WellStar Center For Nursing Excellence Executive Director And Founder .

This integrative review provides a comprehensive summary of the literature on new nurse leadermentorship practices. The scope includes nurse leaders who could have various titles such as nursemanager or nurse director or other middle management titles in the healthcare setting. It also discussesthe various themes identified in the literature and outlines the best practices for new nurse leadermentoring.BACKGROUND.There are limited research studies on nurse leader mentoring practices that. Most research shows thatthese studies are conducted by specific programs and center around the individual needs of nursesbeing mentored. Although studies have been conducted in many regions of the world, the outcomes arenot longitudinal and are not often considered when a mentoring program is being developed. Thisreview explores best practices and research that has been doneconducted on formal mentoring for newnurse leaders assuming a leadership role are.The nurse leader workforce is aging rapidly daily leaving organizations to grapple with limited successionoptions for leadership positions. Developing nurse leaders is an inevitable pathway for excellence innursing. Nurse leaders are not only important to the organization but also important to the profession ofnursing. Their role cannot be ignored and must be developed to provide the support needed for youngnew nurses that are beginning their careers in this demanding yet rewarding profession. To fill this gap,today's nurse leaders need to actively help support the next generation of nurse leaders to learn and fitassimilate into leadership roles. Any type of leadership involves action and the present nurse leaderought to work fervently to establish the role of the nurse. However, there is less evidence and standardpractices for mentoring new and advancing nurse leaders.Nurse leaders’ mentoring exists in the literature as a fundamental pillar in many organizations, as such,it is playsing a vital role in transforming Nurse nurse leadership practices. Because leadership is inherentin all nursing roles, mentoring relationships are crucial in developing and supporting leadershipbehaviors of nurses employed in hospitals (Vatan & Temel, 2016). However, little literature exists thatbuttress this notion.Not all nurses start their career with the thought of becoming nurse leaders, at times nurse leaders arethrust into leadership positions, not because of their leadership skills but either because of their clinicalcompetency or recommendation from colleagues. Thus, find themselves ill-prepared for these roleswhere they lack support and guidance to manage the challenges inherent in leadership roles. Nurseleader mentorship programs provide an opportunity to learn and acquire the skills needed to excel.The History of mentorship dates back in Homer to King Odysseus who asked Athena, the mentor, toguide his Telemachus in process of maturing and taking command of difficult situations (Barker, 2006;Berk, Berg, Mortimer, Moss, & Yeo, 2005; Kilcullen, 2007). In nNursing, aArchival research revealsFlorence Nightingale had many mentor-style relationships (Lorentzon & Brown, 2003). Vance (1982)undertook a pioneer study on mentorship with 71 nurse leaders, and Stewart & and Krueger (1996)conducted evolutionary literature reviews on the then status of nurse mentorship. The support fornurses to mentor those new in their role has well been reinforced over time. This should not bedifferent for new nurse leaders, literature on new nurse leadership mentorship is limited.Mentorship can be both formal or informal; formal mentorship programs being more structured tendto have clear purpose and have the potential to achieve greater results. Several studies emphasize theeffects of formal mentorship programs on nurse leaders, support the benefit of a formal mentorship

program on nurse's leadership behaviors. Vatan &and Temel (2016) studied how they can influencenurse leadership behaviors, including improving individual leadership skills, development of mentoringcapacity, and orientation among nurse leaders. They explored a sample of eighteen 18 professionalnurse leaders (nine mentors and nine protégés) at a university hospital in Turkey. An overall assessmentrevealed both mentors and protégés perceived benefits from the mentoring program and found. Thestudy ascertained a positive change of in tTransformational lLeadership iInventory score. In the studythey observed that theThe researchers contributed the change was brought about by theto themMentoring, aApplication, t Techniques, and education acquired at the study beginning of the studyand the application of the formal mentoring program.Similarly, Roth and Whitehead (2019) developed an evidence-based formal mentorship program fornurse managers with an intent to impact on retention rate and job satisfaction. In Australia, a formalprogram based on principles of action learning proved to be successful in assisting advanced practicenurses to enhance their clinical leadership skills in preparation for formal endorsement as a nursepractitioner and for success in their advanced practice role (Legat, 2015). Other studies that exploredthe benefits of a formal mentorship program on nurse's leadership behaviors reported relational joblearning and the mentees' personal skill development ( Lankau & Scandura, 2002; Mccloudghen, 2014).Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Line spacing: singleAnother nurse leadership program (NLDP) was found to be a significant and an effective means toenhance perceived competence in a group of emerging nurse leaders (Fuschs & Humphires, 2018). Theyreported aResearchers found a significant increase in their perceived level of competence to managethe business, lead the people, and internalize leadership values and belief. The benefits of the programwere recognized as positive return of investment for development of future nursing leaders. Duygulu(2007) supports Like Fuschs and Humphires findings,. He Duygulu (2007) investigated the effects of atransformational leadership program on leadership behaviors among the nurse managers. The studyidentified aDuygulu found a significant increase in mean scores of their sub-dimensions and totalleadership applications after the program. In the same report, Duygulu also reported a significantincrease in the mean scores of leadership applications after the leadership development educationprograms in her previous studies. Montalvo &Veema (2015) recommended focusing on the three areasoutlined by IOM ( institute of medicine) report (spell out- assuming this is Institute of Medicine? Orsomething else) on tTransformational lLeadership: leadership development, mentorship, andengagement in health policy. The study further agrees that organizational cultures ought to establishsystems for sustainable mentorship where experienced nurse leaders engage and cultivate a protégée.What is our contributuion?Formatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri), 11 pt,BoldMethodologyDesignFormatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri)Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri)Formatted: Line spacing: single

