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DEPARTMENTS: Message From the NLN Chair

Mentorship for New Graduates: Responding to the Challenge of Transitioning to Practice in a Tumultuous and Demanding Health Care Environment

Poindexter, Kathleen

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Nursing Education Perspectives: 5/6 2022 - Volume 43 - Issue 3 - p 143-144
doi: 10.1097/01.NEP.0000000000000978
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Today I am writing with a renewed sense of hope and optimism. It is exciting to see students and faculty returning to the classrooms and listen to the chatter of voices and the flurry of activity in the halls. Most of all, smiles, once hidden behind masks, are once again visible. As COVID-19 rates decline and restrictions are lifted, life is returning to a new sense of normal. It probably helps that the days are getting longer, and we know spring is right around the corner, symbolizing new beginnings.

For most of us in academia, spring is also a time we say goodbye to our graduating students and welcome them into our profession as colleagues. Thousands of new nurse graduates are about to enter the health care workforce in the coming months, anxious and ready to assume their professional roles. As we celebrate their accomplishments and share in their enthusiasm, we need to remain cognizant of the unique challenges they encountered during their educational experiences. I think we can all agree, the academic preparation of this year’s graduates required a wide variety of creative educational strategies and clinical rotations, and outcomes associated with student learning during the pandemic are not yet fully understood. Studies currently underway will provide insight into their readiness for practice, their confidence, and, ultimately, retention rates in nursing.

We must acknowledge the realities facing our new graduates as they enter the workforce. The class of 2022 is entering a health care environment that is rebuilding after the devastating aftermath of the pandemic. Nurses are in short supply, and the use of travel nurses and float nurses is at an all-time high. Workloads have increased, and nurses are experiencing burnout and exhaustion. A lack of resources to support robust orientation and residency programs is the reality and may place additional stress on novice nurses as they transition into new environments.

We must acknowledge the realities facing our new graduates as they enter the workforce. The class of 2022 is entering a health care environment that is rebuilding after the devastating aftermath of the pandemic…. Workloads have increased, and nurses are experiencing burnout and exhaustion. A lack of resources to support robust orientation and residency programs is the reality and may place additional stress on novice nurses as they transition into new environments.

Earlier reports indicate that transition to practice, under the best of conditions, is stressful for novice registered nurses (RNs) and advanced practice registered nurses (APRNs). Reports indicate that new graduates experience high rates of stress related to unanticipated workloads, feelings of being unprepared for the realities of practice, lack of mentoring, workplace hostility, role confusion, and lack of confidence in caring for patients. Dismal statistics indicate that up to 48 percent of new RNs leave their positions within the first year of practice and 52 percent of APRNs leave within the first two years (Dillon et al., 2016; Labrague & McEnroe, 2018). These statistics are even higher for minority nurses as they transition into the profession (Van Dyke, 2016). The results of new graduates entering an even more tumultuous and demanding health care environment could have even greater effects on professional retention rates.

Although I am reporting some disappointing statistics, I feel the need to return to optimism and opportunity. I am reminded of the National League for Nursing (NLN) mission of “promoting excellence in nursing education to build a strong and diverse nursing workforce to advance the health of our nation and the global community.” Our core values—caring, integrity, diversity and inclusion, and excellence—serve as the foundation for all our activities and goals. Perhaps our role as NLN members and educators does not end once our students exit, proudly displaying their nursing pins and hard-earned degrees or certificates. Looking through my NLN lens, I am reminded of the tremendous efforts our members and students put forth to prepare future members of the nursing workforce. During the pandemic, many of our programs collaborated with our health care peers to be part of the solution, versus adding stress to overburdened systems. Once again, we have the opportunity to be part of a solution designed to enhance retention of nurse graduates and make a significant impact on the revitalization of our own profession.

New graduates have reported a lack of mentoring as one of the issues they encounter during their transition period that contributes to their decision to leave the profession. The establishment of formal or informal mentorship programs to provide support to new graduates during the first year of practice may reduce attrition rates and contribute to a more productive transition period. Studies on the outcomes of participation in a mentoring process report increased retention, satisfaction rates, and confidence (Moss & Jackson, 2019; Van Dyke, 2016; Voss et al., 2022).

An esteemed colleague of mine, Beronda Montgomery (2018), writes extensively on the power of mentoring. She uses the analogy of how humans approach the care of plants. As a plant starts to show signs of distress, such as wilting or discolored leaves, we recognize that the environment or the caregiver failed to provide adequate resources for the plant to thrive. The general response is to attempt to determine what is necessary by providing support and resources such as water, nutrients, or supplements so the plant can once again thrive. Our care is unique and individualized to meet the needs of the plant.

Novice nurses who show signs of distress may be deemed inadequate or simply unable to thrive in this new health care environment. However, if we respond to the novice nurse as we would to a distressed plant, by providing adequate individualized support and resources through mentoring, the nurse will be able to thrive.

Most academic programs have the potential to support a mentorship program at some level. A quick search of “new nurse graduate mentoring programs” will provide some excellent examples of successful mentoring activities employed by nursing programs. One approach is to recruit mentors by partnering with established nursing organizations in your area. Another is to reach out to alumni members, retired faculty, or graduate students who have experience in a similar practice area who may be willing to serve as mentors. Consider establishing a website or app where novice nurses and mentors can share areas of expertise and characteristics that are similar and reach out to establish a mentoring relationship.

Be sure to share resources and recommendations for a successful mentor-mentee relationship with students before they graduate, as well as a list of potential mentors. I encourage you to emphasize the benefits of participation for both the mentor and the mentee. When mentorship programs are well designed, mentees tend to demonstrate higher levels of job satisfaction, role clarity, job performance, increased productivity, and retention rates. Mentors who serve as positive role models report higher levels of personal satisfaction and purpose, knowing they were able to contribute to the successful transition of a novice nurse as a member of our profession. In a blog post written for NLN Nursing EDge (https://nursingedge.nln.org), NLN President Dr. Beverly Malone writes movingly about what a mentorship program meant to her as a young, inexperienced psychiatric nurse and educator and the importance of paying it forward. If we all work together, we have the potential to increase the retention rate of new RNs and APRNs during a time of crisis in our profession and ultimately improve the overall health of our nation.

REFERENCES

Dillon D. L., Dolansky M. A., Casey K., Kelley C. (2016). Factors related to successful transition to practice for acute care nurse practitioners. AACN Advanced Critical Care, 27(2), 173–182.
Labrague L. J., McEnroe P. D. M. (2018). Job stress in new nurses during the transition period: An integrative review. International Nursing Review, 65(4), 491–504. 10.1111/inr.12425
Montgomery B. (2018). From deficits to possibilities: Mentoring lessons from plans on cultivating individual growth through environmental assessment and optimization. Public Philosophy Journal, 1(1), 1–12.
Moss C., Jackson J. (2019). Mentoring new graduate nurse practitioners. Neonatal Network, 38(3), 151–159. 10.1891/0730-0832.38.3.151
Van Dyke M. (2016). Mentoring the next generation of minority nurses. Minority Nurse, 8–13.
Voss J. G., Alfes C. M., Clark A., Kezia L., Lily K. D., Moore S. (2022, February). Why mentoring matters for new graduates transitioning to practice: Implications for nurse leaders. Nurse Leader. Advance online publication. https://doi.org/10.1016/j.mnl.2022.01.003
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