Effective Mentorship For Recruitment and Retention of Newly Registered Nurses at A Tertiary Care Hospital, Trinidad
Effective Mentorship For Recruitment and Retention of Newly Registered Nurses at A Tertiary Care Hospital, Trinidad
shortage of nurses were already facing a growing to recruit and retain new graduate nurses, including
demand of healthcare (International Council of the use of mentoring.
Nurses, 2015). In 2002 the World Health Organization,
Recent economic challenges have issued resolution WHA 54.12, calling attention to
temporarily affected the nursing shortage and the the global shortage of nurses and midwives,
need for nurses in some regions of the Trinidad and advising member states to take action towards
Tobago. However, with the combination of older improving nursing and midwifery services (World
nurses retiring from practice, academia, and Health Organization, 2010).
administration, and dissatisfied nurses leaving The global economic crisis has resulted in
nursing, the profession of nursing must identify many nurses being forced to seek work elsewhere,
strategies to increase recruitment and retention to outside their home country (ICN, 2015). The
address the nursing shortage, especially in practice nursing shortage in five Caribbean Community
and academia. (CARICOM) countries namely, Guyana, Jamaica,
Mentoring may be one such strategy. St. Lucia, St. Vincent and the Grenadines and
Although the nursing shortage in any one of the Trinidad and Tobago, is critical. It is estimated that
areas may be viewed in isolation, there is an there are about 7,800 nurses (in 2007) in the region.
interdependent aspect to the nursing shortage. A This translates into a ratio of 12.5 nurses per
nursing shortage in the area of clinical practice 10,000 populations (ICN, 2015).
affects academia, administration and research. In CARICOM countries the vacancy rate
While a nursing shortage in academia, in turn, stands at 30 per cent (ICN, 2015). While nursing
affects the clinical practice arena (American shortage has many reasons, annual attrition rates of
Association of Colleges of Nursing, 2006). 8 per cent are due to migration, which adds to
The concept of mentoring is not new to further loss. It is estimated that the number of
nursing, as Florence Nightingale was known to English-speaking CARICOM-trained nurses
have mentored many nurses in her day. Hurst and working abroad was roughly three times the
Koplin-Baucum, 2003; Stewart and Krueger, 1996; number working in the English speaking
Yoder, 1990; Yoder, 1995; Vance and Olsen, 1998; CARICOM (ICN, 2015).
Walker, 1998; Billings, 2008; Fox, 2010; National This international trend has also become a
League for Nursing Board of Governors, 2006 and local trend, caused by the severe shortage of nurses
others have contributed to the published nursing in Trinidad and Tobago. In this country there is
literature on mentoring in nursing. However, also a shortage of nurses, in the public health sector
further nursing research is needed related to (Schmid, 2003). The shortage of nurses is directly
outcomes and effectiveness of mentoring, such as related to emigration (Schmid, 2003).
career satisfaction and intent to stay in the After graduation from the schools of
profession. nursing, New Registered Nurses (NRNs), are
Recent studies show that along with required by the Ministry of Health, to serve the
feelings of uncertainty that new nurses tend to country for a compulsory two year period. In spite
experience in their new role, new nurses can also of the requirement, a total of about one third of all
experience resistance in the form of more senior NRNs, resign from their nursing positions in the
nurses “eating their young.” As a new nurse trying public health sector, to take up nursing positions
to handle these negative behaviors, inner conflict is abroad. This high attrition rate of NRNs is related
often present. The new nurse could be tempted to to migration to the United States, to the United
compromise his or her values and beliefs in order Kingdom, to Canada and to other countries
to “fit in” with the senior nurses and succeed. New (Schmid, 2003).
graduate nurses will not stay in this conflicting The General Secretary of the National
environment for long, and they may seek other job Health Workers Union (NHWU), in an open letter
opportunities and even change careers within the to the Prime Minister of Trinidad and Tobago,
first year. pointed out that the recommended nurse patient
Hence, having a mentor can make a new ratio by WHO is 1:6 (Smith, 2015). At the selected
graduate nurse’s professional life exponentially general hospital the nurse-patient ratio is 1: 22
better than having to go it alone. Nurses who are (Smith, 2015).
involved in mentoring say that every nurse The Chairman of the South West
deserves a trusted mentor. With the current Regional Health Authority (SWRHA), speaking at
shortage of new nurses, many healthcare facilities an opening ceremony for achievement in nursing,
and organizations are now reviewing why new at the general hospital, confirmed that there is a
graduate nurses are not likely to stay in their new shortage of approximately 1,000 nursing vacancies
position. As a result, health care leaders and for nurses, throughout the South Western Region of
administrators are seeking creative new measures the country (Dhalai, 2013).
