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Mentorship: Nursing and Practice

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The aim of this assignment is to choose a key aspect of facilitating learning and assessment with a learner, whilst critically evaluating my practice, using professional standards and current theory and literature to illustrate how I have developed as a mentor and educator in practice.

For the purpose of this assignment, the key aspect I will be focusing on will be standard 4 – creating an environment for learning, from the Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice: mentors.

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Throughout this assignment, I will incorporate the principles of Gibb’s (1988) reflective cycle to help guide me through this process. I will also be referring to my learning plan throughout, which can be seen in appendix 3.

The role of a mentor has been demonstrated to be pivotal to the student’s clinical learning experience (Myell et al., 2008). The Department of Health (2001a: 6), defined a mentor as a qualified or experienced nurse who can effectively facilitate learning within the practice setting, with their role being to guide, support and supervise a mentee through the process of learning and assessment.

This statement is supported by the Royal College of Nursing (2007) who illustrate the importance of the practice mentor when, teaching, supervising and assessing students in order to ensure they are purposely fit for practice. The role of a practice mentor consists of a number of responsibilities. However, mentorship judgement and the decision in which the practice mentor makes regarding whether the student is fit for practice rests on the mentor’s accountability (NMC 2008).

The learning and assessment process to which I am now referring took place on a busy emergency assessment unit between me and a second year student nurse undertaking her critical care placement, who for the purpose of this assignment I have named Jenny, a pseudonym to project confidentiality.

Through discussion, the examination of the PR2 and the use of SMART, a joint decision was formed that Jenny would learn the skill of carrying out an assessment document in correspondence with practice proficiency 2.3 – ‘Undertake and document a comprehensive, systematic and accurate nursing assessment of the physical, psychological, social and spiritual needs of patients, clients and communities.’

In order to begin the mentorship process, Davison (2005) states that mentors need to plan ahead as good preparation can ease the experience for all parties. Watson (1999) also states that if teaching opportunities for students are to be meaningful and productive, planning is an important part of the mentor’s role. It was during this planning stage that it became evident that one of the major factors effecting Jenny’s learning was the environment in which she was to be taught.

Downie and Basford (2003) state that facilitating learning in a formal classroom setting is somewhat different to doing so in a workplace learning environment therefore in order to ensure the environment was conducive to learning, a SWOT analysis was undertaken (Appendix 2). Advantages and disadvantages of the practice setting were utilised allowing an understanding of how experiences and the learning environment facilitates professional development (West et al, 2007, p33).

The emergency assessment unit is often seen as a good learning environment for student nurses and as identified in the SWOT analysis it provides many learning opportunities due to the varying conditions of patients and the large diversity of the multi-disciplinary team that are situated within the department. When carrying out Jenny’s initial interview past experiences were discussed along with learning opportunities and areas of interest.

This gave me a good idea of skills already possessed and a good indication of how we could plan our time together. It also gave me an insight into what Jenny felt she needed to achieve from the placement and allowed me to plan and support any learning experiences that would be beneficial to her development.

In order to give Jenny a range of learning experiences, opportunities were sort to work with other members of the team allowing involvement with a larger scope of patient conditions. Lloyd Jones et al (2001) indicate that when another staff member stands in for a mentor they do not put the same effort in or willingness to share knowledge and explore the full potential of the role with the student. A statement I do not fully agree with as I believe this depends on the individual delivering the teaching.

Essential standards to provide patients with safe and effective healthcare must be gained before entry onto the NMC Register (NMC 2008). Unfortunately, this cannot be achieved if an evidence-based learning experience is not provided (Carr, 2008). Kolb’s (1984) experiential learning model underpins how knowledge is embedded through experience and reflection allowing students to have a deeper understanding of the situation.

However, according to Quinn and Hughes (2007), without initial experience students are unable to develop theories contributing to practice. Working with newly qualified nurses on the unit also were of great benefit to learning as they were very enthusiastic about their jobs and keen to share their knowledge. I was also aware that Jenny would be able to discuss any concerns she had about being a student as they were still in the transition period themselves

According to Stuart (2007), the clinical environment must be an environment where learning can take place, however the SWOT analysis identified poor student support as a threat. Pellatt (2006) states that in busy working environments, time constraints can affect the mentorship role therefore hinder student learning. Ward managers are looked at to guide and support mentors,(Wilkes, 2006, p45) however due to government targets, they are often unapproachable whilst senior nurses are often busy with more junior staff on eau.

