Mentorship of Novice Pediatric Critical Care Nurse Practitioners to Improve Role Transition

Abstract

The transition from registered nurse (RN) to nurse practitioner (NP) is difficult for many new graduates, leading to low job satisfaction and poor retention with high cost to the employer (Fitzpatrick & Gripshover, 2016; Horner 2017). A mentorship program was developed and implemented to improve transition to practice.

A six-month formal, structured mentorship program for critical care NPs was implemented at a large pediatric teaching hospital. Mentor-mentee dyads were created using a novel matching algorithm based on career trajectory and mentoring functions, with the novice period defined as the first two years of practice. The dyads viewed a training video and were given optional discussion prompts to use in monthly one-hour mentoring sessions. Pre- and post-program mentee data was collected using the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS), Nurse Practitioner Role Transition Scale (NPRTS), and Clance Impostor Phenomenon Scale (CIPS). The MNPJSS was used pre- and post-program in the mentors. Narrative feedback was solicited at the end of the program.

Four dyads were enrolled in the study. In the mentees, MNPJSS scores decreased post-program but did not reach statistical significance. NPRTS scores increased significantly, p = .04, showing improved role transition post-program. CIPS scores improved significantly, p = .02, indicating fewer impostor phenomenon characteristics post-program. A positive correlation (r = .8) was found between NPRTS scores and years of prior RN experience, meaning that novice NPs with fewer years of RN experience may have a more difficult role transition. Feedback from the participants was positive, with mentees citing the support, advice, and career coaching provided by the mentors, and reporting time as the biggest barrier to completion of the program requirements.

This small sample of pediatric critical care NPs reported a positive experience in this 6-month mentorship program pilot, and demonstrated improved NPRTS and CIPS scores post-program, without a significant decrease in MNPJSS scores. These findings are limited due to the lack of a control group and the small sample size. Further controlled prospective research with larger sample sizes is warranted to determine any causal relationship between mentorship, successful RN to NP transition, and retention.