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  1. Sample Graduate StudentPracticum Deliverables

  2. Libby ZamisGraduate Nursing StudentUniversity of Illinois at ChicagoFall, 2008Practicum Deliverable

  3. Becoming a Nurse Mentor Northwestern Memorial Hospital February 12, 2009

  4. Introductions Review the purpose and goals of the program Mentees – new grads and experienced nurses Roles of a Mentor: Coach Consultant Relationship builder Active Listening Conflict Management Techniques The specifics of NMH’s program Agenda

  5. Introductions

  6. By the end of this 4 hour session, you will be able to: Identify the needs of a nurse new to an organization Distinguish the difference between a mentor and a preceptor Describe attributes of each of the three primary roles of a mentor Apply specific techniques the mentor uses for active listening Use tools and steps to successfully manage or resolve conflict Verbalize the expectations of a mentor Learning Objectives

  7. Idea of a program started in ???? [process/steps – get information from Rachel] Sparked idea Literature findings: (Journal for Nurses in Staff Development, 2006; JONA, 2006) 20% Nursing Best People and Professional Excellence Committee created a New Hires Socialization Program

  8. Literature findings: 30% turnover rate Replacing 1 RN costs ~$60K NMH data 50% Nursing Best People and Professional Excellence Committee created a New Hires Socialization Program

  9. The New EmployeeNew Grad and Experienced Nurse 1 2 3 4 5

  10. Scott, Engelke, & Swanson (2008)

  11. Scott, Engelke, & Swanson (2008)

  12. Marlene Kramer developed this concept in 1974 It is when the student-turned-professional realizes that what they learned in school is not what is done in real life 4 Phases are: Honeymoon Shock Recovery Resolution Reality Shock

  13. Patricia Benner – “From Novice to Expert: Excellence and Power in Clinical Nursing Practice” (1984) Novice Advanced beginner Competent Proficient Expert The meaning of experience Each step builds on the other by refining and expanding abstract principles through experience Do they have 10 years of experience or 1 year’s experience 10 times? Experienced Nurses

  14. Novice No experience with situations in which they are expected to perform Advanced Beginner Starting to have experiences so they can see some recurring components Competent Have similar situations for ~2-3 years and sees their actions impacting care plans and patient goals Proficient They see the whole picture and are reactive to nuances Expert Intuition that delves into problems with accuracy and without spending energy on alternative diagnoses and solutions Experienced Nurses

  15. Experienced Nurses The Imposter Syndrome There is something I don't know,That I am supposed to know.I don't know what it is I don't knowAnd yet am supposed to know.And I feel I look stupid if I seem to both not to know it,And not to know what it is I don't know.Therefore, I pretend to know it.This is nerve-wracking since I don't knowWhat I pretend to know,Therefore, I pretend to know everything. R. D. Laing (1970)

  16. Break 1 2 3 4 5 6 7 8 9 10

  17. Congratulations on becoming a mentor! Ulysses deriding Polyphemus - Homer's Odyssey by Joseph Mallord William Turner (1829)

  18. “A mentor points to doors – they don’t open them. But they enable you to find the strength to open them yourself…”(SCOPME, as cited in Dancer,2003, p.1) Preceptor • “An instructional role in which a nurse is paired for a specific time period with a new nurse in order to orient the new nurse to the organizational and professional practices and competencies” • A structured process Mentor • “An advisory role in which an experienced, highly regarded, collegial person guides another individual in the development and examination of their own ideas, learning, and personal and professional development” • An unstructured process The University of British Columbia, 2004. Retrieved October 30, 2008 from http://www.health-disciplines.ubc.ca/pm/managingprograms/precepting-vs-mentoring/continuum.htm

  19. A Trusting Relationship Used with permission from www.FreeFoto.com

  20. Coach Consultant Relationship Builder Primary Roles of a Mentor

  21. Provides encouragement Encourages open discussion Provides inspiration and motivation Provides direction and shares the vision Identifies needs and areas to improve Is open to change, willing to try new ideas Communicates expectations Focuses on solutions not problems Believes in people; sees their potential Has high expectations; assists people to achieve their potential Focuses on the “why” not the “how” CoachA coach does not play in the game, but helps the playersidentify areas to improve their game, andcelebrates the successes with them”- Byron & Catherine Pulsifer, 2004, “What does a coach do?”

