Flight nurse Morgan Hand, BS, RN is never in the same place for too long.
Her employer is Sanford AirMed, and she calls Fargo, North Dakota home, but when Hand clocks in each day, she never knows where her shift will take her.
“One of my very first flights, we actually had to fly all the way out to the Montana border, and then fly that patient all the way to Rochester. It was basically a really big triangle. I want to say maybe seven, eight hours.
“With (Sanford) AirMed, we could transfer anywhere within the United States. We even do transports to Canada if it’s necessary. We can go pretty much anywhere,” Hand explained.
And she’s gone pretty much anywhere, even escaping the wind-cutting-right-through-ya Midwest winters for a much more temperate climate.
Empowering other nurses across the globe
Hand returned from a working trip to Costa Rica on Feb. 19. It was part of Sanford World Clinic’s newly launched Global Nurse Mentor Program, aimed at impacting health care across the globe.
In this program, which was launched at the beginning of 2022, providers like Hand share their skills and experiences with international providers.
“Really what it’s designed to do is to take nurses within the Sanford system and mentor nurses throughout our different partnerships throughout the world,” Hand said.
Hand was sent to Hospital Metropolitano, a hospital in San José, Costa Rica.
“With my World Clinic mentor, my person who I work with directly in the World Clinics, we decided pretty early on that trying to empower nurses and looking at the culture was going to involve me going there right away,” she said.
Always looking to get better
Hand spoke highly of the already existing care at Hospital Metropolitano, saying, “their foundation is already there.”
She added the providers at Hospital Metropolitano keep their egos at the door and only focus on what’s best for the patient.
“A lot of the workers, whether it’s physicians or the nurses, they want to grow. They want Sanford’s help. So, that was really enlightening to see that they wanted me there. Even if you are the best health care in the world, you could still grow and learn,” she said.
Hand said it’s humbling that Hospital Metropolitano asked to partner with Sanford Health.
“A couple of their physicians have worked here in the United States. Their chief medical officer trained in the Twin Cities. So, he had known about Sanford. They saw that Sanford had grown and has done all these things with quality and safety, really helping them be one of the best. They saw that and said, ‘We want to take that in and be just like them,’” she said.
Hand will participate in the mentor program for the rest of 2022.
Reaching beyond Costa Rica
Initially, Hand was excited about growing health care in Costa Rica. Once she was there, she realized just how much of a reach Hospital Metropolitano has.
“There’s actually a lot of different patients that they serve from around the world. There was a patient there from Argentina. I got to talk to a family that was from Canada that actually had to have a procedure done while they were there.
“So, it’s not only impacting Costa Rica, but it’s truly impacting multiple countries around the world,” she said.
Hand said she considers the Global Nurse Mentorship Program a once-in-a-lifetime opportunity.
“I love that Sanford’s doing this. It’s a really good partnership. I think we all went into health care to help people get better. To do that on a global scale is something that honestly, I can’t really put into words.”
Power is defined as the capacity to knowingly participate in change for wellbecoming (Barrett, 2015). Barrett (1986) assumes that everybody has power, but at times people may experience powerlessness depending on life circumstances. Mentoring is a modality that can help students overcome barriers that hinder their power to excel in their programs and as professionals in the field.
Mentoring has been used in nursing to help both nurses and nursing students grow and advance in their careers. It has been depicted as important to the growth of nursing (Navarra et al., 2017) and as a catalyzer for increasing diversity and the inclusion of minorities in nursing (Talley et al., 2016). It is not surprising that mentoring was cited as a modality that can help nurses excel. Excel is one of the components of the American Nurses Association (ANA) 2020-2021 Year of the Nurse theme: “Excel, Lead, Innovate” (Indiana State Nursing Association, 2021). In addition, mentoring fits into the mission of the CUNY School of Professional Studies (CUNY SPS), which is to offer customized programs that are responsive to its students’ needs, and its vision to enable students to grow and excel (CUNY School of Professional Studies, n.d.). Mentoring also aligns with the CUNY SPS nursing program’s mission to guide students in attaining the necessary tools (knowledge, skills, values, and ability to make sound judgment) to excel in the profession of nursing (CUNY SPS Nursing Department, n.d.).
