Mentoring in Nursing: A Concept Analysis

Abstract

Aim: The purpose of this concept analysis is to clarify and analyze the concept of mentoring in nursing. Background: Mentoring is as old as the profession itself, right from the time of Florence nightingale, the founder of modern nursing, has herself been referred to as mentor of matron. Mentoring has been a key element to development. Mentoring in nursing seems to mean different thing to nurses. Thus, a concept analysis requires clarifying the concept of mentoring in nursing, and examines how proper understanding of the concept could affect nursing profession. Design: the method used in this study was the approach proposed by walker and Avant Data Source: The Walker and Avant's method was used and the conceptual and empirical Literature searches were used to inform the concept analysis. Articles from PubMed, Cumulative Index to Nursing Health Literature (CINAHL), Ovid Medline, PsycINFO, Eric and EMB, EBSCOhost and web of science Reviews, were used. Review Method: the concept analysis was based on the proposed 8- step method by walker and Avant. Result: The analysis clarifies the definition, interpretive use of mentoring and application of mentoring in nursing practice. It also establishes a conceptual meaning of mentoring to examine the existence of mentoring measures and to assess the utility within nursing and other related field. It also creates a foundational work for model development in mentoring in nursing. Conclusion: This concept analysis has shown that, mentoring in nursing has a great influence on the production of better nurses in future and easy handing-over of nursing profession to the younger generation. It also helps to understand the characteristics of mentoring in nursing thereby promoting the body of knowledge in the profession.

Headnote

Abstract

Aim: The purpose of this concept analysis is to clarify and analyze the concept of mentoring in nursing.

Background: Mentoring is as old as the profession itself, right from the time of Florence nightingale, the founder of modern nursing, has herself been referred to as mentor of matron. Mentoring has been a key element to development. Mentoring in nursing seems to mean different thing to nurses. Thus, a concept analysis requires clarifying the concept of mentoring in nursing, and examines how proper understanding of the concept could affect nursing profession.

Design: the method used in this study was the approach proposed by walker and Avant

Data Source: The Walker and Avant's method was used and the conceptual and empirical Literature searches were used to inform the concept analysis. Articles from PubMed, Cumulative Index to Nursing Health Literature (CINAHL), Ovid Medline, PsycINFO, Eric and EMB, EBSCOhost and web of science Reviews, were used. Review Method: the concept analysis was based on the proposed 8- step method by walker and Avant.

Result: The analysis clarifies the definition, interpretive use of mentoring and application of mentoring in nursing practice. It also establishes a conceptual meaning of mentoring to examine the existence of mentoring measures and to assess the utility within nursing and other related field. It also creates a foundational work for model development in mentoring in nursing.

Conclusion: This concept analysis has shown that, mentoring in nursing has a great influence on the production of better nurses in future and easy handing-over of nursing profession to the younger generation. It also helps to understand the characteristics of mentoring in nursing thereby promoting the body of knowledge in the profession.

Key Words: mentoring, nursing, concept, analysis

Introduction

Nurses, Doctors, Pharmacist and other health professionals are under increase pressure to produce more personnel in the health care team, due to outbreak of new diseases which make most health workers to overstress themselves, especially in an attempt to maintain standards of care (Allen et al., 2001). In addition to their duties to help the patients, they also have a responsibility to train other health workers that can step in their shoes in future. The need to develop high skilled nurses in clinical area, academia and nursing research, has been a key issue currently faced by many nurses.

One major way of promoting development of human capacity in nursing profession is through mentoring. Mentoring in nursing is as old as the profession itself, the founder of modern nursing; Florence nightingale was the first person to introduce mentoring in nursing and she was referred to as mentor of matron. Researches also proved that mentoring has a great impact and influence on professional development and its academic outcomes. Unfortunately, majority of Nigerian nurses, especially those in clinical areas are more concerned with patient-centered care only and pay low or no attention to human capacity building in nursing. One major factor that is capable of killing the future of any profession is absence of mentoring. It is therefore fundamental for nurses to have more knowledge about mentoring and how it can be used as a tool to develop next generation of nursing workforce.

