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Mentorship ReSPeCT Study: A Nurse Mentorship Program’s Impact on Transition to Practice and Decision to Remain in Nursing for Newly Graduated Nurses

Open AccessPublished:August 14, 2022DOI:https://doi.org/10.1016/j.mnl.2022.07.003

      Abstract

      The COVID-19 pandemic has worsened a pre-existing US nursing shortage, leaving newly graduated nurses vulnerable in their early career. This study analyzed the effectiveness of a mentorship program offering individualized mentorship through culturally congruent, customized pairing for 96 mentees. Key findings of this study show that this nursing mentorship was beneficial for the majority of mentees on their decision to remain in nursing, and on their self-confidence, problem-solving, professional communication, and transition to practice, with perceived benefits steadily increasing for mentees up to 2 years. These findings have valuable implications for innovative recruitment and retention interventions to address the nursing shortage.
      Key Points
      • The Be1Support1 nursing mentorship program had positive effects on the decision of newly graduated RNs (NGNs) to remain in nursing, their self-confidence, problem-solving, professional communication, and transition to practice.
      • Perceived benefits of mentorship steadily increased for mentees up to 2 years.
      • Integrating mentorship during the current nursing crisis can serve as a strategy to support the well-being of NGNs early in their professional nursing careers and may have implications for retention.
      Although there are 4.3 million active registered nurses (RNs) in the United States (US), the US continues to experience a nursing workforce shortage.
      NCSBN. Active RN licenses: a profile of nursing licensure in the U.S.
      ,
      • Chan G.K.
      • Bitton J.R.
      • Allgeyer R.L.
      • Elliott D.
      • Hudson L.R.
      • Moulton Burwell P.M.
      The impact of COVID-19 on the nursing workforce: a national overview.
      The Covid-19 pandemic worsened the US nursing shortage, impacting everyone from nursing students to nurses who choose to resign, leave the profession, or retire early.
      • Berry D.M.
      • Bitton J.R.
      Not working well: clinical placement for nursing students in an era of a pandemic world. 2020. Oregon Center for Nursing.
      Incredible Health Staff. Study: 186% pandemic spike in nurse demand worsens turnover and stress. incredible health. March 11, 2021.
      • Samee Ali S.
      Why some nurses have quit during the coronavirus pandemic. May 10, 2020. NBC News.
      COVID-19 magnified structural and social factors that contribute to the current nursing shortage in the US, including staffing, safety concerns, work-related stress, vicarious trauma, burnout, moral distress, and vaccine hesitancy.
      • Chan G.K.
      • Bitton J.R.
      • Allgeyer R.L.
      • Elliott D.
      • Hudson L.R.
      • Moulton Burwell P.M.
      The impact of COVID-19 on the nursing workforce: a national overview.
      ,
      American Nurses Foundation
      Pulse on the Nation’s Nurses Survey Series: COVID 19 two-year impact assessment survey. March 2022.
      Incredible Health Staff
      Study: 34% of nurses plan to leave their current role by the end of 2022. Incredible Health. 2022.
      • Van der Heijden B.
      • Brown Mahoney C.
      • Xu Y.
      Impact of job demands and resources on nurses’ burnout and occupational turnover intention towards an age-moderated mediation model for the nursing profession.
      As a result, nurses have left the profession at an alarming rate, and lower nurse retention and higher nurse turnover further impair the ability to onboard, precept, and mentor new RNs.
      Incredible Health Staff
      Study: 34% of nurses plan to leave their current role by the end of 2022. Incredible Health. 2022.
      First-year turnover rates for new nurses range from 13% to 31%, indicating that a nurse leaves or transfers within the work environment.
      NSI Nursing Solutions
      NSI National Health Care Retention & RN Staffing Report. 2022.
      ,
      • Kovner C.T.
      • Brewer C.S.
      • Fatehi F.
      • Jun J.
      What does nurse turnover rate mean and what is the rate?.
      Among nurses under age 35 years, 63% report that they intend to leave or are considering leaving their current position, and 66% of nurses reported feeling burned out, a syndrome resulting from chronic workplace stress that hasn’t been successfully managed, which is far higher than for other age groups.
      American Nurses Foundation
      Pulse on the Nation’s Nurses Survey Series: COVID 19 two-year impact assessment survey. March 2022.
      ,
      World Health Organization
      Burn-out an “occupational phenomenon”: International Classification of Diseases. 2019.
      The heavy workload experienced during the nursing shortage impacts both nurse and patient safety.
      University of St
      Augustine for Health Sciences. The 2021 American nursing shortage: a data study. 2021.
      Therefore, it is incumbent upon leaders in health care organizations to address and mitigate this nursing workforce crisis.
      Multiple interventions are required to effectively support newly graduated RNs (NGNs). These include clinical training and social support such as mentorship. Mentorship is the support provided by a mentor, who offers a nurturing relationship that involves sharing knowledge and experience, providing emotional support, advice, constructive feedback, role-modeling, and guidance, that extends over time.
      • Mijares L.
      • Baxley S.M.
      • Bond M.L.
      Mentoring: a concept analysis.
      Although the focus of nurse orientation and residency programs remains largely on clinical training, mentorship can assist the NGNs transitioning into professional practice. Nursing mentorship has been proven to be beneficial by enhancing communication skills, increasing self-confidence, and increasing job satisfaction, which ultimately encourages nurses to stay in the profession.
      • Saletnik L.
      The importance of mentoring.
      Also, mentorship can ease some stressors of the novice nurse by offering support, guidance, resources, and camaraderie, and may have a protective effect against nursing burnout.
      • Temkar A.
      Research: mentorship reduces nurse burnout.
      Because mentorship programs are not customized, standardized, or widely offered to all NGNs, more data are required to validate the effects of mentorship on NGNs.
      The purpose of this study was to evaluate the effectiveness of the Be1Support1 mentorship program that offers individualized mentorship through culturally congruent customized pairing between experienced nurse mentors and novice nurses. This mentorship ReSPeCT study explored the effects of mentorship on these 5 dimensions for mentee NGNs (which explain the acronym): decision to Remain in the nursing profession, Self-confidence, Problem-solving, professional Communication, and Transition to practice.

