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Working Toward a Competency-Based Preceptor Development Program

Introduction to Importance of Mentoring and Preceptorship

Mentorship or preceptorship is a medium or program through which a mentor who is a more skilled and experienced person trains, teaches, counsels, encourages and acts as a role-model to enable the professional and personal growth of the less experienced or skilled person (Zhang et al., 2019). Preceptorship has been used widely in nursing to continue to educate while supporting the transition of the newly graduated nurses to become registered nurses (Gueorguieva et al., 2016). Work readiness also has an important role to play in the provision of a smooth transition into the clinical workplace. Work readiness has been described as a concept which focuses on an all-round approach and development including clinical skills, competence, ability, teamwork, time management, emotional intelligence along with communication skills (Edward et al., 2017). It has been established that newly graduated nurses experience many challenges and stress during their transition to a clinical setting. The aim of this article is to discuss the importance of mentoring and preceptorship for new graduate nurses when transitioning to their new role as a registered nurse.

Discussion on Importance of Mentoring and Preceptorship

There has been a lack of uniformity with respect to the amount of clinical practicum duration essential for successfully earning a degree for nursing which suggests a dearth of consensus regarding the duration and amount of exposure to clinical settings significant for determining the work readiness (Edward et al., 2017). However, in Australia, eight hundred hours of clinical work experience have been declared mandatory.

Clinical education and clinical exposure are vital in order to lay down the foundation for a successful and effective mentor-mentee relationship between the newly graduated nurse and the professional which also helps enhance the readiness for practice for the new nurse. Thereby, it is essential for the preceptors and clinical educators to work with an integrated approach to obtain adequate clinical exposure for the graduating students.

According to studies conducted by Zhang et al. (2016) it was found that the rate of turnover for the newly graduated nurses varies from 8% to 69% and from 26.2% to 57% in their first and second year at job respectively. The huge turnover rate leads to a shortage of nursing staff apart from being an added burden for human resources costs for the organization. Hence, it is essential to work on the areas for a smooth transition for the new nurses and understand the underlying factors that the high turnover rate can be attributed to.

One out of every five newly graduated nurses reported insufficient preparation for nursing and pointed out it to be a contributor to the extreme burnout levels they experienced (Pasila et al., 2017). It was also understood that orientating the nurses that have recently graduated to their profession could significantly improve their well-being, decrease the burnout as well as enhance self-assurance, satisfaction and competence in their profession. The major purpose of the orientation would be to ease the transition of the nurse from a new graduate to a professional qualified nurse who could provide better, safe and independent patient care.

It was also established that there can be no set pattern for the mentorship as different countries have a different amount of clinical time allotted for the student nurses and the structure, duration and content of the orientation would differ from organization to organization (Pasila et al., 2017). Also, it was noted that the terms preceptor and mentor were often confused and used interchangeably whereas they are two different terms with different meanings. A preceptor is usually a staff member who models the behaviour and care to be replicated by the new nurses and preceptorship is generally of a shorter duration, than the mentorship, which occurs during the orientation. Also, while mentorship can be for all the staff members, preceptorship is only for the newly joined members.

The new, challenging and stressful workp environment can lead to frustration and lower confidence levels among the newly recruited nurses (Tiew et al., 2017). Lack of reward, poor relationships with colleagues and head and absence of organizational support may increase the pressure experienced by the new nurses. It has been established that the newly graduated nurses experience discouragement, physical exhaustion, moral distress and ultimately quit the profession. These can be worked on by formal guidance by the mentors or preceptors. 

It has been established that the gap between the theoretical concepts and practical skills contributes to the increased difficulty for the transition of the new graduates and these difficulties that occur in transition period overwhelm the nurses, eventually leading some of them to quit their jobs (Zhang et al., 2019). Since this has presented itself as an issue worldwide, it makes it even more critical to govern the transition and increase the retention of the newly graduated nurses in the profession by the nursing for all the hospital and nursing heads.

Mentorship or preceptorship, as established by research, helps the newly graduated nurses to develop higher confidence, competence, critical thinking, emotional intelligence and job satisfaction while reducing their levels of anxiety and stress Studies that reviewed the impact of preceptorship and mentorship on the turnover in nursing depicted that the turnover reduced by an average of 11% (Irwin et al., 2018).

The experienced nurses with a great level of knowledge, professionalism and clinical skills and proficiency are the preceptors who work with the newly graduated nurses in order to expedite and expand the clinical skills, awareness and education of the new nurses by sharing experiences of patient care (Van Patten & Bartone, 2019). The preceptorship program can be implemented in diverse ways including a basic or simple preceptorship wherein a preceptor is assigned to each one of the new nurses or a complex preceptorship wherein days are allotted to clinical supervision, core study followed by teams to monitor, coordinate and support the nurse’s development.

There has been a steady increase in the dependency of the patient as well as the role of the nurse practitioner has been expanding over the last few years (Irwin et al., 2018). It makes it even more essential for the nurses to be more effective, efficient and warm while providing care. According to various studies that have been conducted by O’Shea and Kelly, Whitehead and Maben and Macleod Clark regarding preceptorship and mentorship it was established that mandatory and formal preceptorship has great potential to increase the competence and confidence of the mentees.

It has been understood that the newly graduated nurses enter the profession sans a proper phase of transition and often they show a dire need of support to successfully integrate and effectively transfer the skills and competencies acquired by them into their professional practice (Van Rooyen et al., 2018). To encourage, educate and support the new nurses to be independent and competent practitioners it is important that the professional nurses guide them through.