  22. PICK a Mentoring Lesson From Sharing Wisdom: The Practical Art of Giving and Receiving Mentoring, 2000

  23. Helps to identify problems and develop solutions Promotes reflection and personal accountability They don’t: Do all the thinking Provide all the answers Do all the work Consultant

  24. Basic 6-step process for problem solving Define problem Brainstorm ideas Prioritize ideas Develop action plan Implement ideas Evaluate the solution Rework the solution if it isn’t working! Consultant

  25. PICK a Mentoring Lesson From Sharing Wisdom: The Practical Art of Giving and Receiving Mentoring, 2000

  26. Assists the mentee in managing relationships Necessary to have: Excellent communication skills Excellent listening skills Conflict resolution skills Negotiation skills Relationship Builder

  27. Alternative Intelligence (Goleman, 1996) Emotional intelligence Self awareness Self regulation Self motivation Social intelligence Social awareness Social skills Empathy Relationship Builder

  28. The competence/intelligence behind personal interactions and behaviors Concepts used to make sense of social relationships and rules used to draw conclusions: What situation am I in and what kind of person is this who is talking to me? What did he/she mean by that? What am I going to do about it? Relationship BuilderSocial Intelligence

  29. Social awareness Empathy Attunement Social cognition Empathy Understanding and developing others Service orientation Understanding diversity Political awareness Social skills Communication Leadership Conflict management Collaboration and co-operation Team capabilities Relationship Builder

  30. PICK a Mentoring Lesson From Sharing Wisdom: The Practical Art of Giving and Receiving Mentoring, 2000

  31. I, I, I, I, IYou’re a good/poor listener!

  32. Break 1 2 3 4 5 6 7 8 9 10

  33. A complex and demanding activity It is a way of listening and responding that focuses on the speaker Overt messages Covert messages Responding is more than answering Active Listening

  34. 5 key elements Pay attention Show you are listening Provide feedback Defer judgment Respond appropriately Active Listening

  35. Tip: if you find you are responding emotionally to what is being said, say so and ask for more information. “I may not be understanding you correctly, and I find myself taking what you said personally. What I thought you just said is ___, is that what you meant?” (http://www.mindtools.com/CommSkll/ActiveListening.htm) Active Listening

  36. Paraphrasing Letting the mentee know that you hear, understand, and care. Clarifying Letting the mentee know that you hear, but you’re not sure of what you heard Language of Support • In other words… • What I’m hearing… • From what I hear you say… • I’m hearing many things… • As I listen to you, I’m hearing… • So, you think… • It sounds like you want… • Let me see if I understand… • To what extent…? • I’m curious to know more about … • I’m interested in… • Tell me how that idea is like (or different from)… • So, are you suggesting…? From the Virginia Department of Education Mentor Training, 2007

  37. Mediating Allowing the mentee to reflect or raise awareness Imagining Helping the mentee to think about alternatives. Language of Support • It’s sometimes useful to … • A couple of things you need to keep in mind … • Something you might try considering is … • To what extend might … work in your situation? • There are a number of approaches … • What do you imagine might … ? • What’s another way you might ...? • What criteria do you use …? • What would it look like if …? • When have you done it like this before …? • What might you see happening if …? • How was …different from …? • How do you determine …? From the Virginia Department of Education Mentor Training, 2007

  38. PICK a Mentoring Lesson From Sharing Wisdom: The Practical Art of Giving and Receiving Mentoring, 2000

  39. Break 1 2 3 4 5 6 7 8 9 10

  40. Conflict Management Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  41. “Confront: to hold someone accountable, face to face” When handled correctly: Conversation is open Conversation is honest Both people are candid Both people are respectful Result: Problems are resolved Relationships benefit What is a Crucial Confrontation? accountability Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  42. In a study, researchers posed as doctors, phoned nurses and asked them to medicate a patient. Which percent of nurses tried to comply? What’s A Crucial Confrontation? • 10 % • 30 % • 55 % • 95 % Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  43. Very often new employees are confronted with conflict between themselves and co-workers, preceptors, or managers Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  44. “I made a Freudian slip last night. I called my husband by the name of my first boyfriend It was embarrassing!” “Speak when you are angry, and you will make the best speech you will ever regret!” FESTER FESTER FESTER FESTER FESTER FESTER FESTER “I did the same sort of thing. I meant to say to my husband, “please pass the potatoes,” but I said, “Die, loser, you’ve ruined my life!” FESTER FESTER FESTER Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  45. Signs you’re dealing with the wrong problem The solution doesn’t get you what you want You’re consistently discussing the same problem You’re getting increasingly angry Choosing What Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  46. How to choose WHAT Break-up the problem bundle. B L S Look at what is really bothering you. Shorten the issue into a single sentence. Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  47. Tools to Get to the Correct Confrontation Content C P R Pattern Relationship Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  48. Failed promises are clear cut Unclear situations? Consider the consequences 2 ways to decide IF: You are not speaking up and you should You are speaking up and you shouldn’t Decide IF you ShouldHold the Confrontation Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  49. You are not speaking up and you should Am I acting out my concerns? Is my conscience nagging me? Am I choosing the certainty of silence over the risk of speaking up? Am I telling myself that I’m helpless? You are speaking up and you shouldn’t Will you ever be in this position again? What are the “unwritten” rules for what is addressed and which issues slide? Do you want to differentiate yourself Are you willing to do that without the “social support” Decide IF you ShouldHold the Confrontation Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005

  50. “What’s the matter with her?” Changing a what into a WHY “Why would a reasonable, rational, and decent person do that?” Crucial Confrontations: Tools for Resolving Broken Promises, Violated Expectations, and Bad Behavior, 2005