Osaghae (2012) opined that mentoring is the backbone of a successful career development among medical practitioners, absence of mentoring in the nursing profession lead to different complications such as: poor clinical etiquette, lack of intellectual proficiency, and inability to pass nursing ethics from the present generation to future generation. The Place of mentoring in promoting and developing nursing profession is therefore, imperative to nurses in order to increase their performance, productivity and easy integration of new nurses into the health care industry within and outside the country. Mentorship in nursing is a therapeutic relationship that exists between experienced nurses and less experienced nurses to help them gain more knowledge or experience in the profession. The age is not an issue in mentoring, the mentor may be younger or older than the mentee, but he or she must have a particular area where he or she is more knowledgeable than others that can be passed on to other nurses that are less experienced in the same area.

Over the years, concept analysis is directly associated with knowledge development. Therefore, any professional or researcher who is involved in the development of knowledge and theory for their discipline must surely take concept analysis very seriously and give priority to the role they play in knowledge development.

Concept analysis

Defining concepts and concept analysis has been a major hard-nut for philosophers since the time of Aristotle and Plato. Up till our present day there is still no consensus or agreement on theory of concepts. Although, these great philosophers gave legitimacy to efforts directed at definition and analysis of concepts by establishing the process as a fundamental scientific activity. According to Olorunfemi and Ojewole (2017) sees concept analysis as a scientific method of enquiring into the essence of concept; laying foundation for new theory and models; setting up a hypothetical statement and open up new field of knowledge for exploration.

Walker & Avant (2005) opined that Concept analysis is a scientific investigation of concept to find out the meaning of the concept and the misconception about the concept. In most cases, concept analysis is described as a word or phrase, which gives the totality of a phenomenon, which could be in concrete or abstract form (Olorunfemi, & Ojewole 2017). In nursing, there is a vast growing of literatures through which researchers used to synthesize and improve their knowledge on concept analysis (Walker & Avant, 2005). A concept analysis is always embarked on primarily to identifying new concepts or poorly understood concept, to giving precise operational and theoretical meaning of the concept in other to expand the knowledge scope of the concept in theory and research (Castaneda & Scanlan, 2014).

In this article, Walker and Avant (2005) concept analysis method is used to define and elucidate the phenomenon of mentoring in nursing. Walker and Avant's method is an appropriate guide to understand the meaning of mentoring in nursing profession. Walker and Avant (2005) proposed eight-steps involved in concept analysis which are;

* Selection of Concept for Analysis.

* Aim and Objective of Analysis.

* Identifying Uses of the Concept.

* Determining the Defining Attributes.

* Constructing a Model Case.

* Constructing Additional Cases.

* Identifying the Antecedents and Consequences of the Concept.

* Defining the Empirical Referents for the Concept.

Walker and Avant (2005) opined that concept topic selection should reflect an area of interest to the researcher. Mentoring among nurses and all other health team are tools needed to develop future generation of nursing and other health care workforce; this provokes the curiosity of the researcher in exploring the concept.

Aim and Objective of Analysis

The objective or aims of this article is to illuminate the philosophical and theoretical constructs surrounding the identified concepts through concept analysis, which will provide more knowledge, definition and clarity of the concept 'mentoring in Nursing' using walker and Avant, 2005.

Definitions and use of mentoring in nursing

The first step in concept analysis is to carry out an inclusive analysis on the use of the identified concepts by different people or professional body. In Greek, mentor literally means "to endure". Merriam-Webster's online dictionary (2018) notes that we acquired "mentor" from the literature of ancient Greece. "In Homer's epic The Odyssey, Odysseus was away from home fighting war and journeying for (20) twenty years. During that time, Telemachus, the son he leftas a babe in arms, grew up under the supervision of Mentor, an old and trusted friend. When the goddess Athena decided it was time to complete the education of young Telemachus, she visited him disguised as Mentor and they set out together to learn about his father." In modern day, we use the word mentor for anyone who is guiding with positive influence on another person's life. (Business English) Cambridge online Dictionary (2018) defines mentoring as a business man or woman with knowledge or experience in a job who supports and advises someone with less experience to help them develop the skill necessary for the work. Oxford learner online dictionary (2018) sees mentor as a progression whereby a knowledgeable person in an organization or educational institution counsels and trains new students or employees; regular meetings between mentor and trainee help guide young engineers through their early years. A person with more experience in a given area who take responsibility for helping someone with less experience to develop needed knowledge and skills (Medical dictionary, 2017).

