Running head: NURSE MENTORSHIP AND NURSE RETENTION

Research Proposal: Nurse Mentorship and Nurse Retention

Corinne Bradley, Theresa Connors, Amy Herrington, Jessica McClusky, Jennifer McDermitt, &
Sarah Rousseau
Ferris State University

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CHAPTER 1: INTRODUCTION
Research Proposal: Nurse Mentorship and Nursing Retention
The U.S. Bureau of Labor Statistics (BLS) has projected that registered nurses will be the
top occupation in relation to job growth through the year 2020 (Rosseter, 2012). The turnover
rate among new graduate nurses within the first year is 30% or higher, by the second year it can
reach greater than 50% (Hillman & Foster, 2011). The United States is currently experiencing a
nursing shortage that is projected to continue as the baby boomer population ages and the
increased need for healthcare grows (Rosseter, 2012). In expectation of the nursing shortage,
colleges and universities alike have begun to implement ways to increase the number of
graduating nurses each year. It is important to explore any opportunities to improve retention
rates among these new graduate nurses. There is limited research on this topic, what research
there is has shown that nurse mentorship programs have a positive impact on the new graduate
nurses experience (Welding, 2011). So, is there a correlation between the nurse mentorship
programs and nursing retention among new graduate nurses?
Entering into nursing practice as with any profession, comes with many new challenges.
New graduate nurses face emotional stresses such as: the expectation of a smooth transition from
novice to expert, converting their new education into practice, working midnight shifts, finding
their way through new environments, and much more (Welding, 2011). During this transitional
period is when new graduate nurses require the guidance and knowledge of the more experienced
nurse. Mentoring allows the new graduate nurse to learn from the experience of others, it has
been shown to be a valuable strategy to advance positive healthy work environments (Latham,
Ringle, & Hogan, 2011, p. 345). Therefore, nurse mentorship programs and the effect on new
graduate nurse retention rates must be researched as a possible tool to increase job satisfaction
and improve retention rates among new graduate nurses.
Abbreviated Literature Review

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Using mentorship programs as a means to provide overall staff satisfaction, development,

and retention has been well discussed in the nursing research. Wallen et al. (2010) discusses the
use of a mentorship program in improving perceptions of using evidence-based practice among
clinical staff. This led to a positive increase in attitudes regarding the use of evidence-based
practice, consequently increasing the quality of bedside care along with nursing productivity. The
staff nurses also reported that the mentors helped them to feel more supported through a time of
change. This research shows the values of mentors on the morale of staff, especially during
difficult times, such as the implementation of a culture change. However, the mentors for the
study were all in positions of leadership, such as management and education. More research
would need to be completed to determine if utilizing clinical staff nurses as mentors would be
just as effective.
Latham, Hogan, and Ringl (2008) present a 3-year mentorship project run congruently at
two hospitals. Mentors were paired with mentees to improve the overall work environment for
nurses. The study found that not only did the program improve self-perceptions for the mentors,
but the mentees reported feeling more supported, more comfortable in their work environment,
and also an increased desire and confidence to become a mentor themselves. The mentors were
also instrumental in preventing 24 nurses over three years from leaving the institutions due to
poor job satisfaction. This study clearly demonstrates the benefits of the mentor-mentee
relationship; however, it is focused on the experience of established nurses, and does not discuss
benefits for the orientation period of a new graduate nurse.
Leners, Wilson, Connor, and Fenton (2006) also discuss that the benefits of mentorship
programs reach beyond the satisfaction of the mentee, and also positively impact the mentor as
well. By assisting less experienced staff nurses, the mentors were shown to gain more job

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satisfaction and improvement in their own leadership skills. This led to positive outcomes with
the retention of these more experienced staff nurses.
However, new graduate nurses remain the most available and coveted population for
health care systems (Fox, 2010). Faron and Poeltler (2007) discovered that new graduate nurses
find themselves feeling unsupported following their immediate orientation period, causing low
job satisfaction and increasing turnover rates. A small number of studies have been done to look
at the direct relationship between a mentorship program and the retention of these new graduate
nurses.
Scott, Engelke, and Swanson (2008) found that a structured orientation program focused
on providing support to new graduate nurses is associated with increased satisfaction and
decreased turnover. However, these results were related to the use of an orientation program, not
specifically a mentorship program. Similarly, Pine and Tart (2007) found a substantial decrease
in new graduate nurse turnover following the use of a nurse residency program. These studies
show a correlation between a structured and supportive orientation environment and the decrease
of turnover; however, the use of an actual mentorship program is not discussed, demonstrating
that the outcomes of a mentorship program for a new graduate nurse is an area that needs to be
addressed.
As stated, a few studies have been published discussing the correlation between
mentorship programs and new graduate nurse retention. Fox (2010) discovered that the
implementation of a one-year mentor program led to a decrease in the turnover rate among firstyear registered nurses from 31% in 2004, to 10.3% in 2009 in a large health system.
Additionally, these new graduate nurses reported higher job satisfaction. Similarly, Cottingham,
DiBartolo, Battistoni, and Brown (2011) outline the development of a community-based

