I recently had 2 nieces graduate from nursing school: one in mid-thirties, wife, and mother of 2 from an AD program and the other just turned 21, single, from a BSN program. As I listened to their experiences in their clinical rotations, one issue became exceedingly clear. The value of their clinical experiences was directly proportional to the mentoring of their preceptor. The quality of their preceptors during their clinical orientation to their hospitals will contribute to their development as staff nurses. However, the mentors they choose as they continue their careers are vital to their growth as registered nurses.
Dr Patricia Benner wrote in her seminal work From Novice to Expert: Excellence and Power in Clinical Nursing Practice that expert nurses develop skills and understanding of patient care over time with a sound educational program and a multitude of experiences.1
Who provides these experiences? Who coaches the new nurse, gives constructive feedback, and guides them on the road to expertise? Are all expert nurses expert mentors? William Arthur Ward, scholar, author, editor, pastor, and teacher, wrote that "The mediocre teacher tells. The good teacher explains. The superior teacher demonstrates. The great teacher inspires." I find that these words also describe the great mentor!!
The Society of Trauma Nurses is composed of many great teachers and mentors. They teach ATCN, TOPIC, and the Optimal Course. In their daily lives, they mentor new nurses, new trauma program professionals, and new physicians. In the STN, they mentor those who wish to expand their roles and participation in the organization. I will never forget Judy Mikhail, past president of STN, asking me to be on the annual conference committee or Marla Vanore, past president of STN, encouraging me to run for the office of secretary.
The following words of wisdom were shared by STN officers, mentors, and teachers.
* I don't know who said this to me but it has stuck with me and I pass it on. "You have to learn to trust your gut. It's part of your check and balance system. If something doesn't seem right, go back and walk yourself through your process, assessment, and evaluation. You usually will find an answer or another question that will guide you."
* A good trauma nurse is anticipatory. He or she prepares for the unexpected, whether it's a transfer to CT, OR, or another facility. You have to be prepared to manage that patient.
-Amy Koestner, MSN, RN, ACS, COT Liaison
Trauma Program Manager Borgess Medical Center, Kalamazoo, Michigan.
My preceptors taught me to:
* Treat all patients as they were your loved one, one day they will be.
* Always ask questions when you are unsure of something, no question is stupid
* Always be prepared, your day will never be as you anticipate, especially in the intensive care unit
My advice to those I mentor:
* Nursing is a profession, not just a job, love what you do
* Always reach for the next level; you can get there if you want it bad enough
* Once a nurse always a nurse
-Betsy Seislove, MSN, RN, CCRN, President-elect
Trauma Program Director
Lehigh Valley Medical Center, Allentown, Pennsylvania.
* Never assess a patient in isolation. Assess the patient relative to the context of his background and surroundings. Meaning-look at the patient in relation to what has come before. Do not run in the room and take a set of vitals and run out again. How is the patient now compared to last shift? How are his vitals compared with previous vitals?
* How is his LOC compared to how his family knows him to usually act?
* Picking up the subtle cues, especially of hypoxia is what separates a great nurse from an average nurse. Taught to me by a master clinical nurse specialist and critical care administrator and mentor: Margie Murray-Wright, MSN, RN, Flint, Michigan.
-Judy Mikhail, MSN, RN, MBA, JTN Liaison
Trauma Program Administrator
Hurley Medical Center, Flint, Michigan.
A couple of things that I can think of straight up that I learned from my ICU RN mentor-Cacie Johnson, RN, CEN, CCRN
* Never let a certification pass you by that you can obtain and hold on to forever.
* When asked by a physician, why didn't you go to Medical School, ask them why they didn't consider being a nurse.
* Advice I give my newer nurses, especially in trauma, trauma is a team sport, you should never be or feel alone in needing to make a critical decision about your patient-ask for help, ask questions.
* To follow up that advice, I tell all my trauma nurses, you can be uninformed, or uneducated, be you cannot be unprepared-think A, B, C, D, E all the time, practice being prepared with EVERY patient, even the "stable" patients.
-Melinda Case, RN, Board of Directors
Trauma Program Manager
Sunrise Hospital & Medical Center Sunrise Children's Hospital, Las Vegas, NV.
* Advice received from my ED head nurse at Penn in 1990's: Make sure you have given your staff the 3Ts in order to succeed. The TOOL, TRAINING, TIME, when you evaluate them.
* Advice I give to new leaders: "You can lead through inspiration or intimidation. One results in your staff achieving more than you or they ever thought possible, the other results in mutiny!!"
-Kathleen D. Martin, MSN, RN, CCRN, TOPIC Chair
Trauma Program Nurse Director
Landstuhl Regional Medical Center, Germany.
Lastly, from me:
* "Every patient writes his own book" was advice given to me by Mrs Sheets, RN, and nursing instructor in my senior year of nursing.
My advice to those I mentor includes:
* Never let them see you sweat, if you decompensate, those around you will too!!
* If the numbers don't match the patient, believe the patient.
* The most important question to ask yourself is 'why'? Why is the BP down? Why am I giving this drug? Why is this patient ready to be extubated? Why do I think this patient is in trouble?
* Look at every chart through a site surveyor's eyes.
Do you have what it takes to be a good mentor? Become a mentor to another.
There is a nurse out there who needs you!!!!
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