Mentoring and Group Identification System

Discuss about the Mentoring and Group Identification System.

Introduction:

The report highlights the public health issues of workplace bullying in clinical practice and lack of understanding regarding the mentorship role in health care organization. This issue is highlighted through the case scenario of Shannon, a nursing student on a clinical placement who experience bullying and disrespectful behavior from his mentor, Morgan.  The review of the case study suggests that such incidents have become common in workplace and this is the main cause of nursing staff shortage in clinical setting. The report set the scene for discussing the procedure regarding dealing with such incidents by means of incident report about Shannon. Secondly, the essay also critically analyzes the personal and organizational level actions that is needed to improve mentoring experience in nursing practice and prevent victimization of nursing students.

Description of the incident: Shannon Doe, a third year undergraduate nurse came to the Charles Darwin University Hospital on clinical placement. On the first day, Shannon’s preceptor Morgan Lane gives detail to Shannon regarding her work for the day and instructs her to review the self-directed learning modules on WHS, infection control, mandatory reporting and aggression management. Shannon did not contacted her on that day. On the second day, Morgan makes fun at her which made Shannon embarrassed. Shannon gave answer to Morgan’s questions, however the comment made by him was in the form of criticism. On the third day too, when Shannon performed a CPR on a non-responsive patient with pneumonia, Morgan ask her just to complete the cycle. He does not contact her even during the clinical debriefing process. The final day Shannon calls the Nursing Unit Manager to say that she is not coming as she feels she been bullied. 

Brief description of injury/illness: Shannon experienced negative experience at her clinical placement due to bullying and criticism by nurse Shannon. Morgan did not invited her in the clinical debriefing session after completing the CPR for the non-responsive patient.

Treatment following injury: Shannon was subjected to criticism and derogatory remarks by Morgan on all four days of clinical placement. Following this incident, no actions were taken to correct the actions. When the patient was non-responsive, Shannon commenced CPR on the patient.

Person who saw the incident or came first to the scene:  After feeling bullied, Shannon informed about the incident only to the Nursing Unit Manager. While the nurse was conducting resuscitation, Morgan first came to the scene.

Procedures dealing with the incidents:

Both informal and formal procedures exist to deal with bullying incidents in health care organization. The informal procedure is a problem-solving approach where the main aim is to assess the allegation and address the issues within a specific time frame. The time frame may differ according to different organizational bullying prevention policy. The first step would to get detailed incidents report and analyzes the specific issues reported. Secondly, it would be necessary to evaluate whether the complaint comes under the definition of bullying or not. An informative session between two parties can clarify regarding the acceptable interaction needed between mentor and mentee (Birks et al., 2014). Hence, informal resolution occurs by clarifying about bullying to the offender, getting the offender to accept that their behavior was inappropriate, and they would not repeat the same procedure again. Counseling support and awareness regarding the responsibility of a mentor for nursing students can also help in closing the case. The Nurse Unit Manager can also take similar action after receiving complaint from Shannon.

In addition, the formal procedure is followed to deal with bullying incident in clinical practice when issues cannot be resolved by the informal process. The first step in the formal investigation process is to obtain written complaint from the person reharding allegation of bullying against a person.  The most important action is that the complainant must be ensure full supporting during the investigation process. The next step is investigate about the complain in accordance with the Bullying Prevention Policy.  The next phase is to establish the facts by meeting with both the offender and complainant. In case, the alleged behavior is identified in the person, then taking disciplinary actions will be important (LaSala, Wilson & Sprunk, 2016).. In case of Shannon, the inappropriate mentoring process in Morgan could have been eliminated by means of education regarding behavior expected from mentors in health care practice. The most crucial element would be teach communications while engaging in the mentoring job (Topa, Guglielmi, & Depol, 2014).

