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Preparation for mentorship portfolio of learning. Introduction. Within this assignment I aim to demonstrate achievement of the five identified learning area and the ensuing ability to use these to act as an effective mentor and role model for nursing students within my clinical area.
In order for me to show my capability in applying the theories to practice I am going to use the Gibb cycle of reflection as stated in beginning reflective practice (jasper 2003), I feel that this will help me further understand and enhance my knowledge and theory behind the clinical practice I currently undertake and how to keep improving this with each new student nurse I come to work with in the future.
The concept of mentorship dates back to the Greek mythology when mentor, a friend of Odysseus was asked by the king to guide and advise his son while away fighting in the Trojan war (Carroll 2004). Within nursing there was research conducted by Lorentzon and Brown (2003) showing that Florence Nightingale may have been one of the first nursing mentors known with Florence having a mentor styled relationship with a fellow nurse Rachel Williams who was working at the time in St Mary’s hospital in Paddington.
I feel that it is important to know where mentorship started with in the nursing profession so that we can see how the nature of mentorship and nursing have progressed and will continue to progress for years to come. Assist students in practice to identify their current learning needs Upon my students arrival I used my interpersonal skills to introduce myself to him and explain that I would be his mentor for the next 10 weeks.
Due to working in a community setting there are always people coming in and out of the office, so until I was able to get a quite room for us to sit down in, I showed him around the building going through the safety regulations that he would need to know should anything happen ie: fire alarm, attack alarm, I also gave him a student orientation pack with all this information within it, along with all the contact information for the team and for myself.
Once we were finally able to get a quiet room we sat down on an informal basis to talk and discussed the placement in more detail. Levitt-Jones et-al (2009) wrote how students judged the receptiveness of the nursing staff by the welcome that they received on the 1st day o the placement. My student was a third year degree student who had just come from doing a placement on a Psychiatric intensive care unit (PICU), he told me that he has never undertaken any community placements before and thus is unsure about what tasks are undertaken by a community based mental health service.
I spent time discussing the working philosophy of care that is undertaken within a community mental health service to the student. The student showed enthusiasm about working within the team and showed good overall knowledge of mental health care. I used the first meeting with the student as an informal meeting to sit and look through the university documentation that he had brought with him for this placement; he also had the documentation from his last placement for me to look at.
I asked him what he wished to get from this placement, and the things that were identified from his last mentor on the PICU. As the student had not had any experience of working within a community setting before he was did not know what he wanted to get from the placement, so I agreed to sit down with him on a more formal basis to complete his initial interview later in the week, which allowed him time to think about what he wanted to learn and also see a little of what our role is within the community.
I also took a copy of the paperwork that needed completing as it was new to me so that I would have a greater understanding of it before I had to complete this. When I met with the student a few days later to complete the paperwork, he had been able to identify two specific areas that he felt that he needed to work towards during his community placement, along with the main areas of need that were identified with his last mentor, all of which were appropriate and realistic within the length of his placement.
Following this meeting the student and I came up with a clear and concise plan as to what the student had to do to meet his required learning outcomes and had put things in place to ensure that these were reasonable and obtainable. At the end of the meeting I was happy with the proposed action plan, also as my student had never worked within a community setting before I reassured him that should he feel that he needs to talk about something to approach me and we can sit and discuss this is a constructive way so that it will not impede his learning.
I was initially hesitant about becoming a mentor, as I had only just moved into my current job and was still getting used to the nature of the work, also my work environment had only just been approved for nursing students, and this was the second student to come to the team, therefore as a multidisciplinary team of nurses, Social workers and Occupational therapists we were concerned about the nature of the experience the students would receive as it was not clear as to if the clients would allow the students access to the visits and participate in these, and should this happen they would not be able to gain the knowledge needed to pass the unit. However I had confidence in my communication and interpersonal skills, and hoped that the clients within the community would allow my student access to the visits.
Baille (1993) said that students within community placements felt that their experiences were limited at times due to the role been mainly observational and was felt to be uncomfortable, and would have preferred to participate more. Following the fist meetings that I had with my student I felt that we had built a good working relationship which is important factor when ensuring an effective student mentor relationship (NMC 2008). I was concerned for my students learning when he told me that he has never worked within a community setting before, and reported that he did not feel that this was an area of nursing that he would like to work in once qualified.
