Mentoring the Next Generation of Minority Nurses

Recruiting more minority nursing students is one battle that must be won to increase nursing diversity. Another important battle: ensuring these students graduate and stick with nursing through their first few years when turnover tends to be high. Mentoring is proving to be a critical type of support to help novice nurses steer successfully through early career challenges.

Marisol Montoya, BSN, RN, had one semester left at the SUNY Downstate Medical Center’s College of Nursing when she recognized she needed help navigating the next phase of her career. “I knew I would be walking into a foreign land very soon,” Montoya says. “I would have to take my NCLEX, and then I was going to have to look for a job.”

Thanks to a mentoring program offered through the National Association of Hispanic Nurses (NAHN), Montoya has spent the last year under the tutelage of a fellow Hispanic American nurse, Miriam “Mimi” Gonzalez, BS, RN. Gonzalez was able to provide Montoya with targeted support right when she needed it, drawing on her experiences and connections as one of NAHN’s founding members and a 50-year career as a labor and delivery nurse.

“I believe mentorship relationships are incredibly valuable anytime anyone is going through a transitional period,” says Montoya, who recently started a job as a postpartum nurse at Mount Sinai Health System in New York City. “It is very helpful to have someone in your life who has already done what you’re doing and knows the territory better.”

Culturally sensitive mentorships are proving critical to keeping novice minority nurses in the pipeline, helping to ensure they graduate and stay on the job after earning a degree. Research suggests that minority nursing students tend to feel lonely, isolated, and alienated on top of having financial and academic difficulties—all of which can lead them to drop out.

Student retention programs that offer mentoring and other support tend to have lower attrition rates. For instance, the SCRUBS program at Georgia Southern University increased retention rates among minority nursing students to 95% (from 69%), and NCLEX pass rates to 100% (from 84%), according to a 2013 study in the Journal of Nursing Education and Practice.

Similarly, mentoring can help reduce on-the-job vacancy rates among newly graduated nurses. In the California Nurse Mentor Project, only 8% of new hospital nurses who were assigned a mentor left within a year of being hired, compared to 23% who did not have a mentor, according to a study published in 2008 in Nursing Economics.

The first step for novice nurses looking for support and advice is not to shy away from the experience of mentoring, says Vivian Torres-Suarez, RN, MBA, BSN, director of NAHN’s Mentorship Academy. “I sometimes think people perceive that needing a mentor is like needing a tutor. They see it as a remedial type of thing. And it’s not. It’s about collegiality; it’s about learning from those who have been through a process before us. All of us should be open to it.”

Understanding What Novice Nurses Need

Three years ago, the Washington Center for Nursing (WCN), based in Tukwila, Washington, surveyed local minority nursing students and new graduates to assess their needs. In addition to finding a lack of mentoring programs, the survey identified specific topics that novice nurses were interested in: “The students really needed somebody to help them with work-life balance issues,” says Sofia Aragon, JD, BSN, RN, the executive director of WCN.

Other highly ranked topics on the survey were developing a professional sense of identity, honing leadership and communication skills, and transitioning from education to practice. The diversity committee at WCN also identified lateral violence and bullying as issues that contribute to attrition among minority nurses.

Mentors interviewed for this article stressed that many novice nurses also need help developing practical skills, such as putting together a resume, applying for a scholarship, or sorting out what paid-time-off time is all about. Nilda (Nena) P. Peragallo Montano, DrPH, RN, FAAN, would put time management and critical thinking on the top of the list. “You want them [novice nurses] to learn to think critically and make choices that are best for them,” says Montano, dean and professor at the University of Miami School of Nursing and Health Studies. “The mentor doesn’t always have the solution for the person. The student has to learn how to resolve whatever situation they come across. That’s part of learning.”

The mentees interviewed for this article emphasized how much they appreciated the empathy and encouragement they received from their mentors. “It’s good to have another person constantly telling me, ‘You can do this. I’ve gotten through this. Other nurses have gotten through it,’” says Jasmine Carter, an undergraduate in the nursing program at Arizona State University.

