By Traci Hanlon MN, RN, Consultant at Creative Healthcare Management
With the increasing complexity of the healthcare environment, increased amount of technical knowledge required to practice, shorter lengths of stay, and increased acuity of patient populations, nurses are faced with a phenomenon that has been dubbed by research from the University of Minnesota as “complexity compression.” Complexity compression over time has been linked to clinician’s experiencing compassion fatigue, burnout, and decreased ability to think critically, which has a direct correlation to poor clinical outcomes.
Preceptors help bridge the theory-to-practice gap for new graduate nurses and act as a buffer between the new graduate and the phenomenon of complexity compression. This buffering serves preceptees by allowing them to build confidence, build on the knowledge they gained in school, and to apply this knowledge at the point of care where there are many competing priorities and interruptions to their routine and thinking.
As described in Benner’s Novice to Expert Model, nurses do not usually reach the competent level until after the second year. It is between the first and second year, when new graduates are on their own, that they experience difficulty in managing complexity compression. Add to that the relational skills that the new nurse has to navigate, such as seeking clarification and sometimes questioning physicians, or speaking up when something does not seem right but not knowing exactly what the issue may be, and you have the perfect storm for a nurse to lose confidence in his or her ability to perform. Nurses at this juncture are also trying to navigate the unique social norms of their unit, and this can be a risky venture. If they ask too many questions, or ask the wrong question of the wrong peer, new nurses may fear that their competence might be questioned. This is a critical time in a clinician’s development. This is the time when a mentor can make all the difference.
Mentoring vs. Precepting Relationships
Mentoring relationships differ from precepting relationships in that precepting is a time limited relationship that is evaluative in nature. The preceptor is a guide, teacher, and coach, but at the end of the day the preceptor determines if a new graduate is a good fit for the unit and has influence over the employment status of the new nurse.
Mentors provide a different kind of guidance. Mentoring relationships are not defined by time and are not evaluative in nature. Mentoring is a reciprocal relationship in which the mentor and mentee engage in a collaborative process to define goals, actions, and behaviors that will ultimately help the new nurse be successful. Mentees can confide in their mentors, ask questions they would not feel comfortable asking their peers, and seek advice in matters that deal with difficult relationships with peers or supervisors. Mentors provide stability, guidance, and experience to help the nurses navigate the complexity of their environments.
Mentors also provide an infrastructure and roadmap to professional development of the new nurse. In Part II of this blog, I will define the three top priorities of a successful mentor/mentee relationship.
Traci Hanlon MN, RN is a consultant with Creative Healthcare Management and specializes in preceptor, nursing orientation, and transition to practice program development.
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