Critical care nursing requires the acquisition of specialised knowledge and skills. Due to this requirement, the intensive care units have always been manned by competent acute care nurses. However, due to the nursing shortage that has been experienced over the years, the intensive care units (ICUs) are now hiring new graduate nurses. The new graduates are assigned a mentor to help them develop knowledge and skills of handling the sensitive cases that they handle within the intensive care environment. The current shortage of nurses has led to fatigue, burnout, frustration and lack of support thereby reducing the morale of nurses. The mentor program therefore helps new nurses to work under experienced nurses and learn in a safe and supportive environment. This will help the mentees develop the confidence for their future professional growth. The mentees in the intensive care environment learn from the insights from their experienced counterparts. On the other hand, mentors have the satisfaction that they contributed to the professional development of a colleague. For such an arrangement to succeed, mentors need to have specific qualities and attributes. This paper critically discusses the skills and qualities that mentors need to be effective in their role within the intensive care environment.
Mentors are considered as guides, councillors, teachers, role models, advisers and supervisors to new nurses (Ali & Panther, 2008 p. 36). Nursing education has changed in most parts of the world. The new system has a structured nurse mentor program to teach, supervise and assess new nurses in their professional development. The mentoring concept emerged in the nursing profession in the 1980s. This is the first time that the program was applied to a clinical learning environment. However, there are other accounts that suggest that informal mentoring started a while back (Buffum & Brandon, 2009 p. 358). In the intensive care unit, mentors spend most of their time with the mentees hired in the ISU. The mentors are therefore able to judge the abilities of the students and guide them towards improving their strengths. The mentors should support the students in their learning and judge their proficiency (Ali & Panther, 2008 p. 36). Good mentoring help mentees in applying their theoretical knowledge to practice, provide learning opportunity for the mentees and help in getting the best out of them (Odom, 2003 p. 143). In summary, in the intensive care environment, mentors have different responsibilities including: organization and facilitation of learning, professional competence and being a role model to the mentees (Evans, Costello, Greenberg & Nicholas, 2013 p. 72). It is important to note that mentor relationships are voluntary, supportive and trusting. In some cases, mentors are not the most experienced of the nurses in the country. However, they volunteer to participate in the program. They are just people who are confident of their skills and want to have a positive effect on the professions of other new nurses (McGrath, 2009 p. 106). There is a mentor committee that manages the relationship between the mentor and the mentee. This committee handles the contract between the two parties. The contract outlines the objectives of the mentor program, schedule of contract and the ways in which the contract will be maintained between the parties (Brediger, 2009 p. 111).
According to Sorensen, Iedema & Severinsson (2008 p. 536), there are many uncertainties in an intensive care environment including end-of-life considerations and unknown patient outcome. This can have an effect on the emotional stability of nurses. The result of this is that there can be reduced cooperation and communication thereby reducing the quality of care offered to patients.
The first skill that mentors need to have to be effective is availability. The intensive care environment is a very challenging environment due to the critical state of the patients and the emotional state of their families. Mentors should therefore always be available to provide clinical support and answer any questions or concerns raised by the mentees (Elcigil & Sari, 2008 p. 120). The support will help in reducing emotional exhaustion, burnout, fatigue and other negative effects that are associated with the intensive care environment. The new nurses can also learn from the manner in which the mentor interacts with the patient’s family. The mentors should be easy so that they can be approachable. The meetings should not be limited to working hours only; the mentor’s doors should be open to the new nurses any time a learning need arises (Rouse, 2009 p. 465).
The other quality that the mentor should have is that he or she should be knowledgeable (Ihlenfeld, 2005 p. 175). Mentors should have both clinical and professional knowledge. They should also have an ability of transferring this knowledge to the new nurses. One important element of transfer of this knowledge is communication skills. Due to the nature of the intensive care environment, the mentees in this environment work under a lot of pressure. The mentors should therefore be able to show empathy and compassion for the mentees. Good communication also requires trust, respect, honesty and tolerance. The mentor should therefore have a quality of developing strong relationship with the mentees. This will enable the mentees to learn better and ensure that the learning process is enjoyable to the mentees. Evaluation and feedback are also important in the communication process. This is because feedback helps the mentees to know their weaknesses and improve on them. While evaluating the mentees, the mentors should always try to give positive feedback (Race & Janet, 2010 p. 165). This will play a role in motivating the mentees. The criticisms should be positive and should not be made personal between the mentor and the mentee.
One important element of communication skills is listening skills which mentors in the intensive care environment should have in order to be effective (Turnbull, 2010 p. 574). The mentors should be able to listen to the grievances and concerns raised by their mentees. While at this, the mentors should not judge mentees when they ask questions or raise concerns (Fox, 2010 p. 313). Through this, the relationship between mentors and their mentees will be improved ensuring that the mentees are adequately motivated so that they continue their service in the nursing profession.
Mentors need to be trustworthy. Further, they should be nonthreatening to the mentees. Through this, the relationship between mentors and the mentees can be improved thereby helping mentees to attain a certain level of autonomy required to practice in the intensive care unit. This autonomy comes with responsibility, self confidence and competency (Fox, 2010 p. 313).
