Professional development and mentorship: Nursing retention toolkit
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- Goal statement
- Initiative – Transition programs: Develop and implement formal transition program for new grads, new managers or leaders, etc. that foster development of clinical and leadership competencies
- Initiative – Mentorship programs: Deliver formal mentorship program, characterized by relationships that are based on collaboration and trust, and include training for mentors
- Initiative – Career pathways and bridging programs: Develop programs that provide supports for clinical nurses who are interested in other domains such as clinical education, research, and policy
Goal statement
Provide nurses across the entire career span options to enhance their skills and pursue their career goals.
Initiative – Transition programs: Develop and implement formal transition program for new grads, new managers or leaders, etc. that foster development of clinical and leadership competencies.
Intended outcome
- Strong transition programs enable a smooth transition from being a new graduate to a practising nurse, and provide support for mid-career nurses in times of transition into a new professional role.
Description
This initiative focuses on providing programs for nurses going through transitionary periods in their career.
- Scope: Transition programs should be applied across health settings, including hospital, home, and community care settings. Led by nurse educators and nurse managers, such programs provide education, reduce stress, and offer moral support. The program curriculum is a key component and should include clinical and leadership competencies to prepare nurses for the diverse aspects of their new professional role.
- Duration: Transition programs vary in duration. Some entry-to-practice programs last for the first year of practice, and the period of support may be expanded for further competency development including preceptor or mentorship skills. Transition programs may begin before graduation (e.g., nurse learners who have completed over half of their program), with the completion of the academic program in a clinical environment. The duration of programs for new managers depend on program objectives and customized to the needs of nurses.
- Integration: To prepare nursing students for practice, a transition program may be integrated with university or college programs, to begin supporting transition to practice before exiting the classroom. For programs for new graduates or new managers in the workforce, nursing faculty may be invited to participate in, or collaborate with the programs, providing insights into the current state of health care practice and aligning educational content with real-world needs. Strong academic and health system partnerships can help to support program development and resourcing.
Planning considerations include:
- Educator and manager involvement: Engage experienced nurse educators and managers to lead the program, offering guidance, mentorship, and support.
- Practical application: Incorporate hands-on experiences, simulation training, and real-life scenarios to bridge the gap between theory and practice.
- Resource allocation: Organizations need to consider allocation of resources to curriculum development, training materials, and mentorship support. Organizations also need to build in sufficient time for knowledge transfer when new grads are entering roles to ensure continuity.
- Preceptor development: Provide training and support for preceptors and mentors to effectively guide and mentor new graduates and managers.
- Collaborative workshops and training: Health care organizations, universities and colleges can jointly organize workshops, seminars, or training sessions that bridge the gap between theoretical knowledge and practical application.
- Monitor Program Outcomes: Pre- and post-program assessments can be used to monitor clinical competency and leadership. Participant feedback surveys and program completion rates may also be monitored.
Target nursing population
Those entering and re-entering the workforce or transitioning to new roles: Students (including clinical externs), New Grad, New Managers or Leaders, Mid-Career in transition (e.g., new unit, returning to work), Internationally Educated Nurses (IENs), Late Career, underrepresented populations within the nursing community (e.g., Indigenous, Black).
Stakeholder involvement and role of nurses
- Responsible: Nursing leaders and nurses should be empowered to lead the development, maintenance, and implementation of transition programs and practices.
- Accountable: Each health care organization is accountable for the transition program.
- Consulted: Collaboration should occur between the transition program and local educational institutions to ensure best practices are up to date and align with educational teaching methods.
Reference resources and examples (See appendix for links)
- McGill University Health Centre (MUHC) Genesis Nurse Residency Program: Program designed to support new graduate nurses (0-12 months) in their transition to professional practice by providing a structured curriculum, mentorship, and clinical experiences. The program aims to enhance critical thinking and clinical reasoning skills while fostering a supportive learning environment. Includes both educational support (through experiential, case-based learning) and moral support (through dedicated time for new graduate nurses to connect with nurse managers).
- Shared Health Manitoba Clinical Transition Program: Students in the nursing program are paired with an experienced nurse to introduce them to the department, act as a mentor and help guide them through to graduation.
- Nova Scotia's International Community of Health Workers Engagement (NICHE) Program: provides integration support through education, training, and supervision to internationally educated health professionals entering the health care system.
