On the Fast Track

Are you one of the growing number of minority students who are entering nursing school later in life, or returning to school mid-career to continue your education by earning a baccalaureate or post-graduate degree? If so, you may be wishing there was a way to make up for lost time, a way to somehow earn your advanced degree just a little more quickly than usual so that you can put it to work for you as soon as possible.

Happily, fulfilling this desire is not impossible at all. Enrolling in a so-called “fast-track” nursing program—i.e., a program that allows students to earn two degrees concurrently or even bypass one degree level altogether—could be the perfect solution for your needs.

The fast-track approach to advancing your education means that you don’t have to follow the traditional route of first gaining basic registered nurse (RN) preparation in hospital-based (diploma), associate (AA/AD/AS) or baccalaureate (BSN) programs and then sequentially attaining master’s and doctoral degrees. Fast-track programs are a more customized alternative in which, to cite just two examples, a student with an AD degree can go directly to a master’s degree without having to separately earn a baccalaureate, or a nurse with a BSN can go directly to a PhD, bypassing the MSN.

If this approach sounds appealing to you, one of the first and most important decisions you will need to make is choosing the nursing program that will best facilitate your career goals within a fast-track context. With at least 600 nursing programs available throughout the United States, you will find many that offer contemporary options that are far more flexible and non-linear than traditional nursing programs.

When perusing a program’s literature, look for phrases like “individualize your program,” “may be required” and “flexible options.” These phrases signal that the traditional degree sequence may be circumvented or combined, depending upon the student’s needs.

Which Lane is Right for You?

For a closer look at how fast-track degree programs work, and to give you an introduction to the many different possibilities available, here are just a few examples of successful programs from around the country.

Non-Nurse with BS or BA to RN with Master’s Degree. Even if you are not a registered nurse, it is possible to graduate as an RN with a master’s degree in nursing. For example, the University of California, San Francisco, School of Nursing offers the Masters Entry Program in Nursing (MEPN), a three-year program leading to an MS degree for persons without previous nursing preparation but with a baccalaureate degree (BS/BA) in another field. For more information, see the university’s Web site (http://nurseweb.ucsf.edu/www/ucsfson.htm).

About 60 students are admitted to the MEPN program each year. The first year of study, which spans four quarters, provides a general foundation in nursing and qualifies the student to take the California Board of Registered Nursing licensure examination. The final two years of the program are more individually paced.


RN with Diploma or Associate Degree to RN with Master’s Degree. Several universities offer accelerated coursework for RNs with two-year degrees who wish to earn a master’s degree in nursing, bypassing the BSN. The Department of Nursing at California State University, Los Angeles (www.calstatela.edu/dept/nursing/), currently offers two different fast-track MS degree options. The first program is for RNs with non-nursing baccalaureate degrees; the other is for RNs without a baccalaureate degree. The admission requirements, program length and coursework vary depending on the educational track entered. Both programs offer basic and advanced nursing study.

The University of Michigan School of Nursing (www.umich.edu/~nursing/) is another school that offers an RN-to-MS degree program; however, this option is available at the Ann Arbor campus only. You can complete the RN-to-MS pathway as a part-time student in three to four years, depending on your master’s specialty. The program integrates your prior education and experience into the curriculum by using your transfer credits and by allowing you to earn credit through examinations.

RN with BSN to RN with PhD. If you are an RN with a baccalaureate degree, you can earn a PhD in Nursing Science without having a master’s degree. For instance, at the University of Washington School of Nursing, Seattle (www.son.washington.edu), an RN with an bachelor’s degree can either earn a master’s degree while also pursuing a PhD degree, or graduate with a PhD without going for the master’s.


Other schools, such as Johns Hopkins University School of Nursing in Baltimore (www.son.jhmi.edu) have programs where an RN with a BSN can earn a combined MSN/PhD concurrently. Both the Seattle and Johns Hopkins programs are highly selective, have an integrated course of study and allow students to develop their own research programs with faculty guidance.

Can You Handle the Speed?

Fast-track educational options have both benefits and limitations. Because these positives and negatives are interrelated, it’s important to consider them carefully within the context of your career goals. The benefit of completing the required coursework for two degrees in an accelerated format, for instance, is coupled with the fact that the coursework is more intense and time-consuming. The shorter length of fast-track programs requires you to learn more information in less time than a student enrolled in a traditional program in which each degree is earned sequentially.

