National Nurses United

Mentors 12/12/06 12:16 PM Page 12 Right: California Nurses Foundation development director Joyce Mills, RN discusses the mentor program during a recent meeting. Far right: Foundation program director Anna Mullins, RN says that with data showing that mentoring cuts attrition, they will work on expanding their programs. B oth nurses and hospitals have for decades bemoaned the high attrition rate of new and returning nurses. The number of new nurses leaving after 18 months of work has been as high as 50 to 60 percent for some hospitals, according to the Foundation. These turnover rates reflect an unstable workforce of new nurses struggling to adjust to the realities of working in a hospital. Without assistance and support, their untreated anxiety can harm patient care. And, from hospital management's perspective, high turnover is not cost-efficient. Every time a nurse leaves, the average replacement cost for each RN, including recruitment and retraining, is at least 1.5 times the total annual salary of the position. Enter the California Nurses Foundation, a nonprofit supporting organization to the California Nurses Association. The Foundation believed that if new and returning nurses had an institutionalized support system led by staff RNs, and on whom new and transitioning nurses could depend for advice and encouragement, they would survive those crucial first years better than those without. Choosing veteran staff nurses as mentors for new and transitioning nurses seems intuitive, but Joyce Mills, RN and program development director for the Foundation, finds that one of the fundamental problems with other programs is their use of managers as mentors. "The assumption is usually that managers are the best mentors," she says. "Maybe that's true for nurses stepping into management roles, but it is the experienced staff RN currently working at the bedside who can make or break a new RN's experience." The nurse mentorship program launched at two hospitals in 2003 and led to a series of pilot programs developed after extensive inquiry into literature in this field and interviews of staff RNs. Sponsored by the California Endowment, the Gordon and Betty Moore Foundation, and the San Francisco Foundation, the program is now being tested in seven major acute care hospitals throughout California, four as part of an agreement with Catholic Healthcare West. Aside from Sequoia in Redwood City, the participating hospitals include Mercy General in Sacramento, Kaiser Permanente in Hayward, O'Connor and Good Samaritan hospitals in San Jose, St. Bernardine Medical Center in San Bernardino, and San Gabriel Valley Medical Center in San Gabriel. To date, the CNF programs have reached more than 800 RNs. Veteran staff nurses act as the mentors, and are selected from volunteers with at least three years' experience at their facility and who show good leadership, cultural competency, and strong patient and nursing advocacy skills. Mentors complete a three-day mentor certi12 REGISTERED NURSE fication class and then meet with mentees several hours a week or month over the course of up to two years. The mentee-mentor relationship is confidential, creating a safe space for new nurses to raise their concerns in a supportive environment. The critical position to ongoing implementation of the program is the lead mentor—a staff nurse mentor who helps run the program in the hospital by overseeing other mentors while also mentoring mentees. The lead mentor matches mentors with mentees, considering any requests for compatibility such as gender or ethnicity. "These 12 lead nurse mentors have crafted their own unique role and they are the key secret to implementation of the program," said Mullins. In addition to the mentor program which focuses on professional survival and development, CNF is also testing a cultural competency program and a preceptor program. The preceptor program was developed after the Foundation found that clinical orientation, particularly for newly-graduated nurses, was sorely deficient in many hospital units. More than 100 RNs in four hospitals have attended the preceptor programs so far. The cultural competency program has reached more than 260 RN preceptors in other hospitals. "While all of our programs include cultural competency, this stand-alone program can reach even more staff RNs involved with either clinical or professional development of new and transitioning nurses," said Catherine Kennedy, CNF program manager. "Together with the ongoing work of the Professional Practice Committees and Quality Liaisons established over the last 10 years by the California Nurses Association, these programs go a long way toward creating a better and safer work environment." M entors help newly-hired rns in all kinds of situations. "One young girl made a pretty big medication error and it was bad enough where she felt like she was going to quit," said Carol Koelle, lead mentor at St. Bernardine Medical Center. "We had the opportunity to call a mentor who came to the hospital, took her downstairs, and sat down to have lunch and talk with her." The hospital later transferred her to a unit with a less intensive pace. "That's somebody we would have lost, who may have quit on the spot. People spend so much time in school to become nurses and then come into the real world and it's pretty devastating. I have seen probably two or three events where, if they had not had a mentor or someone to talk to, they would have quit the nursing profession W W W. C A L N U R S E S . O R G NOVEMBER 2006

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