The statistics confirm that there is a regarding the practice of mentorship, to increase
critical shortage of nurses at the selected general mentorship outcomes for NRNs and ultimately
hospital. The Ministry of Health is currently effect improvements for the patients they care for
embarking on a national recruitment drive for (Nowell et al., 2015).
recruitment and retention of NRNs (Dhalai, 2013). The study would provide current evidence
Currently, there is no formal mentoring program for mentorship interventions at the selected general
for recruitment and retention of NRNs at the hospital (Nowell et al., 2015). This study would
selected general hospital. also identify key considerations for future research
Background and Need for the Study on mentorship in nursing and the enhancement of
Mentoring is a reciprocal, long-term nursing science. Thus, the findings from the study
relationship with an emotional commitment that would have implication for nursing policy, practice
exists between a novice (protégé) and experienced and research. Finally, the results from this study
(mentor) nurse; mentoring implies a knowledge or would be used to guide administrators and policy
competence gradient, in which the teaching- maker’s implementation of mentorship
learning process contributes to a sharing of advice interventions, for addressing the nursing shortage,
or expertise, role development, and formal or at the general hospital (Nowell et al., 2015).
informal support to influence the career of the Objectives of the Study
protégé (Stewart & Krueger, 1996). Mentoring The following was the objectives of the study:
provides protégés and mentors with opportunities 1. To evaluate the existing mentorship
for professional growth and career satisfaction. programme for the NRN’s at a selected
Lack of such satisfaction with a career in nursing general hospital and their satisfaction
may contribute to nurses leaving the profession. with the mentoring programme.
With the predicted shortage and 2. To explore the NRN’s job satisfaction,
anticipated need for nurses in healthcare and development of clinical nursing skills,
academia in the future, it is more important than 3. To analyze the NRN’s job satisfaction,
ever to explore career satisfaction, not just job development of clinical nursing skills,
satisfaction, for nurses. Career satisfaction is and transition into the role of a
defined as the contentment that a nurse feels, as a practitioner with selected demographic
nursing professional, in terms of intrinsic and variables.
extrinsic rewards (National League for Nursing Research Questions
Board of Governors, 2006). Career satisfaction The following were the research questions of the
concerns a nurse’s feeling about the career choice study:
of nursing (National League for Nursing Board of 1. Is there a need for a formal or structured
Governors, 2006). mentoring program for NRNs at the selected
Job satisfaction is related to the general hospital?
satisfaction a nurse has with a current position in 2. Does the existing mentoring programme for
nursing; career satisfaction encompasses more than NRNs provide benefits to the NRN’s job
just the nurses’ job. It refers more broadly to satisfaction, development of clinical nursing
satisfaction with a career in nursing and may be a skills, and transition into the role of a
critical element in retaining nurses in the practitioner at the selected general hospital?
profession. Nurses who have a sense of career
Application of Theory
satisfaction and feel more fulfilled may contribute
The blended theoretical framework of Patricia
to the growth of the profession.
Benner Novice to Expert Practice Theory and
In the past there has been no documented
Hildegard Peplau's Theory of Interpersonal
nursing research, on mentorship of NGNs locally.
Relations, provided the basis of theoretical
This study was the first review of mentorship in
framework for this research study.
nursing at the selected general hospital. The main
When Benner’s Novice to Expert Practice Theory
reason for the study was to complete a mentoring
is applied to mentoring, the NRN progress
needs assessment amongst NRNs, to determine the
through five levels of proficiency, as they move
effectiveness of mentorship on their job
from novice to expert, in development of clinical
satisfaction, clinical nursing skills and transition
nursing skills. These levels are novice, advanced
into the role of practitioner (Weng, Huang, Tsai,
beginner, competency, proficient and expert
Chang, Lin & Lee, 2010; Nowell, White, Mrklas &
(Mariani, 2007).
Norris, 2015).
At the novice level, NRNs have pre licensure
It would help identify key evidence gaps
education and basic clinical nursing skills
and inform the development and implementation of
(Stobinski, 2008). They are inexperienced.
mentorship interventions (Nowell et al., 2015). The
Therefore, they have no clinical experience, in
results from this study would be used to guide
nursing practice. These NRNs require mentors to
nursing administration’s decision making,
guide their development of clinical nursing skills in nursing practice (Stobinski, 2008). It takes a
(Adiong, 2014). NRN an average of five years to thirteen years, in
At the advanced beginner level, NRNs have pre the same area of nursing, to reach the expert level
licensure education, basic clinical nursing skills (Koncaba, 2007).
competencies and limited clinical experience in At the expert level NRNs have developed
nursing practice (Stobinski, 2008). They are advanced clinical nursing skill competencies,
guided by rules and oriented by tasks and which allow them to manage independently
completion. They still require a mentor to assist (Stobinski, 2008). They have an enormous
them with defining clinical situations, to set background of experience and an intuitive grasp
priorities, and to integrate clinical nursing of each clinical situation (Adiong, 2014). Thus,
knowledge with skills (Adiong, 2014). the expert nurse operates from a deep level of
At the competency level, NRNs have post understanding of the total clinical situation
licensure education, basic clinical nursing skills (Adiong, 2014). They no longer require guidance
competencies and limited clinical experience in of a mentor (Stobinski, 2008). They may be
nursing practice (Stobinski, 2008). It takes an mentors themselves, who teach and coach
average of eighteen months to three years for Benner’s novice, advanced beginners, competent
NRNs to reach a competent level (Koncaba, and proficient nurse (Sunkes, 2013).
