Before you leave … a tribute to our next generation of nurses

Before you leave … a tribute to our next generation of nurses

The last few weeks have been a turmoil of final exams, graduation balls and completion ceremonies for final semester nursing students. This is always a special time of year when we reflect on the success and accomplishments of our students and wish them well as they embark on the next stage of their journey. Among the hundreds of students who are completing their nursing degree this year at my university, is my son. So this year’s celebrations have been particularly meaningful and exciting for me.



It’s been a privilege to be part of these students’ journeys and I’ve watched in awe as they have developed into amazing nurses. Although they no longer need my guidance I can’t help but think about the things I wish I’d known at the beginning of my nursing journey. So, before you leave, here are some final words of advice for all soon-to-be registered nurses … Read more

20 expert tips for improving the quality of your mentoring

20 expert tips for improving the quality of your mentoring

The ‘tips for improving the quality of mentoring’ provided in this post were developed by Alexandria Wilson and Micaela Cassar, and were originally presented as an educational poster submitted during their undergraduate nursing degree. As Alexandria and Micaela were mentored by a number of nurses while completing their clinical placements, they are well positioned to provide these illuminative, evidence-based and practical insights about mentoring. I feel honoured that they have given me permission to share these important tips on my blog.




Important attributes for an effective mentor include commitment, motivation, enthusiasm, positivity and passion. Skilled mentors respect and value students as learners and contributing members of the nursing team. The quality of students’ clinical learning experience can be undermined by being allocated to nurses who are unwilling or unprepared to be a mentor [1].


Introduce yourself and the other team members to the students and orientate them to the ward/facility. Welcoming students facilitates their socialisation, belongingness and acceptance as a member of the healthcare team [2].  When students feel unwelcome or as if they are a burden they are less motivated to learn [1].


Clear expectations are essential for students’ progress and success [4]. By making the ‘ground rules’ explicit, students fully understand how their performance will be evaluated [3].


Effective mentors have a high level of emotional intelligence. This attribute allows mentors to manage their own and others emotions, and demonstrate sensitivity to students’ needs, feelings and concerns. [1].


Creating a meaningful learning experience for students requires that you first understand their scope of practice, goals and learning objectives. Students will be more motivated and responsive to feedback when specific and realistic learning objectives are agreed upon [3].


Agree on a ‘safe’ word or phrase that can be used when issues related to patient safety arise. ‘Safe’ words can be used when mentors need to step in and take over a patient’s care from the student, without making their concerns obvious to the patient [1].


Facilitate transfer of learning from theory to practice by adhering to best-practice guidelines, providing rationales for your care, and asking students to explain the reasoning that underpins their decisions and actions [5].  Clinical competence is enhanced when students are able to assimilate theory and practice [6].


Give students permission to ask questions and question your practice. Keeping the channels of communication open in this way empowers students to become active learners and facilitates their ability to link theory and practice [1].


Provide a variety of challenging and practical learning opportunities for students to optimise their clinical learning and confidence [7].  Opportunistic ‘just-in-time’ teaching increases students’ satisfaction and motivation [1].


Ask challenging questions that promote critical thinking and clinical reasoning, for example, ‘What do you think we should do for this patient and why?’ Challenging questions stimulate higher-order thinking and problem-solving skills and encourage reflection in and on practice [8].

Mentoring is an ancient archetype originating in Greek mythology. Homer described how Odysseus, King of Ithaca, left home to fight in the Trojan War and entrusted the care of his son, Telemachos, to Mentor, his wise and faithful advisor. Mentor served as Telemachos’ protector, teacher and guide for many years. The word Mentor has evolved to mean trusted advisor, friend and teacher; and mentoring refers to a developmental relationship where an experienced person invests time and energy in supporting the growth and actualisation of a less experienced protégé.


Share your knowledge, experience and previous mistakes with students to help them learn and avoid common errors in the future [9]. Mentors who are willing to honestly share their experiences promote students’ trust and clinical skills and knowledge development [5].


Model the ability to think aloud, for example during medication administration. This gives students insights into the cognitive and metacognitive processes than underpin expert practice.  Also encourage students to think aloud in clinical situations as this enables mentors to provide constructive feedback about their clinical reasoning processes [8].


