Understanding the meaning of mentoring of newly graduated registered nurses for good work in Hong Kong

Abstract

Background: Nursing in a complex and dynamic health care landscape resembles sailing in stormy seas and rainy weather, while good work is akin to a distant beacon that seems beyond reach, yet must not be ignored. Mentoring has been one of the most frequently suggested strategies for facilitating both the transition of new graduates and good work, as if it were a panacea. Nevertheless, the concept of mentoring in nursing practice remains ambiguous and confused, and the term is often used interchangeably with preceptoring, a related concept in the literature. Mentoring as a way of promoting good work among newly graduated nurses has to date been underexplored. Aim: The aim of this study is to understand the meaning of mentoring newly graduated registered nurses (NGRNs) in the transition and in the pursuit of good work through different stories of experiences that are lived, told, relived, and retold in a complex health care landscape. Design: The research methodology that was adopted was based on Clandinin and Connelly's narrative inquiry. Four methods were employed to collect field texts from four sources of data in eight participating public hospitals in Hong Kong. Eighteen NGRN participants were recruited to participate in the one-year enquiry process through repeated interviews and email conversations. Focus group interviews were also conducted with 11 preceptors and 10 stakeholders (senior nurses, ward managers, and doctors). Relevant hospital documents relating to the participants' stories of their experiences were also reviewed. The research texts were composed from the field texts through the iterative process of narrative and paradigmatic analyses. Findings: Thinking narratively of the participants' stories of their experiences along the three dimensions - temporal, personal-social interactions, and the place of the narrative inquiry space - revealed the complexity of mentoring NGRNs for the transition and the pursuit of good work. NGRNs are in need of ongoing mentoring throughout their first two years of clinical practice in their transition and in the effort to sustain good work in the midst of educative and miseducative experiences. Four interrelated narrative threads are discerned from the NGRN, preceptor, and stakeholder participants' stories of their experiences, hospital documents, and the integration of the findings with the relevant literature. They are: 1) Contrasting stories of the preceptorship programme, 2) Knotmentoring for good work with self, opportunistic, and peer mentoring, 3) Understanding not-mentoring through assumptions about practice readiness and scolding, and 4) Disempowering by sacred hospital or unit stories. Conclusion: This narrative inquiry has served as a springboard to generate insights into how NGRNs are mentored by themselves and others in the midst of ongoing experiences, to sustain their stories of good work in nursing. New possibilities are imagined in the narrative inquiry space to support NGRNs in persisting to sail towards the beacon in stormy seas and rainy weather. Mentoring them to perform good work will benefit patients and their families now and in the future by helping to retain nurses who are committed patient advocates to mentor future generations.