2007). Thus, Benner’s Novice to Expert Practice
At this level, their application to the clinical Theory supports mentoring, the novice to expert
situation becomes less stilted and actions therefore mentoring relationship and clinical nursing skill
more fluent (Dawson, 2006). They begin to development by novice NRNs (Mariani, 2007).
recognize patterns and determine which elements Mentoring is an interpersonal relationship
of the clinical situation warrants action and which between NRN (novice) and mentor (expert)
can be ignored (Adiong, 2014). They are able to (Washington, 2013). When Peplau’s Theory of
devise new rules and reasoning procedures for a Interpersonal Relations is applied to mentoring, it
plan of care and apply these rules of action on the helps explain the nature of the NRN and the
basis of the relevant facts of the clinical situation mentor, in the mentoring relationship. The four (4)
(Adiong, 2014). interpersonal phases of the mentoring relationship
At the competency level, NRNs are viewed as are orientation, identification, exploitation and
having what it takes to function capably, within an resolution (Washington, 2013).
increase capacity to view clinical situations During the orientation phase, the mentor
holistically, but still lack the expertise to handle a and the NRN come to know each other and learn
wide range of clinical situation proficiently how to work together, as the mentor recognizes
(Milligan, 1998). They may no longer require a the need to help with the NRN’s transition to the
mentor (Milligan, 1998). practitioner role (Washington, 2013). The
At the proficient level, NRNs have post licensure identification phase is the time to discover
education, basic clinical nursing skills opportunities for learning and improvement of the
competencies and more clinical experience in NRN and to recognize the mentor as a resource
nursing practice (Stobinski, 2008). It takes a NRN (Washington, 2013). During the exploitation
an average of three to five years, in the same area phase, the NRN uses the mentor, as a resource and
of nursing, to reach the proficient level (Adiong, support, to help meet identified learning needs
2014). (Washington, 2013).
At this level the NRN possesses a deep When resolution occurs with the
understanding of clinical situations as they occur. achievement of the mentoring goals, mentoring
They consciously plan in response to clinical can continue as the NRN become more and more
situations, having developed their critical thinking competent and continues the transition to the
and decision making skills (Adiong, 2014). practioners role (Washington, 2013). Thus,
They perceive clinical situations as a whole, rather Peplau’s Theory of Interpersonal Relations
than, in terms of aspects of a performance. They supports mentoring, mentors and NRNs in nursing
demonstrate the ability to recognize changing education (Mariani, 2007).
clinical situations and implement skilled responses Review of Literature: Mentoring is a
as it evolves (Adiong, 2014). reciprocal, long term relationship with an
At the proficient level, NRNs no longer require emotional commitment that exists between a
the guidance of a mentor. They may be mentors novice nurse (mentee) and an expert nurse
themselves who guide and supervise Benner’s (mentor); mentoring implies a knowledge or
novice and advance beginners (Sunkes, 2013). competence gradient, in which the teaching-
At the expert level, NRNs have advanced nursing learning process contributes to a sharing of advise
education, advanced clinical nursing skills or expertise, role development, and informal or
competencies and even more clinical experience
formal support to influence the career of the made to study the anticipated turnover in the
mentee (Mariani, 2012) absence of a formal mentoring program.
For the purpose of this study, a mentor is a Methodology: A descriptive correlational
SRN who is considered experienced, competent or design was used in this study, to examine the
expert, along the novice to expert continuum relationship among variables.
(Mariani, 2012). The mentor is more experienced The variables under the study were Independent,
than the NRN in terms of knowledge, skills and Dependent and Attributed variables.
competence. Again for the purpose of this study, Dependent Variable: Job satisfaction,
the mentee is a NRN in the mentoring relationship, development of clinical nursing skills, transition
in any area of the profession, who is new to the into the role of a practitioner and anticipated
area of practice. The mentee lacks experience or turnover.
competence, in that area of practice (Mariani, Demographic variable: Age, Sex, Marital
2012). status, General education, Professional
Mentoring provides the NRNs with the qualification, Experience in nursing practice,
opportunity for professional growth, career Continuous education program attended and
development and job satisfaction (Mariani, 2012). Mentoring Program attended.
