Leadership Series: ‘How To’ for Mentoring
Mentoring in the Career Continuum
Of a Nurse: Clarifying Purpose
And Timing
Louise D. Jakubik, Meghan M. Weese, Aris B. Eliades, and Jennifer J. Huth
Introduction to Mentoring and the Career
Trajectory of a Nurse
Mentoring is a term that evokes many different views
on what it is and where it fits in the career lifespan of a
nurse. Ask five people to define mentoring and you will
receive just as many different answers. Mentoring is often
confused with preceptor-facilitated orientation and nurse
residency programs. To dispel the myths and confusion
about mentoring in the career trajectory of a nurse, this col-
umn will provide definitions of mentoring and related def-
initions, including the timing and purpose of mentoring
and related career developmental phenomenon encoun-
tered on the unique trajectory each nurse takes on the
career continuum (see Figure 1) (Nurse Mentoring Institute
[NMI], 2016). At the conclusion, we provide case scenarios
depicting how mentoring can be applied to practice in the
beginning, middle, and later stages of a nurse’s career tra-
jectory.
Onboarding
Onboarding is the mechanism through which a new
employee acquires knowledge, skills, and behaviors to
become an organizational insider. Through this organiza-
Louise D. Jakubik, PhD, RN-BC, CSP, is President and Chief
Mentoring Officer, Nurse Mentoring Institute; and President and Chief
Learning Officer, Nurse Builders, Philadelphia, PA.
Meghan M. Weese, MSN, RN, CPN, NEA-BC, is the Magnet
Coordinator, Akron Children’s Hospital, Akron, OH.
Aris B. Eliades, PhD, RN, CNS, is Director of Operations and
Nursing Research, Rebecca D. Considine Research Institute, Akron
Children’s Hospital, Akron, OH.
Jennifer J. Huth, BSN, RN, CPN, is a Nurse Coordinator,
Craniofacial Center, Akron Children’s Hospital, Akron, OH.
Mentoring has been proposed as a solution for retention and succession planning in nursing; however, there is a lack of information about
“how to” mentor based on evidence. This Leadership Series takes a deep dive into evidence-based mentoring for staff nurses and the
organizations in which they work.
PEDIATRIC NURSING/May-June 2017/Vol. 43/No. 3
tional socialization process, new employees transition from
organizational outsiders to organizational insiders. The pur-
pose of onboarding is organizational socialization. It
involves processes such as environmental orientation (i.e.,
tours of the unit, locker room, and employee lounge), and
required employee procedures and processes (e.g., employ-
ee badges, pass codes, and associate training). Onboarding
can begin before or on the employee’s date of hire, and gen-
erally lasts for weeks or months (Bauer & Erdogan, 2011;
Jakubik, Eliades, & Weese, 2016; NMI, 2016).
Orientation
Orientation is a semi-structured to structured program
using a blend of formal classroom, self-paced learning, and
preceptor-directed learning designed to transfer job skills
and knowledge needed to become a competent profession-
al. The purpose is to train an employee who functions safe-
ly and independently in a specific work setting at the com-
pletion of orientation (American Nurses Association [ANA],
2010). Timing for orientation can range from days to
months, depending on the employee’s experience level and
the complexity of the patient population (NMI, 2016). For
instance, an experienced pediatric medical-surgical nurse
who has transferred from another hospital may only
require a few days of orientation followed by a few weeks of
resourcing, while a new graduate nurse hired into the same
pediatric medical-surgical unit may require an 8- to 10-
week orientation. In contrast, a new graduate nurse hired
into a pediatric critical care environment may require three
to six months of initial orientation to take care of moder-
ately complex critical care patients, followed by a more
advanced orientation to highly complicated critical care
patients after successful completion of 18 months to two
years of competent, safe practice in the pediatric critical
care environment.
149
 Figure 1.
Clarifying Purpose and Timing: Career Continuum of a Nurse
Onboarding Orientation
Weeks to Months Weeks to Months
Purpose: Purpose:
Organizational Transfer of
socialization job skills and
knowledge
Source: © 2015-2017 Nurse Mentoring Institute. Used with permission.
