The current healthcare environment, with regulatory burden, uncertain financial reimbursement, health inequities, and structure and process complexity, challenges healthcare providers in ensuring quality and safety for optimal patient outcomes. As always, the nursing profession keeps focused by putting patients and families at the center of care. For managers, this means supporting units and departments in a way that allows nurses and other healthcare providers to navigate the complex environment with ease to achieve excellence in caring and healing practices. Managers are challenged with steering through this environment while, at the same time, ensuring departmental operational success.
These current challenges put nurse managers under considerable stress, with a strong argument that the role is the most demanding one in the healthcare system. The nurse manager's job can sometimes seem overwhelming: guaranteeing appropriate safe staffing, managing budgets, collaborating within nursing and other healthcare disciplines, and ensuring that staff members stay engaged through a positive and healthy work environment. In order for managers to have success with these activities—especially those new to their role—they need support, education, and guidance to achieve the foundational leadership skills needed for their positions.1 Mentoring and coaching that provides education and support is vital to obtaining this skill set. In addition, nurse mangers must realize that mentoring and coaching are just as important for their staff members to grow, develop, and handle current workplace challenges.
A mentoring program that meets the needs of nurse managers and nursing staff should focus on the following areas:
- defining and outlining mentoring, which enables the protégé to make quality choices about the focus of mentoring relationships
- determining the skill set needed to meet the challenges of the healthcare environment
- exploring the options for how to find mentors
- understanding the potential benefits of mentoring so that the return on investment can be tracked
- examining options for staff mentoring programs.
Kathy Kram's seminal work on mentoring, Mentoring at Work: Developmental Relationships in Organizational Life, based on extensive research on how professionals advance their careers, defined mentoring as a “...developmental relationship that enhances both individuals' growth and advancement.”2 Nurse mentoring has been defined as being “...a reciprocal and collaborative learning relationship between two individuals with mutual goals and shared accountability for the success of the relationship.”3 However, nurse mentoring goes beyond a dyad relationship between the mentor and protégé, extending to include the workplace or organization as an important aspect of mentoring success.4 There's enough evidence to suggest that a supportive work environment impacts the success of a mentoring relationship.
Kram provided a framework of three mentoring functions: career assistance, psychosocial support, and role modeling.2 (See Table 1.) The area of career assistance focuses on the opportunities that the mentor can give the protégé. With psychosocial support, the focus of the mentoring collaboration is motivation and approval. Role modeling provides the opportunity for the protégé to observe others and learn from their actions, particularly in relationship to the application of personal values in work settings and strategic tactics used to address problems.
In the nursing profession, mentoring was adapted from the business world. Formal mentoring programs have been growing in popularity.4 Coaching has also gained momentum. Mentoring is a longer-term relationship in which the focus is on the overall professional growth of the nurse, whereas the shorter-term coaching relationship is aimed at developing a certain skill set or behavior usually associated with performance.5-7 Coaching helps others define their need and address that need, whereas mentoring involves support and guidance through advice and sharing professional wisdom.7 Table 2 compares the aspects of mentoring and coaching.
Determining relevant areas
The mentoring relationship supports the nurse manager in building a leadership skill set. The foundational skill set and competencies needed to perform the nurse manager role can be found at work. The mission, vision, and values of the organization supply the building blocks to create goals for the mentoring relationship. Organizational strategic goals provide the opportunity for the nurse manager to recognize possible gaps in knowledge and competencies that support the overall success of the organization. The nurse manager's job description points to competencies that are essential for success and can become a focus of mentoring.
Based on the Nurse Manager Learning Domain Framework, the American Organization of Nurse Executives (AONE) Nurse Manager Competencies are the foundation for professional practice.8 The framework and accompanying Nurse Manager Skills Inventory were developed in a collaborative agreement between the AONE, the American Association of Critical-Care Nurses (AACN), and the Association of periOperative Registered Nurses.9 The framework encompasses three areas of nurse manager accountabilities: the science—managing the business, the art—leading the people, and the leader within—creating the leader in yourself. In order to be successful, the nurse manager should gain expertise in all three areas. See Table 3 for examples of competencies associated with the framework. Assessing all of the competencies with the Nurse Manager Inventory Tool can provide a gap analysis for deciding on the focus and goals of the mentoring relationship.
For career planning, the AONE's Nurse Executive Competencies are helpful in achieving awareness of the competencies required for director and CNO roles in healthcare organizations.10 The competency domains include communication and relationship management, knowledge of the healthcare environment, leadership, professionalism, and business skills and principles.