A 2014 study published in the Journal of Professional Nursing found that minority nursing students perceived the following traits as the most important characteristics in a mentor:

  • warmth
  • encouragement
  • a willingness to listen
  • enthusiasm for nursing and how the mentor sparks the mentee’s interest
  • clarity regarding expectations for mentees
  • pushing mentees to achieve high standards

Do mentors need to be of the same race or ethnicity as the mentee? Although research suggests that minority nurses can get effective support from nonminority mentors, many nurses point to the advantages of having a mentor with a similar background and culture. “It’s important because they’ll be more likely to have the same experiences as you than someone who is from another race,” says Carter.

Carter’s mentor, Angela Allen, PhD, CRRN, RN, who teaches culture and health in her classes at Arizona State, agrees: “It’s easier for us to be able to relate when we are from the same ethnic culture, whether African American, Caucasian, or whatever. We can immediately make a connection and say, ‘I know you’ve gone through something similar to what I’ve gone through.’ There’s already a foundation for a relationship.”

Finding a Mentor

Montoya and Gonzalez met at a NAHN speed-networking event for prospective mentors and mentees, or protégés per NAHN parlance. After attending an educational session on mentoring, Montoya spelled out her goals for the mentoring experience and identified a few questions to ask potential mentors. Then she had brief one-on-one meetings with experienced nurses who had volunteered and been selected to be mentors.

“They [the protégés] ask the same questions of each mentor,” says Torres-Suarez, assistant vice president of utilization management at Healthfirst. “Then they walk away with an impression of whether that mentor is somebody they’re going to be able to work with.”

One of Montoya’s questions for the mentors asks, “What do you desire to bring to this relationship, and what do you desire for your mentee in this relationship?” As Montoya recalls, Gonzalez said something like, “I believe one of the biggest things I can bring into your life where you are right now is to connect you to everyone I know.”

This response resonated with Montoya.  “In that moment, that was important to me because I felt like everyone whom she [Gonzalez] connects me to will also be a mentor to me. I felt like she was going to provide a village to raise me.”

Formal programs. Formal mentoring programs like NAHN’s is one place for novice nurses to find mentors. So far, about 20 nurses have gone through the association’s year-long Mentoring Academy. Originally piloted at the national level, the program is now being deployed at the chapter level. So far, five NAHN chapters have launched their own programs, and Torres-Suarez hopes to see every chapter create a program.

Similarly, 30 chapters of the National Black Nurses Association (NBNA) have mentoring programs. That’s how Hailey Hannon, MSN, RN, met her mentor. In 2004, when Hannon was a nursing student at Indiana University-Purdue University Indianapolis, Denise Ferrell, DNP, RN, who introduced herself to Hannon one day on campus and told her about the mentoring program offered by the NBNA Indianapolis Chapter. Ferrell, who is now president of the NBNA Indianapolis Chapter, became Hannon’s mentor during college and continued to mentor her through her first nursing job.

“I was new to the nursing program, and Denise caught me at a good time when I needed that mentoring guidance,” says Hannon. “At the undergraduate level, I looked to her for encouragement and help balancing work and being a nursing student. She would say, ‘You can do it. Let’s just talk about it.’ Then once I became a new nurse, she introduced me to the professional development side of things, like, ‘How do you find people on the unit that can help benefit you?’ or ‘Are you on any committees on your unit?’”

The NBNA is getting ready to launch a national mentoring program this year that will connect novice nurses, as well as experienced nurses in career transitions, to volunteer mentors from among the NBNA national membership. “This won’t be taking away from the mentoring programs offered by our chapters,” says Allen, who helped developed the mentoring program. “What we want to do is enhance them.”

Many nursing schools also offer various types of mentoring for minority students. For instance, American Indian and Alaska Native nursing students at the Montana State University College of Nursing are paired with a peer mentor and communicate on a biweekly basis as part of the college’s Caring for Our Own Program (CO-OP). Additionally, perspective high school students interested in pursuing a career in nursing can be paired with a CO-OP mentor who will provide them with information on scholarships, educational preparation, and career options, among other things.

Informal engagements. Not all good mentor-mentee relationships spring from formal programs like NAHN’s and NBNA’s. For instance, Carter and Allen met informally at a NBNA chapter meeting. Carter won a scholarship from the chapter, and Allen recognized her potential and decided to take her under her wing. Now, the two regularly talk, text, and e-mail each other.

