Bill Klaproth (Host): This is a special AONL podcast as we speak with session presenters from the AONL 2023 Conference. With me is Kristy Blust. She is The Director of Women and Infants. And we also have Robert Wanner, who is the Director of Nursing, both from the Ohio State University, and I want to make sure that I said that correctly.

Kristine Blust, DNP, MSN, RN, NEA-BC: You did. Thank you.

Bill Klaproth (Host): Okay. Good. I got it Right. Yes. So their session session was titled Evidence-Based Mentorship Program for New Nursing Managers. This is Today in Nursing Leadership, a podcast from the American Organization for Nursing Leadership. I'm Bill Klaproth. Robert and Kristy, thank you so much for being here.

Kristine Blust, DNP, MSN, RN, NEA-BC: Thank you.

Robert Wanner, DNP, MHA, RN, NEA-BC: you for having us.

Host: You bet. It's great to see you here. So let's talk about this Evidence-Based Mentorship Program for New Nursing Managers. So, Robert, what is the compelling leadership issue or the problem that your session addressed?

Robert Wanner, DNP, MHA, RN, NEA-BC: Yeah, I'm happy to answer that Bill, and it's very timely and important topic right now for all of us in healthcare as we continue to climb back from the pandemic. The role of the nurse manager is often described as one of the most difficult positions within our healthcare setting. They assume 24/7 accountability for their areas. Some of them multiple areas or units and their leadership capabilities, or lack thereof sometimes, ultimately impact our healthcare outcomes, patient safety, retention or satisfaction, and even our healthcare finances. Yet many of these managers are actually assuming those roles based on their clinical performance rather than their leadership competencies.

Host: Right.

Robert Wanner, DNP, MHA, RN, NEA-BC: And despite this, overwhelming amount of responsibility, there is wide variation in our supportive programs for these new nurse managers, leaving some of them to actually just learn through trial and error, rather than providing them the proper structure and foundation to make this difficult transition. And so the lack of mentorship programs for new nurse managers is prominent, not only in our healthcare organizations. But leads to unintended and unfavorable outcomes for not only the managers and the employees, but also our patients.

Host: So we're promoting people that they're really good workers and they're talented and they're skilled, but they might not have the leadership qualities built in them yet. We need to be better at teaching them. Hence the role of the mentor. In fact, from your session, there's a statistic here, less than 7% of hospitals and healthcare settings have formal mentorship programs. That's not a lot. So we're kind of throwing these people and going, guess what? You're a manager now, have at it. Is that right?

Robert Wanner, DNP, MHA, RN, NEA-BC: That's exactly right. You know, we, being a performer, being adept in the clinical capacity, being a charge nurse, a preceptor, doesn't equate to, the same ability to lead a team and lead them effectively.

Host: Absolutely. So Kristy, for a nurse leader who is listening to this, what are the important first steps to take? What key leadership tactics can someone deploy in their own organization?

Kristine Blust, DNP, MSN, RN, NEA-BC: Sure. Thanks, Bill. Well, first of all, I'd say number one out the door, identify a mentor. Have somebody that you can get with, talk with, talk through different situations. The other thing that I'm going to say is if you're looking for something like Robert and I are working on, I'm going to tell you to complete an assessment of your organizational needs and identify gaps in the leadership knowledge, training, understanding, and then look to the literature to help you develop a mentorship program and tailor the content to the organizational or participants' needs. And one thing that Robert and I have realized through this time, is that it's very much about the organization. So obviously we are in central Ohio, so our needs are very different than maybe an organization in Seattle, Washington, or Jacksonville, Florida.

So there's nothing that's a cookie cutter, if you will. And then realize the difference and importance of both orientation and mentorship. Often, those two are synonymous and in reality they're not. And orientation is more performance driven and intended to focus on the immediate job duties or functions of the leader versus mentorship is more development driven. And looks at things more holistically, if you will, and at the individual and at that individual's career development.