Integrative review was done conducted to help review the literature to determine what programs havebeen offered and best practices are identified. This was discussed by a research team approach andincluded discussion with a reference librarian in designing and structuring the search.Formatted: Font: (Default) Headings (Calibri), 11 ptSearch methodsFormatted: Font: (Default) Headings (Calibri)An electronic search of literature was conducted using KSU university databases under the Nursing andAllied health discipline. Additional literature was obtained by systematic read-through of the referencelist of all identified articles. Search terms included “Nurse leader,”,” mentor,”, “mentoring nurseleader,”, “nurse leadership mentoring”, “mentoring nursing leadership,”, “nurse manager mentoring,”,“nurse managers and leadership and mentoring,”, “nurse leader mentor,”, “mentoring new nurseleaders,”, “mentoring new nurse managers,”, “mentoring new nurse leadership,”. intervention.Articles that were screened and evaluated for inclusion were composed of studies that were qualitativeand quantitative research articles which were published in the period of 2010-2020. Commentaries andbooks were excluded. The titles and the abstracts were screened to fit the inclusion and exclusioncriteria. The final screening narrowed down total information to ten articles after exclusion of nonrelevant articles.The search was carried out in September 2020 and included all the results in the databases up to thatdate. All articles written in English were considered. A PRISMA (Moher et al., 2009) flow chart was usedin searching the relevant literature. (See Figure. 1)). This integrative review will explore best practicesand research that has been done on formal mentoring programs for new nurse leaders when they areassuming a leadership role.Search outcomeApproximately 50 articles were found. The search terms and search process included terms that resultedin clinical nurse mentoring articles being identified. As a result, the articles were then hand reviewed.Nurse leader mentoring research articles were included.Figure 1: A PRISMA table (see figure 1) was used to document the search process.Formatted: Font: (Default) Headings (Calibri)Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri)Formatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri)Formatted: Font: (Default) Headings (Calibri), 11 pt

Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptArticles identified through databasesearching( 644)Records excluded(n 508)Abstract and title review(n 136)Articles that did not meetincl sion criteriaFull text articles assessed for eligibility(n 70)Full text articles excluded,with reasons(type, locationNumber included based onmethodology(n 14)Inclusion of grey literatureTotal number of included studiesbased on methodology(n 15)Quality appraisalThe studies were reviewed and evaluated by the primary author using the Johns Hopkins appraisal tool.Discarded studies were discussed by the research team. Articles were included that provided researchon mentoring specifically to nurse leaders. Studies were discarded if the subjects were not nurse leaderswho were part of a mentoring program. A total of 19 articles were used in the final review as the articlesused a variety of methods and approaches to mentor nurse leaders.Data evaluation and analysisAuthors reviewed articles in its entirety for specific information and reviewed citation lists for relevantarticles. Grey literature search was done, and literature reviewed for source, publishing information andtarget audience. After all inclusion criteria and exclusion criteria was applied, all articles were reviewedand highlighted. The article searches yielded twelve relevant studies, two literature reviews and onedissertation.Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri)Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Line spacing: single, Pattern: Clear(Background 1)Formatted: Font: (Default) Headings (Calibri), 11 pt