The Mosby's medical online dictionary (2018) includes two definitions of mentor: (1) "A more experienced, trusted adviser or counselor who offers helpful guidance to less experienced colleagues. (2). A person who enters into a relationship with a new nurse to provide him or her with source of support and information as he or she learns a new role."

Allen, Eby, Poteet, Lentz, and Lima (2004) identified the following models for mentoring which are:

Apprenticeship model: this type of model hierarchical in nature where the most senior and more experienced professional in an organization trained the junior staff. This model is more official because it occurs within the professional relationship that mentees learn from mentors.

Cloning model: This type of model is based on role modeling; the mentor is planning succession and the mentee gradually develop into the role.

Nurturing model: This type of model creates conducive environment for mentees to have direct relationship with their mentor and share their fear and strength with him or her freely, which promote their gradual development.

Friendship model: This type of model promotes horizontal relationship between a mentor and mentee such as same professional level; rather than being involved in a hierarchical relationship.. Out of the four modeling, the apprenticeship model was identified as best method for students, the nurturing model best for new health professionals and the friendship model for senior practitioners/academics.

Bourke., Waite., and Wright (2014) hypothesized the barriers to mentoring in nursing as follow: workloads, fee-for-service system for some practitioners, access to mentors, conflicts among staff, feelings of being judged and wrong business relationships.

Moreover, the review of the literature available at present shows that the term mentoring in nursing is used in the following ways

Usage 1: The relationship between the ward manager and newly graduated nursing officer in the hospital might lead to mentee - mentor relationship called mentoring. In a situation whereby, a newly graduated nurse watches ward manager giving intravenous infusion, he or she can also develop the skill of giving I.V infusion. Usage 2:The relationship between a nurse educator and student nurses in school of nursing could also be referred to as mentoring relationship. A situation whereby, a student is helping their lecturer or educator to collect data and input of data in SPSS during research analysis, along the line, he or she will develop the skill of collecting data, coding and analysis of data.

Usage 3:In a scenario, where there is a lateral relationship between two Nursing officers, and if the nurse is skillful in passing catheter, his or her colleague who is also a nurse can acquire the skill from him or her.

Usage 4:Mentoring can also occur in upward relationship, a junior colleague can also mentor senior colleagues in a hospital. In a situation whereby there is a new or modern practice, that the ward manager is deficient in, but the junior colleagues is efficient in the field; the ward manager can acquire the knowledge from his or her subordinate.

Defining Attributes of mentoring in nursing

Attributes are characteristics that frequently appear in the literature and help define the concept of interest. Defining the attributes is considered by Walker and Avant (2005) to be the heart of concept analysis. According to the results from the literature review on mentoring in nursing, and contextual definitions of mentoring in nursing, six attributes are most significant to mentoring in nursing: role model, nurturing, friendship, experienced person, regular meeting, and endurance.

Role model

Role model defined as individuals whose behaviors, styles and attributes are emulated by others or an adult to whom youth look up to and desire to be like. Role modeling is described as being "teaching by example and learning by imitation (Murray & Main, 2005). Skillful role models could enable students to discover knowledge embedded in clinical practice where they can work with and observe a role model that enables them through a process of reflection, to internalize the role models' behavior and build on previous knowledge and experiences. Role models who portray a positive attitude and are approachable therefore play a vital role in supporting students in the clinical learning environment.

Nurturing: Nurturing is to care for and protect (someone or something) while they are growing. World Health Organization (2018) define nurturing as a process whereby a stable environment is created by mentor to ensures mentee's good health and nutrition, protects them from threats, and gives them opportunities for early learning, through interactions that are emotionally supportive and responsive.