Host: So those are three key takeaways. Identify a mentor. Number one, assess your organizational needs. Very important cause what you need might be different than somebody else across country. And then realize the difference between orientation and mentorship.

Kristine Blust, DNP, MSN, RN, NEA-BC: Absolutely.

Bill Klaproth (Host): So Robert, then, what tactics or initiatives did you use to address or solve this leadership issue? What did you do there?

Robert Wanner, DNP, MHA, RN, NEA-BC: Sure, Bill. So we first went to the evidence in the literature and really looked for themes that we could draw out and leverage to really tackle this issue. The first one that we identified very early on is that structured transition programs with both orientation and mentorship, does provide the necessary development tools to fill the gap of leadership competencies through their transition into nursing leadership. And so using those themes as well as the AONL manager domain framework, Kristy and I developed a six week evidence-based mentorship program for our new nursing managers and assistant nurse managers. The mentors, Kristy and myself, met with these mentees twice per week for six weeks.

Our first meeting of the week was a group meeting, and it was a one hour didactic content and small work group followed by 30 minutes of case studies. The second meeting was an individual face-to-face meeting with Kristy, myself, and the individual participant, that was anywhere from 30 minutes to an hour, maybe even an hour and a half sometimes.

And really, these, one-on-one mentoring sessions, for that second meeting, were the meat and potatoes of our program. It was truly mentee led and used to address specific questions, concerns, or discussion topics that that mentee wanted to talk about. Mentees and mentors also used this time to discuss concerns related maybe to their immediate role or something that they just faced that morning and didn't know how to navigate. And so we found ourselves discussing a variety of topics, but it was completed at a pace that was comfortable for the mentee and was really driven by them as a participant so we could meet their identified and immediate needs in addition to that didactic content we were sharing.

We also understood that self-efficacy is correlated to increased motivation, behavior, and performance in the role, and can be cultivated and measured. And so cultivating that self-efficacy within our nurse managers through a mentorship program, is a predictor of performance. And can help lead to desirable outcomes. We also understood that the mentor and mentee relationship is pertinent to the success of these novice leaders and really needs to be purposeful on the front end to maximize their effectiveness and prepare them accordingly. And then lastly, why we are here at AONL. Obviously their domain framework, The Science, The Art, and The Leader Within is foundational and demonstrates validity and reliability. It's a very useful tool that facilities can use to really build the foundation of these programs and make them effective.

Host: Well said Robert. So have a structured program, right? So you got to have that. Self-efficacy. I've never ever heard that term before, but that's really interesting, you said that can be cultivated, which I think is important. And then understand the mentor-mentee relationship, and then you mentioned the uh, AONL the Science and Art and the Leader Within. Those are really four important steps that someone can take or use to launch a program like this. So then what is the result of this? You and Robert put this into place. Can you share with us what you've learned so far and, what have the results been?

Kristine Blust, DNP, MSN, RN, NEA-BC: So the data from our program suggests that the implementation of an evidence-based new nurse manager mentoring program actually enhances nurse manager core competencies and the nurse manager's self-efficacy to lead. We saw an increase in our data of the nurse manager competencies across all of the AONL's domains.

And additionally the data demonstrated an increase in the perceived manager self-efficacy, which we know correlates with increased performance and influences how they engage in activities, take on new skills, and demonstrate behaviors that define their role. And the managers who actually participated in our program, Bill also reported to feel more confident in facing daily work challenges to enhance patient outcomes.

And specifically I'd like to share a few comments or anecdotal comments from some of our participants. So, yeah, one of them said, I have learned many new strategies and ways to assess and address a variety of situations. Another, this program has provided me with a variety of tools and new knowledge to assist me in maintaining a safe and healthy work environment. And I will look to the literature and utilize my EBP resources to promote the best possible patient care. And lastly, this mentorship program has given me the drive and motivation to seek ways to improve practices, to create a culture of evidence-based practice. All comments that we were hoping to receive through this program.

Host: Well, thank you for sharing that with us. That had to make you feel good when you saw those comments. Those are great testimonials.

