

I will never forget the first time I heard the phrase “nurses eat their young.” I was a first-semester nursing student in the midst of a rather intimidating rotation in a nursing home. Some of the nurses seemed intolerant of our presence and appeared to ridicule our instructor. During clinical conference later that week, the instructor talked openly about the problem. “When you graduate,” she said, “you will run into nurses who choose to eat their young.”

I remember thinking to myself, “I am going to be different. I will never treat students or other nurses the way I have been treated. I am going to be a change agent. I will never eat my young.”

Three short semesters later, I graduated with pride. I vowed to always honor my commitment to uphold professional standards, protect the public and protect my young. I felt that my training had prepared me well to be a change agent. Nothing could stop me as I began my journey to change the world.

I was unprepared, however, for the intimidation that quickly overpowered me. Providing total care for four patients seemed impossible. As I ended each shift unable to prepare in advance for my next-day’s assignment, a knot began to grow in my stomach. Just when I thought the work environment could not get any more stressful, a veteran nurse of approximately 30 years pulled me aside.

I thought I was going to receive congratulations for a job well done. Instead, I was told that new graduates with a bachelor’s degree in nursing think they know everything. “We all just want you to know that we know better. We know that BSN graduates aren’t any better than anybody else,” she said.

Instead of being a change agent, I was forever a changed agent. I left that unit within one year. Sadly, this was my most memorable new-graduate experience. Since then, I have held to the hope that nurses will become more supportive and learn to celebrate differences.

Approximately 16 years have passed since my first semester in nursing school. Hoping to help shape the next generation, I chose, seven years ago, to pursue a career as a nurse educator. In discussing role transitions with students, one of my goals has been to reduce the stress involved in going from student nurse to practicing nurse.

My students frequently recount experiences when they have not felt supported by nurses. I have sought to empower discouraged students by focusing on creative ways to better the environment and develop meaningful relationships with peers, but not all students take comfort in their ability to become change agents. Over the years, several have expressed regret about their decision to become a nurse. They wish they hadn’t chosen a profession where the young are eaten. As I listen, I often think about my own experiences and know in my heart that some of my students will choose to leave the profession. Nurses across the country have openly shared similar experiences.

“Hazing has driven several qualified and valuable nurses from my department.” ... “In the past year, eight nurses have come and gone.” ... “I’ve seen my fellow graduates leave the profession after having dreamed of becoming nurses since childhood.” ... “They were disappointed that their work environments reminded them more of the halls of their junior high schools than of institutions designed to help people” (Thomas, 2003, ¶6).

For the sake of their patients and for their own job fulfillment, nurses need a supportive work environment. Instead of eating our young, we need to focus our energies on supporting and nurturing one another. Character development and professional social skills are just as important as technical skills. The profession needs to provide an environment that fosters development of character and support of others.

Solving the nursing shortage requires more than making supply meet demand. Too much emphasis is placed on accelerated nursing programs as a way to meet demand. The emphasis should be on mentoring, not fast tracking. Fast tracking will produce technicians, not effective nursing leaders. The health care environment needs to be reshaped to allow new nurses opportunity to learn technically and grow professionally.

Mentoring of new nurses should begin immediately upon graduation and continue for several years. The purpose is twofold. First, it enables inexperienced nurses to become skilled in difficult psychomotor concepts. Second, mentoring allows new nurses to grow professionally while developing leadership skills.

Mentors are not preceptors. Preceptors assist nurses technically, while mentors assist nurses by helping to shape character and professional competence. Nursing schools could partner with local health care agencies to develop mutually beneficial mentoring programs. For example, they could provide educators to mentor new graduates. Local health care agencies could reciprocate by providing much-needed clinical instructors. Upon successful completion of a mentoring program, nurses could further develop leadership skills by mentoring other new nurses.

The survival of nursing depends on our ability to shape leaders who will work to unite the profession. All nurses possess the ability to mentor and all have the power to institute change. Mentoring allows nurses to give back to the profession by answering the call to leadership. RNL

Theresa Granger, MN, ARNP, NP-C, a doctoral student at the University of Colorado Health Sciences Center School of Nursing in Denver, Colo., is a pediatric professional development specialist at the Swedish Center for Nursing Excellence, Swedish Medical Center, Seattle, Wash.

References

Thomas, S.P. (2003). ‘Horizontal hostility’: Nurses against themselves: How to resolve this threat to retention [Electronic version]. American Journal of Nursing, 103(10), 87-88, 90-91.

U.S. Department of Health and Human Services. (2000, March). The registered nurse population: Findings from the National Sample Survey of Registered Nurses, 1-135. Retrieved June 11, 2004.