This statement from the student unnerved me, and made me think that he was placing barriers in relation to the nature of the placement and what he would get from this before the placement had really started, however this did not appear to be the case and he was open and engaged in the placement. I did at one point feel overwhelmed by the amount of paperwork that I was presented with to complete from the university, it was also then that it became apparent to me how in some ways I was responsible for ensuring that the student had every appropriate opportunity to fulfil the needs and learning objectives set out within the paperwork, and given that he was a third year student the standard to which he needed to be able to provide oth the university and me with appropriate evidence of learning. I felt that this was possible as it was something that I had done throughout my time as a student nurse but also as a qualified practitioner through my continuing professional development. Overall I feel that the learning needs held within this outcome are met within these two initial meetings that I held with the student. I was able to build a positive working relationship with him, with the interpersonal skills that I have acquired throughout my career, and I gave my student appropriate time to think about what he wished to gain from the placement and then documented these things appropriately within the paperwork.
I am able to acknowledge that I have limitations in this area still, the main one been the paperwork, this document is complex and it took me some time to fully understand what was expected of me within this, I feel that taking a copy of this and spending time looking over this shows a level of uncertainty to the student and is not really best practice, however I feel that it is important to be honest with the students as to why you are doing this as they will respect this. I feel that using the reflective process has helped me greatly in relation to looking into my strengths and limitations in regards to becoming a mentor and a role model. I felt it important to have regular meeting with my supervisor, fellow colleagues on the MDT that I work on and also the student to gain feedback to ensure that I was able to keep being a positive role model to the student.
I always encouraged and gratefully received constructive feedback from my colleagues and student regarding my practice and abilities as a mentor as I felt it important to ensure that I was getting and giving the appropriate supervision and information to the student. The process of developing the learning needs commenced our student-mentor relationship and set the expectations of the student based on their needs and the obtainable learning opportunities. A mutual approach to the development of learning needs ensured that the expectations were realistic and suitable, which was supported by literature to make the practice evidence based. In the future I plan to continue with the methods I have described above when planning learning needs with students, however I feel I ust further develop my knowledge and skills in mentoring students who are not as far advanced in their training as the student I have spoken about in this portfolio, as they have different levels of knowledge and need, and would expect to have to adapt my skills to more effectively mentor these students. I also hope to continue to gain knowledge in relation to changes to the student’s curriculum from regular mentorship updates held by the appropriate trust or university. Develop your own self awareness in order to be a role model. Self awareness is a pivotal tool within all areas and disciplines of nursing. Morton-cooper and palmer (2000) talk of self awareness been a vital component of personal growth and development that fits well with the ‘process of becoming’. Prior to the students starting I had a meeting with my supervisor who was also going to act as my mentor in relation to this module of learning.
During this meeting we discussed the importance of professionalism, and how that must be kept in place at all times when mentoring students as our practice can influence students greatly whether it be in a positive or a negative way. I kept this in the forefront of my mind during all interactions that I had with the student, along with this I also maintained professional regulations and appropriate evidence based practice at all times. Through adhering to these evidence based approaches and the clinical and trust guidance policies it was easy to explain my actions to the student as there was an evidence base available for me to draw upon and direct the student to if they wished to research this more.
Role models are required to be advocates, leaders, professionals in practice, to be able to build effective working relationships, show the ability to evaluate self and peer practice and access support when needed (NMC). Given the level of expectations placed upon them it is easy to see why mentors can become overwhelmed by the amount of duties they have to undertake. In order to manage such feelings it is important to ventilate these feelings appropriately, using reflection is one of the most appropriate ways, in both a supported way i. e. supervision and self directed. Reflection promoted self awareness and the expression of feelings without prejudice in order to respond appropriately (johns 1995).
This process is further supported by giving and receiving feedback through a process like the Johari window which ultimately promoted an environment of self awareness and learning. The process of self awareness was an integral part of developing the skills needed to become an effective mentor and be seeking support from my peers and through supervision channels I was able to recognise my skills and areas in which I still have room to improve. Mentors can experience role conflict which may interfere with their professional practice, however through reflection and self awareness identified skills were enhanced and I continued to be an effective role model to my student.
By been able to recognise the role that mentors play in their student’s development, it is not only possible for us as mentors to improve our own practice but to improve that of the other professionals on your team. In the future I plan to continue to gain supervision with regards to my self-awareness as it is only to be expected that I may experience some of the same role conflicts when mentoring in the future. Given the insight that I have gained during this process I would endeavour to ensure that both my colleagues and the student are more aware of how I am feeling and ensure that I am able to express myself in a constructive manner. Develop, maintain and evaluate an environment for learning in your area of practice.
