Embed mentoring into your organizational culture.

According to the American Association of Colleges of Nursing, approximately 80,000 U.S. nurses leave the profession each year, and nursing pre-licensure program enrollment cannot sufficiently support the demand for future nursing services. The limited pool of qualified nursing staff readily available to provide safe, quality care taxes the human capital management of healthcare organizations worldwide. (See Turnover stats.)

Stress, low self-confidence, and reduced job satisfaction frequently lead to voluntary turnover. To maintain an adequate workforce and prepare for future growth, healthcare organizations must develop a robust, cost-effective retention plan that addresses nurses’ needs. Part of that plan should include structured mentorship programs, which, according to Zhang and colleagues, have been shown to reduce turnover by 2% to 15%.

Structured mentoring can support a newly hired nurse’s sense of belonging and increase job satisfaction while simultaneously decreasing stress and anxiety. Rohatinsky and colleagues found that, although nurses who feel a sense of connection are more inclined to remain in their position, job satisfaction appears to be the most critical factor influencing turnover and retention. Pham and colleagues noted that enhanced commitment and reduced burnout also contribute to nurse retention.

Preceptorship vs. mentorship

A difference exists between preceptorship and mentorship. Although frequently used interchangeably, the terms denote different goals and objectives. A preceptorship describes a relationship between an experienced nurse and a newly hired nurse focused on initial skill and knowledge attainment. Mentoring serves as a partnership between the experienced nurse and less-experienced colleague, which includes shared accountability for mutually defined goals. The aim is professional development rather than skill development.

For new graduate nurses in particular, the preceptor relationship typically terminates around the same time reality shock sets in, leaving the novice nurse without a support system when they most need it. Mentorship can help bridge the gap between academic education and the realities of clinical practice, which ultimately may increase job satisfaction.

Mentorship program benefits

Various structured mentorship programs exist. Hallmarks of a successful program include reduced turnover, increased reported intent to stay, and increased retention of newly hired nurses. In addition, the newly hired nurses—mentees—frequently report increased job satisfaction and increased self-confidence.

Mentee benefits

New graduates require training to meet the demands of multiple professional responsibilities as well as support throughout their stressful transition to independent practice. As new nurses transition from training to clinical reality, mentorship can help reduce stress, offer opportunities to achieve personal and professional development, increase learning, and enhance self-confidence. In addition, the support of a mentor allows the mentee to feel comfortable, confident, and welcome in their new workplace while combating feeling overwhelmed. In the study by Zhang and colleagues, newly hired nurses who received interpersonal mentoring reported feeling more supported and valued, an effect they experienced in as little as 3 months of mentorship.

Nurses uncomfortable in their roles frequently report intent to leave their role or the profession. In addition, new nurses may feel estranged from more experienced nurses. The mentor serves as someone interested in their success. Mentors help mentees increase self-efficacy, enhance career interest, and reduce intentions to leave the profession. According to Baumann and colleagues, newly hired nurses who participate in a mentorship program report a statistically significant higher self-confidence level than those who don’t.

Mentors provide mentees with a safe haven to ask questions and to feel assured that they’ll receive guidance when needed. Mentorship also aids stress reduction. In a study by Van Patten and Bartone, more participants who received mentorship reported less stress than those who didn’t have a mentor.

Mentor benefits

Mentors also benefit from mentorship as they encourage, listen to, and provide counsel as part of a positive teaching role. They also act as role models, advisors, leaders, and coaches. Mentors achieve personal and professional development and a sense of contribution and empowerment, as well as gain a trusted colleague. Ultimately, they play a large and fulfilling role in retaining newly hired nurses.

Organizational benefits

The successful relationship development between mentoring partners helps to retain two employees: the mentor and the mentee. Mentorship program participation also increases employees’ connection to their work, colleagues, and the broader community. As a result, the organization may achieve increased staff productivity, teamwork, and performance and reduced employee turnover, particularly among new graduates. The impact of mentorship in nursing has a lasting effect over time. It extends beyond the mentoring period to increase healthcare resources and improve patient safety and care quality.

