Peer mentoring in leader dyads institute mutually beneficial learning relationships. This leader dyad leveraged co-mentoring to increase first year nurse retention by 47% and reduce patient harm by 60% in a pediatric intensive care unit while enhancing purpose and excellence within their clinical team. The leader dyad consisted of one clinical manager with previous leadership experience leading a team outside of her clinical expertise and one novice clinical manager with expert knowledge of the clinical skills sets for the intensive care environment.
Literature Review
Peer mentoring models are utilized in various nursing disciplines. A component of mentorship encompasses creating developmental networks. Developmental networks are learning environments allowing safe exploration of one’s learning edge (Chandler, Murphy, Kram, & Higgins, 2016). Brody et al. (2016) found peer mentorship as a pathway to early career academic development. Peer mentoring in nursing education is an experience where both mentors can challenge and support each other (Rosenau, Lisella, Clancy, & Nowell, 2015).
Transition of novice nurses in clinical environment is essential to the retention and development of clinical teams. Arrowsmith, Lau-Walker, Norman and Maben (2016) emphasized a theme associated with an emotional journey for novice nurses: “Striving for a new professional self.” Novice nurses consider emotional support and collegiality important for transition to clinical practice (Henderson, Ossenberg, & Tyler, 2015). Professions beyond nursing are also seeking methods to retain millennial professionals. Durocher, Bujaki, and Brouard (2016) speak to financial environments where millennial socialization in professional environments are crafted with bottom-up processes.
Trust Model in the Coaching Setting (Markovic, McAtavey, & Fischweicher, 2014) is the theoretical framework utilized to align behaviors in this peer mentor dyad. Leadership and clinical ability, benevolence for each peer's welfare and integrity of professional values contributed to building a trusting peer partnership (Markovic, McAtavey, & Fischweicher). Both leaders participated in daily reflection of strengths and opportunities.
Implementation
This peer mentoring dyad fostered a balance of expertise with one co-leader in the mentorship holding previous leadership experience and the other co-leader holding experience in the clinical environment. The balance of developmental strengths and opportunities permitted growth and safe exploration of one’s learning edge. Both leaders traveled a path of developing from the strengths of her peer. Additionally, individual professional strengths permitted each leader to seek methods to enhance operational environment. The experienced leader cultivated ideas to support emotional development of novice nurses and reduce incivility in the clinical environment. Enhanced peer socialization methods were implemented in addition to routine one-to-one nurse/leader coaching conversations in the first year of nursing practice. The leader with clinical skill set strengths implemented methods to reduce patient harm. Visual management of skin risk with implementation of a safe handoff for skin interventions was created by a collaboration of clinical nurses and leaders.
Outcomes
Upon implementation of the co-mentorship dyad the team environment consisted of a first year nurse retention rate of 50%. With every two nurses hired to the team one left the environment within the first year. The clinical team experienced an increased rate of hospital acquired pressure injuries (HAPI) with 42 reportable patient HAPI in 2016. An environment of incivility was noted among the team members with few resources to reduce unprofessional behaviors.
At the conclusion of the co-mentorship dyad the team environment consisted of a first year nurse retention rate of 97%. The team implemented methods to support professional development of novice nurses in the critical care environment. Hospital acquired pressure injuries were reduced by 60% in one year by continuous coaching to best practices for skin integrity. The clinical team experienced 16 reportable patient HAPI in 2017. An environment of purpose and professional excellence was verbalized among the team members.
Conclusion
Co-mentoring partnerships foster a safe environment to explore individual strengths and develop leadership skills. By utilizing individual professional strengths the peer leader dyad focused attention on comfort and transition of novice nurses in clinical environment. The clinical team achieved improved nurse retention, reduced patient harm and created an environment of purpose and professional excellence.