Another relevant process to deal with bullying incidents in clinical placement, to take immediate action to find out the cause of such incidents. This is necessary to prevent the shortage of nurse and retain talented nurse in their job. The first action that can be taken in respond to bullying at workplace is establish a culture of mentoring where all employees are respected, open communication takes place between mentor-mentee and mentor spends enough time with the mentor to support them in the learning process. Shannon fell prey to bullying and disrespectful experience from her mentor, Morgan. This incident occurred because effective mentoring culture was not present. Mentor often feel justified in their harsh treatment because they feel they are not competent enough to be trusted. However, they fell to realize that nurse attain clinical knowledge in nursing schools, however they are not prepared to deal with the realities of nursing. In such situation, mentors guide them to correct their action and take the right step (Henderson & Eaton, 2013). Hence, emotional as well as transitional relationship between mentor-nurse is necessary to develop the skills of nursing students and make them confident in delivering advanced level care.

Critical analysis of the case study

The above  incident of Shannon and Morgan is mainly a case of bullying and inappropriate mentoring process in health care. According to the NMC Code of Conducts, the supervisor or mentor of student nurse practitioner has the role of facilitating  nursing students to develop their competence and support them in learning (Casey & Clark, 2011). However, study regarding relationship between nurse and mentors has showed that most of the nurse fins that mentors spend less time with them or some of them even engage in bullying nursing students. In such case, the most appropriate actions taken by the nurse is to leave their professional or clinical placements. This further leads to nursing shortage (Frederick, 2014). Hence, effective mentor-mentee relationship is crucial for positive employee retention and positive recruitment outcomes. In the case of Shannon also, act of bullying was the main cause of her intention to leave the unit.

The case study of Shannon brings to the forefront the prevalence of bullying in clinical practice and lack of awareness of key responsibility among the mentors. Shannon’s experience on her clinical placement showed that her mentor was disrespectful towards her and he had no commitment to provide positive learning experience to the student. As a nursing student, it is very crucial for them to apply their clinical knowledge in real setting. However, as this is a challenging process, the mentors holds the main responsibility to promote quality learning in practive setting and develop the competency of the nursing staff. However, Morgan did not approached Shannon the whole day on her first day of shift after first meeting. Secondly, instead of commending Shannon while she gave her correct answer to his question, he made fun of her This also reflects that he was not committed to develop a positive learning environment. In addition, he did not followed involved Shannon in debriefing sessions, which is seriously a breach of his duties and key responsibility. The critical analysis of the case study suggests prompt action is needed to address such incidence in clinical setting.

The first step in resolving bullying experience in nurse is to make all staffs realized the impact of bullying and disrespectful behavior on both individual and organization. It has emotional and physical health implications for the affected person and it proves detrimental for organizations too. Such incidence hampers organization’s reputation, escalates errors as well as lead to high turn over rate (Ariza-Montes et al., 2013). In case of the Charles Darwin University Hospital, if the mentor Morgan continues with the same attitude, then it would lead to shortage of nursing staffs and high turnover rate. One research study also suggest that staff shortage and declining funds have also increased the likelihood of bullying. A study also showed that one-third of nurse’s experience bullying in the workplace from their colleagues or mentors. Many nurse also express fear in reporting about such incident and suffer silently (Shetgiri, Espelage, & Carroll, 2015). . However, Shannon reported about it too.

The ARRCA resolution model can manage the incident of bullying of nursing students in health care facilities. This model can be useful to manage situation when nurses like Shannon report about bullying. It consists of the phase of acknowledgement, recording, referral, conciliation and action and it promotes taking appropriate action in relation to the event. It promotes information sharing in a controlled environment and enable nurse to identify their personal as well as colleague’s activity or mentors surrounding them (Birks et al., 2014). In the context of Shannon, as main perpetrator of bullying was Morgan, so the final course of action to address his behavior would be to clarify him regarding the competencies and outcome for mentorship in nursing. He also needs to be educated about the essential attributes of a mentor and key phase of mentor-nurse relationship. The first phase in the process of interacting and working closely with each other, second phase is to promote development of clinical placement skills in nurses and final phase is successful termination of the relationship (Ali  & Panther, 2008). Hence, mentors must realize that once they take the mentoring role, they need to consistently support nursing students who will be future nurses.