Torres-Suarez encourages novice nurses to seek out various types of mentors, including informal, short-term contacts. “We have to be constantly open to opportunities to network and connect to individuals,” she says. “You can have an in-depth formal mentorship like in our [NAHN] program. And you can have an informal, five-minute mentorship with someone you just met, somebody that could be a connector for you. You can have sort of an elevator speech prepared to say, ‘I’m a new nurse. I’m not sure where to get a job, and I’m looking for some advice.’”

Torres-Suarez also thinks nurses need to seek mentors from outside of nursing, as needed. “We have to be open to mentors coming from all directions and all walks of life. While nursing mentors are important, we could also get mentoring from people who are in business because, at the end of the day, health care is a business.”

Building a Beneficial Relationship

One of the key steps novice nurses should take before seeking a mentor is to “really understand what their specific needs are,” says Aragon, who has been working to match mentees at two nursing schools with volunteer mentors at the WCN. Developing mentorship goals can help nurses identify and communicate with potential mentors—and find the best mentors for their particular needs.

Aragon shares this example: “When I was getting to know one mentor, she was talking about her journey to be more vocal with other nurses and physicians and a better communicator. She struggled with that but eventually overcame it. Then a mentee said on her application, ‘I really want to find my voice, I’d like someone to help me do that.’ This really helped me match those two up because it seemed like the mentee’s need was exactly what the mentor could give somebody.”

Yet, even the best-matched mentors and mentees need to work at building a durable, beneficial relationship. What helps? The nurses interviewed for this article provide the following lessons learned:

Create a structure that works for you. The exact structure and rules of a mentoring relationship will depend on the program and people involved. One of the requirements of the NAHN Mentorship Academy, for example, is that mentors and mentees agree to communicate with each other at least once a month for a year. Because they both preferred to connect in person, Montoya and Gonzalez agreed to meet for an hour or so before the monthly NAHN New York Chapter meeting. Then, they supplemented their monthly meetings with e-mails and phones calls, as necessary.

During the first few monthly meetings, Montoya and Gonzalez focused on getting to know each other. “We talked about our histories, and I discovered her background in nursing and the history of her life in Puerto Rico and here in the United States,” says Montoya. “When it came closer to me taking the NCLEX, our meetings became more about preparing for the NCLEX. Then we turned to preparing me for my first job interviews. When I got hired, our meetings became about accepting an employment offer. We reviewed all of the paperwork page by page.”

Walk in with intentions rather than expectations. Montoya recommends being open to what can come of a mentoring relationship. “Operate with intentions rather than expectations,” she says. “Know what your intention is. I would say that should be the first conversation that you have [with your mentor], ‘What is your intention as a mentor? What is my intention as a mentee? What is our intention for this relationship?’ Allow that to be your guiding compass throughout the relationship.”

Get personal. It’s virtually impossible for mentors and mentees who have a long-term relationship to avoid talking about personal issues, from money and child care issues to layoffs and illness, says Torres-Suarez. “This is real life. All of those things happen and all those things get addressed as part of the conversation with the mentor.”

Remember, it’s a two-way street. “It has to be a respectful relationship,” says Montano. “It’s not a one-way street where the mentees sit there and expect everything to be given to them.” Montano gives the example of a mentee not showing up for scheduled meetings. “You can’t mentor someone who doesn’t want to be mentored.”

Make use of technology. NBNA’s national mentoring program is gearing up to take advantage of live-chat, texting, e-mail, and other mobile communication technologies, says Allen. This will allow mentors and mentees from different states to communicate. NAHN also uses Skype and other technologies when needed. But Torres-Suarez recognizes the benefit of in-person meetings between mentors and mentees. “Eye contact is an important piece when you’re trying to get to know each other.”

Influencing Generations of Nurses

One argument against mentoring is that it only helps one nurse at a time. But Aragon believes the long-term effects of helping one nurse can multiply exponentially. As an example, she tells the story of the first Filipino American nurse to work in a major hospital in Yakima County, Washington. “She was someone who thought nursing was not in her universe,” yet friends, family, and community members offered her encouragement and paid her nursing school tuition, says Aragon.

“In her lifetime, she’s helped two other nurses go to school and seen the numbers of Filipino American nurses go up over time,” Aragon notes. “So, for me, even though we may only reach a few people by mentoring, just one person could be a champion and really multiply the number of minority nurses a community has.”