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mentoring program in rural areas. This program showed success in not only the primary goal of
increasing retention, but also revealed benefits of increasing professional development and
outreach opportunities among the nurses. Finally, Faron and Poeltler (2007) also discovered
positive outcomes from the use of a one-year nurse mentorship program. In addition to
increasing retention, the new nurses reported more support from unit leadership as well as
hospital leadership, increasing their feelings of loyalty towards the organizations. Increases in
nursing satisfaction, physician satisfaction, and patient satisfaction scores were also seen. While
these studies do show positive outcomes related to mentorship programs, more studies are
needed to replicate the same findings in different healthcare settings.
Finally, few studies were found discussing the qualities of an effective mentor as reported
by the mentee. Cho, Ramanan, and Feldman (2011) present a qualitative study encompassing the
responses in nominations for a Mentorship Award. This study yielded a list of qualities sought in
good mentors, however, with only 53 respondents; this study was done with a relatively small
group. Additionally, these award nominations were for an academic setting. Further research is
needed to identify the qualities of effective mentors in clinical areas.
Overall, mentorship has been shown to be an effective method in the improvement of
work experiences for bedside nurses. However, with the increasing demand for new graduate
nurses entering hospital systems, the development and retention of new graduate nurses is vital
to the nursing profession. More research is needed to solidify the effectiveness and determine the
appropriate structure of nursing mentorship programs for the new graduate nurse.
Problem/Purpose Statement
It is well known there is a nursing shortage across the country. As of 2010, the BLS
projected a 22% increase in the demand for Registered Nurses (RNs) (Rosseter, 2012). As more
nurses plan on retiring, the strain on the already burdened health care system will intensify. In

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addition to the nursing shortage, an estimated 30% of new graduate nurses will voluntarily leave
their positions within the first year of employment and in some cases; the rate is more than 50%
(Hillman & Foster, 2011).
According to Nelson et al. (2012), the new graduate nurse enters his or her first job
struggling with the task of reconciling what was taught in school with the complexities and
fluidness of the real world. When faced with this challenge, new graduate nurses report feeling
apprehensive, fearful, insecure, overwhelmed, and undersupported (Nelson et al., 2012). Most
new graduate nurses state that the reason why they are leaving their profession is due to
inadequate support and mentoring beyond the typical orientation period (Cottingham, DiBartolo,
Battistoni, & Brown, 2010). New graduate nurses finish hospital orientation and believe that they
still need more support and mentoring than is available to them (Faron & Poelter, 2007).
The creation of a nurse mentorship program could be one focus for nursing employers to
help improve nursing retention. Nursing retention has been shown to be affected by quality
nursing leaders developing collegial relationships between leaders and staff (Almada, Carafoli,
Flattery, & French, 2004). Very few studies have been published on the impact of nurse
mentorships programs and the effects on nursing retention of new graduate nurses. Through
research by Welding (2011), nurse mentorship programs have been shown to have a positive
effect on new graduate nurses orientation, decreasing turnover in this vulnerable population. Not
only does this result in a large cost-savings to the employer, but also increased job satisfaction in
the new graduate nurse (Welding, 2011). The purpose of this study is to explore the relationship
between nurse mentorship programs and nursing retention of new graduate nurses.
Theoretical Framework
Theoretical framework is essential to validate the pertinence of the research problem to
nursing practice. Theoretical framework is used when previous research has been conducted in
regards to the problem addressed and there is an idea as to the direction in to which the study

