When is mentoring not mentoring?

My literature review of mentoring in nurse education has had a major reorganisation, from a structure based the on the headings 'Nurse education', 'Workplace learning' and 'Mentoring' to one based on the Lane and Clutterbuck model of mentoring competence structured by the headings 'Doing' (which includes 'relationship management' and 'knowledge transfer') and 'Being' (which includes 'personal characteristics' and 'experience'). I was quite excited by the new way of arranging the literature review under these conceptual headings. I thought it might facilitate greater synthesis of ideas and allow me to maintain a focus on the relevance of the chapter contents to mentoring.

However, this strategy seems to have backfired. I admit it was a struggle sometimes to make things fit under the headings, as so many research findings overlapped these categories. Nevertheless, I was able to create a narrative, or so I thought, to show that actually we know quite a lot about what mentors do, but understand much less about how they experience the role. However, my PhD supervisors complained that the narrative was missing and that perhaps I was trying too hard to speculate what this could all mean. Our discussion of the chapter concluded that perhaps it would be better to abandon the 'Being' and 'Doing' structure. But what to replace it with?

After spending many hours tossing ideas around, going back to basics (What is the purpose of a literature review? What are they supposed to contain?), and feeling totally deflated, I'm starting to think of a new story to tell. It concerns the fact that the role of 'mentor' in placement learning in the specific context of nurse education is very different to any other mentoring role, even in nursing, that involves providing collegial support. This role is much closer the the role of clinical educator in physiotherapy or fieldwork educator in occupational therapy or the mentors in teacher education than anything else.The term 'mentor' has been applied for want of a better one, but it somehow distracts from and conceals the reality of the role.

This takes me back to two pivotal past experiences. First, when I was working as a clinical placement facilitator, I and the network of colleagues I worked with invested a great deal of energy in finding an alternative term to 'mentor' that we could use as a generic term applied to all the clinical professions. We recognised that this was not mentoring in the sense that most people understood. However, we were unsuccessful in coming up with any replacement word that would be acceptable across the professions.The second experience was a brief conversation with David Clutterbuck following a lecture he had delivered on mentoring. I told him what I was planning to investigate for my PhD and he told me 'that's not mentoring'.

Maybe this is the key to unravelling my puzzle.

Mentors do it with a conscience





The nurses in my research who mentored students in their workplace knew only too well what was at stake. They had a responsibility to their patients, colleagues, the health service and their profession to do a good job and make correct judgements about students. As they worked closely with students and befriended them to an extent (in order to help them to settle in and feel comfortable to ask questions, for instance), it could feel like a betrayal of trust tell them they weren't achieving. They did not hesitate to prevent a student from progressing in their training if they judged that to be the correct decision, but nevertheless their conscience could flood them with guilt feelings. The guilt could be associated with self-doubt - could I have done more to help them learn? It was also associated with anticipating the personal impact on the student, who had invested so much in their studies and in pursuing their nursing career. However, the guilt associated with making a decision that could potentially harm patients or the profession in the future was more persuasive.

However much the mentors could rationalise their judgements and decisions, they could not escape the 'call of conscience'. Philosopher Martin Heidegger proposed that humans are never fully at-home with themselves and constantly engage in anxious self-confrontation. To an extent, we can flee from this by inauthentically identifying ourselves collectively with a group, in which case we might tot up in a more detached way our 'good' and 'bad' actions. In being authentic, true to ourselves, we accept responsibility for our actions and there is always going to be some guilt, because we can never satisfy all needs. In taking one course of action, we cut off the possibilities for another. There is always something we didn't do.

Is this at all significant when coming to an understanding of the mentor experience? It is any more than an illustration of their humanity and a small window into the complexity of this and all human endeavours? I noticed that their conscience and their guilt would be formalised, at times when they softened the blow to a student by their careful construction of feedback, or in meticulous gathering of evidence to substantiate their decisions. It would be significant in less formal ways, such as in the way the mentors built allegiances with colleagues and used them as barometers for their mentoring judgements, or where they were 'looking over their shoulders' for anticipated student appeals against their decisions or fearing malicious gossip.

Maybe all I've done is to illustrate an aspect of human nature, but perhaps when we depend so heavily on mentors in the education of our student nurses, we need to be reminded that they are human and not simply commodities that feature in a numbers game.

Placement learning insights

We have a good idea of how people can learn new skills and there's no shortage of information available about it. Established ways of learning include observation, asking questions to enable understanding, watching and then doing, receiving feedback from others as well as from the experience of actually doing it. And then, you need to practice until it becomes second nature so that you're no longer thinking about what you're doing and all the steps involved, but focused more on what you're using the skill for. A common example often used is that of learning to drive a car. You may start by learning what the different controls are, then how to coordinate your movements between the pedals and the gearstick, for instance, and before you know it, you're using the car to get from A to B rather than thinking what your hands and feet are doing. The rules of the road need to be learnt and adhered to, obviously, as part of being a competent driver, similar to a nurse using her knowledge to decide when to apply a skill and when to adapt her practice to a changing situation.

