Successful mentoring relationships can assist nurses in learning the ropes at an organization, increase career satisfaction, and decrease turnover rates.1-4 Mentoring success is reliant on the health of the workplace, protégé and mentor characteristics, and the quality of the mentoring relationship. Going beyond thinking of the mentoring relationship as being between two people (a dyad experience), we can consider a triad model, including the protégé, mentor, and organization, and involving investments and benefits for all three.5 Aligning a healthy workplace and a good mentoring process into a model of structure, process, and outcomes is vital to both the successful creation of mentoring relationships and the subsequent outcomes of those relationships. (See Table 1.)
To organize a mentoring program that meets nursing staff needs, we must understand the potential mentoring benefits so that the return on investment can be tracked, as well as the different aspects of mentoring and the options for program structure.
Outcomes and benefits
One of the key nurse manager role responsibilities is to engage staff members in the development of a healthy workplace, valuing all for their contribution to patient care and unit excellence. The nurse manager, along with other unit leaders, sets the tone for supporting staff personal and professional growth, from newly hired to expert nurse and from protégé to mentor. Mentoring is foundational in providing opportunities for growth, not only for the protégé, but also for the mentor and the organization.
Mentors enjoy the benefits of a mentoring relationship in four areas: having a positive impact on the protégé and his or her practice; deriving a personal sense of satisfaction from giving back to the profession; feeling like they're contributing to unit functioning and organizational improvement; and gaining professional success, such as increasing their own skill set and knowledge, earning a higher salary, getting promoted, and being respected across the organization.1,3,6,7
For the protégé, the benefits of mentoring are varied. It's well known that mentoring can lead to improved job satisfaction, which is critical for retaining talent and succession planning.2 For the newly licensed nurse, improved competencies and transition to the RN role are supported with mentoring during or after a residency, and may bridge a gap between preceptorship and coaching completed by the management team.8
The organizational benefits integrate with the protégé and mentor benefits. Mentoring programs have a positive impact on nurse retention, transition of the newly licensed nurse at both the RN and APRN levels, and nurse satisfaction and engagement.1,2,7,9 Mentoring has been used to decrease bullying, improve the workplace, and in succession planning at all levels of nursing.2,7,10,11 Through increased nurse satisfaction and engagement, mentoring may also support the improvement of patient satisfaction and outcomes.
There's strong evidence to suggest that mentoring programs have a large return on investment. In reviewing just turnover cost, one hospital saved $328,800 with a mentor program.8 Another program found a 391% return on investment.6 Other important outcomes that may be tied to cost savings or cost avoidance are improvements in nurse satisfaction and workplace and unit culture, which impact patient experience and outcomes.
Effective mentoring relationships depend on the skills of both the protégé and mentor, such as brokering the relationship, goal setting, communicating effectively, and managing conflict.12 A critical element in the success of the mentoring relationship is the protégé taking responsibility for his or her development; if the protégé isn't ready to be honest and reflective about his or her need for growth, mentor communication is likely to be unproductive.12 Nurse managers need to encourage protégés who show not only career promise, but also the ability to learn and grow from others in a self-reflective way.
Just as much of a challenge is finding mentors with skill in respecting the protégé's agenda, developing trust, and giving constructive feedback. Aligning feedback with the protégé's agenda is particularly necessary for relationship development. The mentor should understand that successful relationships are based on perspective sharing and exploring the different realities of him- or herself and the protégé. Feedback should be given in an actionable form, even if the mentor is calling for reflection.12
There are four phases of a mentoring relationship: 1) initiation, 2) cultivation, 3) separation, and 4) redefinition.13 Mentoring relationships develop through these phases as the personal and professional perspectives of the individuals are shared, and as the organizational context influences the relationship due to factors such as support for quality interaction.
The focus of the initiation phase is for the protégé and mentor to communicate enough that they discover a basis for positive interactions in which the protégé finds value and the mentor comes to view the protégé as a person worth investment. The nurse manager's role during this time period is to monitor the outcome and potentially assist either party in exiting the relationship early if this phase points to an unsuccessful outcome.