      Methods

      This study evaluated the level of satisfaction and perceived benefits from a nonprofit mentorship program in California that offers collaborative, culturally aware matching and individualized mentorship. A 25-question electronic survey was sent via e-mail to all mentees (n = 151) participating in this Be1Support1 mentorship program as of June 2020. The focus of this investigation was limited to 3 types of mentees: nursing students (NS) who were enrolled in nursing school; NGNs within 24 months of graduation; and post-new graduates (PNG) within 24 to 36 months of graduation. Inclusion criteria consisted of mentees enrolled and matched with a mentor in the Be1Support1 mentorship program at the time of survey participation. Respondents were assigned to 4 cohorts according to their tenure in the program:
      • Mentees who had been matched with their mentor for less than 6 months
      • Mentees who had been in a relationship with their mentor for 6 months to 1 year
      • Mentees with a mentorship relationship of 1 to 2 years in duration
      • Mentees having a mentorship greater than 2 years in duration
      The survey questions addressed a variety of topics, including perceived benefits of the mentorship relationship; frequency and content of the mentor/mentee discussions; the mentee’s satisfaction with their mentor; and satisfaction with program administration and the resources that had been provided to mentees by Be1Support1.
      The survey question and response options included closed-ended questions with a predefined list of options, open-ended questions that allowed for free-form entry of information, questions with drop-down menu options, and questions with Likert scale response options: not applicable, not at all, a little, somewhat, quite a bit, and very much. This study focused on the results of 5 specific questions pertaining to mentee perception about their mentorship, answered using the 5-point Likert scale. These 5 questions assessed the benefits of mentorship and have broader applicability beyond the Be1Support1 program. These questions were:
      • 1.
        Did mentorship influence the mentee’s decision to remain in nursing?
      • 2.
        Did mentorship influence the mentee’s self-confidence in their abilities as a nurse?
      • 3.
        Did mentorship enhance the ability of the mentee to problem-solve work- or school-related issues?
      • 4.
        Did mentorship enhance the effectiveness of the mentee’s professional communication?
      • 5.
        Was mentorship helpful in the transition from new graduate to practicing RN?
      The scope of this paper is limited to mentee experience, so content pertaining to Be1Support1 program administration, the content and quality of mentoring sessions, and attributes of individual mentors are outside the scope of this paper. The responses for mentees who were still in nursing school or who had not yet secured their first nursing position were excluded from the data regarding transition from new graduate to practicing RN.