There are also financial considerations. If you are enrolled in a fast-track option, you may find it impossible to work part-time because of your heavier academic schedule. Therefore, your need for ongoing financial aid is more critical and substantial.

In a fast-track program, you may have fewer opportunities to benefit from educational diversity. For instance, a student earning two separate degrees at two different universities may experience different curricula and teaching styles, while a student earning a fast-track or combination degree will more than likely learn in similar environments with a select group of faculty. On the other hand, students in a fast-track program may be able to form more substantial relationships with their professors over time, building stronger collegial networks which may be beneficial in the future.

One major limitation of earning a PhD without a master’s degree in nursing is that many state boards of nursing, as well as schools of nursing, recognize the master’s degree as qualification for undergraduate- and graduate-level clinical teaching, while the PhD is seen as a research-focused degree. Thus, without the master’s degree, you may not be technically prepared to teach clinical-level coursework—a significant drawback if your desired career plan involves becoming a faculty member.

Getting On the Road


If you are interested in entering nursing with an advanced degree, or are an RN seeking to increase your career potential by continuing your professional education, now is an excellent time to learn more about fast-track degree programs. Use the Internet as a resource to explore the flexible educational options available to you. Many of these programs are tailored to recognize your abilities and talents while capitalizing on your prior educational and clinical experience.

Earning advanced degrees helps you hone your critical thinking and decision-making skills while introducing you to emerging, innovative areas of nursing. Your career options as an RN will multiply as you discover exciting new areas for professional growth and advanced competency.

Mixed Messages

Of the 2.2 million nurses in the United States, the vast majority still conforms to the traditional white/female nurse profile. Only 4%-5% of nurses are male, 4% are African American, 3.4% are Asian/Pacific islander, 1.6% are Hispanic and 0.5% are Native American/Alaskan Native.1

With the exception of male nurses, whose numbers are on the increase, these percentages have essentially not changed in 10 years, despite ongoing changes in the makeup of the U.S. population. For example, the growth of the Hispanic population is now outpacing that of the nation as a whole. And yet, according to the most recent National Sample Survey of Registered Nurses by the U.S. Department of Health and Human Services’ Division of Nursing, Caucasians still account for approximately 90% of the total number of registered nurses in the U.S., even though they comprise only about 72% of the total population.

It seems to me that at least three issues are raised as a result of these figures. First, although there has been a steady change in the racial and ethnic makeup of the greater U.S. population, the nursing profession does not reflect this change. The underrepresentation of minorities in nursing and schools of nursing can be attributed to a variety of factors, including the high dropout rate of minority students at the high school level.2 Additionally, a minority student’s acceptance into a nursing school does not guarantee his or her successful completion of the program.

Secondly, these statistics raise the issue of cultural competency—both within the profession and in nursing education. Providing culturally competent care is the key to ensuring that underserved minority populations receive quality health services. Yet most nursing schools continue to design their curricula around the needs of the majority, leaving out the unique needs of the other 28% of the population. Perhaps nursing schools would be better able to recruit and retain students if they would offer a curriculum that would teach students to take care of people from all ethnic backgrounds.

Towards a Multicultural Curriculum

Embracing multicultural education is a shift from the norm of educating from a Eurocentric perspective, but by doing so, the opportunities for people of different cultures to learn about each other and themselves increase. A multicultural perspective means accepting that a variety of cultures exist and understanding that each one may have its own different traits, beliefs and traditions.


Although there are exceptions, basic nursing education generally does not include information relevant to minority populations. For example, in many instances hair care for African Americans, and also some Hispanics, is different than hair care for whites. Yet this issue is rarely discussed in nursing schools. It is addressed in teaching about personal hygiene, but instruction is generally based on the needs of the white population. This approach leaves nurses underprepared to provide care to minority patients whose hair texture may be different. Unfortunately, what often happens is that the nurse may not provide any hair care at all—a good example of how a lack of cultural competency affects the quality of patient care.

A second example is the dietary instruction that student nurses receive. Sometimes the foods included in the teaching plan may not be the same foods that a minority patient consumes at home. Therefore, the instruction is ineffective because the patient’s cultural food traditions have not been taken into consideration.