The mentors should have leadership skills. Leaders are always visionary, have the right strategies, desire and plan to ensure that their teams achieve their intended objectives. Good leaders should have problem solving skills, maintain the effectiveness of the group and develop a group identity. The leaders should be passionate and be able to motivate and inspire others to perform. The mentors need to have these skills so that they can win the trust and respect of the new nurses. By having the above leadership skills, the mentors are able to wield the necessary power and influence to ensure the professional development of their mentees while also ensuring that professional standards are maintained in the process. For mentors, leadership involves: decision making, delegation of responsibility, resolving conflict that may exist between nurses or between nurses and patients or their families and acting with integrity to protect the image of the nursing profession. In this critical care environment, the mentors need to develop a culture that promotes continuous learning through support and implementation of the best practice methods. To promote the development of best practice models in their work environments, the mentors need to be dynamic (McDonald, 2010 p. 3552).
The other skill that mentors should have is that they should be adaptable to change. The healthcare systems in many parts of the world are changing by the day. The changes are necessitated by the desire to reduce the costs of healthcare while improve on the quality. These changes have brought about a change in nursing roles as nurses are required to be more autonomous, specialist and focus more on the healthcare outcome (Ihlenfeld, 2005 p. 177). These changes have both positive and negative effects on the nursing profession. Due to the cost of healthcare, consumers of healthcare services put a lot of premium on their money. They therefore expect very high quality care. Mentors should therefore have an ability of responding to the above changes and supporting their mentees in adapting to the changes. The mentors should inspire their mentees to believe that the changes and the new expectations required of them are achievable if they can focus on their deliverables. The negative effect of the changes is that the autonomy in decision making may create a conflict between nurses and other professionals in the healthcare setting. Mentors should use their leadership skills to solve any such conflict. Communication skills can then be used by the mentor to inform the other professionals of the new role of nurses so that conflicts are avoided in the future. The nurse mentor should therefore a strong personality that is not easily threatened by others.
Mentors need to maintain a high level of professionalism at all instances. In a case where there is a mixed gender mentor relationship, the mentor should use his or her professionalism to bring out the best value from the different perspectives that men and women in the intensive care environment. The mentor should keep a distance from the other gender to create a proper environment for learning, growth and productivity (Tracey & Nicholl, 2006 p. 29). The mentor should not show any form of bias while dealing with the mentees in his or her group. This is because bias will discourage other mentees since they will not feel valued in the healthcare setting. Due to this, the objectives of the mentor program for the new nurses may not be achieved.
However, the mentor should have interpersonal skills to help him or her befriend the mentees. The affiliation between the mentors and the mentees will make it easy for the mentees to seek advice from the mentor in case of any problem. Furthermore, the affiliation will motivate the mentee and make him or her feel a valued member of the delivery team thereby allowing them to actively participate in the events in the clinical area. This will enhance the learning process for the mentees (Ousey, 2009 p. 181). Interpersonal skills will enhance other skills like communication skills.
Mentors need to be team players. Since the mentor will be working with different mentees, he or she needs to know how to make the people work together. It is important that the team in the intensive care unit have the same interest, that is of always saving the life of the patient. This can be inculcated when the mentor has proper team skills. The mentor should be able to design the strong and supportive team in a manner that encourages faster exchange of ideas and information between the team members. Each team member should be assigned responsibilities at different times and the mentor should have adequate supervisory skills to ensure that the responsibilities are performed (Wåhlin, Ek & Idvall, 2010 p. 266).
Mentors are faced with many challenges during their work. Some of the challenges include limited time, double responsibility of handling mentees and patients and high workload depending on the number of mentees that the mentor is assigned. Other challenges may stem from mentors’ limited knowledge on the learning process and the different theories of learning, limited knowledge on assessment methods and lack of ideas on how to generate positive criticisms and feedback (Ali & Panther, 2008 p. 38). The mentors should have the necessary qualities or abilities of surmounting the challenges and ensuring that only positive attributes that are related to their work are highlighted in their practice. In short, the mentors should have the skill of eliminating these challenges because some of the challenges may have an adverse effect on the quality of care delivered in an intensive care environment (Wolak, McCann & Madigan, 2009 p. 65).
From the above discussion, mentors have a critical role in the life of their mentees and to their learning and education. In most cases, mentors provide the necessary support for the mentees to feel connected or integrated in the work environment; mentors also play a role in ensuring that mentees are valued as important team members; and that the mentee is treated as a team learner within the same work environment (Myall, Levett-Jones & Lathlean, 2008 p. 1837). This results in improving the motivational levels of the mentees translating in increased job satisfaction for the new nurses who have good and supportive mentors (Staykova, Huson & Pennington, 2013 p. e1). However, the contrast is true for the case when the mentor is not supportive. The new nurses will feel that the work environment is hostile and they may not achieve their full potential in the role. The demotivation results in low quality of care delivered to the patients. This is a catastrophe because the nurses are in the intensive care unit where proper care is needed to save lives of people. There can be successful mentorship if mentors, team leaders and new nurses understand one another and function as a whole.
