Mentoring is fundamentally a two-way relationship. A mentor has a critical role to facilitate the development of future clinical practice of a pre registration student. Students have an obligation to utilise any opportunities and learning strategies from each clinical placement. Mentorship enables the students to apply their theoretical knowledge and put it into practice in a supervised clinical situation. A mentor is an experienced nurse with additional training who acts as an advisor and teacher in the clinical setting.
In this essay the focus will be on the challenges facing a mentor when supporting an underperforming or failing student and strategies to overcome them. Also ???how??™ a mentor plays a significant role in a student??™s learning process. According to the NMC, Code: Standards of conduct, performance and ethics for nurses and midwives (2008), it is the duty of the practitioners to enable students to develop their competence. The Nursing and midwifery council (NMC) has set eight domains to emphasize the responsibilities and accountabilities for a mentor, these includes creating a good environment for learning activities in clinical practice by acting as a facilitator, assessor and finally as a ???gate keeper??™ in taking decision about the achievement of proficiency at the end of the programme (NMC ,2008). However, there are some challenges which you could face and must learn to overcome in the process of mentorship.
A study was conducted by one education institution in south east England and based on the new standards introduced by the NMC (Ven Veermah 2012): The aim of this study was to identify the challenges faced by a sample of 346 mentors who had completed the programme and to work out ways to support them. A considerable number of mentors who took part in this study highlighted an increased workload and lack of time as major constraints. Other challenges are inadequate preparation for the role and being overloaded by responsibilities. Ven Veeramah also mentioned about another research where a postal questionnaire was sent to a group of students who had completed the mentorship course between September 2007 and January 2010. As per this result, the most frequently cited challenges were lack of time (70%), inability to cope up with increasing demands of patient??™s care and being a mentor (67%) and lack of opportunities to study the necessary assessment documentation (22%) (Veeramah 2012).
Time constraints have a major impact for good mentoring in clinical setting along with the decision making process while managing an underperforming student. Fraser et al (1998) pointed out lack of time available to work with a student as a possible reason for an average or weak student to achieve pass mark (Duffy k 2003). In the practice area, a mentor has a dual role, that means she or he is accountable and responsible to fulfill professional obligations when caring for the patients as well as spending quality time with a student for face to face discussion, genuine feedback and reflection. Most of the times mentors are under pressure due to conflicting demands of patient care and student mentoring. Lascelles (2010) has mentioned, the main source of ???emotion work??™ is the incompatible ideas of client care and organizational demands. Therefore, mentors will be unable to perform their role as effectively as they wish to .Many mentors responded that in noisy, crowded and busy practice areas, it was absolutely impossible to discuss about the learning needs with the students (Teatheredge 2010).Time management is often difficult while doing the varying shift duties which of course affect the mentor-student relationship. This will give the student the impression that he is left abandoned and not getting adequate attention in the mentoring. At the same time mentors also strive to achieve the expected level of performance in both of their roles. In order to have an effective mentoring relationship, the mentor must try to remove obstacles, give emotional support, and allow time for achievement in the work setting (Sheila 2007 ).
Insufficient time can sometimes effect the assessment of a student. Duffy 2004 states that assessment is the critical part of monitoring process (RCN 2009).Passing a student who is not meeting the assessment criteria will put the patient at risk. A mentor has to devote a considerable time to be spent with the allotted student to give the adequate advice to facilitate the necessary arrangements. It is always be a fair evaluation on the ground of nursing skills or practice during the patient care not by considering just student??™s personal qualities and attributes. To overcome this challenge, the mentor should act as an advocate by liaising the concerns with the managers to negotiate protected time .NMC recommends that the mentor should spend a minimum 40% of their time directly with the student (NMC 2008). But I think, while working with an underperforming student, a mentor should increase the percentage of time to work with the student to meet his or her learning needs and objectives. Furthermore, mentors should take an initiate to assign student??™s shifts with them in the roster to have more protected time and organize two specific members of staff in the absence of allocated mentor to assess student??™s performance will help the students to achieve their set goals and objectives and sort out this challenge to an extent. Involvement of clinical tutors or practitioners in student teaching and assessment of competencies will be most beneficial for the mentors to overcome lack of time.
Inadequate preparations for the role and lack of experience or confidence to fail the student who is underperforming and fear to follow the consequences are the other issues faced by a mentor (Black 2011). Many mentors reported lack of preparation is the main reason to carry out their role effectively (Myall et al 2008).If a student who is not progressing or failing to meet the competencies as per the NMC standards of proficiency, it is the responsibility of the mentor to identify it in early stages and offer guidance, supervision and extra support by revisiting the roles and responsibilities of the student to achieve the necessary skills. Students always expect planned and thorough learning from the mentor. Therefore, they wish to have a knowledgeable and skilled person to be their mentor to clarify their doubts and gain knowledge through proper explanations of care (Gray & Smith 2000). Watson (2000) has underlined that some mentors voiced that they were forced to record the progress in assessment sessions even though they were not happy with the performance of the student or that the student was in fact competent however still forced to fail them (Black 2011). In addition, in Duffy??™s (2003) study regarding the issue of failing to fail, six out of twenty six mentors raised that they didn??™t have enough experience to fail the student. Other??™s belief was that they can only fail the assessment sessions and it is the responsibility of the education institution to take a final decision to fail students. But NMC (2008) clearly states that mentors are responsible and accountable to take the final decision to pass or fail a student (RCN 2007).