The cultivation phase is where the real value of the relationship is discovered and the bond between the parties is enhanced. During this phase, career functions are often the focus, but if the relationship develops with a great deal of trust, the protégé's psychosocial needs may also be addressed. The nurse manager's role during cultivation is to help protégés clearly articulate their needs so that they're aware of the progress made in the relationship.
The separation phase begins when the protégé believes that the mentoring relationship has served its purpose and provided the assistance needed. The protégé experiences a new sense of independence and shows autonomy from the mentor. This is a period where both physical and psychological separation can take place. It's during this phase that there's potential for destructive results, particularly if the mentor isn't ready to let go. For this reason, it's often important for the nurse manager to suggest that the relationship start with an expectation of closure at some point or at least a time frame for checking in to see if the relationship still serves its purpose.
The last phase, redefinition, provides the opportunity to move toward building a peer relationship between the two individuals. Some relationships move to a more distant peer professional mode or even to a friendship mode. This is the point where most organizational involvement in the relationship ends.
The nurse manager helping employees develop good mentoring networks should pay particular attention to two key factors. First, that mentor networks have appropriate breadth and depth to enable a diversity of feedback. Second, that mentoring relationships develop along a successful path for the duration needed and don't become destructive.
An important factor in the effectiveness of mentoring programs is providing protégés with diverse perspectives on their careers and professional dilemmas. Consider “mentoring constellations,” or the formation of many mentors in developing a protégé.14 Diversity is both the number of individuals providing mentoring conversations and also their uniqueness. Ask yourself: Do the individuals come from different social and professional networks? The protégé needs to reach out to different networks, such as different areas of nursing specialty, other healthcare professionals, or even other functional areas of the organization, to gain a diversity of views.
Although nurses can gain valuable mentoring from a variety of individuals, it's also important that some of those relationships provide depth of communication, reciprocity, and even emotional affect. The nurse manager can assist by asking his or her employees to consider these issues when selecting mentors and deciding the amount of investment to make in a relationship.
Organizations have an important decision to make when they decide to address the mentoring needs of their employees: whether to begin a formal structured mentoring program or provide resources and encouragement through more informal means. The advantage of formal programs is that mentoring relationships are formed with organization assistance, usually for a limited time with prescribed goals.15 On the other hand, informal mentoring starts with interaction between potential partners and is driven by protégé-defined goals.
Choosing the right path for a particular organization requires consideration of structural features (goals, training, and types of relationships), matching processes, protégé and mentor characteristics, organizational support mechanisms, and desired outcomes.15 Based on the literature and evidence, it's our suggestion to develop a formal program with informal aspects of the mentoring process, including mentor/protégé selection and pairing, and openness to reverse mentoring or peering.
Mentoring programs need several components to ensure success. (See Table 2.) Establish measurable goals for the program. Choose measures easily obtainable for your unit, such as turnover rates, nurse satisfaction, and some measure of nurse engagement. Consider measures highlighting the protégé and mentor benefits, as well as the unit and/or organizational benefits. As with any new or continuing program, a return on investment is vital to ensure continued organizational support.
The best mentoring relationships are those in which the protégé chooses his or her mentor. Matching protégés with mentors can lead to incompatibilities and poor experiences with the mentoring relationship.16 The nursing literature describes different ways of matching, but evidence suggests having the relationship evolve by providing opportunities for protégés and mentors to find each other. See Table 3 for tips on creating these opportunities.
As workplace technology and relationships become more complex, the types of mentoring have expanded. The traditional view of mentoring is that of a senior professional mentoring a junior. As programs have developed, value has been found in junior professionals mentoring seniors, particularly in relation to skill sets that are needed to keep up with technology. This has been called reverse mentoring, but more recently it's been noted as peering—the sharing of expertise and ideas among protégés and mentors in a back-and-forth networking approach.17 Knowledge, expertise, and competencies are shared among many nurses; for example, the new nurse may be able to assist the older nurse with technology challenges.
Group mentoring, also called collective mentoring, is also an option and can be particularly effective in enhancing employee performance.18 In collective mentoring, a collection of individuals with a common characteristic meet to engage in mentoring activities, such as sharing ideas and supporting each other.19 For nursing, this is often seen as a collection of nurses and/or managers who meet to share ideas and thoughts stimulated from books, case studies, and real-life situations, to name a few. Collective mentoring can be adapted for the newly licensed nurse, the nurse who's interested in the next step on the career path, or the nurse being considered for leadership succession planning.
