This program enhances confidence.

Takeaways: 

• The Neurosurgery Mentorship Program at New York Presbyterian–Columbia University Irving Medical Center pairs novice nurses with experienced nurses to improve clinical confidence and satisfaction and reduce attrition. 
• During the 6-month program mentors and mentees collaborate monthly to discuss topics related to the clinical setting; mentees complete surveys at the beginning, middle, and end of the program. 
• Results from the first cohort indicate that the formal mentorship program improved clinical confidence and staff satisfaction for novice nurses. 

Mentoring is integral to the development and success of novice nurses as well as experienced clinical nurses who are transitioning to a new role. It’s a reciprocal and collaborative relationship that enhances and cultivates a culture of collegiality where the mentor serves as a guide, expert, teacher, and role model to mentees. In a 2014 systematic review of experimental and quasi-experimental studies, Chen and Lou revealed that a one–to–one mentorship program (one mentor paired with one mentee) increased RN satisfaction and overall retention rates as evidenced by mentee self-assessment questionnaires. In addition, Daniel and colleagues found that a formal mentor-mentee relationship had a greater positive impact on job satisfaction among new RNs than an informal one. 

The neurosurgery new–hire RN mentorship program at New York–Presbyterian Hospital/Columbia University Irving Medical Center is a formal unit-based approach designed to mitigate the causes of attrition by creating a professional environment where nurses feel supported, heard, and valued, which increases confidence and ultimately job satisfaction and retention.  

How the program works

Our unit is a 36-bed, high–acuity mixed step-down and general unit caring for neurosurgical and neurological patients. We created a 6-month voluntary program where mentors and mentees are assigned based on compatibility, availability, and mentee preference. Mentors must have a BSN degree, a minimum of 1 year of nursing practice experience, an annual performance evaluation rating that meets or exceeds standards, and their nurse manager’s approval. Most important, they must have a strong commitment to professional and personal development. The mentees are new–graduate RNs or newly hired neurosurgery RNs who have less than 1 year of experience in the specialty. 

 Mentors and mentees are encouraged to meet once or twice a month for 1 to 3 hours to discuss topics that they have agreed to in advance. Topics can encompass specific clinical skills or concepts related to the clinical specialty (for example, care of transsphenoidal patients, N-methyl-D-aspartate encephalitis) or to career and personal development (for example, building resiliency in the workplace).  

In addition, the mentoring pairs coordinate their schedules for clinical shifts, which helps the mentee feel comfortable and build confidence knowing that an experienced resource is available to them as needed. As the pairs progress through the program, the mentees are required to complete three surveys (at the beginning, at 3 months, and at the end of the program) that measure their confidence levels for certain tasks (such as documentation and patient teaching) on a 5-point Likert scale. At the conclusion of the program, the pairs complete their respective program satisfaction surveys. (See Survey says...)

All program documents are available in hard copy and electronically. (See Easy access.)

Program outcomes

The first cohort of the mentorship program, which consisted of six pairs, began in August 2017 and was completed in February 2018. The hypothesis was that the cohort would report increased confidence as he or she progressed through the program and ultimately achieve job satisfaction, which would influence attrition. 

Results from our new RN confidence scale survey corroborated the hypothesis as the mentee confidence levels rose from a mean score of 48 out of 85 on the initial survey to 72.5 on the final survey. (See Confidence rises.)

Mentees demonstrated high levels of confidence in task-oriented responsibilities (documentation, patient teaching, and hand-off report) throughout the program, but their confidence grew in areas such as being a member of the nursing team and working well with other nurses. 

The results also captured trends that point to opportunities to enhance new RN professional growth through education and training related to responding to cardiac arrest or rapid response events. With this in mind, the unit has developed 1-day peer–to–peer coaching that covers didactic concepts and a skills day that covers all other unit–specific competencies. (See Highs and lows.)

In addition, our annual turnover rate decreased from 17.8% in 2016 to 14.5% in 2017 and 3.5% in 2018.  