My area of work is a community mental health team based in the centre of Manchester, this is a multidisciplinary team working with people with severe and enduring mental illnesses in their homes, the team is made up of nurses some of whom were already qualified mentors, social workers, Occupational therapists, psychologists and doctors. I had chosen to undertake my mentorship course as part of my continuing professional development. I continually sought supervision and accessed the appropriate evidence base when undertaking activities with the student. This contributed to the development and maintenance of the learning environment, by providing the student with support and encouragement to learn from evidence based perspective.
When I joined the team they were undergoing the process of assessment for having students, and as I have a passion for furthering my own knowledge and skills base as well as supporting student nurses I put together a number of useful folders each one with different but relevant paperwork within them to support and further the students knowledge, examples of this would be the nice guidelines for illnesses like schizophrenia and bipolar disorder, protocols for safety while working within a community mental health setting amongst others, the risk assessment documents that as practitioners we have to complete regularly. Also access the NHS trusts policies, procedures, guidelines, and clinical governance documentation as well as information leaflets.
This evidence supported the experiences that the student gained while out visiting clients with me and other staff from the MDT. With regards to the physical environment, the team share one big open plan office, and there are no specific areas for mentors to utilise with their students, this was hard, and time spent together had to be booked in advance to ensure that a private room was available. There was no specifically identified computer for the students to use, however there is plenty of computers within the team office and the student were able to access any one of them as they were given access to the network meaning that they were able to gain access to the internet and the university website with ease, it also allowed them to access the e journals with ease.
I also appealed to the management about allowing the students access to the computerised notes system, as all clients records were digital, and without them having access to this they were not able to practice their note writing. Upon appealing this the students were granted access to this and given the relevant training, which then enabled them to take a more active part with the clients. During supervision sessions with my mentor, clinical supervisor and fellow colleagues within the team I was able to identify different ways in which I helped contribute towards the learning environment, but I was also able to recognize areas in need of development.
Following consultation with fellow mentors on the team and students I suggested the introduction of group learning sessions for students on clinical placement within the community setting. The aim of the sessions was to help build their confidence in clinical procedures and extra opportunities to allow them to reflect on their experiences and encourage learning. As my clinical area has only been accepting students for approximately 6 months at present there is no formal feedback questionnaire in use for students to provide us with feedback whether it is qualitative or quantitative on how they found the placement. During this unit I have put a pilot form into use to try and gain some feedback to try and support the team in improving the experiences of student nurses who will come to the team in the future.
I hope to evolve this form further once I have completed this course and have become a qualified mentor. Clinical teaching involves the development of a range of skills in using different skills, Smith and Gray (2000)interviewed 7 student nurses 7 nurses and 2 GP’s about how nurse learn to care and found that mentors organized reflective learning. The Department of health (2004) have since developed guiding principles for communication skills for pre registration education for health care professionals. There is also emphasis now been placed on nurses to work in a student centred approach using lifelong learning and critical thinking to further the educational program (Lambert and Glacken 2005)
I felt that this outcome required me to think in an imaginative way, as it can sometimes be hard to change clinical areas ways of working with students. I felt that this outcome allowed me to identify things that I would have found useful if I had been the student going into the clinical area, and the importance of continuing to build on your knowledge as a health professional. I felt confident about the changes that I put in place, and felt that I was able to put them across is a positive and enthusiastic manner which in turn made the work place a more beneficial place for the students. Using evidence based practice to create and develop opportunities for our student to learn.
Working with community mental health services there are a number of different opportunities for learning that I identified with my student at the initial meeting that we held at the start of his placement. Given that community nursing is varied and you may only see clients on a fortnightly on monthly basis it leads to a level of unpredictability and lack of continuity for the student, so I planned learning opportunities with my student in advance to ensure that we were able to meet the outcomes needed, such as spoke placements to different teams within the community, and also ensuing that they attended CPA meetings and ward rounds with me to gain the community perspective on these. This was done by utilising fellow members of the MDT, contacted via phone and email.
Due to pressures on myself in relation to paperwork, and clients who will not allow students to be present during visits it was not always possible to work with the student, so on days when we worked together we sat down at the start of the day and discussed what we were doing that day and which part of his specific learning needs identified we would be working towards. In order to promote learning, the opportunities provided for my student required him to be actively involved in the task, for example, preparing and administering depot medication in the client’s home under my supervision, this also meant that the student was able to apply theory to his practice regarding the calculation and administration of medication and as he was undertaking a unit of learning and exam on medication calculations during the placement.
