Mentoring African American Nursing Students: A Holistic Approach

Editor’s Note: This article is adapted from a version previously published as a chapter in the anthology Transforming Nursing Education: The Culturally Inclusive Environment (S.D. Bosher and M.D. Pharris, Eds., Springer Publishing Company, New York, N.Y., 2008).

Dance, Professor, Dance

Professor, you don’t know me but I am sure that you have seen me around.
Who am I? What do I look like? Well, that’s not important right now.
I am truly amazed by all of your certifications and nursing degrees.
I see you each day as I sit and listen attentively to you speak.
Boldly I begin to think, That may be me some day,
A prolific nurse educator with diverse knowledge, flair and no-nonsense ways.

Professor, you don’t know me but I am sure that you have seen me around.
Who am I? What do I look like? Well, that’s not important right now.
At first it seems that you wanted me here, but as time passed it became crystal clear.
Today when I approach you I feel instantly rejected.
I start to think, No, this can’t be true of all of you.

Professor, you don’t know me but I am sure that you have seen me around.
Who am I? What do I look like? Well, that’s not important right now.
I sit in your class day to day and we have even stood side by side.
I make no excuse for my silky caramel complexion,
long black wavy hair or even my urban style.
The grades I earn speak for themselves
and my nursing skills are always above the rest.
It’s true I know that what you see in me
is not your vision of the trailblazing nurse of the 21st century.

Professor, you don’t know me but I am sure that you have seen me around.
Who am I? What do I look like? Well, that’s not important right now.
Please remember that I see you as a disseminator of nursing knowledge.
Unfortunately, what you cannot see is that you truly are the mentor and I the mentee.
Together we dance invisibly.

Professor, you don’t know me but I am sure that you have seen me around.
Who am I? What do I look like? Well, that’s not important right now.
I too represent the future and plan to become
the new Nightingale, Peplau, Roy or the prolific Wykle.
Now please don’t be ashamed that you overlooked my talent, worth and skill.
Do not look back at the past.
Look ahead to change your perspective this academic year.
Once again I will sit in your class listening to you teach.
Professor, let’s not again begin our mentor-mentee dance invisibly.

—Lorrie R. Davis-Dick, MSN, RN, BC

Projections from the Health Resources and Services Administration (HRSA)’s most recent National Sample Survey of Registered Nurses suggest that by the year 2020, over one million new RNs will be needed to support the demand for nursing care in the United States alone. In addition, with many of the current generation of nursing educators nearing retirement age, there will also be a great need for a large pool of nursing faculty from diverse specialties and backgrounds to connect to the growing student nurse population.

Unfortunately, the number of African American students in entry-level baccalaureate nursing programs who are dropping out of nursing school without obtaining their degrees is disproportionately high. This attrition contributes to the poor representation of African Americans in the nursing workforce and in graduate nursing programs. In its 2002 Annual State of the Schools report, the American Association of Colleges of Nursing (AACN) suggests that racial/ethnic minority representation remains solid in entry-level BSN programs. Yet the question remains whether African American students, who represent 11.2% of enrollment, will successfully remain in their nursing program and complete the requirements for graduation.

The continued shortage of African American registered nurses is worrisome. According to the 2004 National Sample Survey of Registered Nurses, blacks represent only 4.2% of RNs in the United States, even though they account for 12.2% of the U.S. population as a whole. This disappointing figure seems to indicate that current strategies for recruiting and retaining African American nursing students have failed and that there is an urgent need for a national initiative aimed at increasing not only short-term but long-term recruitment and retention of this student population.

Lack of diversity is also evident among the ranks of nursing educators. Statistics from AACN show that African Americans represent only 8.7% of nursing faculty and 6.8% of nursing deans. In turn, this lack of diversity on both the faculty and student sides of the classroom negatively impacts the recruitment of minorities into the profession of nursing.