The results indicate that a unit-specific mentorship program enhances the mentees’ experiences as they transition into their nursing role in a challenging neurosurgery unit. They gain confidence and job satisfaction, which we believe will continue to decrease staff attrition. Similarly, mentors feel a sense of accomplishment and solidarity with their colleagues, which promotes a positive work environment where nurses feel supported, heard, and valued. 

In their own words 

The best way to capture the importance of nursing mentorship is in the words of some of our former mentors and mentees: 

“One of my former orientees had selected me to be her mentor after the required orientation on the unit was completed. While I considered it to be somewhat an informal extension of the orientation, it turned out to be so much more. We had the chance to discuss many interesting topics, which could not be covered during the formal orientation, yet they were part of everyday nursing. The neurosurgery mentoring program was a rich and fulfilling experience. My mentee and I will continue our professional relationship beyond the program.”—Agnieszka Warenica, RN (Mentor, Cohort 1) 

“Mentoring is effective as long as you build trust and understand that it is an open relationship in which both parties should provide constructive feedback to each other. The quotes below reflect what mentoring is to me: 

‘Leadership is about making others better as a result of presence and making sure that impact lasts in your absence.’ 

‘Mentoring is a reciprocal and collaborative learning relationship between two, sometimes more, individuals with mutual goals and shared accountability for the outcomes and success of the relationship.’”—Danielle Ramos, RN (Mentor, Cohort 1) 

“My experience as a mentor was as much of an honor as it was a privilege. Taking the responsibility to help guide, mold, and build a novice nurse is surely not easy given the intensity our roles play out in this field; yet I watch[ed] her successfully articulate with confidence what she has learned, the mistakes she has learned from and why, therefore becoming more successful in her role…this brings me great joy and gratification. Learning new skills is a process [that] takes time, patience, and understanding. Little did I know that it was I who had learned more about taking risks, actively listening, and developing a different kind of skill set—building confidence as a leader and career satisfaction. Watching my mentee grow is like watching one of your own kids grow into a confident, professional, and disciplined leader of the future.”—Amarilis Soto, RN (Mentor, Cohort 1) 

“What I loved most about the mentorship program was being able to ask my mentor any question without judgment. Throughout the more difficult days, I was able to ask my mentor for help, as well as describe my feelings, whether they were of fear or accomplishment. Not only did the program reassure me, it gave me more confidence as a nurse in providing the best care possible to my patients.”—Nerelis Fernandez (Mentee, Cohort 1) 

The authors work in the neurosurgery department at New York–Presbyterian/Columbia University Irving Medical Center in New York City. Jason Johnson and Jessica Kim are clinical nurse I. Patricia Punzalan is the patient care director. 

Selected references

Bay EH, Binder C, Lint C, Park S. Mentoring the next generation of neuroscience nurses: A pilot study of mentor engagement within an academic-service partnership. J Neurosci Nurs. 2015;47(2):97-103. 

Chen CM, Lou MF. The effectiveness and application of mentorship programmes for recently registered nurses: A systematic review. J Nurs Manag. 2014;22(4):433-42. 

Daniel ES, Ramnarine N, Kathiravan G. Effective mentorship for recruitment and retention of newly registered nurses at a tertiary care hospital, Trinidad. Imp J Interdiscip Res. 2017;3(2):1161-71. 

Jayalakshmi N, Naidu S, Christian K, Joshi S. Evaluation of effect of clinical nurse mentors assigned to nursing students upon level of satisfaction regarding clinical teaching-learning process. Int J Res Nurs. 2016;7(1):19-23. 

Jones SJ. Establishing a nurse mentor program to improve nurse satisfaction and intent to stay. J Nurses Prof Dev. 2017;33(2):76-8. 

2016 National Healthcare Retention & RN Staffing Report. NSI Nursing Solutions, Inc. 2016. avanthealthcare.com/pdf/NationalHealthcareRNRetentionReport2016.pdf