Nevertheless, it always has a magical feel for me, considering the transformation from a novice to a competent practitioner and onwards to expert. Patricia Benner, of course, did much to further our understanding of the transition from novice to expert, at least what the different levels look like in practice and how to help people make the transition. In her application of the Dreyfus and Dreyfus skill acquisition model, she stated that being a novice is contextual - an experienced nurse could be a novice in a novel situation (e.g. encountering premature babies for the first time) just as much as a student nurse would be a novice going into a practice area for the first time. However, in that case, there must be a difference between purely contemplating skill level and the 'being' of being a qualified nurse, because when a nurse reaches qualification stage they are not in the same place as a new student, even if they lack skills in certain specialised situations.

Student nurses are in a process of becoming a qualified nurse and need mentor support to get there. My research has been investigating the 'being' of mentoring, so not so much concerned with mentoring skills, but what it means to be a mentor for student nurses. Understanding this better can improve the way mentors are prepared, developed and supported. What is becoming clear is that there is no easy way of knowing when learning is happening, or to judge when a student is really competent.

According to Benner, the competent nurse is one who has typically been on the job in similar situations for two to three years. Given that student nurses might spend 8 weeks on a placement and continously move from one speciality to the other during their course, we must be using a different measure of competence for placement students.However, by the end of their three year course, they must be able to demonstrate that they can practise independently. Practising independently must be open to wide interpretation, because we know that nurses are part of a wider network of professionals and a nursing hierarchy, and it is recommended that they have a period of pereceptorship after qualifying. They are always part of a wider system.

The wider system, and what this means to any practising professional, is fascinating. Becoming a nurse means becoming familiar with the world of patients, treatments and care, the required attitudes and qualities expected in a nurse, the networks of professionals, nursing equipment and environments, and so on. All these things carry meaning to a nurse as part of a 'referential whole' to use one of Martin Heidgger's terms. Everything carries meaning to a nurse in a way that someone who isn't a nurse wouldn't see. A mentor's job is partly to enable a student to enter this world and see it with different eyes, as a nurse.

The mentor's journey

The metaphor of journey is commonly applied to student learning. It is easy to conceive of a student on a journey from one preliminary state of being to another, more educated state. They arrive at their destination knowing more, seeing the world from a new viewpoint and with more nuanced understanding of the world. The journey changes them. A mentor's destination might not be as clearly articulated as that of a student, or even considered at all, but they are undisputedly on a journey of transformation - they cannot fail to be affected by their relationship with a student. Perhaps, though, the extent to which they are transformed depends upon opportunities to reflect. This might occur in the company of a critical friend, through flashes of insight during practice, or in conversation with their students.

Daloz (1999), drawing on his research with adult learners in higher education, suggested that mentors do three distinct things - they support, challenge and provide vision. Mentors make intuitive judgements of when to support and when to challenge so that they provide sufficient support to enable the student to trust them and to feel confident enough to try out new things. Too much challenge can destabilise a student and cause them to retreat into a 'safe' mode which stifles development. Providing vision can be achieved, for example, by modelling the endpoint of the learning journey (when students might have aspirations to become like their mentor), or offering students ways to see the practices and ways of working that make up the tradition they are entering.

In my PhD thesis, there appear to be several journeys - the student journey that mentors dip in and out of, the mentor journey and my own journey of transformation. Any journey of this sort can be hard and forces one to leave something of the old self behind. The people around  you may also need support to recognise the journey you have travelled.

Daloz, L. A. (1999). Mentor: Guiding the Journey of Adult Learners, San Francisco, Jossey-Bass.

Why would nurses be interested in my PhD findings?

Perhaps I  need to answer this question before moving on. I'm doing this study because I think it is important to promote and extend understanding of the mentor experience. Mentors are such a crucial part of the whole enterprise of educating new nurses. Practice skills cannot be learnt in the classroom. However, the work of mentors seems precariously dependent on goodwill.

There are risks to being a mentor - students can challenge your practice in a slightly misjudged way through their lack of experience; you are vulnerable to gossip around the university; you open up your workplace to students who may slow the pace of work; you feel guilty when you have to tell a student they are failing; you feel responsible for letting someone through who you have doubts about and hope they improve in their next placement.

You give generously of yourself to help students - your time, energy, patience, enthusiasm for nursing. Mentoring is an integral part of being a nurse, and the challenge of passing on what makes a good nurse is never an easy one. Sometimes it is felt or sensed, part of who you are, rather than something that is easily taught. You want students to adopt the values and approaches that you have come to value in your work.

