New graduate nurses (NGNs) go through a difficult transition from student nurse into a professional role (Pasila, Elo, & Kaariainen, 2017). The rate of turnover of NGNs that leave the profession within the first year of their nursing career is over 28%; the highest amongst all bedside staff (NSI Nursing Solutions Inc, 2018). Considering the reality of nursing shortages, and the projected increase in need of bedside staff of 45%, adequate NGN preceptorship is integral (AACN, 2019; NSI Nursing Solutions Inc, 2018). A number of investigators have highlighted the benefits of structured orientations and residency programs including improved retention, satisfaction, and clinical competency (Rush, Adamack, Gordon, Lilly, & Janke, 2013; Van Camp & Chappy, 2017), however the impact of having a mentor separate of their preceptor may provide additional resources and comfort during the professional transition. With this, an attempt to provide a mentorship program coinciding with orientation training for trauma/surgical NGNs occurred with mixed results.
Using the Academy of Medical Surgical Nurses’ Mentorship (AMSN) Program guidelines, goals of the program included: develop supportive and encouraging relationships, guide nurses in their professional, personal, and interpersonal growth, promote mutuality and sharing based on the needs of colleagues, and communicate information concerning expectations, learning opportunities, and stressors (AMSN, 2012). Due to the facility being a level one trauma academic medical center, mentorship programs are implemented on a unit by unit basis with specific, individual needs supported by the staff nurse service line councils.
Though the effort was with good intention, the project was initiated during the pandemic of 2020; a time of pure chaos. With priority placed in staffing and constant evolving needs, including significant changes in practice such as the transition to virtual learning, the mentor/mentee relationship was placed on the backburner. The program experienced low participation and minimal feedback from both mentors and mentees. Expectations of the partnership only included communication every other week with two in person meetings, however, groups still struggled to meet this goal.
The planning and implementation phase showed effective interprofessional collaboration, with guidance from leadership and management, engagement with NGNs and experienced nursing staff, and support from the Staff Development and Clinical Nurse Specialists. This part of the project was successful, but the group experienced challenges with evaluation and follow-up due to increased demands of the COVID environment. Deadlines were missed, documentation as far as program surveys were not completed, and an overall sense of low priority was felt during the process.
With our facility currently experiencing another COVID surge with no end in sight due to the upcoming winter months and potential flu patients on top of the already extremely high acuity, the leadership team is unsure on how to approach another attempt at a mentorship program. What evidence based research or guidelines have you used to facilitate a mentor/mentee relationship? What interventions have you used in your facilities to engage both NGNs and experienced staff during this unprecedented time? Is there a better solution to support both new and experienced staff without creating a formal mentor/mentee relationship?
Resources:
American Association of Colleges of Nursing, (2019). Nursing shortage. Retrieved from https://www.aacnnursing.org/News-Information/Fact-Sheets/Nursing-Shortage.
NSI Nursing Solutions, Inc., (2020). 2020 NSI National Health Care Retention & RN Staffing Report. Retrieved from https://nsinursingsolutions.com/Documents/Library/NSI_National_Health_Care_Retenti n_Report.pdf.
Pasila, K., Elo, S., & Kääriäinen, M. (2017). Newly graduated nurses’ orientation experiences: A systematic review of qualitative studies. International Journal of Nursing Studies, 71, 17-27. https://doi-org.libproxy.eku.edu/10.1016/j.ijnurstu.2017.02.021.
Rush, K. L., Adamack, M., Gordon, J., Lilly, M., & Janke, R. (2013). Best practices of formal new graduate nurse transition programs: An integrative review. International Journal of Nursing Studies, 50(3), 345–356. https://doiorg.libproxy.eku.edu/10.1016/j.ijnurstu.2012.06.009.
Van Camp, J., & Chappy, S. (2017). The effectiveness of nurse residency programs on retention: A systematic review. AORN Journal, 106(2), 128–144. https://doi org.libproxy.eku.edu/10.1016/j.aorn.2017.06.003.