Internship? Residency? Nurse Mentoring

Whatever you wanna call it…

I’m going to slip into educator mode for a minute and talk about a topic that will lead to other topics. Let’s talk about nurse residency programs. Or preceptor/preceptee/nurse mentoring programs. I’d like to go on record saying this is the most excellent thing and I’m glad that it’s becoming a thing around the country.

Raise your hand if you remember your first year out of nursing school. Now keep your hand up if it was the worst year of your entire career and for a long moment you wondered why you wanted to be a nurse because that year… That year made you feel like everything about nursing was scary, confusing, not at all like school, and you weren’t cut out for it.

Just me?

Most places you get a few months of orientation. For me, was about 3ish months and you prayed you felt okay going it alone. I never felt comfortable and not all of it was just being new. Some of it was never feeling like some of my coworkers wanted to be bothered with helping or teaching me. I felt like a burden, like my questions weren’t welcome, nor was I an asset to the team. I went to work with serious upset stomach every shift and cried on more than one occasion. Nurses eating their young? Know what that feels like. Let’s face it, RN after your name and a license in hand does not a nurse make.

That shaped my nursing career. It took a position change and a few years before I developed some confidence. I found coworkers that treated me like a colleague instead of a burden and I blossomed. I also developed something important that I told to my students and any new person I worked with.

I’m here to help not treat you like crap.

Everyone has to learn and it’s important to cultivate, encourage, nurture, and build up new grads/students/new hires. We have to work side by side some day so I want to make sure I’m offering a hand up. I want to make sure you know what to do. You have a question? We’ll find the answer. Can’t figure out the next step? We’ll puzzle it out. Turning, helping, offering a break, answering a question, showing how to do something, just being a resource? I will do that. Why? Because I know what it’s like to be nervous or unsure and no one have your back.

That’s why I like long residency nursing programs and I like good mentoring programs even more.

Doctors have a residency where they aren’t on their own even after they earn the right initials. There is someone above them guiding and helping them make connections between what they learned in medical school and real life. Nursing should have something similar.

This place I’m at currently gives 6 months of residency to newer nurses. California seems to do a lot of nurse residency programs where the nurse is/isn’t fresh out of school with some having worked in an outpatient facility (nursing home or doctor’s office), and they have the chance to be in a structured learning environment that allows them to safely transition from student to professional.

Think about it: a safe, long-term environment where you can ask questions, practice and perfect skills, be checked off on your learning, and then continue to gain comfort and experience. A sounding board, a patient and guiding hand.

The barriers as always are financial. Paying for someone to work who can’t work solo seems counter productive. You have to work more people on a shift. But think about how much confidence the person has once they are off. They are much more likely to stay if they are invested and feel invested in. They are making the hospital money as they cause fewer errors, both minor and life threatening.

Mentoring offers a good sounding board when the job is tough. Someone to celebrate that successful IV stick, catheter insertion, successful solo delivery, etc, etc. but also someone to push you and offer advice. It’s a true transition period that makes the growing pains not so painful.

I could’ve used 3 more months of just a mentor to refer to who wasn’t busy taking care of patients.

That’s another barrier. No one wants to mentor. Some of this is a lack of proper approach by managers. They fail to recognize those truly gifted with the ability to mentor, they don’t make the right matches of preceptor to preceptee, they over use or abuse the willing mentors, there’s no appreciation for the continued willingness to mentor, or they over load the person precepting with the worse patients.

The last one causes the most headaches. Everyone knows the person with the trainee gets the crappiest assignment under the guise of “teaching the newbie”. No, you overload your trainer and burn them out if every time they work they have a heavy load. I’m not saying make it easy because the newbie has to learn, but think about assigning calm situations occasionally and letting the person watch if something serious comes in. The preceptor can teach without being overwhelmed at the same time. Still learning without exhausting.

I hope this is something that gains traction in some form all over. Finding a way to transition our new grads so they have long-lasting success should be priority. These grads, if encouraged, go on to offer help to others, they become excellent nurses with a solid foundation, and they become people you want to work with on a shift.

To patients? Don’t hate on the trainee, everybody has to learn! That new nurse is trying to grow up so let them take care of you. They have someone there to guide them so they won’t make mistakes. Encourage them when you see them.

This is my two cents. Nurse C on the go’s thoughts that you can take to the bank or leave on the desk.

Here’s to growing nurses.

Travel on, road warrior


3 thoughts on “Internship? Residency? Nurse Mentoring

  1. I can def relate to this. I once worked at an orientation unit where we trained new grads before they got sent to their floors where they are originally hired. The orientation was six weeks or so but they eventually shut down the program and the unit. I think it was due to logistics and budget. But yes, i agree with having a proper orientation period for new grads.


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