Formal nurse mentoring programs may be a key to successful nurse manager professional development. The AACN Healthy Work Environment authentic leadership standard supports this and is foundational to the mentoring relationship: “Nurse leaders must fully embrace the imperative of a healthy work environment, authentically live it, and engage others in its achievement.”11 Critical elements noted for the authentic leadership standard include healthcare organizations making a formal mentoring program available for all nurse leaders and nurse leaders actively engaging in the mentoring of nurses in all roles and levels of experience.11
The current workplace, the competencies needed to support the organization's future vision, and professional accountability to national competencies and standards are the basis for which nurse managers can self-assess their assets and gaps in competencies. The awareness of need will lead to finding the right mentors and should be a first step in professional development.
Finding your mentor
A key to effective mentoring is choosing the right person as a mentor in a particular area of need or interest. How do you find that person? One of the more obvious places to start is your current workplace; many competent mentors are easily accessible in our own organizations. Perhaps it's someone who you've always admired for his or her character and leadership abilities. For nurse managers, we often look for fellow nurses to serve as mentors. But other healthcare and hospital business professionals can be mentors, bringing a different perspective of the workplace.
For the nurse manager, mentoring can come from a variety of professional colleagues, supervisors, or senior directors. Widening the mentoring opportunity with more than one mentor allows for ample exposure to wisdom, advice, and support. Table 4 illustrates an example network that nurse managers may build for their overall professional development and career progression.
A quality mentor is a good listener with strong self-esteem; a positive outlook; excellent communication skills; and the ability to be open, honest, and authentic. An excellent mentor should support the protégé without taking charge. Having the same clinical background may or may not be one of the characteristics of the right mentor. However, making sure that the mentor has the time to invest in developing a relationship is important. Investing in others does take time, but it's often a rewarding professional activity.
If the goal is to improve specific skills or competencies, finding a mentor with coach qualities may be a consideration. Coaches are forward-looking, deliberate, and directed at expanding the potential growth of others' skill sets. Their focus is on the specific development of a skill or competency as they maintain objectivity and give behavior-based feedback. You'll need to find a person who has the ability to coach in the specific area needed or who may be certified as a coach.
An established self-assessment will help you determine the right individuals to serve as mentors. The three mentoring functions—career assistance, psychosocial support, and role modeling—provide a framework to assist you in finding the right person. (See Table 5.)
After identifying possible mentors, arrange a meeting with them to ask further clarifying questions. Do they have time to devote to a mentoring relationship? What other mentoring have they done? What's their philosophy on mentoring? What was the process for their previous mentoring experiences? In addition to asking these questions, goals and objectives of the mentoring experience should be shared with the potential mentor, as well as defining the length of the relationship. The answers to these questions can ensure that there's a good match with your needs and personality. The match between the mentor and nurse manager is a key to a successful relationship.
Understanding the benefits
Successful mentoring relationships are built on trust, which helps establish support, build confidence, and improve the protégé's contribution to his or her position and the organization. Both the protégé and mentor benefit from the relationship.4
The protégé gains an increased level of confidence and global thinking, as well as feeling more empowered as a professional. The underlying insight into unwritten rules and politics also helps the protégé understand the possible political environment and complexity of the workplace.12 The mentor is fulfilled by leaving a legacy and influencing those who'll carry on in the profession. The mentor may also feel the intrinsic benefit of teaching and be more empowered as a result of the mentoring relationship.12
When ready, the nurse manager may want to consider becoming a mentor to others.
Confidence and empowerment
Within the current state of our healthcare system, nurse managers are challenged to meet unit operational needs, ensuring that staff members are resourced and feel empowered to keep the patient at the center of care. Managing a unit or department 24/7 is stressful. Having the right management and leadership competencies is needed to fulfill the obligation to the role, decrease stress, and ensure job satisfaction as a professional leader. Mentoring can help nurse managers develop professional competencies and improve their confidence and empowerment. Picking the right person is foundational to the success of a mentoring relationship. Finding a mentor who supports yet challenges our professional growth is important, but it's the trusting relationship that makes the difference. The benefits of mentoring are vast. Improving leadership skills will lead to increased confidence and a feeling of empowerment that's the key to success as a nurse manager.
Join us next issue for part 2, in which we examine how nurse managers can assist their staff members with their own mentoring program.