The Nurse Practitioner (NP) Mentorship Program: Supporting Role Transition Into Practice

Political, social, and governmental influences have increased the nurse practitioner (NP) demand in the United States (Institute of Medicine, 2010; McMullen & Philipsen, 2012). Graduate NP programs have developed practice competencies and support the Doctorate of Nursing Practice preparation to enhance NP roles (National Organization of Nurse Practioner Faculties, 2012). Although there have been efforts to increase the NP workforce, there remains a current gap in the health care provider supply (Sargen, Hooker & Cooper, 2011). Therefore, it is critically important to support novice NP role development (Poghosyan, Liu, Shang, & D'Anno, 2015). Although novice NPs have varying amounts of registered professional nursing experience, they are becomming new health care providers with significant new advanced role responsibilities. The NP graduates must be socialized to a new professional role and navigate complex regulatory and reimbursement requirements (Barnes, 2014; Fitzpatrick & Grishover, 2016; Simone, 2014). A university affiliated medical center analyzed NP job satisfaction results and the need for a mentoring program was identified (Harrington, 2011; Simone, 2014). The purpose is to describe a NP mentorship program that is supportive of newly hired NP role transition into practice.

Mentoring has been explored as a strategy to foster NP transition into practice (Gerhardt, 2012; Pop, 2016; Rafferty,2015). Mentoring, through a nursing lens, has been a teaching-learning process. Conceptually, mentorship is a relationship in which a more experienced professional provides support and guidance for the novice (Harrington, 2011). Mentorships encompass formal and informal relationships. Formal mentorships are structured workplace agreements that foster mentee success through mentor-mentee matching and are time limited. In contrast, informal mentorships develop as the result of mutual interests and are not confined to time, structure, or third party expectations (Grossman, 2014). Successful mentoring relationships require the participants' time, commitment, communication, availability, and compatability (Fitzpatrick & Gripshover, 2016; Grossman, 2014; Simone, 2014). High quality mentoring relationships have been characterized as being meaningful, mutually beneficial, and fostering professional and personal growth (Allen & Eby, 2003). Mentorship has been identified as a need for successful novice NP transition into practice (Gerhardt, 2012; Pop, 2016; Rafferty, 2015).

Benner's (2000) Novice to Expert Model and Donabedian's (2005) structure and process framework provided the foundation for the NP Mentorship Program development. The novice NPs were newly hired into their first NP position; the NP mentors were identified as experienced NPs who accepted a mentoring assignment (Benner, 2000). The NP Mentorship Program Structure Standard defined the NP practice levels, competencies, onboarding process, orientation, mentor and mentee responsibilities, and NP preceptor roles. The NP mentorships were formal relationships with mentor and mentee matching. During the yearlong mentoring relationship, NP mentors and mentees participated in quarterly invitational meetings. The invitational meetings included mentoring circles and opportunities for professional development, problem solving, and psychosocial support (Maynard, Scandura, & Bishop, 2013).

The NP Mentorship Process Standard described the Mentorship Committee members' role responsibilities. The NP Mentorship Program coordinator role was developed to maintain the mentor directory, communicate with the mentees, match the mentor and mentee, and assist with program implementation and evaluation. Formative evaluation components have been incorporated. Ongoing feedback during the mentoring invitational meetings was welcomed and influenced the future invitational meeting themes. Summative NP Mentorship Program measures included NP job satisfaction, job retention, mentoring relationship quality (Scandura, 2015), and career and psychosocial functions development (Allen, Eby & Lenz, 2006).

The NP Mentorship Program has challenged traditional concepts and ideas (Huizing, 2012); Maynard, Scandura, & Bishop, 2013). Implications for future nursing knowledge development include multiple mentoring strategies exploration, mentor perspectives evaluation, and the long term impact of NP mentoring relationships (Allen & Eby, 2003). Currently,international NP residency, orientation, and fellowship porgrams support NP competency development (American Nurses Credentialing Center, 2016; Brown, Poope, Kaminzky, Wipf & Woods, 2015; Furfari, Rosenthal,Tady, Wolfe, & Glasheen, 2014; Sciacca & Reville, 2016). Mentoring can enhance NP competency through role development within a nuturing advanced practice nursing culture. A NP mentorship program has the potential to support transition into practice and enhance NP orientation, residency, and fellowship program development.