Potentially this could formulate students to judge their mentor, as that known as a ‘disabling’ mentor establishing an unsupportive relationship, restraining a student’s initiative and willingness to learn (Pellatt, 2006, p338). At this point it is reasonable to refer to Maslow’s (1970, cited in, Quinn & Hughes, 2007, p40) hierarchy of needs, suggesting lack of sociality and support limits ones physiological needs whilst poor guiding and involvement provides students with no sense of belonging and discontented safety.

Poor student-to-mentor ratio was also identified as an issue. When evaluating this, it became apparent that this was due to the unit having a high turnover of staff, and at present a large number of newly qualified staff. As already highlighted this meant that much pressure was being put upon mentors to support these individuals leaving the assigned student taking on the role of the health care assistant.

I was very aware that this could happen and it was agreed that on occasions, Jenny could buddy up with a more senior student. According to placements in focus (ENB 7& DOH, 2001a, p20) to facilitate experiential learning in the practice setting the ‘buddy’ system can be incorporated, whereby senior students support and teach those junior students basic nursing skills.

In order for learning to take place, I felt it was crucial for me to be aware of Jenny’s preferred learning style. As a mentor knowing this will allow me to facilitate learning in the way in which the student best adapts. Nicklin and Kenworthy (2000) state that the preferred learning styles of students are often assumed rather than established, an area I had not given any thought to previously but know recognise as important in the mentorship process.

Honey and Mumford (2006) discuss four different learning styles, suggesting whenever possible, it is important to allow the student’s own style to influence your choice of teaching method. They describe learners as activists, pragmatists, theorists or reflectors. They further note that although many people were a mixture, they generally had a preference for one style. This is a statement which I fully agree with. This claim is indeed supported by Walsh (2010) who suggests that learners choose to learn in slightly different ways according to the task.

Through discussion and mostly observation, it was established that she preferred a more stand back and observe approach favouring a reflective approach to learning. I therefore incorporated her preferred learning style into my planned teaching session. I found this type of learner extremely easy to teach, primarily because I was aware that she was not carrying out tasks that she was not competent in doing so. Although, I do bear in mind that not all students will be reflectors and that my teaching styles are going to have to be adapted for each student I teach.

Role modelling is an important part of the learning process. Walsh (2010) states a competent, safe, evidence- based mentor is perhaps the best teaching tool. Registered nurses act as role models for students (Schober and Ash 2006) and are seen as inspiring in the learning process. According to Welsh and Swann (2002), students will try to ascertain the norms and values of the team by observing, perhaps not consciously, the established group members to pick up cues as to the acceptable ways of acting and, by implication, the attitudes and beliefs of the members.

Therefore, according to Stuart (2007), high standards of care need to be modelled as students will hold the performance of the qualified nurse and model their behaviour. This element of learning could also be referred to as the behaviourist theory, well illustrated by Pavlov (1927) often the student observes and responds to a stimulus which is specified by the mentor to allow a positive learning experience to be formed (Hinchliff 2009, p8).

Bandura’s (1977) social learning theory states that behaviour is learned through the process of observational learning. Individuals observe influential models and copy their behaviours. This theory is recognised as important in education and when working with Jenny, I was very aware of this. This on occasions made me uncomfortable as I was aware I was being observed and perhaps even judged on my behaviours and standards of care.

However, this has had a positive outcome for me as a mentor as it encouraged me to look at my current practice and recognise areas for improvement and helped me to ensure that my practice is evidence based at all times. It also prompted me to regularly measure my own standards against that of the NMC (2008) standards for supporting learning and assessment in practice.

Stuart (2007) states questioning and discussion can also be applied to increase the reliability whilst encouraging students to take on the role of active learning. According to Hinchliff (2009), the use of discussion and questioning allows the cognitive theory to be applied whereby students take on the role of critical thinking and perception. Stuart (2007) goes on to say that though discussion; we can assess the development of those attributes desirable of a competent practitioner.