Friendship: Friendship is somebody one can turn to, somebody one respect and trusted, and one knows will always be there for him/ her in time of need or challenge. Ravichandran (1999) said that a friend is a person capable of loving irrespective of whether he is being loved or not. Friendship can exist between the same sex: man-man, womanwoman, or opposite sex: man-woman. It transcends age and could subsist between even an old man and a small boy.

Experienced Person: Experienced person is a wise or skillful person in a particular field through experience. America Heritage dictionary (2018) defines experience as a person with training, knowledge or who has participated in something. Therefore, in ideal setting experienced person is a mentor who is to guide a less experienced person by building trust and modeling positive behaviors.

Regular Meeting

Regular meeting is a meeting held periodically according to the time stated in an organization's regulating documents or under a standing rule which the deliberative assembly has adopted. A regular meeting is also known as stated meeting. For effective mentoring, there must be a regular meeting between the mentor and mentee.

Endurance: It means longlasting, enduring sometimes means long-suffering as when someone has an enduring disposition (Oxford Dictionary, 2018).The mentee must develop enduring disposition and willingness to be mentored.

Construction of Model cases

The model cases will contain all the identifying attributes for mentoring in nursing:

"Dr (Mrs) ojewole, a very skillful Nurse researcher, trained in one of the best university in the world, she is a lecturer in Glotto University. She enjoyed publishing research work in international journals on the monthly bases. One of her supervisee Mr. David, a master student admired this skill of hers and decided to move close to her. Dr. Ojewole took him as a friend and created a good environment for him to learn the skill. She exposed him to the skill of data collection, coding of data, and imputation of data through SPSS and data analysis. Though the experience was stressful but he was focused, Mr. David became a skillful researcher after two years of his program in the school."

This model case contains all the six attributes of mentoring in nursing: role model, nurturing, friendship, experienced person, regular meeting, and endurance. In this case, Dr. Ojewole is a researcher and enjoys doing research (first criterion), she is accessible and friendly to her students (the second and third criterion) which had given the student an opportunity to establish good interpersonal relationship with her. She is a skillful and experienced nurse researcher (forth criterion). She is always available to teach her supervisee through practical teaching method (fifth criterion) and the supervisee was focused and endured the stress involved in the trainee process (sixth criterion).

Identify Additional Cases

Borderline Case Analysis

The borderline cases do not contain all the six identified attributes of mentoring in nursing:

"Nurse Ivie, a young graduate and a very skillful nurse practitioner in modern nursing practice. She is a staffNurse in Premier teaching hospital, where the management of the hospital currently introduced New Modern Nursing Practice. In her ward, the ward manager in the person of Mrs. Mercy graduated (20) twenty years ago when most of these modern Nursing Practices were not included in the curriculum of training. Though Nurse Ivie maintained a good interpersonal relationship with her ward manager and always made herself available to carry out most of the procedure, the ward manager could not humble herself to learn the skills of modern practices from her because of her position. "

This borderline case contains four out of the six components of mentoring in nursing: role modeling, friendship, regular meeting and experience person. However, the case lack "enduring and nurturing". Mentoring required a lot of sacrifice and self-denial, ability to recognize weaknesses in one-self and see strength in others; in the spirit of "Nobody knows it all" to attain this level is a major challenge because of self-ego. Therefore, for effective mentoring to take place both mentor and mentee must be ready to humble themselves.

Related Case Analysis

These are cases that look like concept being studied but all the identifying attributes are not present (Walker & Avant, 2005).

"Nurse Fakua, a young graduate from a low ranked university in her village. She was employed into one of the best hospital in UK with different sophisticated instruments and machines. On her resumption day, she was able to operate all the machines effectively, without any assistance. She was asked where she learnt how to use the instruments; she said God showed her in her dream, a night before her resumption date."

The above cases model does not show all the identifying attributes of mentoring in nursing. However, this scenario could be related to variables associated with mentoring in nursing but none of the identifying attributes are present in the case; it is more of intuitive knowledge

Contrary Case Analysis

Walker and Avant (2005) opined that contrary case is the act or scenario that shows clearly what the concept is not.

