TL9b
Visibility, Accessibility, and Communication TL9
Provide one example, with supporting evidence, of an individual mentoring plan or an established mentoring program for clinical nurses(s).
Example b: Mentoring for Emergency Department Nurse Manager
Ambulatory Example: Nurse Manager Mentoring Plan
Tanner Ross, BSN, RN, was promoted to the role of Nurse Manager of the Catholic Health Initiatives (CHI) St. Vincent Hot Springs (SVHS) Emergency Department (ED) in June 2023. Ross began his career at CHI SVHS as a patient care technician in the ED in 2017. He completed his Bachelor of Science in Nursing (BSN) degree in 2019 and became a nurse in the ED. When there was a change in ED leadership in May 2023, Ross expressed interest in leadership. However, he had minimal leadership experience outside of a few shifts as a relief charge nurse.
Renee Fechuch, MSN, BSN, RN, Clinical Director of Nursing, spoke with Teresa Lambert, MBA, BSN, RN, Vice President of Patient Care Services and Assistant Chief Nursing Officer (role of CNO), about the importance of choosing the right person for the nurse manager job since the ED can be challenging and is the largest unit to manage. Ross had shown dedication as a nurse and lived the CHI SVHS mission and values daily. Fechuch and Lambert were torn about whether to consider Ross for the nurse manager role. They decided to set up a group of interviews and make a decision based on the feedback of the ED staff and other leaders in the facility who would interview Ross.
After the interviews, the staff and leaders unanimously agreed that while Ross lacked leadership experience, he flourished in his passion and was the right culture fit for the role. They decided to offer Ross the position with the agreement that it would be re-evaluated in 90 days, at which point Fechuch and Ross would discuss whether this leadership opportunity would continue.
A mentor is defined as “An experienced nurse who has developed expertise and can be a strong force in shaping a nurse’s identity as a professional” (Anthony, 2006, p. 73). Fechuch had great experiences through mentorship in her nursing career and wanted to offer that to Ross. Ross agreed, as he appreciated this offer to help mold him in this new role.
As healthcare can be busy and sometimes overwhelming, Fechuch and Ross decided to carve out a dedicated time to meet for Ross’s mentoring plan. They determined they would meet 1:1 for 30 minutes at least every other Friday. This time was set aside for Fechuch to give Ross information and advice and support him in areas he was seeking assistance with. The topics included, but were not limited to, leadership techniques, available resources, education opportunities, and conflict management. They used a mentoring meeting form to carry out Ross’s mentoring plan, capture their conversations, and provide to him to keep as a resource.
Fechuch and Ross meet at least biweekly to discuss and address the ED’s needs. Ross’s mentoring meetings are separate from these. Ross and Fechuch held their first mentee-mentor meeting on June 9, 2023. Fechuch addressed an educational opportunity by giving Ross advice on how to write a proposal using the SBAR format (Situation, Background, Assessment, and Recommendation). This is the proposal format used at CHI SVHS and a tool that leaders can use to advocate for the resources needed for employees and patients. Fechuch advised Ross on ways she had learned to communicate her requests clearly and concisely.
Ross also had questions about a conflict management situation, so Fechuch gave him information about the proper way to handle disciplinary action for an employee issue. In addition, Ross asked for guidance on a workplace violence situation. Fechuch advised him that a rule of thumb when making decisions is that one will never go wrong by erring on the side of the patients.
Ross began shaping his identity as a nurse manager during his first mentoring meeting with Fechuch. During the rest of their June meetings, Ross and Fechuch discussed job expectations and roles. While nurse managers have 24/7 accountability, this does not mean they need to be on the unit 24/7, as time management and work/life balance are crucial for success. Fechuch shared that she also had to figure this out as a new clinical director of nursing. She told Ross it is okay to take time off and disconnect and to defer to the supervisor or his one up to prevent burn out. Fechuch supported Ross as she guided him through an upcoming vacation and how to relay to the staff that he would be unavailable and to defer to his one-up; Fechuch emphasized that this is acceptable and expected.
