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Reflective Essay on Mentoring Nursing Students
As a mentor, my role according to Casey and Clark 2011 is to be a good and competent role model for my students. According to the NMC (2008), a mentor is a registrant who facilitates learning and supervises and assesses students in a practice setting. I was informed by my manager that I would be co-mentoring a student nurse who was in his final year and this placement also being his final placement. My first thoughts were, what do I know about mentoring? Then the next thing was am I going to teach them the right things? I panicked a bit but reminded myself that this wasnt the first time theres been a student on their final placement, I guess it was more the fact that this time around, because I was starting my mentorship training, the role seemed a bit more daunting. I knew from the onset that this was going to be a learning curve for me and the students as well, but I knew I had someone to support me should I get stuck.
Fortunately for me, the student was someone familiar and that reduced the anxieties of the first contact. First impressions count, so it is important to introduce yourself, smile, and make eye contact with your student (C. McCabe, F. Timmins 2013) to build that rapport. On the first day, I had to remember that Jay (not real name, protecting students identity) was on placement and not working as an HCA, and had to make the rest of the team aware of this. Levett-Jones, Lathlean, Higgins, and McMillan (2009) discussed that students need to feel like they belong which makes them comfortable and engage in learning opportunities in this case, Jay already belonged to the team but this time around as a student nurse and he was familiar with the learning environment.
It is good to establish a good rapport with your student but according to Wilkes (2006), tread with caution during social development as professional boundaries need to remain clear as getting involved with a student socially and emotionally outside of work can influence your integrity when performing assessments. Jay had his initial meeting to discuss his learning outcome with my manager who was his mentor and I was included in this meeting to know which direction we were going to take. According to Lowry (1997), it is important to identify learning needs with the learner from the beginning and have a learning contract. Right from the onset, Jay stated that he needed support with administering medication as this was one of his learning outcomes which he was still struggling with as he hadnt had enough exposure to it in previous placements.
According to the Nursing and Midwifery Council(2008a), as a registered professional, you are responsible for public safety, therefore by mentoring, you are accountable for ensuring that students fulfill their learning outcomes and develop practice competence. According to the Nursing and Midwifery Council (NMC 2008) mentors should empower students to identify learning opportunities, needs, and experiences that are appropriate to their level of learning as well as motivate themselves to be
self-directed learners. As adult learners, students may have objectives and competencies that they want to achieve in addition to practice competencies.
As the hospital adapted to a new way of signing for medication online, I had to request access for Jay to be able to administer medication in his own settings and I would counter-sign for them. This took a few days to be activated but, in the meantime, Jay was able to shadow me and other nurses whilst administering medication and had the chance to see how the system worked and to ask any questions he didnt understand. Once his log-in details came through, Jay was able to administer medication under supervision and was encouraged to ask questions and do some research himself about the different medication that was used on the ward. Jay needed to achieve some clinical skills including administering injections. We agreed that he would call around the other units and find out if any of them had Depo clinic which he could attend to observe and with time, possibly could administer one as well as none of the patients on our ward required these. Jay was able to identify a ward that had this clinic and managed to book in to go and observe and after a few weeks of going to observe, he was able to administer a Depo and achieve one of his learning outcomes.
Encouraging students to seek out opportunities on and off the ward, attending meetings, forums, and other health departments, and working with the other disciplines (MDT) to acquire more expertise and knowledge to further develop themselves is something essential for a good mentor to facilitate. Mentors also need to be mindful of the quality of learning experiences available to develop the students learning experience through teaching and providing the appropriate knowledge base for nursing interventions. According to Gopee (2011), mentors need additional skills through structured learning and teaching skills to utilize in an environment designed for this purpose. Quinn (2000) states that mentors can enhance a students performance and development by providing the student with feedback and reinforcement.
Jay had his own learning styles and they were not always the same, depending on the task at hand but they were consistent. According to Reece and Walker (2003), before embarking on any program of teaching, it is important to recognize that there are different learning styles to consider. As a mentor, you might have to teach according to the students learning style and as much as many people have more than one style, they always have a preferred style. Working with Jay and observing him, I picked up that he preferred practical experiences and therefore I had to attempt to incorporate these when the opportunities came.
It is crucial for a mentor to also take into consideration the internal and external factors that affect student learning. This can be identified by using the SWOT (strength, weaknesses, opportunities, threats) Analysis. The SWOT Analysis is a useful tool to help mentors identify factors that can either improve or hinder their mentoring skills (Murray and Rosen 2010). The strengths and weaknesses are the internal factors that affect the efficiency of mentoring while the opportunities and threats are the external factors (Murray and Rosen 2010). Teaching a student who is an adult learner will require the mentor to actively seek the students input. This
means that as a mentor, I should not decide on what and how to teach the things that the student needs to learn in the placement, I should brainstorm with the student on how the students learning needs can be best met. This would allow Jay to have a more active role in planning his own learning during placement and seeking help where required.