"Dr. Fumito, a psychologist, from Lowa University was hired to train Nurses in premier hospital on how psychological care can be given to patient. Dr. Fumito was very skillful and friendly, at the end of the training about 90% of the participants was able to apply the new skill effectively in the management of patient."

It is important to this contrary case to provide a clear definition of coaching as it is different from mentoring in nursing. Coaches need not have firsthand experience of the coaches' line of work. The coach can be an independent external professional with expertise in coaching while Mentoring is customarily a planned pairing of a more skilled or experienced person (usually in the same field of work) with a less experienced person (Serrat, 2017).

Identify Antecedents and Consequences

Antecedents, these are events or incidents that happen prior to the occurrence of a concept (Walker & Avant, 2011). The reviewed literature had shown two major antecedents which are time constraint, poor knowledge on mentoring, matching and poor Remuneration. All these have been implicated for mentoring in nursing to occur. This is in agreement with Ganser (1995) who looked at mentoring from the perspective of mentor and discovered that their major challenge is time because most mentors combined mentoring job with their normal job, thereby make it more strenuous for them to be effective in mentoring others. Rowley (1999) also buttress that view by saying that a good mentor required spending more time with the mentee but with their time constraints, this task can be very difficult to achieve.

Secondly, nurses needs to be properly enlighten through publication and dissemination of research, radio and television jingle on positive achievement of mentoring, how to be a great mentor, processes of mentoring, characteristics of mentoring, and benefits of being a mentor and so on. This will promote mentoring and make it more exciting duty. This agree with Callahan and Ruchlin (2003) state "The broader the 'buy-in,' the greater the chances for success. Successful alignment requires effective communication that encompasses ongoing rather than one-time efforts"

Moreover, matching of appropriate mentor to mentee is another major challenge for effective mentoring to take place. It is essential that schools of nursing and hospital management should hire highly skillful and experienced nurses into the duty of mentoring because it is a nurse with the knowledge, the experience and the wisdom that can share with other nurses.

Finally, showing recognition and gratitude by management and mentee for individual contributions, suggestions, and input in mentoring others. This is in agreement with Newhouse and Mills (2002) said that rewarding and Feedback systems are key player in a successful motivational program. Mentoring job is tasking, more nurses will agree taking up the responsibility if management of the hospital take time to celebrate their big or small milestones achieved through mentoring, because recognition of achievements can foster self- esteem. Ultimately, this will stimulate staffinterest in participation and contribution in mentoring.

Define Empirical Referents

This is a concrete, behavioral change that shows that concept of mentoring in nursing has occurred. Successful mentoring relationships were characterized by shared values, reciprocity, clear expectations, mutual respect and personal connection. Failed mentoring relationships were characterized by lack of commitment, poor communication, competition, personality differences, and conflicts of interest (Straus.,Johnson., Marquez., & Feldman (2013). The most important outcome of mentoring is the knowledge or skills obtained as a result of the relationship between mentee and mentor which can be measured or concretized through the three domains of learning, which are, psycho-motor domain, cognitive domain and affective domain characterized by positive and noticeable changes in skills, knowledge and attitude.

Implications for nursing practice

Based, on the reviewed literatures, it shows that this article (1) clarifies the definition, and interpretive use of mentoring in nursing and application of mentoring in school of nursing and hospitals. It also establishes a conceptual meaning of mentoring to examine the existence of mentoring measures and to assess the utility within nursing and other related field .this article created a foundational work for model development in mentoring in nursing.

Although, this article provide the framework for other researcher to build on, but it also raises additional questions for consideration, such as the identified construct of mentoring in nursing, adequate to measure mentoring in nursing? Are there boundaries to mentee- mentor relationship? Is there a basic requirement for a nurse to be qualified to mentor others? How can mentoring be sustained in nursing profession and in our various hospitals, especially now that there is high-rate of retirement among older nurses (Bally, 2007) This article set the field of mentoring in nursing in motion, ready to be explored in nursing.

References

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