Research studies suggest that African Americans do not pursue nursing, or fail to complete nursing programs, for a variety of reasons: role stereotypes, economic barriers, lack of direction from early authority figures, misconceptions about nursing careers, and increased opportunities in other fields.1 Another frequently cited factor is lack of mentors. Buchanan (1999) suggests that the attrition rate for African American nursing students has increased and that failure to retain black students is associated with the lack of mentoring relationships with persons they feel comfortable with and can relate to, learn from and emulate.2 

The Power of Mentoring

Other recent studies have revealed the power of positive mentoring relationships to improve minority nursing student retention.3 One researcher found that students who learn from experienced nurse mentors have enhanced reflective abilities in the learning process.4 According to Scott (2005), mentoring is relevant for both the nursing student and the experienced nurse. Mentoring helps students successfully navigate the complex world of nursing and also helps faculty to become better teachers.5 The literature also suggests that mentoring can be made more flexible and fluid through the use of technology, in particular the Internet, for communication and exchange of information.6

Gray and Smith (2000) looked at mentorship from the students’ perspective.  They interviewed student nurses over a three-year period, focusing on the students’ opinions of what makes a good mentor versus a poor mentor. The students said that a good mentor was “enthusiastic, friendly, approachable, patient, understanding, and had a great sense of humor.”7

Holistic mentoring involves the whole person; it touches both the mind and the heart.

Still other studies indicate that there is an apparent lack of understanding about the concept of mentoring and its implications for nurses acting as mentors. Mentoring is often confused with or used interchangeably with tutoring. Tutoring is only one aspect of mentoring and is not necessarily expected to occur in every mentor-mentee relationship. A nursing tutor is someone who primarily assists in helping a student perform well on essays, term papers, tests and/or improving nursing skills.7

On the other hand, mentors, as defined by the English National Board for Nursing, are “appropriately qualified and experienced first-level practitioners, who by example and facilitation guide, assist and support students in learning new skills, adopting new behaviors and acquiring new attitudes. . .Mentors are there to assist, befriend, guide, advise and counsel students.”8 It is important that mentors and mentees understand the difference between the role of a mentor and that of a tutor. Otherwise, nursing students may have a negative experience with mentoring if they were expecting a private tutor.

Atkins and Williams (1995) explored individual nurses’ perceptions and experiences of mentoring undergraduate nursing students.9 The study focused on identifying critical features within the mentor-mentee relationship from the mentors’ perspectives. It also examined ways in which mentoring affected the mentors’ working lives and their other professional roles and responsibilities. 

The study’s findings suggest that mentors require formal preparation for their role, and that the activity of role modeling needs to be addressed in this preparation. Other findings include:

  • The time for mentoring needs to be included within the mentor’s working day.
  • The role of the mentor is complex and requires high levels of commitment.
  • Organized peer support groups may be valuable for mentors.

Holistic Mentoring

When done correctly, a good mentoring experience is holistic. It involves the whole person; it touches both the mind and the heart. Beyond the formality of the mentoring relationship, the vulnerable spirit of the nursing student must be nurtured.

At the heart of mentoring is the interpersonal relationship between mentor and mentee. The foundation of this relationship is the connection that they share. Here are five recommendations for developing a strong and effective mentor-mentee relationship:

  • Mentoring requires dedication from the mentor and a commitment to participate in the mentoring relationship throughout the academic year—and even beyond it. Mentors and mentees may find that the process of mentorship extends far beyond the suggested time frame of the individualized mentoring program. The mentor-mentee relationship may last for several years, or even a lifetime. There is no price tag that can be placed on such an invaluable relationship. 
  • A significant part of the mentoring relationship is based on the honesty and truth that the mentor and mentee share with one another, and it is critical that both participants recognize this. For example, if a nurse mentor tells the mentee that his/her senior year in nursing will be a breeze and no obstacles will get in his/her path, the mentor may unknowingly instill false hope. It would be more appropriate to support the student by saying that the senior year will be filled with challenges, but that the student should see them as positive, rather than negative, issues in their academic career. 
  • The next critical component of holistic mentoring is mutual respect. Mentors and mentees must treat one another as equals in this relationship. Mentors who belittle their mentee or have low expectations for him/her will lose the vision of the mentoring process.
  • Mentors should reflect a positive and caring attitude towards their mentee at all times. A positive attitude is contagious and so are negative behaviors. For many African American students, mentors may be one of the few lights shining in a dark place. Mentors should keep in mind that nursing students are under a tremendous amount of stress and pressure to do well in their courses.
  • The last component of the holistic mentoring relationship is appreciation of the mentor and mentee as whole persons. A mentee should recognize and appreciate that their nurse mentor may also be a graduate student, parent and/or nurse manager. In turn, the mentor should recognize and appreciate that the mentee may also participate in student nurse organizations, volunteer at a local hospital on weekends and/or work as a student research assistant.

