To date, the focus has been on mentors recognising and responding to the needs of others. However, this third sub-theme illuminates the personal impact of mentoring and the implications for mentors’ professional reputation. Although the overall experience of being a mentor was far from negative, being in a world of high stakes necessarily drew attention to the more precarious elements associated with mentoring. It exposed,
therefore, the importance of defending hard-won reputations and preserving essential job satisfaction. The earlier discussions of guilt and empathy have already revealed some personal costs of being ‘thrown’ in this world, and this exploration of participants’ Befindlichkeit shows that their own sense of well-being and job satisfaction mattered
greatly to them.
Table 5.5 summarises the personal implications of mentoring and why they were important. Professional reputation could be significantly at risk in mentoring situations, for example in making the aforementioned judgements of student competence, or defending decisions to colleagues.
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Table 5.5 Personal implications of mentoring
Personal implications Why important
Professional reputation at risk Erosion of trust in work relationships Erosion of time
Erosion of energy
The need to be credible in the eyes of patients, students, nursing
colleagues, HCA colleagues and the multidisciplinary team.
Threats to their ability to do a good job made them feel vulnerable.
In the following vocative text, attention turns to the implications of a direct threat to reputation.
Maintaining a professional front when challenged (vocative text)
I was doing the first home visit with my new student. My health care assistant and I had a well-rehearsed routine with this patient to re-dress his leg ulcers. I knelt in front of the patient who was sitting in the kitchen area, our equipment spread out in the adjoining sitting room. The health care assistant worked efficiently in the background making sure things were in reach and putting away used items.
The patient was prone to spasms and both legs needed doing. I was stooped over, explaining everything to the student who was hovering closely over my shoulder – why that particular bandage and all about the dressings. I carefully stopped the second bandage just below a scab, maybe three fingertips rather than the customary two below the knee. Before I could explain, the student cut in, questioning me, 'why haven’t you finished the bandage higher up?' At that instant, I felt hot; my hands shook. I was struck by the accusing tone that would seed doubt in my competence. I couldn’t look at anyone, for fear of letting my shock and anger show. I kept my head down and completed the task, keeping my voice steady.
The situation outlined above shows a marked change in mood that occurred when the student presented the mentor with an unexpected and ill-judged (in terms of the timing and tone) challenge. The mentor’s heavy, difficult job required a high skill level, but nevertheless she was able to do this in conjunction with providing a teaching commentary. The student’s question was seen as unfounded criticism, with the potential to damage the mentor’s reputation and her relationships with both the patient and the health care assistant. Moreover, as it arose from a novice, this increased her indignation. The sudden flare of shock and anger disclosed what mattered and how it mattered
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(Dreyfus, 1991: 174). What mattered was being able to practise with integrity and confidence in one’s ability, and to instil confidence in others. How it mattered was the potential to damage trust. The mentor needed to be trusted by the patient, her colleague and the student. She also needed to be able to trust the student and other colleagues to behave in a way that did not threaten the ongoing relationship with a patient. The
intensity of her reaction revealed the great importance of maintaining trust and its fragility within clinical situations.
Being trusted and able to trust others was crucial for the mentors. For the benefit of this discussion, trust is defined as a ‘willing dependency’ on others emerging from ‘the identification of a need that cannot be met without the assistance of another and some assessment of the risk involved in relying on the other to meet this need’ (Hupcey et al., 2001: 290). Absence or loss of trust can lead to feelings of vulnerability and threaten professional integrity (Mayer et al., 1995). Romayne portrayed trust to be a fundamental aspect of her work, instrumental for maintaining team working as well as for worker and patient safety.
In my workplace, like with my colleagues, […] I would want to know that what's been their responsibility for their shift, that that's been done, and if someone had made a mistake, […] that they admit it and own up, or if they've changed a way, I mean here we do a lot of team goals and we need to be consistent, all of us, with the patients […] [Without trust] it would make you feel that […] you'd never be sure that things were being done, even just being done, let alone being done correctly […] but even when you're […] doing a nursing activity or a moving and handling activity, you've got to trust the person you're doing it with, because if you don't, they're at risk of hurting the patient, they're at risk of hurting you, and themselves, so you do have to have ... this trust. (Romayne, interview 2)
Here, Romayne identified the importance of cooperative behaviour, recognising that it had to be based on trust. It was also evident in the interviews that the mentors needed to be able to cooperate with colleagues to support a student’s learning and to make the correct assessment of the student’s competence. They also needed to trust the judgements of those who had previously assessed the students.