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will result (Wood & Ross-Kerr, 2011). The relationship between nurse mentorship programs and
retention of new graduate nurses has been reviewed by multiple researchers as was discussed in
the literature review. The chosen theory is that of Helen Erickson, Evelyn Tomlin, and Mary
Ann Swain, the Modeling and Role Modeling Theory (Erickson, 2010). This theory relates to
the problem statement in relation to the effectiveness of the mentorship program to the retention
of new graduate nurses with effective mentor and role modeling behaviors to demonstrate
acceptable, evidence-based practices, ensuring the success of new graduates. The modeling and
role modeling concepts also reiterate the importance of an open, non-biased, and supportive
relationship between the mentor and mentee to assist in the challenging transition from nursing
student to professional nurse.
Modeling and Role Modeling Theory
Through professional and personal life experiences, Erickson, Tomlin, and Swain
developed the Modeling and Role Modeling Theory (Erickson, 2010). The theory was
developed based on nurse-patient interaction, but has since been used by multiple researchers in
studying nursing mentorship and preceptorship. The major concepts of the theory are modeling,
role modeling, nursing, nurturance, unconditional acceptance, person, how people are alike, and
how people are different (Erickson, 2010, pp. 541-543). Modeling consists of looking at the
experiences of the one being cared for (in this case the new graduate nurse) from their eyes and
experiences (Erickson, 2010). Role modeling consists of the planning and implementation of
specific interventions ensuring the success of the new graduate nurse. The concept of nursing is
based upon the common principles of the profession as stated by Erickson (2010) as to achieve
a state of perceived optimum health and contentment (p. 542). It is essential nurses take care of
themselves in order to care for others, which can be a challenging concept especially for a new
graduate nurse in a stressful environment. Nurturance involves not only caring but

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understanding the world in which the new graduate nurse lives and the importance of the diverse
aspects of his or her life to fully gain appreciation for whom they are, where they come from, and
where they want to be (Erickson, 2010). Unconditional acceptance is imperative in a
mentor/mentee relationship. Nurses come from all walks of life and it is critical that the mentee
and/or mentor do not feel judged based on their personal life choices, but instead feel as though
they are embraced as the unique individual that they are (Erickson, 2010). How people are alike
is based around the fact the individuals are beings with many aspects that create their whole, all
have basic needs, development occurs over a lifetime, and the need to have support to become
independent successful persons (Erickson, 2010). How people differ entails the fact that people
are all genetically different, affecting aspects that there is no control over, differences in how
individuals adapt to different circumstances based on previous experiences, the desire to become
the best at what they do, and the ability to care for ones self (Erickson, 2010). It is important
that these concepts are adapted in the mentorship process to ensure a healthy, non-judgmental,
and open relationship develops. This ensures the success of the program, the mentor, and the
mentee.
Congruence of Theory and Research Problem
There are multiple concepts associated with the designated problem statement that the
Modeling Role Modeling Theory supports (see Appendix A). The concept of nursing retention is
directly correlated with satisfaction of the new nurse graduate, which is the end goal of the
mentorship program. The concept of new graduate nursing satisfaction directly relates to
concepts of the Modeling and Role Modeling Theory. The theory contains three assertions that
are pertinent to the development of the new graduate nurses experience, which directly relates to
retention rates. One assertion is that the development of tasks is directly related to basic
humanistic needs being met (Erickson, 2010). It is critical that the new graduate nurse has basic

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human needs met and feels safe in order to develop the appropriate skills and critical thinking
ability to become successful. Another assertion is that satisfaction of needs is available through
support in a non-threatening way (Erickson, 2010). The nurse mentor must be available to the
mentee and open to all questions and concerns in a comforting manner. This relates to not only
the concept of new graduate nurse satisfaction but also to the concept of ensuring the proper
mentors are chosen. The third assertion is that continued utilization of resources depends on
previous interactions and how they met basic human needs (Erickson, 2010). A new graduate
nurse will need to have continued support during the first year of practice and feel comfortable
and confident in utilizing additional resource. This ensures patient safety, job satisfaction, and
longevity.
Other concepts associated with the Modeling and Role Modeling Theory consist of
effective communication between the mentor and mentee, job satisfaction of the mentor, and
increased use of evidence-based practice by the mentor. In order to facilitate effective
communication there must be a safe environment for the mentee to feel comfortable seeking
guidance. This correlates to multiple areas of the theory, especially the concept of person and
unconditional acceptance (Erickson, 2010). If the mentor has communicated openness for the
relationship based on trust and acceptance, the mentee will feel more comfortable seeking the
necessary support. Job satisfaction of the mentor correlates with the basic need to be the best
person that the individual can be (Erickson, 2010). To be able to assist in the success of another
person not only reiterates care practices, but also creates a sense of self-worth. Nursing is a
caring profession and to be able to fully care for and assist in the future of a colleague creates a
sense of accomplishment. In order to be an effective mentor, evidence-based practice must be
researched and taught. For the Modeling and Role Modeling Theory to be effective, it is
essential to have the knowledge necessary to support another person (Erickson, 2010). The