Effective interprofessional communication, collaboration and teamwork are critical to patient safety. Involving students in team-based clinical activities enhances their skills and confidence in working with other members of the multidisciplinary team, aids workplace readiness [8], and facilitates a sense of belonging [2].


Demonstrate that you value the knowledge that students have gained from their undergraduate studies and that you are committed to your own  lifelong learning  [10].


Give regular and constructive feedback to students about their performance. Feedback must be clear, specific, accurate, immediate, sensitive, direct, and provide a balance of positive and negative examples. Appropriate and timely feedback when clearly communicated can increase students’ motivation, confidence and competence. Constructive feedback is essential to improved performance and quality patient care [3].


When students are not practicing at the required level clearly communicate and document your concerns. Provide strategies, opportunities and support that will facilitate improvement.  Be prepared to fail students if they continue to practice in an unsafe or unprofessional manner [11].


If conflict arises manage it politely and respectfully using negotiation, communication, compromise, and problem-solving skills. Mentors and students may hold differing opinions, values, ideas, or perceptions, therefore it is vital that mentors are confident in resolving conflict [1].


Debrief should occur both spontaneously and regularly. When challenging situations arise, for example, when a student witnesses a patient’s death or a cardiac arrest for the first time,  a debrief is essential. Effective debriefing can prevent psychological harm by allowing students to talk about and process the event with the support of someone they trust [8].


Encourage students to reflect on their clinical performance and decisions. Reflection assists learners to examine their strengths and areas in need of improvement, and to identify meaningful strategies to improve their future practice.  Mentors can also use these reflective processes to identify students’ future learning needs [8].


Mentors should honestly reflect on the effectiveness and outcomes of their mentoring.  Ask students to provide honest feedback about their experience of being mentored and use this information to help you identify personal strengths and areas in need of improvement as part of your ongoing professional development [5].

Mentors remind us that we can indeed survive the terror of the coming journey and undergo the transformation by moving through, not around our fear. Mentors give us the magic that allows us to enter the darkness, a talisman to protect us from evil spells, a gem of wise advice, a map, and sometimes simply courage. But always the mentor appears near the onset of the journey as a helper, equipping us in some way for what is to come, a midwife to our dreams, a ‘keeper of the promise’. Success is a lot more slippery without a mentor to show us the ropes. The mentor is clearly concerned with the transmission of wisdom. They do this by leading us on the journey of our lives. We trust them because they have been there before. They embody our hopes, cast light on the way ahead, interpret arcane signs, warn us of lurking dangers, and point out unexpected delights along the way [12; 13].



How to be a good mentor. These TED talks will help you to help others succeed:



  1. Sinclair, P., Pich, J., Hennessy, M., Wooding, J., Williams, J., Young, S. & Schoch, M. (2015). Mentorship in the health disciplines. Renal Society of Australasia Journal, 11(1), 41-46.
  2. Jokelainen, M., Turunen, H., Tossavainen, K., Jamookeeah, D. & Coco, K. (2011). A systematic review of mentoring nursing students in clinical placements. Journal of Clinical Nursing, 20(19/20), 2854-2867.
  3. Duffy, K. (2013). Providing constructive feedback to students during mentoring. Nursing Standard, 27(31), 50-56.
  4. Brown, B. (2012). Development of a mentoring program for nursing students with plans for implementation and evaluation. The Journal of Chi Eta Phi Sorority, 56(1), 5-10.
  5. Valente, G., Cortez, E., Cavalcanti, A., Cosme, F. & Goncalves, L. (2014). Nursing Mentoring in Primary Care: Building Skills from Practice. Journal of Nursing UFPE, 8(9), 3047-3058
  6. Haidar, E. (2007). Coaching and mentoring nursing students. Nursing Management, 14(8), 32-35.
  7. Muleya, C., Marshall, J. & Ashwin, C. (2015). Nursing and midwifery students’ perception and experiences of mentorship: a systematic review. Open Journal of Nursing, 5(6), 571-586.
  8. Ness, V., Duffy, K., McCallum, J. & Price, L. (2010). Supporting and mentoring students in practice. Nursing Standard, 25(1), 41-46.
  9. Mentoring Relationships. (2013). Minnesota Nursing Accent, 85(1), 12-20.
  10. Halcomb, E., Peters, K. & McInnes, S. (2012). Practice nurses experiences of mentoring undergraduate nursing students in Australian general practice. Nurse Education Today, 32(5), 524-528.
  11. Huybrecht, S., Loeckx, W., Quaeyhaegens, Y., De Tobel, D. & Mistiaen, W. (2011). Mentoring in nursing education: Perceived characteristics of mentors and the consequences of mentorship. Nurse Education Today, 31(3), 274-278.
  12. DalozN. Guiding the Journey of Adult Learners. San Francisco: Jossey Bass; 1999.
  13. ParkesS. The Critical Years: the Young Adult’s Search for Faith to Live By. San Francisco: Harper; 1986.