Ross had questions about a recent disciplinary action situation, so they walked through the actions he had taken. Fechuch gave advice and shared feedback on various scenarios and actions she had been involved with over the years; Ross was receptive and appreciative. Ross and Fechuch also discussed leadership techniques and how to manage patients, families, and coworkers in real time. Lastly, for June, Ross and Fechuch discussed payroll correction forms. She guided Ross through an error he had made, which he was unhappy about, and she stressed how ownership, accountability, and fixing the error solved the problem. Fechuch coached Ross through this situation, showing him that errors can happen, and he noted he was determined to be more cautious. (Evidence TL9b-1, Mentoring Plan, page 3)
Mentee-Mentor Relationship and Interactions
During July 2023, as Ross continued to grow, he shared with Fechuch his challenges with conflict management. During their July 7 mentor-mentee meeting, Ross asked the best way to handle conflict, as he was struggling with this. Fechuch’s advice was to set expectations, be consistent, collect the data/facts, listen, and close the loop. Fechuch added that sometimes people just need to vent and that a leader should not let their emotions play into the conversation. She told Ross that based on career experience as a charge nurse, house supervisor, and now clinical director of nursing, the most important thing is to be an active listener, fix what can be fixed, acknowledge when one makes a mistake, and always remember the three key items of expectations, ownership, and accountability.
July was a struggle for Ross, as he lost his grandmother, who was more like his mother. Ross and Fechuch discussed stress management, family time, and trusting his team to do the job while he grieved this loss. Fechuch and Ross again discussed work/life balance, as she advised him that spending 12-14 hours at work would only lead to burnout. Fechuch told him she keeps a daily list with the must complete items at the top, marking throughout the day the items she did not get done and moving these to the next day’s list. She told him it is crucial to recognize what has to be done and what can wait until the next day. At this point, Ross was doing an excellent job; he was receptive to difficult conversations, listening, and asking for guidance. (Evidence TL9b-2, July Mentor-Mentee Notes, pages 2-5 and 7-9)
In August 2023, Ross and Fechuch collaborated on the challenging issue of ED productivity. They brainstormed various methods of saving on productivity (e.g., staff members not clocking in early or late, decreasing staff during low patient census times when able to, and not taking float staff unless needed). Ross was receptive, gaining a better understanding of the rationale for managing productivity. Ross and Fechuch also discussed his professional development plans, and he expressed interest in obtaining the Certified Emergency Nurse (CEN) certification. He noted that ED nurses had shown interest in obtaining their certification and that this would be an excellent team-building opportunity.
In another mentoring meeting, Ross needed guidance on a situation in the ED. The ED had a patient care coordinator position available, and Ross was struggling with one of the candidates. Fechuch offered advice on choosing the right person for the job. An RN was interested, but Ross would have to hold a difficult conversation to ensure the nurse’s vision aligned with his and Fechuch’s. Ross and Fechuch walked through the conversation, discussing what should be said and examples of how to lead through the conversation.
Ross and Fechuch’s last meeting in August presented a challenge related to a security event in the ED earlier in the week. Ross and Fechuch met with the Security manager and another ED employee the following Monday to discuss what worked and opportunities for improvement. Everybody was on the same page when the meeting was over. The following week, the president of CHI SVHS asked Fechuch about the meeting Ross had requested with the president, which Fechuch did not know about. This opened the opportunity to discuss chain of command, which was a great growth opportunity for Ross to learn the importance of chain of command and the organizational chart of who reports to whom and the steps to take in the future. (Evidence TL9b-3, August Mentor-Mentee Notes, pages. 2, 5, and 6)
In September 2023, Ross and Fechuch again discussed conflict resolution. This is a challenging topic because of the difficulty in managing people, especially in a department with more than 90 employees. Fechuch shared with Ross that she had also previously struggled with managing conflict, stressing that it takes integrity to stand for what is best for the unit, not just for a couple of people. Fechuch and Ross discussed the situation and determined that the best course of action was to continue to monitor it.
Ross sought Fechuch’s advice and guidance on how to handle a recent hire/transfer from another unit who was still on orientation. He was not sure how to handle the situation, as he believed the nurse was not catching on to the pace of the ED. Ross discussed this with Fechuch, who advised him to handle it just like any other employee performance challenge. She advised him to speak with the co-worker to let them know the concerns, offer his assistance, and set up biweekly meetings to monitor their performance. Ross could then take next steps if the co-worker continued to not perform to expectations. Ross was receptive to this advice.
They discussed another professional development opportunity later in September, as Ross committed to obtaining CEN certification within two years. Ross is also exploring obtaining a master’s degree. Fechuch said that if she could do it over, a Master of Business Administration (MBA) degree would have helped more in understanding the budgeting aspect of the position than a Master of Science in Nursing (MSN) degree.
They also discussed CHI’s tuition reimbursement program and its benefits.
In their last meeting in September, Ross and Fechuch returned to leadership techniques. Their discussion included the crucial leadership technique of setting clear and fair expectations for all employees and holding everyone accountable to the same standards, which must align with the hospital’s policies and core values. (Evidence TL9b-4, September Mentor-Mentee Notes, pages 1, 2, 5, 7, and 8)
Fechuch continues to mentor Ross during ongoing biweekly sessions for the agreed upon mentoring plan.