- CASN National Nursing Residency Program: This 6-month competency-based transition to practice program is targeted to new graduate Registered Nurses.
- CASN Preceptor-Mentor Training Program: This online training program builds experienced nurses' capacity to mentor new nurses.
- Patricia Benner's "From Novice to Expert" book: Transition programs can be built with the "From Novice to Expert" Concept, which involves skill and knowledge development through a combination of education and personal experiences.
- Nursing the Future: Framework and resources available related to the state of new graduate transition challenges.
- Saskatchewan Association of Nurse Practitioners (SANP) Mentorship Program: Mentors provide guidance and advice on career transition, clinical resources, work-life balance and more to new Nurse Practitioners.
Initiative – Mentorship programs: Deliver formal mentorship program, characterized by relationships that are based on collaboration and trust, and include training for mentors.
Intended outcome
- Retention of nurses and longevity of nursing careers are promoted within the profession while nurses are supported to help define their own development path over their careers.
- Safe and effective patient care enabled by formal mentorship systems.
Description
This initiative focuses on the delivery of formal nursing mentorship systems and programs in Canadian health care organizations. Mentorship programs outside of clinical care settings should encompass the following attributes:
- Scope: Programs should accommodate skills and individual scopes of practice across a variety of different roles and phases of a career within nursing. Mentorship should be provided outside the clinical setting. Remote or virtual mentorship relationships can be explored to better meet the needs of the mentee. Mentorship may be part of a formalized nursing residency programs.
- Dedicated time to participate in programs: Dedicated time should be provided for nurses to access mentorship and professional development. This may include the development of formalized nursing residency programs and consideration for the diverse learning needs of adults. Furthermore, mentorship should be provided by mentors with a dedicated position (or protected time in role) and title. (See Clinical Supports for more information on protected time and incentives for mentors and diversity in pool of mentors.)
- Interdependencies: Mentorship programs should be closely integrated with nursing orientation, preceptorship, and succession planning programs.
- Participation: Voluntary participation in programs is recommended as research has shown that mandated programs have lower success rates. Staff should be provided the opportunity to identify their need for a mentor and the organization should respond to this need by resourcing mentors. Mentees should have the opportunity to be mentored by someone with similar lived experiences to themselves. Organizations should promote equitable distribution of mentorship roles across their workforce.
- Length: The length of time of the program should be flexible and directly tied to the need of the mentee, rather than a set time period.
Target nursing population
Those entering and re-entering or transitioning to new roles: Students (including clinical externs), New Grad, New Managers or Leaders, Mid-Career in transition (e.g., new unit, returning to work), Internationally Educated Nurses (IENs), Late Career, underrepresented populations within the nursing community (e.g., Indigenous, Black).
Stakeholder involvement and role of nurses
- Responsible: Nursing leaders and nurses should be empowered to lead the development, maintenance, and implementation of mentorship programs and practices.
- Accountable: Each health care organization would be accountable for their mentorship programs. Organizations could seek supports to develop and implement their programs.
- Consulted: Collaboration should occur between the mentorship program and local educational institutions to ensure best practices are up to date and align with educational teaching methods.
- Informed: All nursing staff (to increase awareness of mentorship opportunities), HR (to monitor and address workload adjustments and align the program with organizational policies), Nursing Associations and Unions and Educational Institutions (to foster collaboration, support, alignment).
Reference resources and examples (See appendix for links)
- Ontario's Clinical Scholar Program: This program pairs an experienced nurse as a mentor with newly graduated nurses, IENs, and nurses wanting to upskill to ensure that they have the support they need to confidently transition.
- UBC's Mentorship Program: This program connects senior nursing students with program alumni as they enter the workforce.
- Alberta Health Services Nursing Mentorship Network: This system-wide network provides mentorship opportunities and monthly community of practice sessions to listen and learn from one another.
- The Ottawa Hospital's Clinical Coach Initiative: A new role called "Clinical Coach" was created at The Ottawa Hospital to translate nursing knowledge, skill, experience, and expertise from retired nurses to novice nurses through coaching sessions focusing on non-technical skills (critical thinking, organization, prioritization, and time management) with the goal of enhancing nursing practice, patient care, and nurse retention.