According to Van Rooyen et al. (2018), the benefits of preceptorship are abundant and exist at every level, that is for the new nurses, the mentors or preceptors and the organization as a whole. For the newly graduated nurses, the benefits include increased confidence, better social skills, enhanced clinical skills and understanding, a greater sense of responsibility and better commitment towards the profession. For the mentors or preceptors, the benefits are the development of supportive skills and mentorship skills, learning management of skills, time and duties, enhanced commitment towards the organization, greater feeling of responsibility and the sense of value addition towards the profession of nursing. For the organization, the benefits include better staff satisfaction leading to better recruitment and retention of the staff, dedicated team, lower turnover of the professionals and increased quality of care by the nursing staff along with better healthcare experience of the patients.

A mentor-mentee match that is carefully deployed is a key to successful mentoring (Tiew et al., 2017). It has been reported that mentees when suitably matched to a well-experienced mentor help decrease confusion, stress, mental-exhaustion and provide support as well as guidance to the new nurses which eventually improves their performance and job satisfaction. It has also been suggested that the nature, quality and understanding of the mentor-mentee relationship as a vital factor that affects the learning and working experience of the mentee (Van Patten & Bartone, 2019). On the contrary, poorly managed mentoring can lead to adverse effects on the performance of the new nurse which affects their job satisfaction and retention.

Also, it was found that the transition of newly graduated nurses into their professional role in critical care areas was considerably more difficult as compared to the other units (Innes & Calleja, 2018). This could be because of the more specialised knowledge, skills and understanding required to cater to the needs of the patients in the critical care wards. Some themes identified that could contribute to the disparity between transition into professional roles in critical care ward and other wards are knowledge and skill acquisition, socialisation, workplace culture and availability of a designated mentor or preceptor.

A study conducted by Laschinger et al. (2016) demonstrated that there exists a positive relationship between support for professional practice, structural empowerment, understanding relationships between colleagues and leaders, quality of patient care and sense of job fulfilment. All of these were recognised to be contributors to a better perception of their profession by the newly graduated nurses. Another vital finding in this study was the perceived notion regarding the care and services provided by the newly graduated nurses according to the professional standards. Which means the new nurses felt accomplished if they were able to provide the healthcare services as per the standards maintained in their organisation.

Conclusion on Importance of Mentoring and Preceptorship

It has been established by many authors, through various pieces of evidence and diverse studies that have been conducted, mentorship or preceptorship is essential for the smooth transitioning of the newly graduated nurses into the professional role of the nurse. It has been observed that globally a high turnover exists during the first two years of the job for the newly graduated nurses. This high turnover rate can be attributed to increased amounts of stress and challenges faced at the workplace, the gap in the theoretical knowledge and practical application as well as lower levels of confidence and competence. Mentorship and preceptorship as a part of properly planned orientation can prove to be adequately beneficial to increase the job satisfaction and retention for the newly graduated nurses. The mentors and preceptors can act as guides as well as support the preceptors and mentees during their transition which can help enhance their confidence, competence, skills and experience to provide independent and high-quality care to the patient. Mentorship or preceptorship is known to benefit all, the mentees, the mentors or preceptors and the organisation as a whole.

References for Importance of Mentoring and Preceptorship

Brook, J., Aitken, L., Webb, R., MacLaren, J., & Salmon, D. (2019). Characteristics of successful interventions to reduce turnover and increase retention of early career nurses: a systematic review. International Journal of Nursing Studies, 91, 47–59

Edward, K., Ousey, K., Playle, J. & Giandinoto, J.-A. (2017). Are new nurses work ready – The impact of preceptorship. An integrative systematic review. Journal of Professional Nursing, 33(5), 326–333.

Gueorguieva, V., Chang, A., Fleming-Carroll, B., Breen-Reid, K.M., Douglas, M. & Parekh, S. (2016). Working toward a competency-based preceptor development program. The Journal of Continuing Education in Nursing, 47, 427–432.

Innes, T. & Calleja, P. (2018). Transition support for new graduate and novice nurses in critical care settings: An integrative review of the literature. Nurse Education in Practice, 30, 62–72.

Irwin, C., Bliss, J. & Poole, K. (2018). Does preceptorship improve confidence and competence in newly qualified nurses: A systematic literature review. Nurse Education Today, 60, 35–46.

Pasila, K., Elo, S. & Kaariainen, M. (2017). Newly graduated nurses’ orientation experiences: A systematic review of qualitative studies. International Journal of Nursing Studies, 71, 17–27.

Laschinger, S.H. K., Zhu, J. & Read, E. (2016). New nurses’ perceptions of professional practice behaviours, quality of care, job satisfaction and career retention. Journal of Nursing Management, 24(5), 656–665.

Tiew, L. H., Koh, C. S. L., Creedy, D. K. & Tam, W. S. W. (2017). Graduate nurses’ evaluation of mentorship: Development of a new tool. Nurse Education Today, 54, 77–82.

Van Patten, R.R. & Bartone, A.S. (2019). The impact of mentorship, preceptors, and debriefing on the quality of program experiences. Nurse Education in Practice, 35, 63–68.

Van Rooyen, D. R. M., Jordan, P. J., ten Ham-Baloyi, W. & Caka, E. M. (2018). A comprehensive literature review of guidelines facilitating transition of newly graduated nurses to professional nurses. Nurse Education in Practice, 30, 35–41.

Zhang, Y., Huang, X., Xu, S., Xu, C., Feng, X. & Jin, J. (2019). Can a one-on-one mentorship program reduce the turnover rate of new graduate nurses in China? A longitudinal study. Nurse Education in Practice, 40, 1-8.

Zhang, Y., Qian, Y., Wu, J., Wen, F. & Zhang, Y. (2016). The effectiveness and implementation of mentoring program for newly graduated nurses: a systematic review. Nurse Education. Today, 37, 136–144.

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