NRNs lack of job satisfaction, professional growth, The sample was N=60 NRNs who had
and career development may contribute to them participated in a mentoring program within the past
leaving their jobs, in nursing or the nursing 18 months and currently employed at the selected
profession (Mariani, 2012). general hospital.
The first year of practice has been The subject was chosen by non-random
identified as the most difficult time in the NRN’s sampling method called convenient sampling or
career (Martin & Wilson, 2011). NRNs orientation volunteer sampling.
programs are typically designed to be completed The subjects in the study were recruited
within three to six months (Dyess & Serman, from the population of NRNs, at the SFGH. The
2009). Transitional support for NRNs is needed for NRNs was recruited knowing that they meet the
an extended period of time, well beyond the eligibility criteria identified (Wood & Harber,
orientation and preceptor programs. Thus, 2010). The Nursing Manager was asked to provide
provision of extended support throughout the a list of NRNs who meet the eligibility criteria and
NRN’s first year of employment is recommended were recently employed, at the SFGH. The Nurse
(Dyess & Serman, 2009). Manager, through the SWRHA’s Human Resource
The research studies identified many Department, supplied the names and contact
mentoring outcomes of formal mentoring programs information of eligible NRNs, at the SFGH. A
(Nowell et al., 2015). Positive mentoring outcomes second cover letter explaining the purpose of the
indentified in this literature review are increased study and requesting participation in the study was
NRNs job satisfaction, development of clinical forwarded to select NRNs (Catalano, 1997). The
nursing skills, transition into the practitioner role, questionnaires were then distributed to the
anticipated turnover, recruitment and retention. consenting NRNs who agree to participate in the
Mentoring programs provides transitional support study voluntarily (Kavoosi, Elman & Mauch,
to NRNs, during the first year of practice, the most 1995).
difficult time in their careers (Nowell et al., 2015).
Inclusion Criteria: NRNs who,
This literature review demonstrated that
were working at the selected general
mentoring is a prevalent phenomenon in nursing
hospital only
(Mariani, 2002). Mentoring is a concept that is well
supported in the literature, for bridging the theory- had undergone the mentoring programme
practice gap for NRNs and helping NRNs had given consent for the study
experience job satisfaction and career satisfaction. Exclusion Criteria: NRNs who,
Mentoring also helped decrease NRNs turnover were not registered with the nursing
and ultimately decrease the impact of the nursing council
shortage (Mariani, 2012). were not available during the study period
Nursing research that continues to explore Ethical Consideration
mentorship in nursing can help demonstrate the Permission was secured from the Campus Ethics
positive mentoring outcomes in nursing (Mariani, Committee, of the University to conduct the study
2012). The present study is an attempt to study the at the Hospital. Similarly permission was secured
effects of a mentoring program on NRN’s job from the Ethics Committee of Selected Regional
satisfaction, clinical nursing skills and transition Health Authority. Informed consent was secured
into the practitioner role, in lieu of the trends from the NRNs, to conduct the study through the
observed in research. An attempt has also been Hospital.
were reversed to match the response scale for the (2.653) 11.718**
positively worded questions.
The model fitted on total response score (3.431)
showed a good fit with the adjusted R2 of 0.627, Ward - -
-6.754*
Urology 14.480** 2.03
i.e., 62.7 per cent of variations in the dependent 5.633
2
variable was explained by the variables (3.324)
(2.571)
incorporated in the model. The analysis also Ward - -6.025** 2.243
exhibited that, of the fourteen explanatory variables Emergency 3.856
1.11
included the model fitted, nine were found to be 0
(1.563) (2.020)
significantly determining clinical skills Ward - Others -
3.152*
development and transition to practitioner role 11.925** 6.77
2.315
among NRNs. 2
(1.362)
The results of the multiple regression model (1.761)
exhibited that gender was a robust indicator of Experience -0.312 0.413
1.04
development of clinical skills and transition to 1.025
9
practitioner role. As the NRN happened to be female, (0.305) (0.394)
Formal mentor 3.763* 9.381**
she seemed to be acquiring significantly good clinical 6.02
3.126
skills and quickly getting ready for transition to 5
(1.204) (1.557)
practitioner role, with a regression coefficient of 7.452. Period of -0.287 4.359**
It is also worth noting that, the age of NRNs mentorship 0.238
2.80
serving at the selected general hospital played a pivotal 2
(1.203) (1.555)
role in the development of clinical skills and their Adjusted R2 - 0.627
transition to practitioner role. The NRNs in the age 0.710
groups of 26-30 years and more than 30 years attained Number of - 60
significantly better clinical skills and transition to 60
observations
practitioner role with the coefficient of 5.795 and 6.584, F - 8.097**
respectively, over the NRNs in the age group of less 11.300**
than 26 years. These results reiterated that age was an
important criterion which (See Figure 2) would enable Figures in parentheses indicate standard errors.
the NRNs to get accustomed to their roles. * Significant (P ≤ 0.05); ** Significant (P ≤ 0.01).