In case study of Sharon, it was also found that Morgan did not involved Shannon in clinical debriefing. For a student, this is a derogatory act because clinical debriefing sessions mostly occur in group setting to discuss and reflect about a clinical case. This method of reflection and blame free dialogue helps in identifying mistakes, learning new skills ad developing clinical evaluation skills. Hence, if Morgan had invited Shannon to this session, the nurse could have learn what was wrong or right actions and this would have created a positive mentoring environment (Dreifuerst 2015). In such case, Shannon would have never left her job and she could have developed confidence in dealing with similar situations in the future. This incident in the case study calls for stabilizing the nursing profession by encouraging mentors to engage in positive mentoring process so that nurse love and respect their profession. Health care organization also have the responsibility to train mentors and provide them with all resources and equipment to engage in effective mentoring process. The mentoring culture can also be established when mentors display authentic leadership skills and genuinely respect the talent of nursing students (Elcock & Sookhoo, 2017). A lot needs to be learnt about the mentoring process to fight against bullying and stabilize the workforce.

Conclusion:

The essay summarized the procedures that can be taken to prevent and address bullying incidence in workplace by means of reviewing the case study of Shannon and Morgan. The critical analysis of the case presented the need to improve mentoring role as well as the organizational process to establish a culture of mentoring in health care. With the application of the suggested approach, the health care system can address staff shortage issues and also maintain the requirement workplace health and safety by taking system disciplinary actions for perpetrators of abuse and bullying.

Reference

Ali, P. A., & Panther, W. (2008). Professional development and the role of mentorship. Nursing standard, 22(42), 35-39, Retrieved from: http://journals.rcni.com/doi/abs/10.7748/ns2008.06.22.42.35.c6579

Ariza-Montes, A., Muniz, N. M., Montero-Simó, M. J., & Araque-Padilla, R. A. (2013). Workplace bullying among healthcare workers. International journal of environmental research and public health, 10(8), 3121-3139, doi:10.3390/ijerph10083121

Birks, M., Budden, L. M., Park, T., Simes, T., & Bagley, T. (2014). Addressing bullying of student nurses on clinical placements: The ARRCA resolution model. In New developments in nursing education research. Nova Publications, New York, Retreived from:https://www.researchgate.net/profile/Lea_Budden/publication/268812218_Addressing_bullying_of_student_nurses_on_clinical_placements_The_ARRCA_resolution_model/links/56d6377108aebabdb4005794.pdf

Casey, D. C., & Clark, L. (2011). Roles and responsibilities of the student nurse mentor: an update. British Journal of Nursing (Mark Allen Publishing), 20(15), 933-937.

Dreifuerst, K. T. (2015). Getting started with debriefing for meaningful learning. Clinical simulation in nursing, 11(5), 268-275, Retrieved from: http://eprints.leedsbeckett.ac.uk/948/1/Roles%20and%20responsibilities%20of%20the%20student%20nurse%20mentor.pdf

Elcock, K., & Sookhoo, D. (2017). Evaluating a new role to support mentors in practice. benefits, 10, 32, Retrieved from: https://www.nursingtimes.net/nursing-practice-clinical-research/evaluating-a-new-role-to-support-mentors-in-practice/304598.article

Frederick, D. (2014). Bullying, mentoring, and patient care. AORN journal, 99(5), 587-593.

Henderson, A., & Eaton, E. (2013). Assisting nurses to facilitate student and new graduate learning in practice settings: what ‘support’do nurses at the bedside need?. Nurse education in practice, 13(3), 197-201, Retrieved from: http://dx.doi.org/10.1016/j.nepr.2012.09.005

LaSala, K. B., Wilson, V., & Sprunk, E. (2016). Nursing academic administrators’ lived experiences with incivility and bullying from faculty: consequences and outcomes demanding action. Nurse educator, 41(3), 120-124, doi: 10.1097/NNE.0000000000000234

Shetgiri, R., Espelage, D. L., & Carroll, L. (2015). Practical strategies for clinical management of bullying. New York: Springer, Retrieved from: https://link.springer.com/book/10.1007/978-3-319-15476-3

Topa, G., Guglielmi, D., & Depolo, M. (2014). Mentoring and group identification as antecedents of satisfaction and health among nurses: What role do bullying experiences play?. Nurse education today, 34(4), 507-512, Retreived from: http://dx.doi.org/10.1016/j.nedt.2013.07.006