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Teamwork sometimes extended to passing on responsibility for a student to a colleague. If they had any misgivings about trusting a colleague with their student, the mentors could feel vulnerable about sharing the responsibility in this way. For example, Cate asked a colleague to mentor her student while she was on holiday during a period when the student’s interim assessment needed to be done. In her event diary, she gave a dispassionate account, presenting the situation as unproblematic, but her reflection in the interview indicated that her confidence was less firm:
I was […] slightly wary that erm … the form would be done quickly without much thought about where we were going for the next bit, not very much depth. (Cate, interview 2)
The rich picture that Cate referred to in the interview (Figure 5.2) depicted a scenario punctuated by questions: ‘Structured learning? Appointments? Standards?’ It revealed uncertainties as to whether the colleague would do a sufficiently thorough mentoring job. This colleague did not have the same stake in the student. It was a heavy responsibility to leave to someone else, but she had little choice. Her body, she explained in describing her picture during the interview, was portrayed as weighing scales, with one side
weighed down by mentoring responsibilities. On the other side, she was looking forward to relaxing in the sun. Cate was identifying her insight and feelings relating to her
responsibility towards her student and her concerns about leaving this task to someone else. She had earlier described having a student as ‘an extra weight [...] that you carry through the day’ (Cate, interview 1). She knew the standards that the student was
required to achieve and how important it was to maintain the momentum of their learning. However, she had little alternative but to rely on her colleague.
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Figure 5.2 Cate’s rich picture of the weight of responsibility
This pervasive responsibility revealed important insights about the mentor Umwelt. Continuity of their mentoring relationship and correctly documented
achievement mattered, along with the importance of mentors’ personal knowledge and experience. Cate felt her knowledge and experience could not be adequately transferred to another person; her mentoring relationship was unique and non-transferable. In this way, Cate had an eigentlich (‘authentic’) mode of engagement in her mentoring role, reflecting Heideggerian Eigentlichkeit (‘authenticity’), a mode of being in which
individuality is manifested, which implies accepting the burden of accountability (Mulhall, 2005). An uneigentlich (‘inauthentic’) mode of being in the world is a way of thinking of people as ‘interchangeable occupants of impersonally defined roles’ (Mulhall, 2005: 71). Cate did not feel interchangeable with her colleague, and in her eigentlich mode of being, she was, by implication, more heavily burdened.
Mentoring has been shown here to increase the participants’ vulnerability, threatening professional reputation and having the potential to undermine trust within work relationships. In addition, they felt burdened by the role, which could translate into a reduction in well-being or of satisfaction at work. This sense of ‘being burdened’ could become exacerbated through lack of resources, particularly time. For example, Trudy
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explained how mentoring could encroach into personal life, such as before or after a shift:
The ward is busy and understaffed quite a lot of the time and you just don't get that protected time, so quite often what I find myself doing is meeting [the student] at the beginning or the end of a shift. (Trudy, interview 1)
Insufficient time to do the nursing work and additionally mentor a student, which added to the workload, could sometimes seem like an unmanageable burden, as Marion
described.
It can be very hard if you take a student, especially if the student […] needs a lot of support. It can put a lot of extra work on you. And if you are up to the eyeballs already it can push you over the edge! (Marion, interview 1)
Students sometimes leaned heavily on their mentors, for example, when they were anxious about their performance in practice, or in balancing both academic and practice demands. This could be wearing for the mentors, as they became increasingly drawn into the student’s sense of the high stakes attached to their training. Romayne (interview 1) recognised that it could make her feel tense or miserable, and ‘in my general work I’m much more ... content’, but found it hard to express why she felt this way.