How to implement a mentorship program

Once an organization has committed to developing a structured mentorship program, successful outcomes require some essential elements, including networking, socialization into the profession, and relationship development.

An organization can create a homegrown version of a structured mentorship program or adopt one from organizations such as the Academy of Medical-Surgical Nurses Mentoring Program or the Robert Wood Johnson Foundation/American Association of Colleges of Nursing Mentoring Program. These ready-built programs frequently provide additional tools to aid implementation, training, and evaluation. (See Structured mentorship programs.)

Select program type

Mentoring can occur one-on-one or in groups. One-on-one mentoring involves pre-arranged sessions that meet the scheduling needs of both participants and increase the level of contact (number of interactions between the mentor and mentee). Group mentoring involves one or more mentors working with a group of mentees. This option can serve as a viable and cost-saving option if mentees can attend sessions consistently to reach a high frequency of contact (one meeting or more per month). According to Williams and colleagues, group mentoring with low levels of contact can lead to turnover intention.

One-on-one mentoring may require more financial investment to implement, but studies indicate that it offers more benefits over group mentoring. In a study by Williams and colleagues, mentees who participated in one-on-one mentoring (compared to those who participated in group mentoring) positively rated their experience with regard to aiding transition to practice, professional development, and stress management. In addition, according to Brook and colleagues, one-on-one mentorship programs have demonstrated the highest impact on retention, with dedicated time for mentees and mentors to connect.

Determine program length

Program length plays a role in effectiveness. According to Brook and colleagues, programs that run 27 to 52 weeks have the most benefit on retention and turnover; however, even the shortest intervention has a positive effect. Each new graduate reaches a point at which they reassess the reality of the role and begin to acquire confidence. This point is individual to each nurse, so a more extended program may capture various timelines of mentee needs. Short programs may miss this window. Regardless of program length, mentorship benefits outweigh the costs of implementing a program, and the effects last over time. Williams and colleagues report that programs lasting at least 6 months produce positive results. Those that run for a full year have an impact on other factors related to retention, such as job satisfaction, self-confidence, and stress management.

When considering length, also consider when your organization will offer mentoring to the newly hired nurse. Mentorship doesn’t measurably impact skill attainment, so it proves most relevant after nurses have developed their clinical skills to a level of independent practice. When the mentee achieves independence in practice and has experienced a degree of reality shock, the mentoring relationship can help to improve self-confidence and reduce stress, which ultimately may overcome an intention to leave.

Define accountability

Infrequent contact and lack of communication between the mentor and mentee can contribute to low satisfaction with the relationship. Establishing a meeting schedule that takes into account the needs of both participants can help overcome this challenge.

The program should set expectations for how frequently mentors and mentees meet. Mentoring participants have cited time constraints (related to differing schedules and shifts) as the most common barrier to effective mentorship. To assist mentoring dyads that can’t connect outside of work, some organizations establish designated protected time.

Other factors that may impact accountability include a mentee’s willingness to receive mentoring and fully commit to the relationship. Mentors should have the capacity to build a positive relationship and have meaningful interactions with the mentee. A mentor’s interpersonal skills are just as important as their clinical nursing skills.

Design a matching process

Mentorship rapport requires mentee willingness to receive mentoring. In the study by Rohatinsky and colleagues, mentors and mentees rated the connections made between the dyad as meaningful, highly valued, and vital to mentoring success. The relationship can increase the mentee’s perceived link with and willingness to remain in their position. In addition, a newly hired nurse seeking a mentor indicates career interest and intent to stay.

Mentors should embody specific characteristics, including a firm commitment to the organizational mission and the program’s goals, as well as availability. They also must exhibit the ability to maintain respectful, considerate com­munication and a willingness to assist in the mentee’s growth. The ideal mentor candidate should have strong interpersonal and leadership skills balanced with charisma, patience, approachability, and accountability. They should possess the ability to think logically and strategically and to help the mentee learn from mistakes and celebrate successes.

Currently, no best practices exist for mentorship matching, but consider using a standardized matching method to ensure that mentees and mentors have similar values and interests, which will help support the development of their relationship. For example, the AMSN Mentorship Program includes a tool for gathering participant background to aid matching. Some programs use the Myers-Briggs Type Indicator, which can help connect mentoring dyads with similar personality types.

