Identifying the barriers that minority nurses will face allows leaders and healthcare organizations to create more opportunities to groom them for leadership positions. Mentoring is a strategy used in many organizations to attract and retain individuals. In nursing and other professions, mentors influence the career path of their mentees by building relationships based on trust, respect, open communication, and ongoing dialogue. Mentors are often revered as advisors and honored as true friends. Minority nurse leaders who share stories of their journey claim that having a mentor was critical to their success.
Candor, compromise, confidence, complexity, and champion have been described as the competencies necessary to mentor a minority leader. Mentors must permit open conversation and be willing to provide honest feedback to mentees. Mentors may need to help their mentee understand circumstances in which compromise is necessary. This may also include managing the mentees' feelings of folding to organizational pressure or losing on issues important to their culture or race. Mentors preserve the mentee’s confidence and ensure integrity in all their interactions. This is particularly important in circumstances in which the minority leaders may feel like their individuality has not been considered. Mentors also help mentees navigate issues of workplace diversity that may be heavily charged. Most importantly, mentors support mentees and the issues that are of concern to them. They advocate for the mentee and seek out opportunities for the mentees' skills and talents to be recognized and assist them with progression within and outside of the organization.
These are examples of how the competencies of mentors should be used to develop minority nurse leaders. One of the great benefits of mentoring relationships is that the only cost is the time that it takes to connect or meet with one another. Sometimes these meetings can occur during lunch or during planned organizational events designed for networking or fellowship. Many times, these meetings are set up on an ongoing basis such as monthly or quarterly, and they can occur over the phone or through a web conference. Mentors and mentees can be very creative about finding ways to ensure that they continue to meet with one another and address the goals and concerns of the mentee.
Minority nurses often face a lack of exposure and opportunities to enhance professional growth and development. Mentoring provides valuable support and helps to reduce health care inequality among diverse populations. Nurses who can speak the same language and understand their patient's cultures, values, and beliefs can provide better care. Encouraging minority nurses growth equips them with the resources for a successful career and positions them as future nurse leaders.
Here are the five competencies when mentoring a minority nurse. First, nurse mentors exhibit candor with mentees to have honest, open, and sincere interactions. Mentors should foster an environment of safety and trust. Demonstrating a willingness to listen and providing clarity regarding expectations helps to develop trust between the mentor and mentee.
Second, nurse mentors compromise to bridge gaps in understanding by connecting the mentees perspective and knowledge to new learning and experiences. Finding that common ground develops a problem-solving mindset rooted in the mentee's sense of self to translate their cultural experiences into the care they provide. Third, nurse mentors instill confidence in mentees to solve problems and remain resilient in pursuing solutions. They encourage the mentees growth in their own role and inspire enthusiasm for nursing.
Fourth, nurse mentors demonstrate complexity to help mentees recognize the diverse needs of other cultures, as well as acknowledge and accept personal and others microaggressions. Cultural diversity demands openness, flexibility, and acceptance due to its broad range. Modeling these behaviors and encouraging the same in mentees promotes acceptance and understanding that cultural diversity requires lifelong learning from mentors and mentees alike.
And finally, nurse mentors champion mentees through advocacy and support. Nurse mentors in organizational positions can facilitate organizational or policy changes necessary to allow mentees to succeed. Also, nurse mentors can support mentees by pushing them to achieve high standards.
As a quick recap, mentorship provides valuable support to develop minority nurse leaders and addresses the needs of a growing, diverse patient population. Nurse mentors help develop minority nurse leaders by demonstrating the following competencies. First, exhibit candor to establish a bond and build trust with mentees. Second, compromise to bridge gaps that encourage mentees to translate their cultural experiences into patient care.
Third, instill confidence and resilience, so mentees continually seek solutions. Fourth, recognize the complexity of cultural diversity by identifying microaggressions and modeling lifelong learning. Last, advocate and support mentees by championing their needs and promoting policy changes that encourage minority nurse's professional growth.
Mentors of minority nurses should be aware of all available opportunities within the organization so that they can share them with their mentees. Such opportunities for leadership development and growth may include a clinical ladder program. Clinical ladder programs have existed for decades in nursing and are designed to recognize the expertise of bedside nurses in contributing to improving patient outcomes as they increase their nursing knowledge and skill.
Often, achieving milestones on the clinical ladder program means additional compensation for nurses, thus increasing their salary. In clinical ladder programs, nurses demonstrate the contributions that they have made to patients, their clinical unit, the organization, and the profession, and how they have developed professionally. Serving as the Co-Chair of a unit governance council, becoming a CPR instructor, obtaining certification in your nursing specialty, and presenting an improvement project at a meeting are some examples of contributions that may be considered in a clinical ladder program. These contributions are usually written up and provided to the Nurse Manager, then a review committee makes a determination about the nurse’s progression.