As early as 2007, research on e-mentoring was being reported, and robust literature has developed on successful electronic communication.20,21 There's a void in the nursing literature on e-mentoring programs and their success. One program established an e-mentoring program for DNP students, resulting in an overall positive experience; however, time was noted as a barrier to success.22 With e-mail as the communication approach, the drawbacks include lack of confidentiality, e-mail fatigue, lack of nonverbal cues, and the time it takes to communicate electronically.23
Growth and development
Nurse managers are in the unique position to ensure that structures and processes are in place to support staff growth and development. Investment in nursing staff is vital to improvements in culture, leading to best outcomes for patients and families, and a positive fiscal bottom line for hospitals. Nurse leaders at all levels can create positive learning environments, recognizing that nurses at the bedside are crucial to staff, unit, and organizational outcomes. Mentoring is one way to support this learning environment. Valuing professional growth as the key to unit excellence can go a long way in maintaining workplace cultures that are respectful, thriving, and healthy.
1. Gruber-Page M. The value of mentoring in nursing: an honor and a gift. Oncol Nurs Forum
2. Johnson JE, Billingsley M, Crichlow T, Ferrell E. Professional development for nurses: mentoring along the u-shaped curve. Nurs Adm Q
3. LaFleur AK, White BJ. Appreciating mentorship: the benefits of being a mentor. Prof Case Manag
4. Gazaway SB, Schumacher AM, Anderson L. Mentoring to retain newly hired nurses. Nurs Manage
5. Jakubik LD, Eliades AB, Gavriloff CL, Weese MM. Nurse mentoring study demonstrates a magnetic work environment: predictors of mentoring benefits among pediatric nurses. J Pediatr Nurs
6. Cottingham S, DiBartolo MC, Battistoni S, Brown T. Partners in nursing: a mentoring initiative to enhance nurse retention. Nurs Educ Perspect
7. Vergara JY. Implementation of a mentorship program to increase staff satisfaction and retention in critical care. Nurse Lead
8. Buffum AR, Brandon DH. Mentoring new nurses in the neonatal intensive care unit: impact on satisfaction and retention. J Perinat Neonatal Nurs
9. Horner DK. Mentoring: positively influencing job satisfaction and retention of new hire nurse practitioners. Plast Surg Nurs
10. Frederick D. Bullying, mentoring, and patient care. AORN J
11. Griffith MB. Effective succession planning in nursing: a review of the literature. J Nurs Manag
12. Zachary LJ. The Mentor's Guide: Facilitating Effective Learning Relationships
. New York, NY: Wiley; 2011.
13. Kram KE. Mentoring at Work: Developmental Relationships in Organizational Life
. Glenview, IL: Scott Foresman and Company; 1985.
14. Van Emmerik IJH. The more you can get the better: mentoring constellations and intrinsic career success. Career Dev Int
15. Bauch SG, Fagenson-Eland EA. Formal mentoring programs. In: Ragins BR, Kram KE, eds. The Handbook of Mentoring at Work: Theory, Research, and Practice
. Los Angeles, CA: Sage; 2007:249–271.
16. Green J, Jackson D. Mentoring: some cautionary notes for the nursing profession. Contemp Nurse
17. Grossman S. Peering: the essence of collaborative mentoring in critical care. Dimens Crit Care Nurs
19. Funderburk AE. Mentoring: the retention factor in the acute care setting. J Nurses Staff Dev
20. Ensher EA, Murphy SE. Mentoring: next generation research strategies and suggestions. In: Ragins BR, Kram KE, eds. The Handbook of Mentoring at Work: Theory, Research, and Practice
. Los Angeles, CA: Sage; 2007:299–322.
21. Merritt SM, Havill L. Electronic and face-to-face communication in mentoring relationships: recommendations on communication media and frequency of interaction. Dev Learn Organ
22. Harris R, Birk SB, Sherman J. E-mentoring for doctor of nursing practice students: a pilot program. J Nurs Educ
23. Pietsch TM. A transition to e-mentoring: factors that influence nurse engagement. Comput Inform Nurs