Nursing work is itself physically and mentally demanding, and so mentoring can present a further burden involving depletion of time and other personal resources. The personal implications of feeling drained meant that the participants would be less able to meet the intensive demands of their normal job and thus became more vulnerable to physical and mental exhaustion:
You can feel that you’re tired, not from having to take care of the patient, not from having to get up early in the morning for work, but simply because they’re on at you all the time, you’re having to meet certain expectations for them. (Shrimpy, interview 1)
Shrimpy expressed here that even when the nursing work was challenging it was manageable, whereas having an anxious, persistent and demanding student at her side further depleted her energy. Similarly, Emma provided an example of an occasion when
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she sought recovery time during her tea break, only to find herself trapped in the office by her anxious student:
This particular student was with me in the office for a break and she'd found a particular article and she was asking me do you think it should be this one or that one, […] and she just sort of talked at me for five minutes and I just said that's fine, and I expected it to end there, and then she was saying and how am I going to do this and how am I going to do that and by the end of it I was ‘Goodness me, get the patient's notes’, you know, ‘why don't you go and have a look and get on with it’, […] I was almost sort of laughing to myself, thinking gosh if she doesn't shut up, but at the same time I just thought cor I could really do with, just sit here in silence, you know, the phone's not ringing for once, yeah, just want to enjoy my cup of tea. (Emma, interview 3)
The persistent student needs for attention and support that could occur became very wearing, as described further by Gina and Shrimpy:
It was draining, to be honest, very draining. Because even when you're trying to do paperwork at the computer, it was constantly, oh I've read this, what do you think? I've read this, what do you think? It was constant, and I mean for a whole shift. (Gina, interview 2)
She wanted to know everything now […]… just got this voracious appetite, like a locust. And it does, it just takes so much out of you, you just sag. (Shrimpy, interview 1)
The unpleasant and distressing nature of the mentors’ exhaustion, illustrated above, highlights the importance of having the physical and mental energy to meet the demands of this work. Students who drained the mentors’ energy reserves could equally provoke their resentment and a feeling that such behaviour was unreasonable.
Some mentors identified the limits of their mentoring capacity, where these demands became excessive. For example, Shrimpy indicated the risk of exhaustion and burn-out in mentoring and Cate recognised her vulnerability from the pressures if she took more than three students in a year. In addition, participants found that their colleagues did not always support the time needed to mentor students, and differing agendas and priorities could put their collegial relationships at risk. There were instances where mentors had knowingly neglected their own needs in order to support a student. The vocative text below illustrates this on an occasion when a mentor was ill at work.
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Stakes becoming more pressing when ability to mentor is under threat
(vocative text)
My throat itched all the way down to my chest, I could hardly breathe and I shouldn’t have been at work with this cold, but I hadn’t had much opportunity to work with my student nurse, so I was damn well gonna work with her. She really needed to develop confidence and we were running out of placement time. I wanted her to see that she was caring for this patient too. We had the haemofilter running, the patient on a ventilator, TPN6, enteral feeding, you name it; everything was going, inotropes as well.
Doctors, three of them, closed in around the observations board, reviewing the patient. I was listening for the day’s plan, keeping an eye on the patient, the haemofilter, and making mental notes. I thought ‘I’ll explain to the student about the changes in ventilation settings, and then we can look for effects in the blood gas. I really must record those changes on the chart.’ I suddenly felt dizzy, and slid down onto the floor. The doctors went, hey, what’s going on, and someone shouted let’s have the blood pressure cuff and let’s have the portable monitor, and they’re saying, ‘what’s the blood sugar’, ‘my blood sugar’s fine’, ‘well let’s take it anyway’, ‘MY STUDENT CAN TAKE IT!’ I was told there and then, stop teaching.
I was sent home. I felt I was running out on her. She didn’t even get the chance to do the finger-prick blood glucose on me.
In this account, the mentor showed a gritty determination to be there supporting her student. She was aware of the urgency of the student’s needs to meet some key learning targets. Leaving the job to a different mentor would have set back the student’s progress, and negated the investment she had already made in getting to know the student. Even when in a state of collapse, she was actually thinking of teaching
opportunities and pursuing her student’s need to practise certain skills, to the extent of offering up her own body for such purposes. This extreme drive to mentor against the odds might have been a signal of a fear of failure, of letting the student down. The mentor’s Dasein was in this respect ‘open and vulnerable to the world’ (Mulhall, 2005: 77), fearful of letting the student down, yet also threatened by her illness that she had little control over. On this occasion, the fear of letting the student down far outweighed the threat of illness and indicated what really mattered to her.
6
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Being vulnerable to a breakdown of trust, feeling burdened or drained, and
fearing the consequences of not being able to support the student were serious concerns of being a mentor. The participants relied on the same strategies that helped them de- stress in their usual nursing role: reflecting and unwinding on the journey home; talking to the dog; taking a coffee break; mulling over with a colleague, or ranting to the computer. Keeping hold of evidence long after the event as a record of their decisions and rationale also provided some comfort and reassurance for their guilt feelings. Although this
chapter highlights some of the vulnerabilities for mentors, it is important to state that mentoring could also be very rewarding. The more rewarding aspects are revealed in future chapters.