Discussion played a large part in the assessment process and was an element of assessment that we both felt comfortable with and was appropriate for the competency Jenny was trying to achieve. According to De Young (2003) good discussions do not just happen spontaneously, they require careful planning. This is a statement I disagree with. Although some of the discussions were planned, many happened spontaneously as the situation arose and were extremely beneficial to learning and were used as an opportunity to give feedback.

Another form of assessment is the practice assessment document (PAD) or portfolio. This type of assessment enables an assessor to measure students learning, acts as a tool for reflective thinking, illustrates critical analytical skills and evidence of self-learning and provides a collection of detailed evidence of a person’s competence (Norman 2008). Quinn (2000a) states that it is important to have knowledge of the student’s programme and the required outcomes in order to ensure effective learning.

At first I found the PAD very daunting, but once I become familiar with it, I found it extremely useful. Not only did it guide me as to the expected level that Jenny should be working at, it also encouraged me to read around areas of care that I felt crucial to her development. Again, it encouraged me to think about my own practice and helped highlight areas for myself as both a nurse and a mentor that were in need of updating.

Competence can be identified through professional learning and practice in conjunction with professional competencies set out by the NMC. Referring to the portfolio allows students to gather essential evidence to assist with personal and professional development through the means of critical analysis (Norman, 2008, p5-7).

In order to facilitate student learning and assessment, I felt it was imperative to professionally measure my own knowledge, skills, achievements and progress, Standard 1.1 (NMC, 2008). According to Aston and Hallam (2011), effective self-evaluation is central to developing good self-awareness, and is a key skill for mentoring. In preparation I completed the Nursing and Midwifery Council (2008) Standards to Support Learning and Assessment in Practice self assessment document (appendix 3).

By completing the self assessment against professional standards, I was able to identify existing skills and knowledge that I already possessed, together with areas I feel still needed developmenting (in black). This was a tool I found incredibly useful and one which I completed again following the completion of this module (in red). By repeating the process I was able to assess where I was at then and where I am now at which has enabled to me formulate an action plan for further development and was very surprised to see how much I had achieved in a short space of time.

However, one area I feel still needs much attention is that of NMC standard 3.d. When evaluating this I feel it is primarily due to me being novice in this area but I know that with experience and support it is an area I will gain confidence in. According to Race and Skees (2010) assessing is a learned art and skill that takes time and practice just as everything else we desire to achieve.

In order for myself to assess competence I must firstly understand the purpose of competence in relation to NMC standards and university based proficiency’s. As nursing is a competency based profession the role of the mentor as a assessor is strenuous due to the nature of student assessment whilst also continuing to provide nursing care, support and advice to patients (Rutkowski, 2007, pg36-37). In order to promote self-directed learning attributes such as knowledge, skills and attitudes need to be addressed. Liaising with a guidance tutor or placement facilitator in relation to complicated proficiency’s could also help facilitate assessment and recognise competence.

Through undertaking and completing this module, I have developed a sound knowledge and critical awareness of being a mentor. I have been encouraged to look at my own practice, ensuring that it is evidence based at all times, therefore enabling me to fully support students in applying evidence base to their own practice.

I am also aware that as I become a more experienced mentor in my clinical area, junior mentors may call upon my expertise in order to help them through the same process I am currently going through and this is a role I am fully prepared to engage in. I have made recommendations to my unit manager that a student welcome pack is needed. According to Papp et al (2003), if students are welcomed, then the clinical learning experience is considered positive.

The exploration of learning theories and styles within the module has allowed me to acquire valuable understanding of the many theories surrounding learning, teaching and assessing and when planning learning experiences for students I now feel more equipped. I am aware that in order to coach, share my clinical expertise and guide students through personal and professional development mutual trust must be gained. According to Thomson (2006), this can be referred to as a continuing one-to-one relationship with a professional friend.

However I am aware that the professional relationship must not accumulate into friendship therefore formulating prejudice judgements. I also understand the importance of attending regular mentor updates provided by the university and by my current place of employment. This will in turn enable me to mentor students more effectively.

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Mentorship: Nursing and Practice. (2016, Jun 10). Retrieved from https://graduateway.com/mentorship-nursing-and-practice/

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