Development of clinical skills and
transition to practitioner role was seen among
NRNs practicing in medical, obstetrics, urology
and surgical wards (-11.92+1.8, -11.72+3.4, -
6.75+3.32 and -6.37+2.06 respectively). Having a
formal mentor (9.38+1.6) and the period of
mentorship (4.36+1.5) was found significant.
Findings are consistent with the previous research
studies (Chen & Lou, 2014).
Development of
clinical skills &
Job satisfaction
Explanatory transition to
variables practitioner scale Figure 2: Age-wise NRNs Job Satisfaction and
Parameter ‘t’ Parameter Output Scores
‘t’ value
Estimates value Estimates
-0.279 -0.320
0.42
Conclusion: In conclusion, NRNs who received
0.476
1 formal mentorship were more satisfied with their
Qualification (0.588) (0.760) jobs. Fifty three per cent of NRNs indicated that
Ward - Surgery 3.314* -6.367** the mentorship program had helped them gain
3.08
2.076 confidence, learn and practice clinical skills. The
5
(1.596) (2.064) findings further indicated that mentoring did help
Ward - 4.874** -2.393
Pediatrics 1.14 NRNs transit into the role of a practitioner.
3.008
2 The previous research studies also identified many
(1.621) (2.096)
Ward - 6.944* positive mentoring outcomes of formal mentoring
3.41
Obstetrics 2.617 -
5 programs. Positive mentoring outcomes that were
indentified included increased NRNs job
satisfaction, development of clinical nursing skills, 8. Billings, D. (2008). Developing your career as a
successful transition into the practitioners role and nurse educator: the importance of having (or being)
decrease turnover (Mariani, 2012). a mentor. Journal Of Continuing Education In
The research studies trends have demonstrated that Nursing, 39(11), 490-491 2p.
doi:10.3928/00220124-20081101-09. Retrieved
mentorship in nursing is well supported for helping from
NRNs experience job satisfaction, develop clinical http://search.ebscohost.com/login.aspx?direct=true
nursing skills and transition into the practitioner &db=rzh&AN=105569118&site=ehost-live
role (Mariani, 2012). 9. Bjerknes, M. S., & Bjørk, I. T. (2012). Entry into
Therefore, there is a need for a formal or structured nursing: an ethnographic study of newly qualified
mentoring program for NRNs at the SFGH. Finally, nurses taking on the nursing role in a hospital
the study concluded there is a need for future setting. Nursing research and practice, 2012.
nursing research studies, to explore mentorship in Retrieved from
nursing, to help demonstrate the positive mentoring https://www.mendeley.com/catalog/entry-nursing-
ethnographic-study-newly-qualified-nurses-taking-
outcomes in nursing, at the SFGH. nursing-role-hospital-setting/
10. Burr, S., Stichler, J. F., & Poeltler, D. (2011).
Recommendations Establishing a Mentoring Program. Nursing For
Several recommendations are made from the Women's Health, 15(3), 214-224.
study’s results such as doi:10.1111/j.1751-486X.2011.01636.x. Retrieved
Mentoring Task Force, mentoring Committee, from
Formal Mentoring Program Proposal, http://search.ebscohost.com/login.aspx?direct=true
&db=rzh&AN=2011183812&site=nrc-live
Period of Mentorship, Formal Mentoring Program 11. Carrion, J. (2010). Development and
Budget, Formal Mentoring Environment, Training implementation of a new graduate nurse mentorship
of Mentors and Mentees, Matching Mentors and program for the medical surgical specialty (Order
Mentees Compensation, Reward, Recognition and No. 3428243). Available from ProQuest Nursing &
Celebration, Culture of Mentoring Formal Allied Health Source. (818718603). Retrieved from
Mentoring Program Assessment, Formal Mentoring http://search.proquest.com/docview/818718603?acc
Program Evaluation. ountid=45039
12. Catalano, A. M. K. (1997). Faculty development
activities in baccalaureate degree nursing programs
References as perceived by administrators and nursing faculty.