Mentoring for the Future

There is no denying that the process of mentorship is complex. However, if both mentor and mentee consistently follow these guidelines, they will establish a mutually beneficial relationship that can have a lasting impact not just on individual mentees but on the future of African Americans in the nursing profession. If we are able to increase the retention rate of black nursing students through mentoring, there will be more baccalaureate-prepared African American registered nurses to care for the nation’s expanding and rapidly diversifying population. The hope is that these African American BSN graduates will then go on to obtain an advanced degree under the umbrella of nursing so that they can increase the supply of black nursing faculty and clinicians available to mentor future generations.

As a successful African American RN, nurse educator (I am a clinical assistant professor of nursing at my alma mater, North Carolina A&T State University), member of Sigma Theta Tau International and a recipient of the gift of mentorship during my own career journey, I feel that I have an obligation to reach out to future African American registered nurses. We are all familiar with the African proverb, “It takes a village to raise a child.” I encourage nurses and schools of nursing throughout the nation to create a village of holistic mentoring to help African American students achieve their goal of becoming registered nurses of the 21st century. 

Through my own experiences, I have learned that what African American nursing students need and deserve is to be connected to an African American nurse mentor in their community who can spend a relatively small but rewarding amount of time empowering a student nurse. By providing the necessary co-curricular activities and support, such as structured mentoring programs that leave a lasting imprint in the academic travels of black nursing students, we can ensure a bright future for African Americans in nursing. Remember that diversity in nursing is not a dream—it is an achievable goal that is essential to the future health of our nation.

References:

  1. Washington, D., Erickson, J.I. and Ditomassi, M. (2004). “Mentoring the Minority Nurse Leader of Tomorrow.” Nursing Administration Quarterly, Vol. 28, No. 3, pp. 165-169.
  2. Buchanan, B.W. (1999). “A Mentoring Pyramid for African American Nursing Students.” ABNF Journal, Vol. 10, No. 3, pp. 68-70.
  3. Nugent, K.E., Childs, G., Jones, R. and Cook, P. (2004). “A Mentorship Model for the Retention of Minority Students.” Nursing Outlook, Vol. 52, No. 2, pp. 89-94.
  4. Burnard, P. (1987). “Towards an Epistemological Basis for Experiential Learning in Nurse Education.” Journal of Advanced Nursing, Vol. 12, No. 2, pp. 189-193.
  5. Scott, E.S. (2005). “Peer-to-Peer Mentoring: Teaching Collegiality.” Nurse Educator, Vol. 30, No. 2, pp. 52-56.
  6. Knouse, S.B. and Webb, S.C. (2001). “Mentors, Mentor Substitutes, or Virtual Mentors: Alternative Mentoring Approaches for the Military.” Managing Diversity in the Military: Research Perspectives from the Defense Equal Opportunity Management Institute, Dansby, M.R., Stewart, J.B. and Webb, S.C. (Eds.), Transaction Publishers, New Brunswick, N.J., pp. 145-162.
  7. Gray, M.A. and Smith, L.N. (2000). “The Qualities of an Effective Mentor from the Student Nurse’s Perspective: Findings from a Longitudinal Qualitative Study.” Journal of Advanced Nursing, Vol. 32, No. 6, pp. 1542-1549.
  8. Suen, L.K. and Chow, F.L. (2001). “Students’ Perceptions of the Effectiveness of Mentors in an Undergraduate Nursing Programme in Hong Kong.” Journal of Advanced Nursing, Vol. 36, No. 4, pp. 505-511.
  9. Atkins, S. and Williams, A. (1995). “Registered Nurses’ Experiences of Mentoring Undergraduate Nursing Students.” Journal of Advanced Nursing, Vol. 21, No. 5, pp. 1006-1015.

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