Tall poppy syndrome …. Still rearing its ugly head in nursing

Tall poppy syndrome …. Still rearing its ugly head in nursing

Nearly 3000 years ago Heroditus told the story of how King Thrasybulus was asked by a fellow monarch about the best way to govern his kingdom. In response the King went to a nearby field and, walking through the rows, whacked the heads off the tallest, brightest ears of corn. The Romans continued the analogy in their literature, but changed the corn to poppies, and the term ‘tall poppy syndrome’ was coined (The Histories, 440 BC).



A few weeks ago my friend and colleague, Dr Lorna MacLellan, graduated with a PhD. Professor Isabel Higgins and I had the honour of supervising her throughout her candidature. Lorna explored the transition experiences of ten Nurse Practitioners (NPs), interviewing them each 3-4 times during their first 12 months of practice.


The findings from this study revealed a pervasive problem in the upper echelons of the nursing profession. Although the metaphor of ‘nurses eating their young’ has become an a recognised part of the nursing vernacular, Lorna’s study identified that bullying also pervades senior levels of the nursing profession and manifests as ‘tall poppy syndrome’.

Tall Poppy Syndrome describes a social phenomenon in which people of genuine merit are resented, attacked, cut down or criticised because their abilities or achievements elevate them above or distinguish them from their peers  ~ Segen’s Medical Dictionary (2012).

NPs were first endorsed in Australia in 2000 as a result of more than ten years of political lobbying by the nursing profession. However, their numbers have been slow to increase and in 2016 there were only 1380 endorsed NPs. The multiple challenges associated with transition and, in particular, recurring episodes of tall poppy syndrome, may be partly responsible this problem.

In Lorna’s study the experiences of the ten NPs varied, and although a few experienced a relatively smooth transition, many encountered such a difficult and turbulent beginning that they resigned without completing their first year of practice. Many of the NPs were plagued by self-doubt, insecurity and feelings of isolation as a result of horizontal violence and the lack of support they received.

The NPs were victims of professional jealousy and they described how their nursing colleagues frequently conveyed disrespect and contempt for the NP role.  At a time when the NPs needed support and camaraderie, they were often the victims of bullying, hostility, sabotage and tall poppy syndrome. The comments  below illustrate their concerns: Read more

Do we really need to teach health professionals to be empathetic?

Do we really need to teach health professionals to be empathetic?

Next month I am going to an Empathy conference in Oxford and needless to say I’m more than a little excited. For someone who is a self-confessed English history devotee the opportunity to meander around the 12th century university college buildings in the ‘City of Dreaming Spires’ will be wonderful. However, as an educator and researcher with a passion for exploring the concept of empathy, the conference promises to be thought provoking (even though we are forbidden from using either ppt or written notes in our presentations … eeek!).

oxford image

‘Healthcare is more than the sum of its parts. All healthcare professionals must be knowledgeable, clinically astute and able to provide empathetic care’1

I’ve become increasingly interested in empathy over the last decade. For a long time I thought that people were either born with an empathetic disposition (as I assumed most health professionals were), or they weren’t (these are the narcissistic people we’ve all met at some stage in our lives). I didn’t conceptualise empathy as a skill that should and could be taught.

Then along came Naleya Everson, an exceptionally gifted and insightful person who taught me so much about the empathy deficit. Naleya was one of my undergraduate students, she soon became an honours student and is about to commence her PhD. She set me on a path where I became determined to fully understand this elusive construct and to discover ways to teach and assess students’ empathy skills.

So often you find that the students you are trying to inspire are the ones that end up inspiring you ~ Sean Junkins

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