Negative Reinforcement

A third issue, based on my own experience as the only Latina student in my nursing program, is the way students of color may be perceived and treated within the educational experience—by faculty, administration and peers. In researching my doctoral study, “Understanding the Experiences in Nursing School: A Latina Perspective,” Latina students described to me such incidents as a faculty member telling a student: “Spanish students do not pass my course.” Another student told of being asked by a fellow student if she was “hiding a knife or a gun” in the brace on her leg, because “you Puerto Ricans are always shooting people.”

In another incident, a Latina student who felt she had received an unfairly low grade on a paper took her case to the school’s director of nursing, who asked, “Is Spanish your primary language?” The student replied, “No. What does that have to do with it?” The director’s response was: “I wish you had said ‘yes,’ because that would explain the problems you are having.”

Being continually bombarded with cultural insensitivity and negative stereotypes can be detrimental to a minority student’s success in school. Non-inclusion can also be a contributing factor to a student’s failure to complete his or her nursing studies. Students of color need to receive positive messages and images to enhance and support their learning experiences. A nurturing educational experience is beneficial to all students, not just those who are white.

Whatever their race or ethnicity, students need to feel they are a respected part of the educational experience, and they need to be trained to offer culturally competent care to a diversity of patients. If educators don’t provide all nursing students with an opportunity to develop a multicultural perspective—i.e., to view nursing and patients from a broader perspective than just a Eurocentric one—then we have shortchanged them in their education.


1. U.S. Department of Health and Human Services, Bureau of Health Professions, Division of Nursing (1996). National Sample Survey of Registered Nurses.

2. Nieto, S. (1996). Affirming Diversity: The Sociopolitical Context of Multicultural Education (2nd edition).

Old Enough to Learn Better

As a senior at Chicago State University, Beverly Stewart has a schedule filled with classes and extracurricular activities, including a position in student government, as well as a job doing hospice work as a certified nursing assistant. In May, she will graduate with a bachelor’s degree in nursing.

Her classmate Markitha Reacco is also in her final year of the Chicago State nursing program. Reacco combines her rigorous classload with an EKG technician job at Rush-Presbyterian St. Luke’s Medical Center and volunteer work at the Hyde Park Neighborhood Club. She says becoming a nurse has been a lifelong dream.

Stewart and Reacco may sound like typical “20-something” nursing students—but in reality they are part of an emerging trend of nursing students who are getting their professional education later in life. Stewart is a 45-year-old mother of four and Reacco is a 44-year-old with two children and two grandchildren. Both women are also African American and single mothers.

As older students than their classmates, these women face many challenges. They have had to make the adjustment to college while juggling the responsibilities of jobs and family life. They have faced the financial burden of paying for their nursing education at a time when others are planning for retirement. And they worry about having fewer years in which to move up the career ladder and make their contribution to the nursing profession when they graduate. But both Stewart and Reacco are confident that they have indeed made the right choice.

Marketable Assets

Stewart explains that she actually began her nursing education in the late 1980s—even finishing the majority of her prerequisite classes. But with small children at home she was forced to put her studies on hold and put her family first.

Today, Stewart doesn’t see her age as a hindrance to getting her nursing education. In fact, “I see it as an asset,” she explains. “I am more focused now, because I don’t have the distractions of small children. I have a go-get-it attitude. I am reliable. I am responsible. I see my age as a more marketable aspect than anything else.”

One of the most positive results of her collegiate experience, Stewart adds, is that her two younger sons are now hoping to earn college degrees as well. “They see me up at night studying; they see how driven I am and how I am succeeding. It makes them believe they can do it, too.”


A former medical assistant whose mother and sister are both nurses, Reacco says she has found going to school later in life challenging because it is difficult to juggle the demands of schoolwork, family, work and other commitments. “There is a lot to absorb,” she explains. “I find I have to put a little bit more into it than I did in my 20s. It takes a lot of discipline.”

Reacco says she has also felt the pinch of financing her education while putting her daughter through college. “I had to reduce my working hours to about 23 a week, which meant a cut in pay,” she explains. “Finances are the biggest challenge.”

But that doesn’t stop Reacco, who hopes to work as either a critical care or geriatric nurse, from planning to continue on to get a master’s degree, and perhaps even a PhD. “The nursing profession is trying to bring in more young folks, so I have a lot of competition out there,” she explains.

The Graying of Nursing Students?