      Results

      In total, 96 mentees completed the survey, representing an overall mentee response rate of 63.6%. Of the 96 respondents, 57 were NGNs, 36 were NS, 5 were recently graduated RNs also pursuing a BSN or MSN (NGN + NS), and 3 RNs were 2 years PNG. According to their tenure in this program, the number of respondents in each of the 4 cohorts was:
      • 60 mentees had been in a mentoring relationship for 6 months or less.
      • 12 mentees had been matched with their mentor for 6 months to 1 year.
      • 20 mentees had been mentored for 1 to 2 years.
      • 4 mentees had been mentored for longer than 2 years.
      The graphs in the figures display the mentees’ responses to each question by cohort and duration of mentorship to reveal differences by tenure. The data table of each graph displays cross-sectional data for respondents in each cohort and the percentage of the cohort who selected each response option. For questions pertaining to professional communication, self-confidence, and problem-solving, 1 mentee did not answer the question, resulting in a total of 95 responses.

      Influence on Decision to Stay in Nursing

      The majority of mentees who answered this question (58.9%, 56/95 mentees) reported that their mentoring relationship had positively influenced their decision to stay in nursing, and the positive influence was reported by all 4 cohorts. The increase in the positive impact was most pronounced (70%) for the 1-to-2–year cohort, and the perceived influence diminished considerably for the cohort who had been working with their mentor for greater than 2 years (Figure 1).

      Influence on Self-Confidence in Abilities as a Nurse

      A similar trend was noted in the dimension of perceived enhancement of the mentees’ self-confidence as a nurse, with the majority of the 95 mentees who answered this question (64.2%, 61/95 mentees) reporting that the mentoring relationship had provided a positive influence on their self-confidence. Examination of this dimension in relation to tenure in the program revealed a positive influence for all mentee cohorts and a steadily increasing positive impact on self-confidence through the second year of mentorship. The greatest positive impact on self-confidence (84.2%) was reported by mentees who had been in a mentoring relationship for 1 to 2 years (Figure 2).

      Ability to Problem-Solve Work- or School-Related Issues

      The same trend was noted in the dimension pertaining to enhancement of the mentees’ ability to problem-solve work- or school-related issues. The majority of the mentees who answered this question (55.8%, 53/95 mentees) reported that their mentorship had provided a positive influence on their problem-solving ability. When examined in relation to the mentee’s tenure in the program, all cohorts reported a positive impact on problem-solving ability, with the positive impact increasing steadily through the second year of mentorship. The greatest positive impact on problem-solving ability (84.2%) was reported by mentees who had been in a mentorship relationship for 1 to 2 years (Figure 3).
      Figure thumbnail gr3
      Figure 3Ability to Problem-Solve Work-or School-Related Issues

      Effectiveness of Professional Communication

      The majority of the 95 mentees who answered this question (57.9%, 55/95 mentees) reported that their professional communication skills had been enhanced as a result of the mentorship. When the responses were examined in relation to the duration of the mentorship, mentees in all 4 cohorts reported enhanced communication effectiveness. The greatest positive impact on communication skill (75%) was reported by mentees in the 2 cohorts corresponding to mentorship of greater than 1 year (Figure 4).

      Helpfulness of Mentorship in Transition to Practice

      Some of the mentees had not yet graduated from nursing school at the time of survey participation and were therefore ineligible for employment as a professional nurse; many of the newly graduated and licensed mentees had not yet secured their first nursing position. As a result, 31 of the survey participants responded “not applicable” to the question pertaining to transition to practice, resulting in 65 responses for that question.
      For the mentees who had secured a position as a professional nurse, the majority (66.2%, 43/65 mentees) perceived their mentorship relationship as having been helpful during their transition from new graduate to practicing professional. When this dimension was examined in relation to tenure in the program, each cohort reported steadily increasing perception of helpfulness throughout the duration of their mentorship, with 100% of the mentees in the greater than 2 years cohort reporting this positive perception (Figure 5).

      Discussion

      This study addresses the effectiveness of a customized nursing mentorship program provided by experienced nurse mentors for NGNs in the United States. The key findings of this ReSPeCT study indicate a beneficial effect of this nursing mentorship program on 5 dimensions, with 4 cohorts according to their tenure in the program. When examining the data by cohort tenure, NGN mentees who received mentorship for greater than 2 years did not believe mentorship impacted their decision to remain in nursing, which requires further study. However, a majority of mentees perceived benefits from mentorship on all 5 dimensions, with the greatest benefit being between 1 and 2 years.
      Overwhelmingly, these data suggest a benefit of mentorship to assist the NGNs transitioning into professional practice. This can supplement formal residency or training programs, which last a few weeks in duration, when available. These data also suggest that extended customized mentorship programs may offer NGNs benefits past the typical onboarding orientation and duration offered.
      The results indicate that mentorship can enhance problem-solving ability and professional communication. These can positively impact teamwork, quality, and safety, which may be associated with improved patient outcomes. Furthermore, the positive influence on problem-solving ability for work- or school-related issues has implications for both academic and practice settings. An advantage may exist when mentorship begins in nursing academia, during nursing school/training programs, and extends into work settings through the creation of novel partnerships.
      The current nursing workforce crisis is a paramount issue, and the results of this ReSPeCT study provide valuable insights for US nurse leaders and employers to address the unique needs of NGN development. These data can inform the creation of robust recruitment and retention strategies to address the overall health of the nurse, improve the work environment, and positively influence NGNs’ decision to stay in nursing. It’s critical that we invest in the overall health of our nursing workforce environment with a renewed commitment to enhance the well-being of the nursing workforce. Prior studies prove that creating a healthy work environment results in better nurse staffing and retention, less moral distress, and lower rates of workplace violence for nurses.
      American Association of Critical Care Nurses. The Impact of Healthy Work Environments.
      Health care organizations have an obligation to invest in multimodal strategies to improve the overall health of our nursing workforce.