The nursing program at CUNY SPS is a fully online program that offers many opportunities for nurses to further their education and climb higher in the profession. It includes a BS in nursing and four BS dual joint programs that ensure a seamless transition from Borough of Manhattan Community, Bronx Community, La Guardia, and Queensborough Community College. It also offers several MS degrees in nursing informatics, nursing organizational leadership, and nursing education, as well as an accelerated RN to BS-MS in nursing informatics.
The CUNY SPS nursing program uses two unique mentoring initiatives that target new students in the BSN program. The Black Male Initiative (BMI) is a CUNY-wide initiative that facilitates retention and degree completion success for Black and Hispanic men in higher education. The BMI program, which was designed to level the playing field of inequity and inequality in higher education, uses “a peer-to-peer mentoring model”. At CUNY SPS, the BMI program is used to enhance its Career Ladders scholarship program and to implement the BMI mentoring model (CUNY School of Professional Studies, 2021). It takes into account cultural differences and trains experienced high-performing students to serve as culturally competent peer mentors for new and struggling nursing students. Peer facilitation has been shown to boost both peer facilitators’ and students’ confidence (Davis and Richardson, 2017).
At the beginning of the fall semester, the CUNY SPS nursing department launched its first mentoring program. The aim of the program is to support nursing students in their journey to professional nursing. This decision was spearheaded by the need to provide support to adult students who very often are juggling school with full-time work and family, in addition to other life responsibilities. These realities were worsened by the COVID pandemic. The nursing department’s mentoring program is voluntary for both the mentor and the mentee. It targets new students entering the BSN programs. In contrast to the BMI peer mentoring program, the mentors are professional nurses who are active in the profession. Although all the mentors are currently CUNY SPS nursing faculty who volunteered to participate, mentors can also be professional nurses outside of the program. Careful measures are taken so as not to pair students to faculty who teach them. The hope is for students to use this resource for career guidance, confidence building, and collegial support. As we continue to evolve in an ever-changing world, it is our hope that these two mentoring opportunities can support our students’ aspirations, facilitate their ascent to higher grounds, and increase their power. As they knowingly ‘participate in change for their wellbecoming’, so too will those they serve. “Power is being aware of what one is choosing to do, feeling free to do it, and doing it intentionally” (Barrett, 2015, p 498).
References
Barrett, E. A. M. (1986). Investigation of the principle of helicy: the relationship of human field motion and power. Explorations on Martha Roger’s Science of Unitary Human Beings, 173-184.
Barrett, E. A. M. (2015). Barrett’s theory of power as knowing participation in change. In M. C. Smith and M. E. Parker (Eds.), Nursing theories and Nursing Practice (4th ed. pp. 495-508). F. A. Davis Company.
COVID-19 has been a game-changer for a lot of what we would consider normal life activities. Many nursing students are learning virtually now. But they still need to think about future career goals — even if they end up changing.
Nicholas McGowan, BSN, RN, CCRN, is a staff nurse in the ICU at Kaiser Permanente as well as the owner of Critical Care Academy, where he teaches critical care certification to aspiring ICU nurse. He is a preceptor and mentor to nursing students and took time to give advice to nursing students about how to set their career goals.
What are the first steps you would advise that nursing students take in order to outline their career goals?
The first step I recommend in outlining career goals is to take an honest self-assessment. Much like fingerprints, everyone has unique goals and aspirations that they need to fit with their obligations.
A good start is to outline short-term and long-term goals. For example, compensation is usually one of the first things nursing students think about as they get closer to graduating. This might be important in the short-term as student loans and other debts accrued during school must be paid back. But there may be more important factors to consider in the long-term such as autonomy, flexibility, or overall job satisfaction. Do you plan on traveling? Or do you plan on having a family? Most seasoned nurses would advise starting with long-term goals first. Focus on building your skillset, formal education, gaining experience, and finding your passion. The money will always follow.
Suppose they feel overwhelmed and aren’t sure what facet of the field they want to work in? What are some tips they can use to start defining what they want to do?