Transition into Practice Program (TIP)/
Nurse Residency
A Nurse Residency program is a formal, structured pro-
gram/curriculum aimed at role transition, workplace accul-
turation, and retention with an assigned “preceptor or
mentor.” The program begins during or after orientation
and extends throughout the first 12 to 18 months of
employment (NMI, 2016). Research from Marlene Kramer
(1974) on the term she coined “reality shock” documents
the difficulty nurses have transitioning from the nursing
student’s protected, utopia of the classroom environment
to the challenges of the less-protected, complex, and fast-
paced environment of being a nurse in clinical practice.
Although Kramer documented this phenomenon in the
1970s, it was not until the 1990s that hospital administra-
tors began to see the link between reality shock and
turnover of nurses within the first 18 months of hire
(Kramer, Brewer, & Maguire, 2013). Due to the high cost of
a single RN’s turnover, estimated between 75% to 125% of
the RN’s annual salary (Beecroft, Kunzman, & Krozek,
2001), coupled with the negative impact on safe care deliv-
ery and the workplace environment, it is no surprise that
administrators, clinicians, and educators alike sought solu-
tions to quelling the impact of reality shock. Studies and
reports focused on incorporating the Quality and Safety
Education for Nurses (QSEN) competencies to improve
quality and safety practices of graduate nurses, while
increasing job satisfaction, reducing work stress, and
decreasing turnover began to emerge (American Nurses
Credentialing Center [ANCC], 2016; Institute of Medicine
[IOM], 2011; Sherwood & Barnsteiner, 2012; Spector et al.,
2015). Transition into practice/residency programs were
created in response (Beecroft, Dorey, & Wenten, 2008;
Krugman et al., 2006).
It is worth noting that the timing of transition into prac-
tice/residency programs is very specific. Because the purpose
150
Residency Mentoring
12 to 18 Months 1 Year Experience to Retirement
Purpose: Purpose:
Workplace Lifelong learning,
acculturation, professional,
role transition, advancement,
and retention engagement,
succession planning
is retention and role transition in the beginning phase of a
new nursing role, these programs are designed to either over-
lap or follow unit-based orientation and continue through
the first one-year to 18-months of practice. Research shows
that nurses who are retained through the first 18 months of
employment are much more likely to be retained long-term
once they have successfully transitioned through this high-
risk period of “reality shock” (Kramer et al., 2013).
Mentoring
Mentoring is an intentional, long-term career develop-
mental relationship among an experienced nurse, a less-
experienced nurse, and their workplace involving six men-
toring practices (facilitated by the mentor and the work-
place) that are associated with six mentoring benefits (for
the protégé, mentor, and workplace). The purpose of men-
toring is lifelong learning, professional advancement,
engagement, and succession planning. Mentoring is associ-
ated with employee engagement, increased employee satis-
faction, and succession planning (Greene & Puetzer, 2002;
Tourigny & Pulich, 2005). Robust mentoring cultures afford
nurses retained by transition into practice/residency pro-
grams to be engaged and developed within the workforce,
thus creating an improved work environment.
Mentoring is a career developmental phenomenon
that should begin at one year of experience and continue
throughout the career of a nurse until retirement. Formal
and informal mentoring programs and initiatives should
begin where nurse residency concludes. As the transition
into practice is complete through TIP/Residency programs,
the process of ongoing career and role development should
be facilitated by mentoring. Mentoring can be used to
develop horizontally within or across a role and vertically
into more advanced roles.
PEDIATRIC NURSING/May-June 2017/Vol. 43/No. 3
 Figure 2.
Common Topics for Mentoring
Certification
Pursuit of formal education (BSN, MSN, DNP, PhD)
Professional organization membership and involvement
(networking, leadership roles, committee work)
Navigating organizational politics
Research, evidence-based practice, and/or performance
improvement projects
Career ladder program advancement
Leadership role
Presentations, public speaking
Publications
Teaching (e.g., clinical instructor, new faculty role)
Project management
Interprofessional collaboration
Committee/Shared Governance Council involvement
Career advancement/professional development plan
Relationship development/networking
Precepting
Advocacy
Leading change/innovation
Entrepreneurship
Business savvy
Technology
Setting priorities-work/life balance
Perspective/positive optimism
Simulation
Advanced practice role
Dealing with adversity/conflict
Application to Practice
The mentoring relationship by its very nature is focused
on the career goals of the protégé within the context of the
organizational succession planning needs (Jakubik, Eliades,
Weese, & Huth, 2016). Mentoring, therefore, can be both a
very powerful career and organizational development phe-
nomenon. Examples of the types of topics for mentoring are
depicted in Figure 2. As goals for career advancement
change, the focus within the mentoring relationship will
change. At times, a protégé will identify the need for a dif-
ferent or additional mentor to focus on a different career
goal in which another mentor has particular expertise.