Another option is to allow mentoring dyads to become acquainted before making a formal match. Through informal conversations they can determine for themselves if they’ll work well together.

Mentors and mentees working on the same unit have the opportunity to develop a close relationship naturally as the number of encounters increases through the common work environment. However, matching individuals on different units could potentially create more open communication between mentoring partners. Those who work on the same unit may hesitate to disclose negative information, especially if the level of trust within the mentoring dyad isn’t well-established. No evidence exists to support one approach over another.

Provide mentor training

How an organization provides training is less important than the robustness of the curriculum and ongoing leadership support. Effective training should empower mentors and ensure an effective mentoring experience. Important topics include relationship-building strategies, communication approaches, effective mentoring techniques, adult learning theory, conflict-resolution and problem-solving best practices, and leadership skills.

Training also should emphasize mentor and the mentee role expectations and the program’s objectives. Mentors should feel empowered and supported by the organization to make a positive change in a less-experienced nurse’s professional development. Mentors need guidance from a program coordinator, nurse leader, or experienced mentor to help them navigate the nuances of mentorship. Other support could come in the form of reliable, self-directed resources or formal check-in’s depending on available program resources.

Offer ongoing support

The healthcare organization must commit to mentoring success via program leadership, which provides clarification of mentor responsibilities and mentorship objectives. By removing time constraints and supporting the mentoring dyad, leaders can help embed mentorship into the organizational culture.

Establish a program coordinator role to provide initial training and ongoing support. The coordinator’s responsibilities should include facilitating effective relationship development, resolving conflicts, and supplying additional resources such as journal articles, books, and other educational content to enhance mentoring skills. In addition, the coordinator and mentor should schedule formal check-ins to ensure continuity of communication. The program coordinator also may need to identify struggling mentoring relationships and dissolve partnerships if necessary.

Measure program success

After an identified period, the coordinator should measure the program’s success. A homegrown program might look only at objective data; for example, mentee retention at 3 months, 6 months, and 1 year. Programs offered through professional organizations typically have a reliable and validated tool for measuring success beyond retention rates, including intent to stay, job satisfaction, and mentee self-confidence.

Implications for nursing practice

Turnover of newly hired nurses presents a costly problem for healthcare organizations globally. Mentorship programs effectively increase retention by providing individualized support throughout a stressful period of uncertainty for new nurses. At the national level, retaining qualified nurses will reduce healthcare costs and improve patient outcomes. Meeting the demands of healthcare and remaining poised for future growth require a stable nursing workforce. Mentoring programs act to strengthen that workforce sustainably from within the profession.

Organizations that adopt a mentoring culture stand to improve camaraderie and promote the professional development of the staff. By providing resources and facilitating personal growth, organizations help employees feel pride and satisfaction in their work. To successfully integrate mentorship into the organization, leaders must support the mentors and mentees throughout their partnership, encourage participation, and provide relevant resources. Ultimately, the organization benefits by lowering turnover, which can lead to annual cost savings as a result of reduced contract labor and overtime, as well as improving quality ratings.

On the nursing unit, newly hired nurses who participate in mentoring will gain confidence and experienced nurses will welcome them. The unit will recoup the time and resources devoted to training a new employee as a result of increased retention of those who participated in the program. As staffing levels and unit cohesion rise, mentoring may reduce job stress and burnout. Confident and engaged employees provide high-quality nursing care, which impacts patient satisfaction and reimbursement rates. (See Success stories.)

Anticipate success

Mentorship contributes to camaraderie and provides an avenue for professional development for mentors and mentees. It has the potential to create a goal-directed and future-oriented organizational culture. In addition, organizations can anticipate retention of newly hired nurses, a reduced turnover rate, and increased intent to stay.

Kristin Gill-Bonanca is the administrative director for critical care services at Saint Anne’s Hospital in Fall River, Massachusetts.

American Nurse Journal. 2024; 19(8). Doi: 10.51256/ANJ082406

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Key words: Mentorship, mentor, nurse retention, new nurses, mentoring program