Kristine Blust, DNP, MSN, RN, NEA-BC: Yeah. Yeah.

Host: That's proof of what you and Robert have done really is working. And more importantly it's making a difference for your workers and it's also creating better health outcomes too, I would imagine. So Robert, overall then, what is the key takeaway or things to remember when we talk about evidence-based mentorship?

Robert Wanner, DNP, MHA, RN, NEA-BC: Sure. I think the key takeaway away that we need to remember is that our nurse managers, you know, they really serve, or sit at that critical intersection between our staff, our patients, interdisciplinary teams and senior leaders as well as ongoing strategic initiatives that all of us have going on. Quite frankly, Bill, the success of the nurse manager and the teams that they support is a foundational driver behind our organizational success. And so if organizations were to focus on the gap of knowledge, training and education, that these managers face, give them the structured resources needed to strengthen their competencies and increase their self-efficacy as a leader, and provide them that one-on-one mentoring to support their immediate concerns and needs; they may feel better equipped to lead their teams and drive quality in our patient care. We continue to become more complex, demand value instead of volume and focus on patient satisfaction through our system, but we as an organization, and organization, healthcare organizations as a whole just need to place some heavier emphasis on the importance of the frontline nurse manager to deliver those sustainable results.

Host: Let me ask you this, Robert, how does somebody go about identifying a mentor? Is that something you helped with?

Robert Wanner, DNP, MHA, RN, NEA-BC: Yeah, I think that's a very purposeful process I would say. And, something that you need to spend some time in. We all learn very differently. We all engage differently. I think an assessment of your team and of your leaders is important if you're going to look to pair individuals. There's also a variety of platforms or vendors that you can look to to do that pairing kind of in the background. And really have not only maybe experiences, that are very similar but you have personalities, that are similar. And you feel not only connected, but safe. That psychological safety, is huge in that mentor mentee relationship.

Bill Klaproth (Host): That's

Host: That's a good thing to remember. Well, thank you for that, Robert. I appreciate that. I think what you said there is really important, and as we wrap up, I'd like to get final thoughts from each of you and Robert, any final thoughts you'd like to share when we're talking about evidence-based mentorship programs?

Robert Wanner, DNP, MHA, RN, NEA-BC: Sure. I think my first thought is it's critical to establish that safe space for the mentees and mentors to learn, share ideas and really have fluid thoughts back and forth and conversation. Another takeaway I would throw out there is that learner needs vary between organizations and institutions. And so it's important to know what topics are critical, not only to you as a chief nurse exec or someone rolling these programs out, but what is important to the mentee's immediate needs? For example, while I may be teaching the concept of value-based purchasing and reimbursement, and it is an important topic, that new learner may retain very little of what I'm talking about because they are struggling to manage unit attendance or an issue that they may not know how to approach that's causing them a daily stress. So I think, honing in on the mentee and what their immediate needs are is just as important as me pushing information out to you to give you the additional tools and support that I want you to have as a nurse leader.

Host: Yeah, that's a really good point. Understand the mentee's immediate needs. They can only learn so fast and you can't get way ahead of them. If they're understand they might be struggling with this right now. So we really need to take our time in teaching them and making sure that they really understand this core component right now. And Kristy, let's have you wrap it up for us. Any final thoughts you'd like to share?

Kristine Blust, DNP, MSN, RN, NEA-BC: Maintaining the confidentiality and personal conflicts the mentees share while reassuring you as the mentor, we're there to support them anytime through and after the program has shown to be beneficial to all of our participants. So, yeah, I just like to stress that and like Robert said, that psychological safety is very important.

Host: Got to provide that safe space. People operate better in a safe space where they really feel supported and heard for sure. Well, you guys have done great work. Kristy and Rob, thank you so much for your time today.

Kristine Blust, DNP, MSN, RN, NEA-BC: Sure.

Robert Wanner, DNP, MHA, RN, NEA-BC: We appreciate it.

Host: Yeah.

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And check out the full podcast library for topics of interest to you. This is Today in Nursing Leadership. Thanks for listening.