1. Adiong, A., M. (2014). Patricia Benner (Novice to (Order No. 9735230, Boston College). ProQuest
Expert Theory). Retrieved from Dissertations and Theses, , 171-171 p. Retrieved
http://www.slideshare.net/xenna_85/patricia- from
benner-38508791 http://search.proquest.com/docview/304336507?acc
2. Al-Aameri, A. S. (2000). Job satisfaction and ountid=45039. (304336507).
organizational commitment for nurses. Saudi 13. Chen, C. M., & Lou, M. F. (2014). The
Medical Journal, 21(6), 531-535. Retrieved from effectiveness and application of mentorship
https://www.mendeley.com/research/job- programmes for recently registered nurses: a
satisfaction-organizational-commitment-nurses-3/ systematic review. Journal of nursing management,
3. American Association of Colleges of Nursing 22(4), 433-442. Retrieved from
(2006). Nursing Shortage Fact Sheet. Retrieved http://search.ebscohost.com/login.aspx?direct=true
from &db=rzh&AN=2012573443&site=ehost-live
http://www.aacn.nche.edu/Media/FactSheets/Nursin 14. Dawson.P.K. (2006). Jigsaw and jugglers:
g-Shortage.htm. Disposition, discourse, and decision-making in the
4. American Association of Colleges of Nursing. assessment of student nurse practice. Retrieved
(2014). Nursing Shortage Fact Sheet. Retrieved from
from http://www.aacn.nche.edu/media- http://dspace.stir.ac.uk/bitstream/1893/91/1/EdD%2
relations/fact-sheets/nursing-shortage 0Thesis.pdf
5. Beecroft, P., Santner, S., Lacy, M., Kunzman, L., & 15. Dhalai,R (2013). Severe nursing shortage in the
Dorey, F. (2006). New Graduate Nurses' South West Regional Health Authority. Retrieved
Perceptions of Mentoring: six-year programme from http://newsday.co.tt/news/0,187747.html
evaluation. Journal Of Advanced Nursing, 55(6), 16. Dictionary.com . (2015). Registered nurse.
736-747. doi:10.1111/j.1365-2648.2006.03964.x. Retrieved from
Retrieved from http://dictionary.reference.com/browse/registered+n
http://search.ebscohost.com/login.aspx?direct=true urse
&db=rzh&AN=2009311011&site=ehost-live 17. Dictionary.com. (2015). Practitioner. Retrieved
6. Benner,P (1984). From Novice to Expert: from
Excellence and Power in Clinical Nursing Practice, http://dictionary.reference.com/browse/practitioner
Addison-Wesley, Menlo Park, California ,USA. 18. Dyess, S., & Sherman, R. (2009). The first year of
7. Benner,P. (2001). From Novice to Expert: practice: new graduate nurses' transition and
Excellence and Power in Clinical Nursing Practice, learning needs. Journal Of Continuing Education In
Prentice-Hall, Upper Saddle River, NJ, USA. Nursing, 40(9), 403-410. doi:10.3928/00220124-
http://search.ebscohost.com/login.aspx?direct=true needs-expectations-generationy-human-resources-
&db=rzh&AN=2011478994&site=ehost-live practitioners-preparing-next-wave-strategic/
39. Mc Ewen,M., & Wills.M.E. (2002). Theoretical 51. Murrells, T., Robinson, S., & Griffiths, P. (2008).
basis for nursing. Philadelphia: Lippincot Williams Job satisfaction trends during nurses' early career.
& Wilkins. BMC Nursing, 7. Retrieved from
40. Merriam-Webster, Incorporated (2015). Attrition. http://search.ebscohost.com/login.aspx?direct=true
Retrieved from http://www.merriam- &db=rzh&AN=2010189396&site=ehost-live
webster.com/dictionary/attrition 52. National League for Nursing Board of Governors
41. Merriam-Webster, Incoperated. (2015).General (2006). Position statement: mentoring of nurse
Hospital. Retrieved from: http://www.merriam- faculty. Nursing Education Perspectives, 27(2),
webster.com/medical/general%20hospital 110-1134p. Retrieved from
42. Milligan, F. (1998). Defining and assessing http://search.ebscohost.com/login.aspx?direct=true
competence: the distraction of outcomes and the &db=rzh&AN=106439942&site=ehost-live
importance of educational process. Nurse Education 53. Norushe, T. F., Van Rooyen, D., & Strumpher, J.
Today, 18(4), 273-280 8p. Retrieved from (2004). In-service education and training as
http://search.ebscohost.com/login.aspx?direct=true experienced by registered nurses. Curationis, 27(4),
&db=rzh&AN=107291269&site=ehost-live 63-72. Retrieved from
43. Ministry of Health. (2015). South West Regional https://www.mendeley.com/research/inservice-
Health Authority. Retrieved from education-training-experienced-registered-nurses/
http://www.health.gov.tt/sitepages/default.aspx?id= 54. Nowell, L., White, D. E., Mrklas, K., & Norris, J.