According to a recent study by the U.S. Department of Health and Human Services, Health Resources and Services Administration, Division of Nursing, the average age of graduates from basic nursing education programs is on the rise. In the period from 1991 to 1996, the average graduation age of nurses was 31.7 years—up from 23.2 years in the 15-year period prior to the study.

The survey also found that the average age of nursing students graduating from associate degree programs in 1991-1996 was 33.5 years, compared to only 28 years for baccalaureate program graduates. Although the study does not break down these statistics by race or ethnicity, many educators believe that minority students often opt for associate degree programs, because of financial constraints.

Sandra Barnes, PhD, RN, associate professor of nursing at Chicago State University, says there are a number of older nursing students at her school, which is a predominantly black university. Their average age, Barnes says, is about 36. “Many older students are going back to school after they have established families. Nursing is something they have always wanted to do and now they have the time and freedom to do it.”

Many of these older students are in the university’s RN-to-BSN and LPN-to-BSN programs. The generic baccalaureate program has more students right out of high school, says Stewart, who adds that she and Reacco are two of only four students over 30 years of age in their senior class.

Older students have a strong investment in program completion, explains Barnes, who is African American. “They are at a point in life where they have made a commitment to undertake a career that they will be able to stay with until retirement. They have goals that they are determined to meet,” she says. Nursing educators also agree that older students are easier to teach than recent high school graduates, because they have more life experience.

Migdalia Rivera Goba, EdD(c), MS, RN, a clinical assistant professor at the University of Massachusetts at Amherst School of Nursing, believes older minority students bring a lot to the table. “I think their life experience, both professionally and personally, is a huge asset, including their experience living as an ethnic minority in the United States,” she says, adding that age isn’t really a barrier to getting a position after graduation, because of the nationwide nursing shortage.

Feeling the Squeeze

Ann Joyner, 44, a senior at North Carolina A&T State University School of Nursing, another historically black school, says she began her education to become an RN at a community college but later transferred to her current school’s baccalaureate program. “I had been doing okay at the community college, and I thought, ‘Why am I doing this program when I can go to the university and get a BSN?’'” she says.

According to Joyner, the most challenging part of her nursing education experience is dealing with the diversity of ages within the student population. “The young ones see things so differently, while the older ones are more relaxed, calm, a little more focused and not in a hurry,” she says. Many of her classmates call her “Miss Ann” out of respect, she adds, and her nursing sorority recently elected her as president.

Joyner, who has two children, nine and 25 years old, says she and her husband are beginning to feel the squeeze of financing her education. She spends approximately $1,000 per semester on tuition and between $275-$350 on books.

Angela Cisero, RN, says she and her husband saved and budgeted for several years to enable her to go through the UMass RN-to-BSN program. Cisero, who is 34 and African American, is the mother of three children and works 34 hours a week as a nursing supervisor at a long-term care facility. She says she will spend approximately $5,000, which includes books, on the year-long program. “It was a personal achievement goal, something I always wanted to do, she explains. “Overall, it has been challenging but very invigorating. I have to be very organized.”

Nursing Careers for All Ages—and Genders

Although she always excelled in math and science, Cisero says she was not recruited in high school to go into nursing—a trend many nursing educators see as a problem.

“Many minorities who go into nursing enter the field at an older age and attend programs at junior colleges,” says Bette Keltner, PhD, RN, FAAN, dean of the Georgetown University School of Nursing and Health Sciences. “While that’s a positive thing, because the experience of older nurses enriches the profession, it is also a negative thing, because these students end up in positions where they will not advance or have influence in minority health decision-making.”

Keltner, who is American Indian, feels there should be a systematic outreach by nursing schools to high school students, and in particular, minority students. “In the past, nursing schools did not have to do proactive outreach, because the students were coming to us. But today, the dynamics of recruiting have changed,” she explains. “And we continue to perpetuate the idea that nursing is a female profession, instead of making an effort to actively recruit more male students.”

Romanitchiko Samiley, RN, of West Los Angeles, says he never considered nursing as a profession when he was in high school. “Males often don’t think about entering the field,” says Samiley, who is 31. “Even though I had some friends and family members who were nurses, most of them were female. I never considered becoming a nurse.”

Samiley, a Filipino American, went to the University of California at Berkeley and earned a BS degree in integrated biology. He then worked as a health educator and developed an interest in nursing, earning his ADN degree in his mid 20s. Because his ultimate goal is to become a nurse practitioner, Samiley is currently attending the University of California at Los Angeles in the three-year RN-to-BS-to-MSN program.