By using hermeneutic phenomenology, I'm trying to interpret all these elements of being a mentor in a way that throws new light on the meaning of mentoring. Perhaps mentors are taken for granted a little too much. Perhaps we can learn a little more about the skill and personal involvement of mentoring that will help to enhance mentor preparation and support. Perhaps there are some answers to the perpetual puzzle of how people can be supported to learn in the workplace and how you should judge and assess workplace learning.

Fragments and hope

I was recently re-working my two findings chapters on the themes 'working with fragments and having a sense of the whole' and 'having hope for the nursing profession'. Whereas the theme of being aware of high stakes was analysed according to 'being-already-in',the fragments theme is focusing on 'being-amidst' and the hope theme is focusing on 'being-towards'.  At a distance, it has a very logical feel, but when digging into the data and vocative texts with these analytical filters it becomes a very hard task. Discussing narrative accounts of concrete events and more general dispositions towards mentoring relies on the use of data that is already spoken and representative of the experience. It is already removed from the actual experience. so, I have to consider whether a description of an event or of practice is really showing Dasein's falling, as in being-amidst or whether it is something else.

If working with fragments indicates being absorbed in coping, then it might also need to be linked to concepts of equipment use in terms of being ready-to-hand (in use) or present-at-hand (an object of contemplation). I think there are also things to be learnt from the differences in the different technologies, say, in the context of blood pressure measurements. What is the difference between taking manual blood pressures and using dynamaps and why does it  matter so much?

Being on the edge of something

I've written two sets of drafts of my findings chapters. First time around, I was approaching the writing from the perspective of being immersed in the data. Hence, there was not a strong narrative for the reader, even though when I was writing there was a perfectly logical flow of ideas. Second time around, I've made it more structured and added an interpretation of the findings through the lens of Heidegger's concepts of Dasein. However, I'm still struggling to nail down what makes this mentor study so special and so captivating for me. And, I haven't convinced my supervisors in my writing that the interpretations I've layered over the top, in terms of Dasein, are helpful. Still, I feel convinced that they are.  

First, in terms of attunement, facticity, affectivity and mood, all these words can be used to represent the idea of 'being-already-in',  that we have been 'thrown' into the world, so that we are 'always already' in a situation that is coloured by mood. I like the German word 'Befindlichkeit' that Heidegger used which can be translated as how you are finding things, or how it is with you.  In terms of attunement, we are attuned to our world by mood. We cannot escape or manipulate these primordial moods, they are facitically part of our existence. There's another layer of mood, that might be more easily thought of as emotion, that we notice and can be acutely aware of. We clearly do have some control over these. The world that the mentors are 'thrown' into is a world of high stakes. For all the different participants in the world of the mentor - students, patients, colleagues, the university,  employers and the professional body, the stakes are high. Whether or not they do a good job of educating their students matters greatly to everyone in different ways. The high stakes and mentoring mood combine into a potent mix.

Then, there is understanding, which is more about being capable, competent, having know-how, seeing the significance of situations, rather than a cognitive process that we commonly think of 'understanding' as.  Understanding discloses our existence, which itself can only be understood in terms of potentiality-for-being. Existence is always ahead-of-itself in a process of becoming. One understands something when one can cope with it, so that mentors understand mentoring through their competence at mentoring.  Mentoring is for-the-sake-of- something, which is to produce competent nurses for the future, which in turn keeps the profession strong and preserves the standards of care that the mentors value.



Being on autopilot - is this like inauthentic Dasein?

There's a jumble of ideas in the middle of all this. Mentors work with fragments of different sorts in a web of meanings, a referential whole. In their everyday engagement with their mentoring practice, when absorbed in coping, they assume a collective identity, or 'inauthentic self', a 'they-self', in which they are 'being what I am doing'. The role dominates, through accepted ways of practising, doing what you've learned to do in the role. Perhaps it is a kind of 'autopilot' in which you just get on and cope with things. This 'being-what-I-am-doing' covers up individual, authentic Dasein in a process of 'falling' away from itself. Equipment is 'ready-to-hand' most of the time, which means that it is used in context, but you might look right past the equipment to the work you're doing with it. I interpret 'equipment' quite loosely here, to refer to all the artefacts associated with nursing and helping a student learn the practice. If you stop to think about the equipment when it is not in use, or when you are not skilled at using it, it loses the direct meaningfulness that it had when you were using it. It then becomes 'present-at-hand', an object of theoretical contemplation. The implications for teaching and learning could be quite profound.

The use of language goes alongside all of these different ways of being-in-the-world. Language is used to signify meaning, allows one to articulate what one is doing. Sometimes, language can get in the way of the real Dasein, the who-I-am and how-it's-going-with-me, because it can only be a representation of Dasein's existence. We can understand at the level of the everyday talk, but this can hide, or put a veil over, the being underneath. However, we need to operate at this level in practice, or nothing would ever get done.