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Modeling and Role Modeling Theory of Erickson, Tomlin, and Swain supports the authors
problem statement and purpose of the research proposed.
Research Questions
A review of the literature showed that there is a lack of information regarding the effect a
mentorship program has on the retention of new graduated nurses. From this, it is evident that
this relationship needs to be further explored. With the current nursing shortage, it is important
to recognize different aspects of nursing that can affect the retention of new graduated nurses.
The research question proposed is: What is the relationship between nurse mentorship programs
and nursing retention among new graduate nurses?
This question will be explored through a qualitative study. A qualitative study utilizes six
characteristics. The first characteristic involves the notion that there is not just one truth but a
variety of realities, meaning individuals experience things differently and all experiences must be
considered to comprehend a situation (Streubert & Carpenter, 2011). Second, the research
question directs the method of data collection in a qualitative study and often more than one data
collection strategy can be utilized. This characteristic lends itself to identifying the best
approach to understanding the phenomenon studied (Streubert & Carpenter, 2011). In addition,
qualitative research is dedicated to discovering the viewpoint of all participants through
exhaustive interviews, observations, and studying any pertinent documents or artifacts (Streubert
& Carpenter, 2011). Another characteristic is guiding the research in a way that results in
minimal interference of the normal routine for the participants. While discovering the exclusive
viewpoints of the participants, the researcher must be very reverential of the participants
thoughts and feelings (Streubert & Carpenter, 2011). The fifth characteristic is that the findings
of qualitative studies are documented in a rich literary style (Streubert & Carpenter, 2011). Last,
qualitative studies are subjective and the researcher is an active participant in the study (Streubert
& Carpenter, 2011).

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All of the characteristics of a qualitative study are appropriate for the proposed research
question. A qualitative study is ideal for this research because it will allow the researchers to
identify the many realities that different nurses experience in the nursing profession, particularly
new graduated nurses. In addition, the qualitative method is dedicated to truly understanding the
perspective of participants involved. Through extensive observation, interviews, and various
other data collection, the researcher will identify various perspectives and truly understand the
experiences of a newly graduated nurse in a mentorship program. This method will develop
abundant data and narratives about the relationship between a mentorship program and the
retention of new graduate nurses.
The method of qualitative research to be employed is action research. Action research is
most commonly used as a research method by practitioners, including nurses, educators and
human service workers (Streubert & Carpenter, 2011). The root of action research comes from
theorist Kurt Lewin who is known for his change theory and the processes involved in change
(Streubert & Carpenter, 2011). The most significant difference that has occurred in action
research since Lewin is that there is no longer a definitive end to the process, it instead is open
ended and continues to be open for conversation and further research (Streubert & Carpenter,
2011). Action research is appropriate for this research study because it is does not have a
definitive end and it can continue to evolve. Although the research may discover pertinent
information that leads to change, that change does not need to be viewed as permanent, but as a
step in an evolving process of improvement. It is important for those in nursing practice to be
flexible and open to change in hopes of improving the nursing shortage and the nursing
profession as a whole.
Summary
The objective of this study is to examine effects of mentorship programs on retention
rates of newly graduated nurses using a qualitative research approach. The turnover rate among

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first-year graduate nurses ranges from 30%-65%, with most new graduate nurses stating the
reason why they are leaving the profession is due to inadequate support and mentoring beyond
the typical orientation period (Cottingham, DiBartolo, Battistoni, & Brown, 2010). This
demonstrates the importance of developing a mentorship program. Through research by Welding
(2011) and others, nurse mentorship programs have been shown to have a positive effect on a
new graduate nurses orientation, improving satisfaction and reducing turnover.
The study will utilize Ericksons Modeling and Role Modeling Theory (Erickson, 2010).
The study directly relates the theory to the concept of new graduate nursing satisfaction. There
are several assertions of the theory that are pertinent to the development of the new graduate
nurses experience, directly relating to the retention rates.
A review of the literature showed that there is a lack of information regarding the effect
of mentorship programs on the retention of new graduated nurses. From this, it is evident that
this relationship needs to be further explored. With the current nursing shortage, it is important
to recognize different aspects of nursing that can affect the retention of new graduated nurses.
While these studies do show positive outcomes related to mentorship programs, more studies are
needed to replicate the same findings in different healthcare settings. Through extensive
observation, interviews, and various other data collection methods, this study will identify
various perspectives; truly understand the experiences of a new graduated nurse in a mentorship
program.
In Chapter II, support for the Modeling and Role Modeling Theory will be presented as
well as the rationale for selecting this theory. A literature review will also elaborate on the major
concepts of the study. Finally, the gap in research will be examined including further research to
help substantiate findings from earlier studies as well as adding to existing knowledge.

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Appendix

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