Negative experiences of students regarding mentoring

The Oxford Dictionary (2010:406) defines negative experiences as experiences of something bad, harmful having happened, or having been found. In the context of this study, it was evident from the reported experiences of student nurses in the clinical learning environment that there were few positive and many negative experiences regarding mentoring by registered nurses.

According to Mabuda et al. (2008:24), the negative attitude of registered nurses towards student nurses can compromise open honest interaction between students and personnel, which can impact negatively on student learning and even on patient care. Waldock (2010:14) suggests that it is the negative attitudes and behaviours of registered nurses in the clinical practice area that has the most profound effect on the student nurses in clinical practice.

Effective communication between the mentors and mentees involves forming good relationships during clinical teaching as negative experiences develop where

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professional nurses accept student nurses conditionally and make them feel rejected and devalued (Waldock, 2010:16).

4.4.1 Factors prohibiting mentoring

Prohibiting factors involve the act of ordering that something is not to be done or used, forbidding, discouragement, dissuading and suppression (Merriam-Webster Dictionary, 2013). Categories and sub-categories are discussed in detail and with supporting literature in the following sections.

4.4.1.1 No orientation for learners

Orientation plays a key role in mentoring; in the context of this study there was no orientation, however, as the student nurses felt unwelcome and had no assurance that their clinical learning outcomes would be met. Cele, Gumede and Kubheka (2002:48) alludes that nurse preceptors in the clinical area make it their responsibility to orientate the student nurses of the surroundings of the unit, as well as the unit procedures. Ineffective mentoring may be demonstrated in the following ways: unwanted duties delegated to the students; noticeable dislike of his or her job and/or the student; lack of knowledge of the programme; demonstrating poor teaching skills; lacking expertise, breaking promises; throwing the students in at the „deep end‟ (Gray & Smith, 2000).

Characteristics of an ineffective mentor may include: being distant and unfriendly, unapproachable, unreliable, intimidating, unpredictable and overprotective (Gray & Smith, 2000).

62 4.4.1.2 No teaching programme set for learners

The author concluded that clear nursing objectives and an awareness of a need for flexible change is an important aspect in mentoring to improve student learning (Clearly, Horsfall & De Carlo, 2006:145). According the South African Qualifications Authority (SAQA) (2001:31), a curriculum/learning programme is a combination of courses, modules or units of learning, i.e. learning materials and methodology, by which learners can achieve the learning outcomes of a qualification. In the context of this study, the curriculum and clinical objectives do not meet the criteria or help facilitate and teach the student due to the absence of a formalised, standardised and approved teaching programme in the institutions.

Registered nurses working with student nurses in the clinical setting have a major influence on student performance; they have the ability to promote and facilitate student learning or cripple the student‟s ability to apply knowledge and skills, and accommodate new learning in clinical practice (Waldock, 2010:10).

Waldock (2010:10) also indicates that teaching has become a large part of the nurse‟s role, including the facilitation of student learning, within the changing health climate. Yet there continues to be lack of clarity around who is responsible for the clinical teaching of students on a daily basis and what the role entails. From an international perspective, student supervision in the clinical setting appears to have been devolved to clinical nurses. This has created a degree of discomfort for many nurses, as they believe they lack experience in student supervision, particularly through clinical teaching. Given this situation, it is not surprising that the quality of student supervision and role satisfaction for both nurses and students cannot be assured through current practices (Waldock, 2010:11).

The majority of recent research on mentoring has come from the United Kingdom in response to Project 2000. Studies have explored students‟ perceptions of mentors (Suen & Chow, 2001; Watson, 1999); the roles and responsibilities of mentors (Watson, 1999 Pulsford, Boit & Owen, 2002; Gray & Smith, 2000; Neary, 2000; Hayes & Harrel,

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1994); and relationships between mentors and students (Andrew & Roberts, 2003; Spouce, 2001; Andrews & Chilton, 2000). Brammer (2002), however, identified variability in how „mentoring‟ was operationalised and noted relatively little evaluation of nurse mentorship programmes. The most frequently cited problem for mentees was lack of time with mentors (Ehrich et al., 2002).

Tshabalala (2011:37) indicated that, with adequate mentoring, nursing students develop confidence, increased self-esteem, autonomy and competence, because it is believed that nursing students experience a sense of belonging within the team in which they are placed in order to boost their self-image, confidence and self-efficacy. Findings in the current study confirm that no clinical programmes had been instituted to meet the clinical learning experiences of student nurses.

4.4.1.3 No support given to learners

Available literature by Waldock (2010:14) has alluded to a number of key factors influencing registered nurses. These include support provided by the education faculty and health provider; preparing the nurse for the supervisory role; time and workload allocation; and the student-nurse relationship. The quality of clinical placements as perceived by students in terms of support, clinical teaching and learning, and the integration of theory into practice, vary considerably from one experience to the next. It is the attitudes and behaviours of registered nurses that have the most profound effect on student learning. It is crucial, therefore, that these key factors are addressed in order to better prepare and support registered nurses in their role as facilitators of student learning in clinical practice.

Emanuel (2013:109) states that appropriate clinical placements are an essential part of nurse education. They provide students with the opportunity to learn practical skills and gain knowledge, so students‟ learning is heavily dependent on the quality of support that mentors provide. According Emanuel‟s study (2013:109), a recurring theme to emerge from these evaluations is that students often perceive mentors as being too busy to

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provide the required level of support. This can lead to increased levels of anxiety for students as they may feel unsupported. Mentors are one of the critical factors affecting students‟ ability to learn and cope while in their placements.

Grossman (2007:28) further affirms that students are allocated to the clinical setting and are formally and informally guided by registered nurses through their experiences over a predetermined period of time as prescribed by SANC. This allows students to gain clinical experience, thus becoming competent in the relevant required skills. Benner (2001:10) explains competency as the real world of practice which consists of conscious, deliberate planning, where the nurse sets priorities and is efficient and effective in routine situations. Competence is also developmental in nature, ranging from novice to expert.

4.4.1.4 Negative attitudes of staff

The quality and success of the clinical experience depends largely on the individual nurse‟s attitude, willingness and ability to facilitate teaching and learning opportunities in a supportive way. When experiences are positive, the facilitation of learning is demonstrated better by students, leading to successful completion of clinical placement. If clinical teaching practice is to remain the nurse‟s responsibility, then much needs to be done to prepare and support him/her to provide positive clinical teaching (Waldock, 2010:12).

When there is a negative attitude (Mabuda et al, 2008:24), this negative attitude of registered nurses towards student nurses can compromise open and honest interaction between students and personnel, which can impact negatively on student learning and even on patient care.

Negative attitude, according to Wikipedia.org/wiki/attitude, is revealed through not wanting to do what other people want you to do, or hating what you are supposed to do,

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or not wanting to cooperate with other people. In the context of this study, the registered nurses have a negative attitude towards the student nurses and vice-versa.

According to Gray and Smith (2000:546), negative perceptions of student nurses about nurse trainers appear to be a concern. Werner (2003:47) warns that incorrect perceptions and attributes can be perceived as unfair, which can harm interpersonal relationships.

Du Plessis (2004:76) reported that student nurses felt that their facilitators could not be seen as role models and they felt cheated because of the apparent lack of preparation for sessions, or the lack of skill in preparations on the part of the facilitators.