The student was initially unsure regarding the giving of depot injections as he has not given many injections during his training, however the more he did this throughout his time with me it became clear that his confidence improved significantly. Along with his improved confidence in administering medication via injection he also showed good communication and engagement skills, but was less confident in other areas, mainly related to care planning and risk assessments. This required me to put in place a learning contract with the student and make opportunities for him to undertake these tasks regularly. It was agreed that as he had built a good therapeutic relationship with a few clients that he had been visiting I agreed to supervise him undertaking a risk assessment and care planning session.
As I have mentioned above a successful learning environment is dependent on an effective MDT, so I encouraged my student to use myself and my colleagues as a resource, which involved him asking appropriate questions and seeking appropriate guidance when completing set learning tasks. I also set time aside to allow the student to ask any questions or to go through the evidence base supporting the activities that he had completed that day. This set time also allowed us time to reflect on learning from both a mentor and student point of view. For each task that the student undertook as part of the learning plan I asked them to identify relevant evidence to underpin the practice. I provided some direction to the student as to where he may find this information, for example, trust policies and guidelines and the appropriate journals.
As mentioned at the start of this outcome there were times when I was not able to be with the student, this caused me to feel culpable and frustrated, as I was responsible for ensuring their learning. However I felt happy with myself as on the majority of these days I was able to find a colleague for the student to work with, or I was able to organise the spokes around the days that were not appropriate for him to be with me. I felt confident in my communication skills used to promote reflection, and felt empathetic to my student as he would have felt “in the way” at certain times which was evident in his reflective work. On the whole the process of learning outcome went well, and I felt that I achieved the outcome.
I recognise that I met this out come with the support of my colleagues, clients and the student, who showed good understanding at times when he was not able to undertake visits with me, and was pro active in organising things with other practitioners to ensure he would meet his outcomes. While my student was on placement there was also two others at different stages of the training I felt it useful to identify the differences in their learning styles in order to develop more individualised learning opportunities for my student. By drawing on literature around different learning styles and theories, the promotion of learning opportunities was supported by an evidence base.
The Nursing and midwifery council (NMC) suggest that effective learning will occur if learning opportunities are planned and prioritised (NMC 2008), which in practice allows for more need appropriate and structured learning opportunities for the student. The development of learning opportunities contributes significantly to the effective learning and outcomes for the student and this must be remembered by each mentor. The development of opportunities should be need appropriate and individualised in order to ensure the best outcome. Each student has their own preferred learning style or styles (Bayley, chambers and Donovan 2004), activists, reflectors, theorists and pragmatists (Honey and Mumford 1986) and it is important as a mentor to be aware of these so as to tailor tasks to allow the student the best chance of learning.
This process enabled me as the mentor to adopt the andragogy approach (Howard 2001) as the student was one of a mature age, we were able to assess what it was he required to learn and was capable of researching this independently. Learning theories can underpin learning opportunities, but must be supported by reflective exercise and effective mentoring skills. In the future, I intend to further develop my skills as a teacher, which will necessitate further reading and skill development. I would also like to continue to update the resources available to students coming to my area of work to guarantee that it remains relevant, and supports the evidence base of the work that we undertake with the students.
I also expect to be faced with challenges in the future when developing new learning opportunities for students in different stages of their nurse training; I hope that the skills that I have developed over the period of this unit of working will be transferable. Using approved assessment procedures assess the practical ability of at least one student I mentored my student from the commencement of his placement under the supervision and guidance of my mentor; I was responsible for the assessment of his practical ability in practice. I had frequent meetings with my mentor were I discussed my methods of assessment and the valid evidence base behind this.
Pellatt (2006) has stated that the mentor are responsible for the formative and summative assessment of student learning in practice, however chambers 1998 feels that the assessment within clinical practice, and at times has caused problems with objectivity and reliability and validity. I then discussed the activities I had already undertaken with the student and reflected on the effectiveness of these in practice. We also spent time discussing the paperwork that was required to be completed during the duration of the student’s placement. The first and most important document was the student’s portfolio of learning which had their learning outcomes within it.
These outcomes were specific to the nature of the placement area and module of learning he was undertaking so it was clear that we needed to use the outcomes within that document to develop our action plan right from the start of the placement, and then used this as one of the main assessment criteria to measure the students ability to progress. The document was a standardised tool recognised by all the three universities within Manchester and each student is given the same document to complete. The primary method of determining the student’s ongoing improvement of ability is to observe them with the clients. Given the nature of the placement area it was not practicable that the student visit clients independently so he was supervised at all times and it was during these times that the assessments took place. The student would be shown how to do something by either me of a colleague and then the student would then repeat this.