In conclusion, due to the shortage of nurses that has been experienced by many developed nations, intensive care units are also hiring new nurses. This is a break from the past practice where the intensive care unit only had experienced nurses. To ensure that they are well integrated in the nursing profession, the new nurses are assigned mentors who guide them through the process. Mentors play an important role in supporting new nurses in their clinical experience. The role of a mentor is an effective mechanism for practice learning. The relationship of the mentor and the mentee is very important to ensure the success of the mentor program. There are different qualities and skills that mentors need to be effective in their role within the intensive care environment. A good mentor is a good listener, is supportive, is respectful and encourages the mentee to realise his or her full potential in the nursing profession. The other traits that mentors should have are that they should be knowledgeable and enthusiastic about the nursing profession. Through this, they will help in promoting an effective learning environment and help the mentee in his or her socialisation to the nursing role. It is important for student nurses to have a commitment to continuous learning to help them in their professional growth and development. On the other hand, mentors have a responsibility of communicating the demands and relating to the student in a manner that will impart positive skills. This is a very important element for the students.
Ali, P. A.; Panther, W. (2008). Professional development and the role of mentorship. Nursing
Standard, 22(42), 35-39.
Brediger, R. (2009). Developing a Mentor Program for Our Cardiovascular ICU. Clinical Care
Nurse, 29(2), 112-111.
Buffum, A. R; Brandon, D. H. (2009). Mentoring New Nurses in the Neonatal Intensive Care
Unit. Journal of Perinatal & Neonatal Nursing, 23(4), 357-362.
Elcigil, A; Sari H. Y. (2008). Students’ opinions about and expectations of effective nursing
clinical mentors. Journal of Nursing Education, 47(3), 118-123.
Evans, L; Costello, M; Greenberg, H; & Nicholas P. K. (2013). The attitudes and experiences of
registered nurses who teach and mentor nursing students in the acute care setting. Journal of Nursing Education and Practice, 3(2), 67-74. DOI: 10.5430/jnep.v3n2p67.
Fox, K. C. (2010). Mentor Program Boosts New Nurses’ Satisfaction and Lowers Turnover Rate.
The Journal of Continuing Education in Nursing, 41(7), 311-316. Doi:10.3928/00220124-20100401-04.
Ihlenfeld, J. T. (2005). Hiring and mentoring graduate nurses in the intensive care unit.
Dimensions of Critical Care Nursing, 24(4), 175-178.
McDonald G et al. (2010). Continuing connections: the experiences of retired and senior
working nurse mentors. Journal of Clinical Nursing, 19, 3547-3554. DOI: 10.1111/j.1365-2702.2010.03365.x
McGrath, J. M. (2009). Mentoring Nurses for the Complexities of Neonatal Care. Journal of
Perinatal & Neonatal Nursing, 105-107.
Myall, M; Levett-Jones, T; Lathlean, J. (2008). Mentorship in contemporary practice: the
experiences of nursing students and practice mentors. Journal of Clinical Nursing, 17, 1834-1842. DOI: 10.1111/j.1365-2702.2007.02233.x
Odom, J. (2003). The nurse as mentor. Journal of PeriAnesthesia Nursing, 18(2), 143-144. DOI:
Ousey, K. (2009). Socialization of student nurses – the role of the mentor. Learning in Health
and Social Care, 8(3), 175-184. DOI: 10.1111/j.1473-6861.2008.00209.x.
Race, T. K; Janet, S. (2010). Changing tides: improving outcomes through mentorship on all
levels of nursing. Critical Care Nursing Quarterly, 33(2), 163-174.
Rouse, R. A. (2009). Ineffective participation: reactions to absentee and incompetent nurse
leadership in an intensive care unit. Journal of Nursing Management, 17, 463-473. DOI: 10.1111/j.1365-2834.2009.00981.x
Sorensen, R; Iedema, R; & Severinsson, E. (2008). Beyond profession: nursing leadership in
contemporary healthcare. Journal of Nursing Management, 16, 535-544. DOI: 10.1111/j.1365-2834.2008.00896.x.
Staykova, M. P; Huson, C; Pennington, D. (2013). Empowering nursing preceptors to mentoring
undergraduate senior students in acute care settings. Journal of Professional Nursing, 29(5), e32-e36.
Tracey, C; Nicholl, H. (2006). Mentoring and networking. Nursing Management, 12(10), 28-32.
Turnbull, B. (2010). Scholarship and mentoring: An essential partnership? International Journal
of Nursing Practice, 16, 573-578.
Wåhlin, I; Ek, A. C.; Idvall, E. (2010). Staff empowerment in intensive care: Nurses’ and
physicians’ lived experiences. Intensive and Critical Care Nursing, 26(5), 262-269. doi:10.1016/j.iccn.2010.06.005.
Wolak, E; McCann, M; Madigan, C. (2009). Perceptions within a mentorship program. Clinical
Nurse Specialist, 23(2), 61-67.