- Trillium Health Partners Mentorship Program: This program provides mentors to nurses who have registered as a nurse within the last year.
Initiative – Career pathways and bridging programs: Develop programs that provide supports for clinical nurses who are interested in other domains such as clinical education, research, and policy.
Intended Outcome
- The enablement of clear developmental pathways for nurses to advance their careers, including dedicated resources and supports at an organizational level for nurses to pursue career pathways and bridging programs.
- Increased retention of nurses through job satisfaction, ultimately creating workforce stability.
- Increased opportunities for internationally educated nurses who have experience or interest in education, research and policy, so they are better able to utilize and apply their diverse skills in the Canadian health care system.
Description
This initiative focuses on enabling career pathways (lateral or upward) and bridging (e.g., to a new designation, renewal of licence) for nurses throughout their careers. This initiative recognizes that the nursing profession is comprised of multiple domains – not only clinical, but also education, research, policy, and other domains; the direction of pathways or bridging may not always start from the clinical domain (e.g., nurses may re-enter clinical practice from the research domain). To do so, it is recommended that organizations, in collaboration with nursing education programs, consider:
- Bridging programs: Opportunities should be explored to reduce the time needed to complete bridging programs, in particular those from Registered Practical Nurse or Licensed Practical Nurse to Registered Nurse, and Registered Nurse to Nurse Practitioner. This includes facilitating and streamlining education that supports bridging from one licensed nursing role to another. Bridging programs for IENs should be standardized across organizations to support labour mobility and be designed to support nurses to stay in the workforce while being enrolled.
- Career pathways: Career pathways can be project-based and self-directed for nurses to complete and may provide nurses with opportunities for targeted professional growth, and enhance career satisfaction, expertise, and versatility.
Planning considerations include:
- Interdependencies: Career pathways should incorporate leadership development and be closely integrated with mentorship programs.
- Clear communications: Guidance should be available within organizations on the different roles that exist in nursing and how these may be pursued. Communication strategies should be developed or refined to support nurses in understanding available bridging and career pathway opportunities.
- Support: Providing support to nurses pursuing career pathways or bridging opportunities through financial reimbursement, reduced work arrangements, temporary leave, and protected time. Specific supports may be required for IENs as they integrate into the Canadian health system for the first time (e.g., community support).
- Alignment with nurses' career aspirations: Needs surveys can help inform the design of career pathways and bridging programs at specific organizations.
- Monitor Program Outcomes: Pre- and post-program assessments can help track successful transitions to different clinical areas or positions, job placements, career advancement. Participant feedback surveys and program completion rates may also be monitored.
Target nursing population
Those entering and re-entering the workforce or transitioning to new roles: New Grad, Mid-Career in transition (e.g., returning to work, changing designation, exiting clinical practice to academia), Internationally Educated Nurses (IENs), underrepresented populations within the nursing community (e.g., Indigenous, Black).
Stakeholder involvement and role of nurses
- Responsible: Nurses should be empowered to develop career pathways within their organizations, in partnership with professional practice, or education and professional development teams. Nurses, in collaboration with post-secondary institutions, support and develop bridging programs.
- Accountable: Employers will be accountable for provided resources and supports.
- Consulted and informed: Unions.
Reference resources and examples (See appendix for links)
- New Brunswick's Step Up to Nursing Initiative: Combines work and education by providing salary and tuition support for Personal Support Workers to bridge to Licensed Practical Nurse, or Licensed Practical Nurse to Registered Nurse.
- Vancouver Community College Nursing (BSCN) Advanced Entry: Practising Licensed Practical Nurses will receive advanced standing into term 5 of the BScN program following completion of admission requirements and the 4 required Bridging Licensed Practical Nurse to BScN courses.
- Micro-credentialing with the Michener Institute of Education at UHN: This institute offers a wide variety of courses and certificate programs for health professionals to refresh skills, and gain micro-credentials (e.g., critical care nursing, clinical research).
- Support for Bridging Programs in Manitoba: The collective agreement in Manitoba supports nurses taking a Leave of Absence for bridging programs. Nurses are also supported to pursue education positions for up to two years.
- Career laddering pilot at the McGill University Health Centre (MUHC): This pilot included both horizontal laddering (e.g., to other specialties such as wound care) and vertical laddering (e.g., education).
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