The great thing about most nursing schools—that are often undervalued—are the clinical rotations and internships. This is perhaps your greatest opportunity to experience first-hand how nurses in each field function. I didn’t know what field I wanted to work in until my last semester of nursing school when I watched a nurse in the ICU manage a very sick patient. Many of my colleagues fell in love with newborns and went on to work in the NICU. And many others enjoyed their skilled-nursing rotation and went on to work with the elderly population.
Once you begin each clinical rotation, try to imagine yourself in that role long-term. Then ask to be paired with a nurse in that facility who shares that same passion and observe their work. Most nurses are happy to share their career successes, and more importantly, career regrets. Take good notes here.
What should they do when thinking about their first jobs? If they have strong feelings about working in a specific area, but can’t get a job in it, what should they do?
In the field of nursing, persistence pays off more often than not. Find creative ways—such as volunteer opportunities or local organizations to join to increase your visibility and establish rapport. Once you find an area that you are determined to work in, find out who the hiring manager is and make yourself and your intentions known to him/her.
It’s a good idea to keep your resume available and be ready for an impromptu interview. Chances are likely that they will ask others around the unit how they perceive your attitude, work ethic, and ability to maintain patient safety. Nursing is a very small community and your reputation—good or bad—will quickly precede you.
Should they have mentors? Why?
Mentors can serve a pivotal role in helping nursing students to establish a career path and grow in any position. Even without a formal program or agreement, many seasoned nurses become mentors to newer nurses because advancing nursing practice simply depends on it. You should always be seeking opportunities to align with a preceptor or mentor in your chosen field.
If they don’t have a mentor, how can they go about getting one? Should they simply ask someone they admire? Please explain.
Finding a nurse to mentor you depends on a few factors. Perhaps the easiest way would be to search online through social media like LinkedIn or allnurses.com. Facebook has a large nursing group called “Show Me Your Stethoscope.”
You should also consider joining a local nursing organization or chapter such as the American Association of Critical Care nurses. There are plenty of ways to seek out official nurse mentors through these channels, but be prepared to provide compensation.
Another way is to align yourself with a nurse during your clinical rotation or internship. Ask around the unit about who is available or would be willing to teach you about the job. Most nurses enjoy teaching students and watching them grow. Quite often a student develops a natural rapport with a nurse and a mentorship is formed. Just be sure to provide them with a return on their time investment. If you are eager to help me with my patient care or answering call lights, I will be eager to teach you whatever you want to know.
What are the biggest mistakes nursing students should be aware of when they begin to outline their careers?
Many nursing students make the mistake of “chasing the money” first. They may have several job offers in front of them and choose the one with the highest salary over the one with the greatest potential for growth and experience. You will quickly regret it when you lose those nursing skills you worked hard to achieve.
Another thing to consider is your education. It doesn’t—and shouldn’t—stop when you receive that nursing pin. Nursing is a career, but it’s also a calling. The profession is always evolving, and we are always learning more. This requires continuing education. Make sure you save a space in your life to continue your education an increase your value as a nurse.
The key to being an amazing preceptor to a new graduate nurse is to always remember what it’s like to be a brand new nurse. The idea that “nurses eat their young,” if true, is neither helpful to the new nurse nor to the patients that they care for. Starting a new job is stressful enough, so facing untoward behavior from a preceptor or new colleagues only further discourages the new nurse, and potentially hinders their skills development and patient care. Here are seven ways to be an amazing preceptor and support new nurses and their patients.
1. Assume they don’t know.
One of the most problematic instances between preceptors
and new nurses is
the preceptor’s assumption that the new nurse knows something they don’t. This
could involve speaking in jargon specific to a specialty, teaching complex
skills without a basic understanding, or delegating tasks to a preceptee that
they are not capable of carrying out. Keep in mind that no matter how many
hours the new nurse spent in clinical, learning to be a nurse and being a nurse
are two very different things. Use language that a layperson could understand
and explain terminology in a non-patronizing way before using it.
2. Answer questions objectively.
Even if a new nurse asks a question that seems too
elementary, never express judgment or criticism toward them for asking. The
last thing a patient needs is a nurse who is too frightened to ask questions
for fear of being ridiculed. It is essential to every nurse’s growth that they
learn and practice in an environment that supports their learning and
development.