At this point, he sees his age as an advantage. “I have had some experience working,” he says. “I have discovered what I like in a career and what I don’t like. When you are doing something you are interested in, you tend to be more focused and you enjoy it more.”

Samiley also works as a staff nurse at Santa Marta Hospital. He says time management is an issue for him. “Being older, I have more responsibilities, unlike the first time around,” he says. “Balancing my education, social life and career is the most challenging part of my current educational experience.”

Keep Moving Up

According to Kay Baker, RN, MSN, associate dean of Student Affairs at the UCLA School of Nursing, the school draws a diverse group of students–both in age and race. Older minority students have much to offer, she says. “They bring nonacademic experience and life experience. And they bring a cultural perspective that we need. Many of them have been working in a community setting or a hospital setting for a number of years, so they know what the needs of the community are.”


Baker believes nursing is a profession where people can continue to progress up the educational ladder, no matter what their age. “Students shouldn’t think of their first nursing degree as their one and only educational experience,” she emphasizes. “Nursing is such a rapidly changing profession in terms of knowledge and technology that you can’t prepare at one level and expect that to carry you through an entire career.

“Some minority students start their nursing education by going to a community college, because it’s more accessible and affordable—but they shouldn’t stop there,” Baker adds. “If I had one message to older students, it would be: Keep moving up to next the level of your professional nursing education. Don’t stop learning.”

Mentoring to Empower

San José State University School of Nursing in San José, Calif., is a state-funded program with a significantly multicultural student body. In 1988, our student population was 75% Caucasian and 25% racial and ethnic minorities. Today, however, thanks to intensive multicultural outreach recruiting designed to better reflect the demographics of the region we serve, those numbers have reversed dramatically: 75% of our students are persons of color, primarily from Vietnamese, Filipino, Hispanic and African-American backgrounds.

But even at a multicultural campus where “minority” students are the majority, many students of color face special challenges in successfully navigating their way to graduation and transitioning into a professional nursing career. Based on more than 12 years of experience mentoring multicultural nursing students, I have found there are two primary areas of need: emotional support and improving interpersonal communication skills. San José State’s School of Nursing Mentor Program has developed effective strategies for assisting students in both of these critical areas.


Students of color often experience feelings of isolation and loneliness during their enrollment in the nursing program. In some cases, this is because the student is the first person in his or her family to attend a university and no family members can share this experience or offer advice. Many of these students feel that while their families are supportive, they don’t understand the stresses that the students are encountering.

To meet this need for emotional support, our mentor program offers students three options:

Professional nurse mentors

Our nursing students of color have found that being matched with a professional mentor, either from their same ethnic background or not, is very beneficial. While the degree of involvement between student and mentor varies in different mentoring relationships, all of these pairings have provided the students with enormous support.

Students report feeling very comfortable with their mentors, who can often relate personally to the students’ experience and have shared the same frustrations and challenges. The opportunity to work closely with a nursing professional also gives the students exposure to successful role models, the realities of nursing practice and the different career choices available to them.

Peer mentors

This option pairs students with other students of color in the nursing program. Students in the advanced levels of the program provide mentoring support to peers in the beginning levels, serving as “big brothers” or “big sisters” to their mentees.

Faculty mentors

In this program, School of Nursing faculty act as mentors to provide students of color with both emotional and informational support. From their unique vantage point, faculty members are aware of university services students may need. For example, Counseling Services can not only provide assistance with personal and family problems but can also help students with test-taking strategies, study skills, relaxation techniques and overcoming math anxiety.

Learning to Talk the Talk

The School of Nursing Mentor Program also focuses on assisting students of color who have significant problems in communicating effectively with faculty members, medical staff and patients.Because of their cultural backgrounds, many of these students view authority figures, including faculty and nursing staff, as busy individuals who don’t have the time or patience to talk with students. The lack of culturally diverse faculty role models is also problematic, further contributing to many minority students’ discomfort about approaching their professors when they need help.

Students have also reported problems with comprehending faculty members who talk too fast and with feeling guilty when asking questions about concepts they don’t understand.

As part of the mentoring process, we encourage the students to write down questions or tape-record conversations with faculty members. This approach is effective because students don’t feel guilty about taking up faculty’s time and they can review the answers at their own pace. I also encourage them to bring a friend along when meeting with a professor, as this is less frightening than facing the faculty member alone.