We talked about the risks that could be faced on the ward as some of our patients can present with challenging behaviours leading to them being physically aggressive towards staff or other patients and requiring them to be restrained and had to remind Jay that for the next few months whilst on placement, he unfortunately could not assist in restraining patients but he could record where each member of staff was during the restraint or redirect the other patients away from where the incident was happening. I reminded Jay that it was my professional duty to ensure his safety and that of the patients as well. We agreed that if he was unsure about a situation, he shouldnt hesitate to ask me or any other nurse he would be working with.
We discussed the importance of report writing and recording and that they are principles that we follow to help with this. I asked Jay to look at the hospital policy regarding information governance and informed him that it can be summed up by saying that anything you write or enter must be honest, accurate, and non-offensive and must not breach patient confidentiality RCN (2009). As nurses, we are accountable for what we document, and it must be factual.
We also talked about having our mid-point feedback and then agreed on a date for the final feedback whereby we would talk about the final grade. I informed Jay that if he felt he needed extra support prior to the dates he should let me know and I informed him that if I had worries about how the placement was going, I would also request to see him support him for him to progress well with the placement. It is essential to give feedback as it is an important component of effective student assessment. Kinnell and Hughes (2010) relate that feedback must be constructive and not destructive . It must highlight the strengths as well as the weaknesses of the student (Kinnell and Hughes 2010). Kinnell and Hughes (2010) further state that it must emphasize areas for improvement and incorporate praises appropriate for the students achievements. Constructive feedback given by mentors and the clinical staff can help with the students growth and development as a future professional (Levett-Jones and Bourgeois 2011). One strategy for the effective giving of feedback is to use a strategy called feedback sandwich. This involves sandwiching negative feedback between two positive feedbacks to avoid hurting the students feelings and self-esteem (Elcock and Sharples 2011).
Whilst assessing a students performance, its my accountability as the mentor that includes making sure that all the possible opportunities for learning have been exhausted and that I gave Jay some time to master the skills that he would be assessed on. It would have been unfair for Jay to be assessed on skills that he was never taught or even given a chance to learn or improve on. There is also the accountability of theme as the mentor towards the public as I would be mentoring the future generation of nurses to come into the field. This accountability
signifies that ultimately my mentors role in guiding students is to ensure that future generations of nurses are truly competent to serve the general healthcare consumers NMC (2008). This suggests that if after giving opportunities to improve, the student has failed to show competence, then I as the mentor should be prepared and must not hesitate to give a failing mark.
On the other hand, a study conducted by Duffy (2003) revealed that failing a student is a difficult thing to do for the majority of mentors and this is because it raises emotional issues for the mentor. The emotional dilemma of failing a student is carried by mentors and sometimes this emotional stress overcomes the need to practice fair and objective mentoring. Working with and observing a student in placement over several weeks can be emotionally challenging and may induce feelings of guilt if the student’s career is jeopardized (Hawe, 2003) It is logical to assume that sometimes the decision to either pass or fail students is influenced by the personal sentiments of the mentor towards the student. This is something that should be avoided because it threatens the very essence of why there is a need to assess students under mentorship. A good mentor is someone who knows when to empathize with students and when to detach themselves to objectively assess a students performance, personal friendly relations which he or she may have established during the mentorship should not affect the grade the mentor gives the student.
According to the study by Duffy (2003), first-year mentors give students the benefit of the doubt when grading them, and some students whose practice was evidently weak and identified at an early stage, should be given the necessary support and removed from the program if there is no improvement. By the time a student gets to their final year and theres no improvement, according to Black (2011), they would be unsafe to be in practice. However, it is accepted that some management skills cannot be tested until this stage and it is probably necessary to have some level of failure in year three. If a student is failing, they should seek out support from their mentor and a mentor should also pick it up before the student gets to the end of placement and they can support them. The mentor can have a meeting with the student and the University tutor to discuss the concerns. If the student gets to the end of placement and theres still no improvement, then the mentor has no choice but to fail the student and it shouldnt come as a surprise to the student if they have been made aware during the duration of the placement.
In conclusion, having completed this module and being a co-mentor, I learned and developed new skills and exploited my mentoring qualities. It made me look more at my own practice and make sure that it is evidence-based and I can apply it when mentoring student nurses. Having learned and explored more on learning styles and theories has made me aware of the different styles people learn and has made me more aware when planning learning experiences for students. I am determined to make sure I will attend regular mentors updates, so I can mentor students effectively. It would give me the chance to meet up with other mentors and share ideas and discuss any issues that I may be facing or have faced, and I would find out how others dealt with such a situation the University would also share with mentors any new regulations and expectations that mentors should be aware of. As a mentor, I also received feedback from my manager who was mentoring me, and from the student that I was mentoring as this was also a learning curve for me. Receiving this feedback made me reflect on my own practice and I got to learn which areas I needed to develop and improve on.
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