3.Address the social atmosphere.
While the main role of the preceptor is to teach, observe, and assess a new nurse’s aptitude for working independently, it is also worthwhile to discuss the culture of the organization they work in and how to thrive in it. For example, if a boss is very lenient about swapping assignments but strict about tardiness, this is worth divulging to the new nurse. Some hospitals have policies about taking breaks that are interpreted very differently in each unit. Sharing this information with a preceptee could save them the potential embarrassment of breaking an unwritten rule. This would also further reinforce the idea that they are supported by their predecessors. Nurses who like the place they work and who trust their colleagues are generally better nurses.
4. Encourage work/life balance.
While it is not necessary to exchange personal details, it is worthwhile to encourage the new nurse to take care of themselves appropriately in their work. Many new nurses are so frightened when they start working, they may not want to ask where the restrooms are, where they can get a glass of water, or when lunch is for fear of seeming uninterested in the content of their training. One of the first activities any amazing preceptor should do with their new trainee is take them on a tour of the unit and show them the facilities available to them. Encourage the new nurse to speak up if they need to use them. Nurses who go without do not make better nurses.
5. “See one, do one, teach one.”
Having a simple outline for training a preceptee such as “see one, do one, teach one,” allows the trainee to fortify and demonstrate their understanding. Many new nurses find that their preceptors allow them to do too much, or not enough. Neither are optimal for allowing the nurse to practice new skills with the fundamental understanding to back it up. Showing the new nurse a skill, then having them perform it, and then having them teach it gives them understanding, skill practice, and a test of their complete understanding. Many hospitals now require nurses to complete documentation for each skill. “See one, do one, teach one,” is an effective way to work through training and skill assessment.
6. Don’t be afraid to pass on precepting.
Just as not every preceptor is made equal, so too with every
new nurse. If a preceptor finds that they cannot establish a positive
rapport with a new nurse or vice versa, they are empowered to request a
switch. If interactions between the preceptor and new nurse are not
founded on mutual understanding, the training will likely not be
optimal. Similarly, if a nurse has been inundated with precepting and
needs to take time between training nurses, they should honor that. A new
nurse would likely benefit more from a preceptor who can be enthusiastic about
training.
7. Be open to new nurses’ observations and feedback.
Many nurses who have been in a job for a long time take for
granted the state of things without question. If a new nurse points out a
policy or system that seems ineffective or inefficient, it is worth considering
that it is coming from a fresh pair of eyes. Even if the temptation is
there to criticize the
nurse for being presumptuous or idealistic, consider the
value of a new nurse who is so enthusiastic about their work that they are
willing to critically think about ways to improve.
No experienced nurse got to where they are without a beginning. Ask the best nurses how they got to where they are and they will likely credit a preceptor who believed in them and pushed them to be their best. Any nurse can be an amazing preceptor, as long as they have an attitude of both compassion and tact in which a new nurse can thrive.
We know firsthand what it’s like to be a parent to a millennial nurse. My millennial daughter is married to a travel nurse. They are out living the dream in their “tiny house” on wheels with a beautiful cream-colored golden retriever named Arlo. Jennifer, a nurse herself for 43 years, is a mother to a millennial travel nurse living the good life in California. We each understand the challenges of raising millennials and the challenges of keeping millennials engaged within your organization.
Millennials have a different view of the world than previous generations. Gauging what’s important to them and how to keep them engaged can be daunting. According to the Advisory Board, engagement for a millennial is not a predictive index of intent to stay with a company. Most people think engagement equals loyalty. This is not the case with the millennial nurse. The millennial nurses of today have witnessed their parents go through the ‘great recession’ where they witnessed their parents struggle as loyalty was thrown aside by their employer. The millennial nurse enters the nursing profession with student debt unseen in other generations, creating the desire to move ahead financially to pay down these debts. The millennial nurse is technologically savvy and enjoys being intellectually challenged in new ways; they will resist outdated training and onboarding methods. The millennial nurse also prefers a set schedule, so they can plan their “experiences,” which is more important to them than owning a big house or a nice car.[et_bloom_inline optin_id=optin_58]
As professionals in the health care industry and parents to millennial nurses, we suggest switching engagement tactics to drive loyalty from millennials. Deciphering what engagement tactics will work is not as complicated as it sounds. Our best advice: think like a parent and be open to trying out our several tactics below.