Role-playing is another highly effective strategy I use to help students of color feel more comfortable in stressful interpersonal situations. I assist them in preparing a “script” to follow and we practice the script with me playing the authority role, giving various types of responses to what the students say.

This plan is also helpful in the clinical setting, letting the students strengthen their skills in interacting with supervisors, coworkers and patients. Through role-playing, they practice assertive behavior and dialogue that will facilitate direct communi-cation among members of the health care team.

The nursing profession values nurses who are client advocates and who act assertively on behalf of their patients. For some students of color, such as those from Asian backgrounds where it is considered disrespectful to question authority, such displays of assertive behavior may be in direct conflict with the student’s cultural beliefs.

This contrast between behavior that is expected in the clinical setting and acceptable behavior at home can cause students to feel emotional distress. Here, too, I use role-playing to model appropriate clinical behaviors and help students develop the assertiveness skills they will need to succeed in the workplace.

Cultural miscommunication between faculty and minority students is another common problem. An example of this occurred when a professor referred a student to my office because the student had not prepared properly for her clinical and was therefore considered unsafe in the clinical setting. Talking with the student revealed that she had researched the patient’s disease process and had read the required sections of the textbook, but had not understood the material.

When the student was quizzed in the clinical setting, she told the professor that she had not done the appropriate readings, when what she really meant was that she didn’t understand what she had read. I was able to help this student by explaining the difference between these two concepts.

Some nursing students of color, especially those for whom English is a second language, will answer “yes” when asked if they understand lecture content or clinical instructions, when in fact they do not entirely understand the material. This behavior is the result of anxiety, embarrassment and the need for approval from an authority figure. A more effective method of evaluating these students’ comprehension is to have them explain the content or procedure in their own words.

Building Clinical Confidence

In the clinical setting, too, many beginning-level students of color may be anxious, self-conscious and unsure of their communication skills. Some students may respond with culturally accepted but inappropriate responses. They may also feel uncomfortable when providing care for Caucasian patients and find it very stressful to interact personally with them.

Once again, role-playing exercises are an excellent way to increase students’ comfort levels in these situations and help them develop confidence in themselves. I demonstrate examples of the types of conversations and behaviors that are acceptable when caring for patients, and then the students practice the art of conversation or “small talk” with each other.


In addition, placing minority nursing students in clinical settings that serve multicultural populations can greatly benefit both the students and their patients. Our mentoring program has found that initial clinical assignments in this culturally familiar setting decrease the students’ anxiety, because they understand the culturally influenced behavior of their patients.

Moreover, multicultural patients may feel more comfortable discussing health care issues with a student nurse from the same ethnic background. This shared understanding of cultural traditions and beliefs can aid in effectively changing patients’ health-related behaviors and compliance with medical treatments.

The goal of mentoring students of color is to empower them. When students feel empowered, they can overcome obstacles, graduate from a nursing program and begin to make immeasurable contributions to providing quality health care in a culturally diverse community.

Mentoring New Nursing Graduates

There is a saying in our profession that “nurses eat their young”–referring to the way certain veteran nurses are said to treat new nursing graduates. But just what does this statement mean? Are nurses like wild animals that carry their young in their arms only to devour them at the first chance they get? Are we the type of people who pretend to care for our young and then, when an opportunity presents itself, we tear the weaker one into little pieces?

Although some people in the nursing profession may believe this is true, we don’t think so. A nurse is someone who devotes his or her life to caring for other people’s physical, mental, social, spiritual and emotional health. Nurses do this not only by taking care of their patients but also by taking care of their co-workers. When we as nurses take care of our new graduates, we are functioning in the role of a mentor.

Not all nurses have the desire or the personality to be a mentor to new graduates, just as not all people desire to be nurses. So the question is, who should be a mentor and what qualities should a mentor have when working with new graduates?

Desire to Be a Leader

Leaders are responsible and accountable for others. There should be a desire to nurture another person in a particular role.

To be a leader of new graduates, you must learn how to lead. By definition, being a leader requires that you have someone follow you. It amazes us when nurses ask their supervisors if they can precept a new graduate and then complain about having “a shadow” follow them for three to six weeks. What a dehumanizing way to describe someone! We should never refer to our new graduates or any preceptee as a shadow.