91 M. (2015). Mentorship in nursing academia: a
44. Mitchell.M., & Jolley.J. (2012). Research Designs systematic review protocol. Systematic Reviews, 4,
Explained. Available from 16. doi:10.1186/s13643-015-0007-5. Retrieved from
http://books.google.tt/books?id=dQQKAAAAQBAJ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC434
&pg=PA286&dq=advantages+of+self+administered 2164/
+questionnaire&hl=en&sa=X&ei=0tZ_VMGTJoqq 55. Pallant,J. (2002). SPSS survival manual. Retrieved
ggSVxYKoDw&ved=0CB0Q6AEwAA#v=onepage from
&q=advantages%20of%20self%20administered%20 http://www.academia.dk/BiologiskAntropologi/Epid
questionnaire&f=false emiologi/PDF/SPSS_Survival_Manual_Ver12.pdf
45. Moeti, M. R., Van Niekerk, S. E., & Van Velden, C. 56. Peplau,H. (1952). Interpersonal Relations in
E. (2004). Perceptions of the clinical competence of Nursing: A Conceptual Frame of Reference for
newly registered nurses in the North West province. Psychodynamic Nursing, Putnam, New York, NY,
Curationis, 27(3), 72-84. Retrieved from USA.
https://scholar.google.com/scholar?as_q=Perception 57. Peplau,E.H. (1992).“Interpersonal relations: a
s+of+the+clinical+competence+of+newly+registere theoretical framework for application in nursing
d+nurses+in+the+North+West+province. practice,” Nursing science quarterly, vol. 5, no. 1,
46. Monnilal,R.(2014).The opening of the San pp. 13–18.
Fernando Teaching Hospital. Retrieved from 58. Peplau,E.H. (1997). “Peplau’s theory of
http://www.google.tt/url?sa=t&rct=j&q=&esrc=s&s interpersonal relations,” Nursing Science Quarterly,
ource=web&cd=9&ved=0CE8QFjAI&url=http%3A vol. 10, no. 4, pp. 162–167.
%2F%2Fwww.housing.gov.tt%2Fpdf%2Fministers 59. Polit,F,D., & Beck,T.C. (2010). Essentials of
_Speech_Commissioning.pdf&ei=4IaVVffTKsWZg nursing research. Appraising evidence of nursing
wSd5ICADg&usg=AFQjCNFePAcXeGo8ehmugoJ research . (7th ed.). Philadelphia, Pennsylvania,
zSfCeAKCWzg&bvm=bv.96952980,d.eXY United States: Wolter Kluwer Health/ Lippincott
47. Morolong, B., & Chabeli, M. (2005). Competence Williams & Wilkins.
of newly qualified registered nurses from a nursing 60. Public Health Research Education & Development
college. Curationis, 28(2), 38-50. Retrieved from Program, (PHRED). (2005). Caring connecting and
http://search.ebscohost.com/login.aspx?direct=true empowering. Nursing mentorship resource guide.
&db=rzh&AN=2009015971&site=ehost-live Retrieved from
48. Morolong, B. G., & Chabeli, M. M. (2005). http://int.search.tb.ask.com/search/GGmain.jhtml?p
Competence of newly qualified registered nurses 2=^BBQ^xdm007^YYA^tt&n=781b1b66&st=hp&
from a nursing college. Curationis, 28(2), 38-50. ptb=D7BF6E63-08A2-459A-8F1F-
Retrieved from ECF2B51097AC&qs=&si=CNaY8erbjsUCFSxn7A
https://www.mendeley.com/catalog/competence- odQFQAcg&ts=1436063694219&tpr=hst&searchfo
newly-qualified-registered-nurses-nursing-college/ r=Formal+mentoring+can+be+described+as+having
49. Mouton, J. (2001). How to succeed in your master's %3A++%E2%80%A2%09a+clear+rationale%2C+r
and doctoral studies: A South African guide and eflective+of+organizational+goals+and+objectives
resource book. (1st ed.). Pretoria: Van Schaik. %3B++%E2%80%A2%09measurable+goals+and+
50. Munro, C. R. (2009). Mentoring needs and outcomes%3B+and++%E2%80%A2%09mechanis
expectations of generation-y human resources ms+for+assessment+and+selection+of+mentors+an
practitioners: Preparing the next wave of strategic d+mentees.+&ots=1436063720500
business partners. Journal of Management 61. Rogers, J., Monteiro, F. M., & Nora, A. (2008).
Research, 1(2).Retrieved from Toward measuring the domains of mentoring.
https://www.mendeley.com/catalog/mentoring- FAMILY MEDICINE-KANSAS CITY-, 40(4), 259.