      Conclusion

      We believe this study adds valuable data to the nurse mentorship literature and highlights the value of providing mentorship for NGNs. A need exists to better understand the availability of nursing mentorship for NGNs and its impact on transition to practice and retention amidst health care provider burnout, a condition impacting safety and workforce outcomes. Future research on mentorship programs should study the impact of mentorship programs on mentors, characteristics of effective mentorship, and provide longitudinal data describing effective mentorship strategies and effect on well-being. Lastly, further study is needed to explore the replicability of this mentorship program in various geographical areas and health systems.

      References

      1. NCSBN. Active RN licenses: a profile of nursing licensure in the U.S.
        (Available at:)
        https://www.ncsbn.org/6161.htm
        Date accessed: April 19, 2022
        • Chan G.K.
        • Bitton J.R.
        • Allgeyer R.L.
        • Elliott D.
        • Hudson L.R.
        • Moulton Burwell P.M.
        The impact of COVID-19 on the nursing workforce: a national overview.
        Online J Issues Nurs. 2021; 26 (Manuscript 2)
        • Berry D.M.
        • Bitton J.R.
        Not working well: clinical placement for nursing students in an era of a pandemic world. 2020. Oregon Center for Nursing.
        (Available at:)
      2. Incredible Health Staff. Study: 186% pandemic spike in nurse demand worsens turnover and stress. incredible health. March 11, 2021.
        (Available at:)
        • Samee Ali S.
        Why some nurses have quit during the coronavirus pandemic. May 10, 2020. NBC News.
        (Available at:)
        • American Nurses Foundation
        Pulse on the Nation’s Nurses Survey Series: COVID 19 two-year impact assessment survey. March 2022.
        (Available at:)
        • Incredible Health Staff
        Study: 34% of nurses plan to leave their current role by the end of 2022. Incredible Health. 2022.
        (Available at:)
        • Van der Heijden B.
        • Brown Mahoney C.
        • Xu Y.
        Impact of job demands and resources on nurses’ burnout and occupational turnover intention towards an age-moderated mediation model for the nursing profession.
        Int J Environ Res Public Health. 2019; 16: 2011
        • NSI Nursing Solutions
        NSI National Health Care Retention & RN Staffing Report. 2022.
        (Available at:)
        • Kovner C.T.
        • Brewer C.S.
        • Fatehi F.
        • Jun J.
        What does nurse turnover rate mean and what is the rate?.
        Policy Polit Nurs Pract. 2014; 15: 64-71
        • World Health Organization
        Burn-out an “occupational phenomenon”: International Classification of Diseases. 2019.
        (Available at:)
        • University of St
        Augustine for Health Sciences. The 2021 American nursing shortage: a data study. 2021.
        (Available at:)
        • Mijares L.
        • Baxley S.M.
        • Bond M.L.
        Mentoring: a concept analysis.
        J Theory Constr Test. 2013; 17: 1
        • Saletnik L.
        The importance of mentoring.
        AORN J. 2018; 108: 354-356
        • Temkar A.
        Research: mentorship reduces nurse burnout.
        (Available at:)
      3. American Association of Critical Care Nurses. The Impact of Healthy Work Environments.
        (Available at:)

      Biography

      Jeneva Gularte-Rinaldo, PhD, RN, is Registered Nurse at Samuel Merritt University in Oakland, California. She can be reached at [email protected] . Roberta Baumgardner, BSN, RN, is Cofounder of the Be1Support1 program in Laguna Hills, California. Tip Tilton, MSN, RN, is Registered Nurse at the University of California San Francisco in San Francisco, California. Vivian Brailoff, MS, RN, is Board Member at Be1Support1 in Laguna Hills, California.