Provide a platform for opinions
Millennial nurses want to have input on some issues and appreciate when their opinions are valued. This makes millennials great contenders for a shared governance model. Giving millennial nurses ownership over projects allows them to have a voice in their practice. During staff meetings, millennial nurses have the opportunity to provide input and voice their opinions on the projects that they own. Their peers also have the chance to give feedback, so that the nurse feels valued and respected.
Giving the nurse decision-making influence sets them up for future career advancement and anchors them to the organization.
Understand the environment millennials have grown up in and adapt
As mentioned previously, millennials are burdened with student loan debt more than any other generation before. The average student loan debt for Class of 2017 graduates was $39,400. Given this financial pressure, millennials are looking to advance more quickly in their careers to earn a salary that will offset the added loan payments. Due to the impracticality of quick career advancement, millennials will often take alternative routes in nursing such as travel assignments to earn more money faster.
Since millennials are flocking toward travel nursing, it’s essential to offer bonuses and paths to career advancement within your organization to get them to commit.
Get rid of formal critiques and establish mentorship programs
Millennials also prefer coaching or mentoring over formal critiques and reviews. Constructive criticism is the preferred method of addressing concerns and improvement among employees. However, millennials are more open to receiving feedback from an ally—someone who is championing for their success.
A well-matched nurse preceptor has much power in determining the loyalty of a millennial nurse. Nurse preceptors have the responsibility to address any concerns of the millennial nurse and offer guidance to any problems. This role requires a lot of empathy and intuition to establish a relationship of trust and mentorship among millennial nurses.
Ask what’s important to them
Asking a simple question could be the defining line of what determines a millennial nurse’s decision to stay with an organization. Ask these types of questions in one-on-one meetings with your nurse:
What is most important to your job satisfaction here?
What are your career goals?
How can I help you achieve them?
What type of recognition do you like to receive?
What is one thing I can do today to make your work more enjoyable?
Asking these questions will show a millennial nurse that you are committed to their success and happiness. They, in turn, will commit to you and the organization if they know you have their best interests in mind.
Tailoring engagement tactics to bring forth loyalty does not have to be a significant project, nor will it require extra time. Following the above guidelines and tracking retention will provide a great baseline to see if your millennial nurses become more committed to the organization.
To help combat the stress of nursing school, the Student Nurses’ Association (SNA) at Grand Valley State University (GVSU) created a Transitions Mentorship Program which is in its third semester. The student-run organization immerses GVSU nursing students into the medical world through presentations, group meetings, and hands-on activities.
Jamie Platt, president of the GVSU SNA chapter, tells Lanthorn.com, “The idea behind the program is to empower our new student nurses. SNA believes that creating a strong environment through positive peer-student relationships during the beginning of nursing school will allow new students to feel confident during a vulnerable time in the nursing program.”
The Transitions program pairs lower-level nursing students with upper-level students so they can meet and discuss topics in their major and receive tips for studying for nursing exams. It offers students someone to lean on while studying in an intensive program.
GVSU’s student nurse association decided to incorporate the mentorship program based on student feedback. Many older nursing students reported the struggles they went through and wished they had had someone to help them through the program. GVSU’s nursing program is comprised of five semesters, so students in their first or second semester are paired with a student in their third, fourth, or fifth semester.
Students in the mentorship program are required to meet five times per semester and are encouraged to meet biweekly. After meeting, the mentors report back on their conversations, many of which have revolved around clinical work which makes up half of the students’ time so that they can practice skills they learn in the classroom.
The program has received positive feedback thus far, making a positive impact on students. Many students feel the mentorship program helps them feel more confident and less apprehensive about future semesters. To learn more about GVSU’s student nurse mentorship program, visit here.
Hand returned from a working trip to Costa Rica on Feb. 19. It was part of Sanford World Clinic’s newly launched Global Nurse Mentor Program, aimed at impacting health care across the globe.