I would then look to assess him on several different aspects, these would be his ability to recall the information and undertake the demonstration of the skill, while giving an explanation to me about why he is doing this. This showed that the student had been able to retain the information given to him and showed a good practicable ability to carry out this task in a competent way. We also met on a regular informal basis to discuss the theory and evidence base for the skill that he had been learning during the placement, at times using a version of reflection to enable him to show how his knowledge was improving throughout the placement; these were supported by three formal meetings where we completed the required paperwork, as required by the university.
At the initial meeting as I explained in an earlier outcome I met with the student and put in place an action plan as to things that he needed to work towards to pass the placement. The interim meeting was used as a formal assessment of his progress towards meeting the initial outcomes that had been set, during this meeting I found certain things that required more support and evidence base as the student was struggling to find any opportunity to undertake these, but also offered praise and support for the things that he was completing to the best of his ability. I also used some case studies with him to see if he was able to apply his knowledge and skills to different situations, he was able to do this well. In the final meeting I used this to consolidate all he information and work that the student had done to determine if he was capable of all the different areas that were expected of him at the level of understanding that was required by the university and the NMC requirements (NMC 2004). For the completion of this assessment I gained information from colleagues who have spent time with the student to ensure that I was able to make a fair and just assessment of his abilities. My discussions helped me validate my decision as my students abilities had been assessed by several different nurses whom have a vast nursing background. During the final meeting with the student I initiated the final reflective session that we had and the student provided some good feedback about gains in self awareness and confidence.
I completed the final paperwork with the support of my mentor as I was aware that I was not able to complete the statement of achievement at the back of the document until I had become an official mentor. Having the responsibility for the student made me feel anxious initially, as I had worked with students in different area but had never been the main nurse responsible for their learning and the scale of the task was very daunting. Through adhering to my studies, I quickly identified that I was not alone in working with the student and that my colleagues could help me with the assessments that were required. This realisation gave me more confidence in my skills and more capable to support my student with assessments out in practice.
As I have mentioned above my colleagues were very supportive of me and this showed the student that team work is an essential part of nursing and in turn my student showed a grave deal of maturity cooperation and assertiveness ensuring that he always had someone to be working with if I was not available. I was satisfied with how this outcome was met, and I feel that I learn a lot of significant things while meeting this outcome. The theme that has become a recurrence throughout this outcome and others within this portfolio was that of the effective relationships required within the MDT within which you and the student work. The levels of assessment that is required when mentoring a student nurse is far more than any one practitioner can undertake, therefore having the contribution of colleagues to help and upport you through this made this more achievable. The NMC (2006) suggests that students are assessed predominantly through direct observation from skilled practitioners, however Neary (2000) states that current methods of assessment have their limitations in that they rely heavily upon subjective judgemement. The complex process of assessment required of students can be as daunting to the mentor as the learner, however this can be rectified by using reliable valid assessment processes, and placing a structure to the assessment to ensure that neither the student or mentor becomes overwhelmed by this, nor the assessments are completed in a manageable way.
Again the input I received from the MDT with which I work was an invaluable source of support for me in meeting these outcomes, as I was able to gain valuable information from them regarding the student’s progress and needs and this helped ensure a fair assessment of competency. I hope in the future to continue to develop my skills in assessing learners and maintain a high knowledge of evidence based practice for the students to draw from. I hope that the literature that I have utilised for this unit will be of use to follow mentor within my clinical area and that this becomes a resource that we as a group of professionals will continue to keep up to date. Conclusion I hope that throughout this portfolio of evidence I have been able to show the skills that I have learnt in relation to my ability to work effectively with students and how been a mentor has enabled me to enhance my own practice.
Using reflection throughout this process has enabled me to gain a critical insight into my workings as a practitioner and analyse the subsequent learning experiences appropriately. However to me the most important thing that I feel I have accomplished is successfully supporting a student through a learning experience and contributing to their future career in the nursing profession. Word count 5,534 References. Baille L (1993) Factors afdfecting student nurses in community placements a phenomenological study. Journal of advanced nursing 18 1034-1053. Bayley H, Chambers R, Donovan C (2004) helping the mentee to reach their potential, the good mentoring toolkit for healthcare. Radcliffe publishing. Carroll K (2004 0mentoring a human knowing perspective.
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