According to Duffy and Scott (1998) failing a student is a personal failure to a mentor as well as to the student (Duffy 2003). Therefore, some mentors are very reluctant to fail a student. At the same time it is a heart breaking experience for the students, they will display a range of emotions. To avoid these unpleasant circumstances, some mentors are pressurized to pass an incompetent student. To fail a student in clinical practice, a mentor must have courage, confidence, experience and sufficient preparation. Duffy (2003) recommends, if a mentor does not have enough experience to handle a failed scenario, they should work with an efficient and experienced mentor, get peer support and also seek advice from the link tutor and education institution to prevent the future outcomes of giving the student the ???benefit of doubt??™. To make a ???fail decision??™with more confidence, a mentor has to provide evidence of this underachievement in the form of written records of telephone calls, formal concerns from the previous mentors or staff members, dates of meetings, action plans and assessment documentation (RCN 2009). It is a mandatory requirement that a mentor should attend annual updates (RCN, 2009).Unable to meet the professional development needs make them having a feeling of being unfit for the role(Myall et al, 2008). Mentors should realise the importance of completing regular updates rather than ticking boxes by spending few hours in the theory session or just signing the attendance.
The third most common challenge is the personal bias between the mentor and the student (Koocher,2006).If the mentor has a very good relationship with the student, for example, sharing personal dilemmas, the mentor will find it difficult to express any underachievement to the student at a professional standard. Continuous monitoring and evaluation by a mentor is imperative in ensuring the professional development of a student (RCN,2009).Personal bias could adversely affect this and thereby hinder the professional development of the student as well as the mentor. Firstly, the mentor should take a neutral stand, that is; he or she should evaluate and provide feedback solely on the basis of the merit of the student. For this the mentor has to keep a professional boundary with the student. Secondly, the mentor should take into account the student??™s overall performance rather than a few specific aspects of the student??™s progress. For instance, it is quite unfair to judge a student as competent or incompetent on the basis of a particular incident. As an assessor, the mentor has also a duty to provide the student with the necessary feedback about the level of their performance. Being the basis for assessment and reflecting the evaluation of the mentor, the feedback ???should be focused on behaviour rather than the person, and on observations or descriptions rather than inferences??™ (Glover, 2000).
Furthermore, the parameters of the relationship between the student and the mentor should also be well defined. Otherwise there would be a chance of personal or vague discussion which is unnecessary and it deviates from the professional ethics. Unnecessary discussions have a tendency to diminish the value of mentoring lessons. Most interpersonal problems are discernible while mentoring when the professional relationship sliding to a personal one. Breach of professional ethics by either party will affect the relationship and the mentoring. Weak performance of the student which is not meeting expectations may affect the mentor negatively. Always the third party??™s remarks for example, experienced supervisor or sign off mentor, are significantly constructive to notify the mentor and student about the unprofessional relationship. This helps both parties for a better understanding of the expectations of a healthy relationship in the mentoring .Most of the problems in the mentoring can be minimized when both mentor and mentee are aware of the clear ideas of the professional relationship and the challenges in the mentoring (Koocher,2006).Students should always bear in mind the trust values, team dynamics and their professional role. A good personal attitude between the student and the mentor will always pave the way for a good oriented relationship before mentoring begins and even throughout the course.
In conclusion, mentoring is a complex role. The nursing sector requires more and more staff but needs at the same time to maintain the same quality of service it has always provided to protect the patients from harm and promote good practice. For this reason it becomes essential that mentors should distinguish and separate the unfit students from the one that are excelling. So while helping and guiding students to translate theory to practice especially underachieving students in the clinical setting, a mentor has to take an excellent effort to overcome the challenges as well as to deliver their role effectively. In my opinion, the coordination and co-operation of team members, managers, academic institutions and sufficient time are the main key points for successful and good mentoring. It will ease the mentors to perform and shine in their multi task role efficiently as well as developing competent and knowledgeable students.
? Duffy K (2003) Failing Students: a qualitative study of factors that influence the decisions regarding assessment of student competence to practice. Available online: http://www.nmcuk.org/Documents/Archived%20Publications/1Research%20papers/Kathleen_Duffy_Failing_Students2003.pdf
? Glover, 2000 Feedback. I listened, reflected and utilized??™: Third year nursing students perceptions and use of feedback in the clinical setting: Available online: http://onlinelibrary.wiley.com/doi/10.1046/j.1440-172x.2000.00218.x/full
? GRAY M.A. & SMITH & SMITH L.N. (2000) Journal of Advanced Nursing 32(6), 1542?±1549 The qualities of an effective mentor from the student nurses perspective: findings from a longitudinal qualitative study
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Available online :http://www.apa.org/education/grad/intro-mentoring.pdf
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? Myall M et al 2008: Mentorship in contemporary practice: the experiences of nursing students and practice mentors.Available online: http://images.coventry.ac.uk/PlacementConnect/professionspecific/resources/Documents/research/nursing_nursing%20(2).pdf
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? Nursing and Midwifery Council 2008: Available online
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? Sheila c 2007: Mentoring in nursing, a dynamic and collaborative review, Available online
https://www.rcn.org.uk/ data/assets/pdf_file/0008/458234/Black_S_PhD_Thesis August_2011.pdf
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