Case Studies in Mentoring
The following case studies are designed to demonstrate
how mentoring can be used at varying experience levels to
achieve career goals both horizontally and vertically across
PEDIATRIC NURSING/May-June 2017/Vol. 43/No. 3
the career of a nurse. Note that mentoring is equally signif-
icant in the career development of the beginning career
nurse as it is for the mid-career and executive nurse.
Beginning Career Nurse
Alexa, a newer nurse working in the Intensive Care
Unit (ICU) for two years, is finally feeling like she is compe-
tent in her specialty and wants to continue to develop pro-
fessionally. She has goals to become certified in critical care
and become more involved in her unit and the American
Association of Critical-Care Nurses (AACN), the profession-
al organization for their specialty. She seeks out Sandy, an
experienced ICU nurse of 10 years and respected colleague
as a mentor to meet her goals. Sandy sees potential in Alexa
and readily agrees to help her pursue these goals. She sug-
gests resources to prepare for certification (e.g., review
course, online study resources, study groups, test taking
strategies). Sandy encourages Alexa to join AACN and
shows her the many resources available on AACN’s website
she found to be valuable. She also mentors Alexa to
advance on the career ladder, join the unit-based council,
and be an informal unit leader in influencing positive unit
culture and practice improvement.
Mid-Career Nurse
Adam, the manager of the asthma subspecialty practice
clinic, has a career goal to become a director. He seeks out
mentorship from Julie, the director of Ambulatory Services,
to guide him in developing the knowledge and skills
required to advance to the next level. Julie recognizes Adam
has what it takes to be an effective leader and mentors him
to foster leadership development. Their mentoring relation-
ship focuses on pursuing formal education, taking advan-
tage of leadership development opportunities, fostering
interprofessional collaboration, and leading systematic
improvements in practice through Lean Six Sigma method-
ology. Julie encourages Adam in his pursuit of a master’s
degree in business administration (MBA) and shares insight
from her experience in the MBA program. Adam is eager to
develop his leadership skills and asks Julie to let him know
of any organizational development courses she thinks
would be of value for him. Julie sponsors him for the orga-
nization’s Leadership Academy. She also promotes him to
be selected to lead a year-long process improvement project
to enhance schedule level-loading and decrease the overall
patient length of stay during visits while improving patient
experience. Adam leads an interprofessional collaborative
project to reduce asthma readmissions. He asks Julie to
share her expertise and advise him of ways to be more effec-
tive in navigating organizational politics and arriving at
group consensus to achieve the collaborative goals.
Seasoned Career – Executive Nurse
Karen, the Chief Nursing Officer (CNO), identifies
Nancy, the Director of Surgical Services, as a potential suc-
cessor and mentors her to acquire the skills needed to
assume the CNO role as part of the organization’s succes-
sion planning process. Karen provides Nancy with opportu-
nities to be more visible to the executive leadership team
and interprofessional staff, including involvement in mul-
tiple interprofessional committees and providing interim
coverage for Karen during planned absences. Nancy is
given the opportunity to be an active participant in high-
level meetings and gain experience and credibility as a
nurse leader with other leaders throughout the organiza-
151

tion. She builds relationships and
gains understanding of organizational
politics. Karen also mentors Nancy to
become a leader outside the organiza-
tion with leadership roles in the local
and state level professional organiza-
tion for nurse executives. Nancy
becomes involved in advocating for
nursing and health care at the state
and national level through the profes-
sional organization. Karen also men-
tors Nancy in leading change. She
identifies Nancy as the project lead in
designing the Surgical Services space
in the new building project. In this
role, Nancy guides her team and
patient-families in a year-long plan-
ning session to design and optimize
the new space to meet patient, staff,
and organizational needs.
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