These people are our fellow colleagues in the nursing profession. Most of these new graduates have attended college for four to six years in hopes of making a difference in someone’s life. By providing leadership to a new graduate, you will have the wonderful opportunity to help shape this person’s attitude about what constitutes excellence in nursing care.

Having an impact on someone’s life is a huge responsibility. You as the leader must decide what motivates the new nurse. You must consider such factors as: What is this person’s learning style? How does he/she respond to stress? Is the person ethical in his/her behavior? Will he/she ask questions when something is not clear?

As a leader, you will create opportunities for learning in a positive manner. How do you make these opportunities available? We suggest having a roadmap that will tell you where the new graduate will start and how to evaluate his/her progress throughout the training period. An example of a roadmap is shown in Figure 1, with each stage of the process lasting two weeks.

Dr. Leland Kaiser, the award-winning health care consultant, educator and author of Mapping Your Future: A Lifework Planning Guide for Health Care Professionals, has said, “If a person is learning, you will know it by their soul’s frequency.” This frequency can be measured by the amount of energy a person releases in joy, creativity, motivation and in having fun. A good leader will recognize these frequencies and learn how to tap into them to make learning enjoyable for the new graduate.

Desire to Be an Educator

Nurses do not necessarily need experience in teaching or training to precept new graduates. What you do need to have is the desire to educate others, along with the ability to share your knowledge and experience in a way that will be meaningful to the person you are mentoring.

All too often, managers are given the task of choosing who will train their new nurses. Not all nurses have the desire to teach, and not all nurses can articulate themselves well. During our own nursing careers, both us of have worked with certain nurses who didn’t want to train new graduates but were required to do so by their managers.

Most of these nurses who grudgingly took on the task utilized what we call the “Watch Me” method of training. Every trainee who was put into these nurses’ care received the same treatment: Watch me and learn. There are two problems with this type of training. First of all, as adults we learn in a variety of ways. Some people are visual learners while others are verbal learners. Still others learn best by demonstration, by hands-on or by a combination of methods.

Secondly, Dorothea Orem’s well-known theory of nursing deals with the self-care model. We want our patients to learn to take care of themselves. As an educator to our new graduates, we should strive for this same result. We should want our new nurses to learn to become independent.

An old Chinese proverb says that if you give a man a fish when he is hungry you feed him for a day, but if you teach him to fish you feed him for a lifetime. The same is true in the nursing profession. If we tell new graduate nurses to “watch me” show them a skill, we teach them for a moment. But if we teach them to perform the skill themselves, we have taught them for a lifetime.

Desire to Be Patient

The online encyclopedia Wikipedia defines patience as “the ability to endure waiting, delay or provocation without becoming annoyed or upset, or to persevere calmly when faced with difficulties.” When mentoring new graduates, it’s crucial to understand that the learning process takes time, that not everyone learns at the same pace and that things may not always go as smoothly as you anticipated.

You may encounter some trainee nurses who are struggling with barriers that can affect their ability to learn effectively. For example, they may face language barriers, such as difficulty understanding or speaking English. They may have behavioral or social barriers, such as shyness, being easily angered or difficulties in getting along with others.  In order to develop teamwork on a nursing unit, it is necessary to address such behaviors very early in the training.

Having patience requires understanding other people’s behavior. But before we can do that, we must first understand ourselves. If you are a nurse who desires to be a mentor, you must first do a self-inventory of your own attitudes, beliefs and biases. Learn what makes you tick. Once we have gained this self-knowledge, then we can help others.

The quality of patience will allow you to give constructive criticism that will promote growth. Communicate your thoughts about the learning process with the new graduate, and don’t be afraid to be honest. At the end of the orientation period there should be no surprises.

Everyone makes mistakes. What is important when working with new nurses is how we communicate their errors to them. This is where patience and compassion comes into the training process. Our new nurses should feel that we are trying to find them doing things right rather than focusing on their faults.

A mentor with patience can be a positive role model to new graduates who are finally realizing their dream of becoming of a nurse. You have the power to set an example of excellence, both in nursing skills and in high standards of personal and professional behavior. Be accessible to others starting out in the nursing profession. Have a goal to train one nurse the way you would want someone to train you. Maintain a positive attitude.

Nurses are a wonderful, caring group of people. We take time with our patients, families and friends, and we give so much back to the community. Now it is time for us to give back to each other in a loving way, by taking the time to work with our new graduates as they help us get over the nursing shortage.