Retrieved from
https://www.mendeley.com/catalog/toward- http://search.ebscohost.com/login.aspx?direct=true
measuring-domains-mentoring/ &db=rzh&AN=2010485579&site=ehost-live
62. Rush, K. L., Adamack, M., Gordon, J., Lilly, M., & 73. Vance,C., & Olsen, R. (1998). The Mentor
Janke, R. (2013). Best practices of formal new Connection in Nursing. (1st ed.). New York, NY,
graduate nurse transition programs: An integrative USA: Springer Publishing Company.
review. International Journal of Nursing Studies, 74. Walker, M. B. (1998). In Reflections of mentors:
50(3), 345. Retrieved from nurse leaders in academe. The Mentor Connection
http://search.proquest.com/docview/1284889271?ac in Nursing. Retrieved from
countid=45039 https://scholar.google.com/scholar_lookup?title=In+
63. Schmid,R. (2003). Emigration of nurses from the Reflections+of+mentors%3A+nurse+leaders+in+ac
Caribbean: Causes and consequences for the scio- ademe&author=M.+B.+Walker&publication_year=
economic welfare of the country: Trinidad and 1998
Tobago. Retrieved from 75. Washington,T.,G. (2013).The theory of
https://sta.uwi.edu/salises/workshop/papers/kschmid interpersonal relations applied to the preceptor and
.pdf new graduate Relationship. Retrieved from
64. Scott, E. M. S. (2005). The transition of new http://www.nursingcenter.com/cearticle?tid=150775
graduate nurses into the workplace (Order No. 4
3164158). Available from ProQuest Nursing & 76. Weng, R.-H., Huang, C.-Y., Tsai, W.-C., Chang, L.-
Allied Health Source. (305374512). Retrieved from Y., Lin, S.-E., & Lee, M.-Y. (2010). Exploring the
http://search.proquest.com/docview/305374512?acc impact of mentoring functions on job satisfaction
ountid=45039 and organizational commitment of new staff nurses.
65. Smith.D.(2015). Open letter to the Prime Minister BMC Health Services Research, 10, 240.
of Trinidad and Tobago. Retrieved from doi:10.1186/1472-6963-10-240. Retrieved from
http://www.caribbeannewsnow.com/headline-Open- http://www.ncbi.nlm.nih.gov/pmc/articles/PMC292
letter-to-the-Prime-Minister-of-Trinidad-and- 9231/
Tobago-26015.html 77. Wood, L, G., & Haber,J. (2010). Nursing Research.
66. Smith,J.M., Carpenter,R.D.,& Fitzpatrick,J.J (2015). Methods and Critical Appraisal for Evidence-Based
Encyclopedia of nursing education. Retrieved from Practice. (7th ed.). St. Louis, Missouri: Mosby Inc
https://books.google.tt/books?id=n9qLBgAAQBAJ 78. World Health Organization (WHO). (2010). A
&dq=definition+of+transition+into+practice+nursin global survey monitoring programs in nursing and
g&source=gbs_navlinks_s midwifery. Retrieved from
67. Stewart, B. M., & Krueger, L. E. (1996). An ttp://www.who.int/hrh/resources/survey/en
evolutionary concept analysis of mentoring in 79. Yoder, L. (1990). Mentoring: a concept analysis.
nursing. Journal of Professional Nursing, 12(5), Nursing Administration Quarterly, 15(1), 9-19 11p.
311-321. Retrieved from Retrieved from
https://www.mendeley.com/catalog/evolutionary- http://search.ebscohost.com/login.aspx?direct=true
concept-analysis-mentoring-nursing/ &db=rzh&AN=107496980&site=ehost-live
68. Stobinski, J. X. (2008). Perioperative nursing 80. Yoder, L. (1995). Staff nurses' career development
competency. Association of Operating Room relationships and self-reports of professionalism, job
Nurses.AORN Journal, 88(3), 417-8, 421-36. satisfaction, and intent to stay. Nursing Research,
doi:http://dx.doi.org/10.1016/j.aorn.2008.05.001 44(5), 290-297 8p. Retrieved from
69. Sunkes,B. (2013). Benner’s novice to expert theory http://search.ebscohost.com/login.aspx?direct=true
and the concept reflective practice. A comparative &db=rzh&AN=107429143&site=ehost-live
analysis. Retrieved from
http://bridgetsunkesacademicportfolio.weebly.com/
uploads/1/9/9/3/19932193/comparative_analysis__b
enner_and_reflective_practice.pdf
70. Tourigny, L., & Pulich, M. (2005). A critical
examination of formal and informal mentoring
among nurses. Health Care Manager, 24(1), 68-76.
Retrieved from
http://search.ebscohost.com/login.aspx?direct=true
&db=rzh&AN=2005074463&site=ehost-live
71. University of Otago. (2013). Clinical skills in
undergraduate medical curriculum. Retrieved from
http://www.google.tt/url?sa=t&rct=j&q=&esrc=s&s
ource=web&cd=5&ved=0CDkQFjAE&url=http%3
A%2F%2Fwww.otago.ac.nz%2Fchristchurch%2Fot
ago040817.pdf&ei=ATqbVYqLK4eiNvSvrpgH&us
g=AFQjCNEwWGM2S6BI-Sb20tkNdL7HBirARA
72. Utriainen, K., & Kyngäs, H. (2009). Hospital
nurses' job satisfaction: a literature review. Journal
of nursing management, 17(8), 1002-1010.
Retrieved from