In addition to compensation, the nurse's title may change.
EXAMPLE
A new graduate nurse may have the title of Registered Nurse Level One, and a nurse who has completed certain steps in the clinical ladder program may have the title of Registered Nurse Level Two.Active participation in a clinical ladder program, or any similar professional development opportunity, increases nurse engagement and develops nursing leadership skills. Clinical nurse ladder programs can help develop a pool of minority nurse leaders who make significant contributions at the bedside and throughout a healthcare organization.
While clinical ladder programs require an individual to invest time in leadership development tasks and seek out experiences, the cost associated with clinical ladder programs is primarily covered by the nurse’s employer.
Clinical ladders are optional organizational programs that allow nurses to advance within their role while remaining at the bedside. These programs encourage nurses to stay updated on the latest evidence-based practices and provide methods to hone their decision making skills. It also recognizes nurses for their investment in improving patient outcomes at their organization and can include financial incentives. Nurses participating in clinical ladder programs often receive nursing leadership promotions.
Now, clinical ladder programs can include four advancement levels, such as novice, advanced beginner, competent, and expert. Though the specifics vary across organizations, advancement through the clinical ladder usually involves progressively more challenging criteria for each category. These categories typically include-- clinical experience, professional development, certification, and formal education.
First, the clinical experience category looks at the number of years spent working as a nurse, as well as within the organization. Increased levels of experience promote better decision-making abilities that improve patient outcomes. Most clinical ladder programs range from little to no experience at the novice level to several years of experience at the expert level.
Next, the professional development category consists of participation in activities that encourage nurses to keep updated about evidence-based practices and measures to improve patient outcomes on their units. These activities include in-service trainings, unit-based committees, short-term teams, and professional nursing organizations. Nurses can also assume leadership roles, such as participating in process improvement projects, serving as mentors, and providing clinical instruction for in-services or other courses. Generally, clinical ladders require nurses to acquire professional development activities beginning at the advanced beginner level. And the requirements increase at each level thereafter.
Next, the certification category involves obtaining and maintaining various certifications. These can include board certification in their respective fields, such as ambulatory care, critical care, medical/surgical, and pediatrics. Specializations allow nurses to master core competencies that improve patient care in those fields.
Other certifications include instructor certification for advanced resuscitation, fetal heart monitoring, and trauma nursing care. Through teaching, nurses pass their knowledge and experience to other nurses. Certifications are often necessary for nurses aspiring to achieve competent or higher on the clinical ladder.
Finally, the formal education category includes obtaining a university-level degree in nursing. These higher academic degrees typically include required courses on nursing leadership, research, and management that encourage more independent and higher-order thinking. Usually, nurses must earn at least a bachelor of science in nursing to rise to the competent level or higher on the clinical ladder.
As a quick recap, clinical ladder programs provide a path for bedside nurses to advance in their roles by incentivizing nurses to participate in activities that improve patient outcomes. These programs typically include four advancement levels. Advancement through the latter involves progressively more challenging criteria for each category.
First, increasing levels of clinical experience contribute to better decision-making skills. Second, professional development activities keep nurses updated on evidence-based practices and measures to improve patient outcomes. Third, obtaining certifications allow nurses to master core competencies and pass their knowledge and experience to other nurses. Finally, formal education provides courses that encourage more independent and higher-order thinking. Overall, participation in clinical ladder programs provides the necessary skills to advance to nursing leadership positions.
A third tool for minority nurse leader development is formal education. Underrepresented minority groups comprise over 30% of baccalaureate, masters, and doctoral nursing programs (Persaud, 2020). The IOM report calls for nurses to attain further education so they will be prepared to take on new roles that emerge with changing healthcare settings and delivery systems. A minority nurse may want to enhance their career plans with formal education, such as a master's or doctoral degree. Such education might serve the purpose of increasing one's clinical capabilities or accrediting them to educate other nurses, manage healthcare organizations, or conduct research in the field of nursing.
Formal education requires additional costs that are usually the responsibility of the nurse. Minority nurses seeking additional formal education should consider options to decrease the cost, such as employer-sponsored tuition reimbursement, graduate assistantships, university or professional association scholarships and grants, and loan forgiveness programs. While additional degrees do not guarantee advancement, their absence can hinder promotion because some leadership positions require graduate degrees. Ensuring that minority nurses can participate in mentoring relationships, engage in career development opportunities, and further their education can help develop a diverse cadre of nurse leaders.
Authored by Khaliah Fisher-Grace, PhD(c), MSN, RN, CPHQ, PCCN-K
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