in this study began by searching for databases using the search term mentioned previously. Abstractswere reviewed to determine whether the article is relevant. Full text of articles identified as relevantwere retrieved. Authors reviewed articles in its entirety for specific information and reviewed citationlists for relevant articles. Grey literature search was done, and literature reviewed for source, publishinginformation and target audience. After all inclusion criteria and exclusion criteria was applied, allarticles were reviewed and highlighted. The authors individually reviewed articles, and then teamdiscussion took place to review the articles. Studies were focused on review of research design,methods, and data analysis. Final information yielded twelve relevant studies, two literature reviewsand one dissertation.See Table 1Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Line spacing: singleResultsSynthesisFormatted: Font: (Default) Headings (Calibri), 11 ptContent analysis was done by review of the articles. The team worked to evaluate themes and commonconcepts in the articles. Overall, the programs and processes varied between the articles. The researchteam collaborated throughout the research to discuss and review the themes and analysis of the articleduring this phase of the project. Three themes were identified and discussed as below.Formatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri)Formatted: Font: (Default) Headings (Calibri), 11 ptMentorship programsVarious mMentoring programs have been conducted to prepare nurses for leadership roles. Formalmentorship programs explored in the review were found to be structured, both in terms of definingpurposes and in the longevity of the relationship. New nurse leaders that participated in formalmentorship programs studied in the review reported improved leadership skills, had enhanced jobsatisfaction which had a positive organization effect with optimal patient outcomes (Roth and &Whitehead,2019; Vatan & Temel, 2016). In addition, formal mentorship programs contributed to therelational job learning of mentors and the personal skill development of the protégé(McCloughen,2014). Another earlier formal mentorship study in Australia demonstrated thatclinicalthat clinical leadership skills were enhanced among nurse practitioners endorsed in advancedinadvanced roles (Legat, 2015).Evidence identified from the literature and earlier successful leadership mentoring programs supportthe role of such programs in enhancing new nurse leader competence. A structured nursing leadershipdevelopment program (NLDP) utilizing the Essentials of Nurse Manager Orientation online (ENMO)program provided future nursing leaders with content aligned with nursing leadership competencies.The participants in the NLDP program reported 100% increase in nursing leadership knowledge: apositive return of investment for future nurse leaders (Fusch & Humphire,2018). The program has beenrecommended by the health system nurse executive committee for blueprint replication. The PriscillaRamseur et al found the ENMO as a significant and an effective means to enhance perceivedFormatted: Space Before: 0 pt, After: 0 pt, Linespacing: singleFormatted: Line spacing: single

competence that contributed to superior performance in a group of emerging nurse leaders. The NewJersey Mentorship program was launched to promote leadership development among its membersthroughout the state. Another program on Leadership nurse leadership mMentoring in NursingResearch conducted by a Dutch nursing faculty, demonstrated that Mentoring mentoring programs thatfocus on transformational leadership style are were associated with improved patient outcomes,working environments, and financial performance of healthcare organizations (Haffstendoiter, 2020).The findings from differing studies suggests things that should be in place to develop successful mentormentee relationship building and experience. They include i) mentoring relationship iirelationship ii)understanding of the lived experiences of Nurse leaders iii) Lived experience of mentorship iv)Structured and timely nurse leadership talent identification v) Best practices employed in the mentoringprocess.Theme 1; Mentoring relationshipsMentoring relationships for nurse leadership was revealed as developing from esteemed connection i.e.,a are created from a distinctive coming-together of two people that provides the foundation on whichmentoring relationships grow (McCloughen et al., 2014; Vatan & Temel, 2016;Fahriye et al., ;.McCloughen, 2009; O'Brien , and & Jackson,2009). The study presented a central theme of esteemedconnection - creating a mentoring relationship found in a larger study that explored nurse leaders'experiences with mentoring, using hermeneutic phenomenology as the framework for their research.Three sSub themes that elaborated elaborated the foundational structure of the esteemed connectionbetween two individuals : this phenomenon. They includeid; include: considering each other withpositive regard, developing respectful boundaries and honoring key humans.Formatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Font: (Default) Headings (Calibri), 11 ptFormatted: Line spacing: singleFormatted: Font: (Default) Headings (Calibri), 11 pt(i) Considering each other with positive regard: Mentees identified in the McCloughen et al studydescribed the importance of establishing a mentee-mentor relationship with people they liked, werehappy and comfortable with. They acknowledged the importance of friendliness, genuine caring, mutualrespect, and belief in each other’s integrity generated a sense of connection and compatibility uponwhich mentoring relationships were based. (McCloughen, 2009). While honesty, integrity and mutualrespect provided mentees with a space to freely discuss sensitive issues and identify areas of concern, itcontributed to boundaries that allowed mentors to be challenging and raise problems. Hence the needto develop well-defined boundaries was foremost in separating mentoring from social relationships orfriendships.Although respectful boundaries allowed for friendliness, a distinct friendship relationship was notintegral to creating mentoring connections (McCloughen, 2009; O'Brien & Jackson,2009McCloughen,O'Brien). Mentors should support the early evolving relationships with their mentees through thepurposeful enactment of key human characteristics. The McCloughen finding stated that mentorsbroadly approached mentees’ needs and potential, engaging in reflection and considera

Kennesaw State University WellStar School of Nursing 520 Prillaman Hall, MD 4102 Kennesaw, Georgia 30144 mhedenstr@kennesaw.edu. 470-578-7969 . 560 Parliament Garden Way NW Room 491, MD 0401 Kennesaw, GA 30144 ssneha@kennesaw.edu office: 470-578-2436; mobile:770- 853-0661 . Affiliation: Kennesaw State University. About the Authors: