Wise Woman Mentor

8/13/2019 Wise Woman Mentor

1/10

EDUCATION AND PROFESSIONAL DEVELOPMENT

Wise women: mentoring as relational learning in perinatal nursing

practice

Annette Ryan, Lisa Goldberg and Joan Evans

Aims and objectives.The focus of this paper is on one of four themes from a study exploring mentoring relationships between

nurses in the intrapartum setting. The theme, relational learning, highlights how perinatal nurses engage with each other and

engage with birthing women on a journey of learning in perinatal nursing practice.

Background.Few studies have explored the contextual, lived experiences of informal mentoring relationships within nursing,

particularly within perinatal nursing.

Design.A qualitative feminist phenomenological study that considered a gender-centred, embodied exploration of human lived

experiences was conducted.

Method. Five registered nursespracticing on a tertiary level labourand delivery unit in eastern Canadawere purposefullyrecruited.Data were collected by phenomenological interviews, practice observations in the clinical setting and reflective journaling.

Results.Four themes emerged through thematic analysis and researcher interpretation: the meaning of nurse-to-nurse mentoring,

mentoring as relational learning, mentoring as embodied learning and a contextual understanding of nurse-to-nurse mentoring.

Relational learning came to be understood through feminist phenomenological analysis, which revealed that expert perinatal

nursing knowledge develops within positive mentoring relationships between perinatal nurses practicing with birthing women.

This learning extends beyond tasks to a holistic understanding of clinical situations within specific health and social contexts. The

mentor models positive perinatal nursing practices and creates a sense of enthusiasm that harnesses the raw passion new nurses

often have for practice.

Conclusion.The findings in this study aim to promote the understanding of the importance of relational, experiential learning for

perinatal nurses professional development.

Relevance to clinical practice. Theresultsfromthisstudywillencouragenursesandnurseleaderstosupportmentoringbyproviding

adequate resources and positive feedback for mentoring relationships. This will foster and sustain expert nurses to support novice

nurses in perinatal practice. The findings also offer insight for perinatal practices beyond nursing, including midwifery.

Key words: learning, mentoring, nursing, perinatal care, phenomenology, qualitative

Accepted for publication:31 March 2009

Introduction

Nurses in practice often use informal, unit-based and

relational sources of new knowledge selection, transfer and

use (Asselin 2001). In the last few decades, nurse researchers

have begun to use feminist and sociological theories to

highlight the unique knowledge base of nurses that is

grounded in the caring relationships and lived experiences

Authors: Annette Ryan, RN, MN, Perinatal Nurse Consultant,

Reproductive Care Program of Nova Scotia, Halifax Professional

Centre, Halifax, Nova Scotia, Canada; Lisa Goldberg, PhD, RN,

Assistant Professor, Dalhousie University, School of Nursing, 5869

University Avenue Halifax, Nova Scotia, Canada; Joan Evans, PhD,

RN, Associate Professor, Director, Communications Skills Program,

Division of Medical Education, Dalhousie University Halifax, Nova

Scotia, Canada

Correspondence: Annette Ryan, Perinatal Nurse Consultant,

Reproductive Care Program of Nova Scotia, Halifax Professional

Centre, 5991 Spring Garden Road, Suite 700, Halifax, N.S. B3H

1Y6, Cananda. Telephone: (902) 470-6619.

E-mail:[email protected]

2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 183191 183doi: 10.1111/j.1365-2702.2009.02852.x


2/10

of nurses as women as opposed to knowledge that is purely

objective and analytical (Hagell 1989,DeMarcoet al. 1993,

Perry 1994, Im 2002, Goldberg 2005, Routledge 2007).

Therefore, it is important to consider the unique daily

interactions between nurses that build meaningful relation-

ships and thus influence uptake of clinical knowledge. This

discussion, then, focuses on mentoring relationships between

nurses in the intrapartum setting and how perinatal nurses

engage with each other and engage with birthing women and

their families, on a journey of learning in perinatal nursing

practice.

Background: exploring the mentoring literature

Mentoring is a broad concept that may include aspects of

preceptoring, role modelling and coaching. However, typi-

cally preceptoring, role modelling and coaching do not

involve long-term, established relationships and are thus,

only components of the mentoring relationship (Fox et al.1992, Haynor 1994, Smith et al. 2001, Faron & Poeltler

2007). According to Parse (2002, p. 97), mentoring arises

when two or more presences engage in a dialogue about a

scholarly opportunity. This mentormentee relationship is

one of complex, non-linear human interactions involving

collaboration and transformation, which are key to profes-

sional nursing growth. Benner (1984) describes professional

nursing growth as a transition and evolution of nursing

knowledge from novice to expert within specific nursing

practice contexts. The five levels of transition include: novice,

advanced beginner, competent, proficient and expert.

There have been several models and frameworks created to

outline the processes of mentoring. At present, no singular

model of mentorship is deemed superior to another. Thus,

although the literature suggests that nurses value mentoring

and mentorship, there is considerable confusion regarding the

mentoring role (Andrews & Wallis 1999). Researchers cited

several benefits of mentoring for mentors, mentees, the

nursing profession and health care organisations. Benefits

include pride in facilitating the professional growth of

another nurse (Groah 1996), the creation of nurses who will

become mentors (Scott 1990, Smith et al. 2001, Moerer-

Urdahl & Creswell 2004), reduced costs for recruitment andretention of nurses, improved patient outcomes and enhanced

patient satisfaction (Smith et al. 2001, Greene & Puetzer

2002,Scott 2005). Therefore, it is imperative for health care

organisations to explore processes of mentoring in an effort

to create and modify organisational policies that reflect value

for nursing and nursing professional development (Almada

et al. 2004, Boswell et al. 2004, McKinley 2004, Murphy

et al.2004, Santucci 2004, Tourigny & Pulich 2005).

Mentoring that occurs in the practice environment and

which is initiated and developed between nursing colleagues

without formal organisational supports is termed informal

mentoring (Tourigny & Pulich 2005). Informal mentoring

refers to a relationship based on mutual identification and

personal development needs (Tourigny & Pulich, p. 71)

where knowledge is transferred between peers and is based

on personal experience, intuition, judgement, know-how,

expertise and individual insight (Tourigny & Pulich, p. 68).

Understanding mentoring relations and the transfer of

knowledge from nurse to nurse is key to providing positive,

supportive practice environments for nurses and an integral

component of recruiting and retaining nurses in practice

(Neuhauser 2002, Hom 2003, Hurst & Koplin-Baucum

2003, Mills et al. 2007). Although structured mentoring

programs have been studied in several professional settings,

few studies have explored the contextual, lived experiences of

informal mentoring relationships within nursing or perinatal

nursing. Thus a phenomenological study with a feministperspective was warranted to explore the meaning of

informal nurse-to-nurse mentoring relationships within cur-

rent historical, intra and interprofessional, social, economic

and gendered health care contexts.

Method

Methodology: for embodied practices

The methodology for this study was feminist phenomenol-

ogy, which considers a gender-centred, embodied exploration

of human experiences. The nurse researcher who works with

Merleau-Pontys existential phenomenology seeks to dis-

cover [study] participants/patients perception of their lived

experience (Thomas 2005, p. 69). Perceptions are based on

intentionality (situated perspective) with the environment,

placed against dynamic, contextualised cultural and socio-

political backgrounds and involve interconnectedness bet-

ween humans and the life world (Thomas 2005). As well as

individual interactions with the world, Merleau-Ponty sup-

ported interactions with others as fellow travellers in lifes

journey (Pollio et al. 1997). This offers opportunity for

dialogue involving reciprocal intersubjective relatedness andcoexistence within a common world (Merleau-Ponty 1945).

Although aspects of existential phenomenology (focus on

everyday lived experiences, embodiment, perception and

contextualisation) are shared by feminist theory (Code

1991), the work of Merleau-Ponty was implicitly framed by

a male perspective (Grosz 1994). This renders invisible the

effects of oppressive and androcentric forces within society.

Feminist phenomenology, however, focuses on the lived,

A Ryanet al.

184 2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 183191


3/10

diverse experiences of women situated in broader socio-

political, historical and economic contexts and thus explores

the complex social relations that shape the lived realities of

women. These realities are often shaped by a male-centred

world (Goldberg et al. 2009). In keeping with the tenets of

feminism, this inquiry was mutual, informative, subjective

and aimed at, not only gathering valuable participant

information, but also in sharing research findings with

nurses. From a feminist perspective, this offered participants

valuable insights into the mentoring experience and poten-

tially aimed to improve perinatal nursing care, patient

outcomes and influence health care policy development.

Participants

Through purposeful sampling, five registered nurses were

recruited from a labour and delivery unit in a tertiary level

hospital in eastern Canada. This provided a sample of

participants who had experiences relating to the phenom-enon being researched (Kruger 1988, p. 150). This form of

sampling is congruent with a qualitative design (Sandelowski

1995, Coyne 1997, Barbour 2001, Byrne 2001). Inclusion

criteria included participants being a registered nurse prac-

ticing on the labour and delivery unit at the tertiary care

centre, who completed orientation and worked on the unit

for at least two years and who stated she has been a mentor

and/or mentee. The participant sample included a diverse

sample of nurses all with a variety of experiential, edu-

cational and professional backgrounds. This enabled the

capture of multiple perspectives to contribute to the rich

interpretive descriptions of storied data. Recruitment

occurred through presentations to nursing staff, information

posted on the bulletin board in the staff lounge and education

room and via an in-hospital email system.

Data collection

On approval from the required health ethics review board,

data were collected using one-on-one interviewing, practice

observations and reflective journaling. Written informed

consent was obtained from each participant prior to

commencing the study and to maintain confidentiality,all study materials were kept in a locked file cabinet. Five

unstructured, conversational interviews ranging from 6090

minutes in duration were completed. Six questions guided the

informal discussions (Table 1).

All interviews were audiotaped and transcribed verbatim

and took place at a time and in a location convenient for the

participants. In the phenomenological analysis process,

pseudonyms were used for participant direct quotes or when

participants referred to colleagues or birthing women. Two

practice observations of approximately 612 hours were

completed on the labour and delivery unit of the tertiary

centre where the study participants practiced. The observa-

tion periods did not always include nurses who participatedin the interviews. The researcher looked for and listened to

the stories of how nurses engaged with each other and with

birthing women and their families and how these engage-

ments influenced nurses learning. Further, the practice

observations provided an opportunity for purposeful focused

observation aimed at providing a deeper understanding of

contextual factors (Maggs-Rapport 2000) that influenced

mentoring relationships. During practice observations, the

role as researcher was clearly articulated to all staff, women

and families and written notes were completed after each

practice observation. In addition to the interviews and

practice observations, a reflective journal was maintained to

reveal the researchers locatedness and to link theoretical,

professional and personal knowledge with the data and the

research experience (Benner 1984,Fakude & Bruce 2003).

Data analysis

Through thematic analysis of interview data in a feminist

phenomenological framework, the commonalties were

explored between nurse narrative responses to highlight the

meaning of the lived experiences of the mentoring relation.

Reflexive notes taken after each interview and after theobservation periods were used to facilitate interpretation of

data. The existential themes of body, time, space and relation

(van Manen 1997) were discussed in a feminist interpretation

that was attentive to the impact of gender, power and

oppression in the perinatal nursing practice environment. The

result of the analysis was textual data of the feminist

phenomenological account of the perinatal nurse-to-nurse

mentoring relation.

Table 1 Interview question guide

1I am interested in nurse-to-nurse mentoring on the unit.

Please tell me about your experience of nurse-to-nurse

mentoring on the labour and delivery unit.

2What is your understanding of mentoring?

3Please tell me about your experiences as:

A. a mentor

B. b menteeC. both

4What factors supported the mentoring experience?

5What factors inhibited the mentoring experience?

6How is the mentoring experience different for you

now compared to when you first began practicing?

Education and professional development Mentoring and relational learning in nursing

2010 Blackwell Publishing Ltd, Journal of Clinical Nursing, 19, 183191 185


4/10

Results and discussion

Four themes emerged from the participants stories and

through researcher interpretation and analysis: the meaning

of nurse-to-nurse mentoring, mentoring as relational learn-

ing, mentoring as embodied learning and a contextual

understanding of nurse-to-nurse mentoring. In what follows,

the theme of mentoring as relational learning is discussed as a

way of understanding how the relationships perinatal nurses

have with each other and with birthing women are central to

the learning and mentoring relationships that support the

evolution of perinatal nursing expertise.

Mentoring as relational learning

In that moment I saw her [the nurse mentee] connecting with the

labouring woman and I knew we did it, we got her thereit took

some time and encouragement but we did itwe got her to the point

where she is a labour and delivery nurse. (Margie, nurse participant)

The elation of Margies words show in her broad smile as she

proudly recalls the moment when she knew that the young

and inexperienced nurse she mentored had become a perina-

tal nurse. This becoming was demonstrated by the nurse

mentees interactions with the birthing woman, not only in

her ability to start an intravenous or titrate an oxytocin

infusion, but more importantly, in the integration of those

skills as she engaged with the birthing woman. It is in the

relationships between perinatal nurses and birthing women

that perinatal nurses engage with each other and engage with

birthing women and their families on a journey of learningand nursing professional development. Through conversa-

tional interviews and participant observations, Goldberg

(2005) explored the relationships between perinatal nurses

and birthing women in the context of hierarchical health care

practices. She found that the relationship between birthing

women and perinatal nurses is unique. In a short period of

time an engagement occurs that unites the two together in an

embodied experience that ends with a remarkable journey:

the birth of a baby (Goldberg, p. 401). Similarly, there is

considerable research about the midwifewoman relationship

(Kirkham 2000). Lundgren and Berg (2007) highlight con-

cepts such as meaning, trust, mutuality and availability in

building a positive relationship between the midwife and the

birthing woman. Thus engagement points to a key finding in

both perinatal nursing and midwifery care.

Julie, a novice nurse from the study describes the learning

relationship as one built on the relational learning that

transpires between and among nurses and birthing women.

She says:

The centre of it all, of all the learning happens in the room with the

labouring woman. We talked about the care and read through the

policies but the real learning was with the woman in labour and

watching the nurse [mentor] be with her and do for her and know

herknow her as a unique person experiencing birththat showed

me who I needed to be.

Further, such learning also transpires between and amongnurses themselves. Bergum (2003) suggests that there is a

relational space between intersubjective objects in the world.

For perinatal nurse-to-nurse mentoring, the relational space is

the space of learning that supports birthing women and that

transpires between nurse mentors and mentees in complex

health, social and gendered contexts. It occurs in a hege-

monic, hierarchical and biomedical birthing space. Young

(1990, p. 59) recognises the challenges of professionals who

perform caring functions for birthing and pregnant women in

the current medical realm. She says:

They are usually women, usually poorly paid and their activities areusually seen as complementing and subordinate to the direction of

activities like diagnostic tests, drug and surgical therapies by the

physicians, usually men. The alienation experienced by the pregnant

and birthing woman would probably be lessened if caring were

distinguished from curing and took on a practical value that did not

subordinate it to curing.

Doane (2002, p. 401) describes relational practice as a

humanely involved process of respectful, compassionate and

authentically interested inquiry into anothers (and ones

own) experiences. Nurses who are able to understand their

own life contexts and the life contexts of others are engagedin this relational learning space and thus, are able to fully

engage in nursing practice. Merleau-Ponty (1962, p. 119)

describes this intersubjective nature of the lived body as

never purely individual. It is constituted in relation to the

Other and is therefore uniquely specific to my social,

environmental and familial situation.

Modelling perinatal nursing practice

Although each relationship with a birthing woman and each

mentoring relationship between nurses occurs in a complex

situatedness, there are some noted similarities realised in the

stories of the participants in the study. Sara, an experienced

nurse from the study, suggests that learning occurs when

nurses observe each other interacting with birthing women.

Cate, also an experienced perinatal nurse, agrees that as a

kinaesthetic learner herself, she often models nursing practice

to nurse learners. Modelling occurs when the nurse mentee

observes and imitates the relationship between the nurse

A Ryanet al.



5/10

mentor and birthing woman. Role modelling and demon-

stration by expert nurses have been found to facilitate student

nurse learning and to improve the uptake of best practices

(Eatonet al. 2007). Cate describes herself as a nurse who:

learns by watching and doing. Im not very good at just reading

something and thinking well, thats how it has to be done. So I teach

in the same way. Ill show, Ill explain, Ill show and as much aspossible, Ill tell people why Im performing that task.

Sara also shares how she models the intimacy of the

relationship between the nurse and the birthing woman

through presence, conversation and touch. She tells of how

she has been with several new nurses who stand far away

from the birthing woman and attempt to engage with her.

Sara says:

They stand at the door, far from the bed or set the table up in the

corner to do their charting but I tell them and show them, you need to

get closer, to interact with her [the birthing woman].

Through her own engagement with the birthing woman, Sara

encourages the mentee to get closer, to be physically engaged

and to talk with the birthing woman and her family. This

enables the nurse to begin to build the relationship with the

birthing woman, to develop a connection that is genuine,

unique and meaningful. Goldberg (2005, p. 405) describes

the initial moments between a nurse and birthing woman as

introductory engagement. She considers this an interaction

[which] is crucial to establishing a relationship with birthing

women. The gazing, touching and listening qualities of a

perinatal nurse are not forgotten by the women who have

been in their presence. This authentic connection (Bergum &

Dossetor 2003) is modelled by the mentor as she interacts

with birthing women, and thus provides the mentee with an

example of how to begin the nurse and birthing woman

relation. A genuine relationship between the nurse and the

birthing woman creates respect and trust. Trust between the

birthing woman and the nurse is described by Goldberg

(2008) as key to fostering the birthing womans trust in her

own bodys power to birth. Trust and respect are not only

key to creating positive relationships between nurses and

birthing women but are also important for mentoring

relationships (Bergum & Dossetor 2003).During the practice observation periods conducted on

the unit, it became clear that the birthing space is also the

learning space without the physical bodily presence of

the birthing woman. In other words, when nurse mentees

and mentors talk to each other about the experiences of

birthing women, as a means to seek advice and/or validation

for nursing practice from their colleagues, they typically do

not speak of women in general terms but they tell stories of

women with unique birth experiences. This woman-centred

view of women as individuals in their unique, embodied,

birth experiences is in keeping with perinatal nursings

holistic view of the patient where all parts of being human

make up the greater whole (Newman 1997) and in keeping

with the philosophical tenets of phenomenology which

espouses an integrated body-subject view of the self (Wilde

1999, Goldberg 2002). Cate, for example, tells how the

unique stories of birthing women are central to her mentoring

relationships. She describes the importance of obtaining the

counsel of her nursing colleagues when caring for birthing

women. She says:

to me, thats very much the mentoring. Its daily, its ongoing, its

subtle, you know. Somebody will come out and say, well, you know,

Ive done this and Ive tried that. Well, your counsels there and its a

group of people at the desk saying, well have you done this, or,

I always try and do this and if that doesnt work, then you know,

maybe youre going to have to call them back and say, its not

working and the trial and so I mean, its not one person you mentor,

its the group.

However, nurses woman-centred philosophy is challenged in

current institutionalised birth environments. Although perina-

tal nurses attempt to regard birthing women as embodied

beings, encapsulating intentionality and capable of determin-

ing their own birthing trajectories, the Cartesian ghost is

forever resurfacing in an attempt to objectify the body of

the Other (birthing woman) (Goldberg 2002, p. 447).

When the birthing woman is the topic of learning, she

becomes a relational subject in the learning. The birthing

woman is the central text on which nurse mentees and nurse

mentors share their relational learning space. What this

means is that the caring relation between the birthing woman

and the nurse mentor becomes the model for the nurse

mentees understanding of how to be a perinatal nurse. The

nurse mentee is able to connect her theoretical learning to

experiential nursing practice. Benner (1984) asserts that

nurses must identify patterns of development and knowledge

acquisition to connect theory to practice and to explore

transitions from novice to expert. This sense of being a

perinatal nurse reaches far beyond the tasks of nursing, to a

place where engagement and conversation with the birthingwoman is modelled by the mentor and mirrored by the

mentee. This mirroring is key to authenticating the success of

the mentor/mentee relationship and it is key in providing

positive feedback to the mentee that she has performed well

and to the mentor that her efforts have created learning in the

relational space (Smith et al. 2001, Mangone et al. 2005).

Modelling not only occurs when perinatal nurses show

each other how to practice with birthing women, but also




6/10

happens when nurses model how to engage with each

other. Cate shared her most memorable stories of being a

mentee. She was relatively new to the nursing profession

and she was in a new and unfamiliar practice setting where

she was marginalised due to cultural differences. Fortu-

nately, the charge nurse, who was a highly regarded,

knowledgeable and experienced nurse, took Cate under

her wing. In fact, Cate said she did not see in herself what

this nurse saw and:

she was just this incredible womanand when you first met her,

youd think, ohhh, god, she looks so sharp and stern. Then shed

smile and I mean, her whole personality was in that smile it was her

example of how she treated me and peoples attitude towards me

[changed] and it took a lot of hard work on my part to be accepted.

And in the end I was and I have to say, I was.and respected, on my

own merit. Without her, it would never have happened.

The above discussion not only demonstrates how the charge

nurse mentored Cate as an individual nurse but also furtherdemonstrates how she mentored the other nurses, by exam-

ple, through the way she treated and interacted with Cate. It

also shows how collegiality, respect, openness to ideas and

believing in others are key to supporting nurses in practice.

Farrell (2001) suggests that to obtain widespread collegiality

in nursing, nurses need to consider a multi-level approach to

battling conflict in and beyond the nursing profession. This

approach considers identifying and challenging broader,

misogynistic structures, organisational structures and work-

place practices and finally, nurse-to-nurse relationships that

perpetuate conflict in nursing.

Beyond the tasks: creating the learning space

Well, you know, its not automatic. You have to it comes over time

and I dont know if thats really something you can teach versus its

just youre teaching all the individual things and you just get faster.

It just, eventually, like I cant fathom coming inand thinking, my

god, I can talk to a patient, ask them everybodys names, their life

story, start their IV and doing theyre screaming and you know, if

theyre really distressed, waiting for an epidural and theyre seven

centimetres and like, doing all that and just talking to them calmly

and remaining calm [myself].

Kayla, a nurse participant, reflects on her learning over time

and how she is able to integrate all her knowledge of being a

perinatal nurse and put that knowledge into action to support

birthing women. Her embodied actions with nursing peers

and birthing women have influenced the evolution of Kayla

as a perinatal nurse. Merleau Ponty (1962, p. 148) describes

how our embodied interactions in the world create our

world. He says:

I am thus socially constituted and my identity is built on the

interpenetration of self and Other and Others are already socially

constructed beings also. The modes of being - and their social

significance - are incorporated into myself and therefore the limits to

my potential modes of being will vary depending on whom I associate

with and under what social/environmental contexts.

To create a positive learning space, mentors focused firston the task-oriented skills of nursing and then transcended

beyond to a point where relations with others, primarily the

birthing women, become the learning space. According to

Bergum (2003), the tasks need to become an extension of the

body of the nurse so that the needle being inserted in the vein is

used in an embodied way and is not the focus of the interaction

with the patient. As Goldberg (2002) suggests, nurses need to

reexamine nursing care beyond the tasks, to celebrate birthing

women as embodied, subjective beings. Although, many of

the study participants acknowledged the importance of

learning new skills as mentees, they focused more so on how

mentors enabled them to build relationships with labouring

women. This emphasises the importance of human-to-human

interactions and relationships in nursing care (Gadow 1988,

Benner & Wrubel 1989). Hartrick (1997)suggests that models

for care in nursing need to move beyondobjective mechanistic/

behavioural models to models of interpersonal practice that

recognise the complexity of human relating. Learning through

human relating involves sharing of narratives with the birthing

woman and sharing between nurses. Gadow (1999, p. 65)

describes this sharing between nurses and patients as ethical

narratives created by patient and nurse from the homeland

of their engagement [which] are thus more than individualaccounts: they are relational narratives. When the life stories

become the focus of nursing care, the nursing tasks eventu-

ally become habitual acts that supplement the nucleus of

the learning space, which is the space shared between mentor

and mentee with the birthing woman.

Perinatal passion and meaning

I can weep just as easily today over a delivery, than I can when I first

startedand a lot of it has to do with the people that youre with and

what you put into it, how much youre putting into it and yes, you

connect better with some than others, but theres always, always,

a lurch in my stomach or in my heart, that says, wow.

Cates eyes glazed with tears as she reflected on what being a

perinatal nurse means to her and as she remembered the

shared moments with women during the miracle of birth. It is

this connection to the heart that provides meaning and

purpose for perinatal nursing practice. Nurses who find

nursing practice meaningful discover a sense of intrinsic

A Ryanet al.



7/10

value, which provides them with self-affirmation (Pask 2003).

When a perinatal nurse has passion, it is an infectious force

that acts as a motivator for those in practice and a recruiter

for those seeking perinatal practice (Borchardt 2005). Julie, a

nurse participant describes comments she received from a

nursing student. She says:

I dont get as much opportunity to be a preceptor, but recently I had astudent nurse for a day. And she just sent me this long card the next

day, saying, thank you so much. You wouldnt believe how much

your passion is contagious and its so great to hear you talk about

how much you love this.

Nurses, both in practice and student nurses coming into

practice, need to hear about the positive stories in nursing

and how perinatal nurses love for being with birthing

women and sharing the life-altering experience of birth, keeps

them practicing. Staden (1998) concluded that, although the

emotional work nurses do to develop relationships with

patients often lacks social value, nurses find the relationshipsthey develop with patients bring them great joy and meaning.

The nurse participants in the study all cited a mentee and a

mentors passion for and commitment to perinatal nursing

practice as integral to supporting a positive mentoring

relation and for supporting positive relations with birthing

women. Cate shares her love for perinatal nursing in the

reverence she has for women and their ability to birth:

ButI mean, its thatincredible,incredible feeling of,wow, when people

say, oh, thank you for all the work youve done and you think,

really, really, if you only knew what your own body has just done.

Thats the phenomenal work, you know. You have done it. I was justhere. I was a guider, I was a councillor, I was a coach, I was but the

work you have doneAnd yes, all the committees and all the rest of it

to make things better, theres still nothing as happy, or theres nothing

as satisfying as doing the hands-on care. And if I give back something,

then I give it back maybein teaching others and being there for others.

Similar to Cate, Goldberg (2004) describes the notion of

reverence enacted in perinatal practice when a nurse elicits

deep respect for the birthing woman and her family through

her ability to individualise care to meet the unique needs of

the birthing woman in her own life context. For Cate,

teaching and supporting other nurses to revere the birthingwoman and her family, creates a sense of excitement,

enthusiasm and philosophical direction that harnesses the

raw passion new nurses often have for practice.

Conclusion

The findings from the study aim to promote an understanding

of the importance of mentoring and experiential learning in

perinatal nursing practice. At a time when the nursing

shortage is escalating, the average age of a registered nurse in

Canada is 45 years (Villeneuve & MacDonald 2006) and

professional development opportunities are few, novice

nurses depend more and more on their expert colleagues

for support and mentoring. This research clearly demon-

strates how informal nurse-to-nurse mentoring is a daily part

of nursing professional development. Nurses become expert

perinatal nurses through learning that occurs in the relation-

ships between nurses and between nurses and birthing

women. Although structured orientation, theoretical knowl-

edge and foundational nursing education provide a frame-

work for becoming a perinatal nurse, experiential learning is

embodied in the mentoring relational space between nurses

and birthing women. This relational learning happens

through engagement with the birthing woman and the

modelling of perinatal nursing practices by the mentor with

the birthing woman. Concurrently, the nurse-to-nurse men-

toring relationship sparks passion and meaning for perinatalpractice and not only motivates the novice nurse to become

an expert perinatal nurse but also inspires nursing students to

engage in perinatal practice. It is important to note that there

are several gendered, historical, political, professional, social

and economic factors that also influence nurse mentoring.

These are explored further in the fourth theme of this work.

As van Manen (1997) suggests, phenomenological work

has the potential to elicit diverse responses from those who

read the work and for those who were participants in the

work. The feelings elicited from readers engagement with the

work may range from feelings of discomfort, anxiety and

guilt, to hope and increased awareness and liberation,

depending on where readers see themselves in the work.

These feelings can advance awareness and thus effect change

in clinical policy and practice.

Relevance to clinical practice

The findings from this research are intended to encourage

nurse leaders, nurse administrators and nurses themselves, to

support mentoring relations by providing adequate time,

human resources and positive feedback for mentoring rela-

tionships. It is anticipated that information from the studycould stimulate changes to mentoring practices that will

improve the perinatal nursing practice environment and

increase recruitment and retention of nurses in perinatal care,

which will have a positive impact on birthing womens well-

being. This inquiry has implications not only for informal

nurse-to-nurse mentoring in perinatal care but in other

nursing and midwifery practice settings as well. It may also

influence the development of policies to support formal




8/10

mentoring programs such as mentor match programs and

preceptoring.

Future research

Future research related to nurse-to-nurse mentoring illumi-

nated by the study include: the importance of exploring

gender and power in nurses subversive communication with

other health care professionals (e.g. physicians), a more

in-depth exploration of bullying or horizontal violence in

nursing and an exploration of nurse-to-nurse mentoring

in other perinatal practice settings such as antepartum or

postpartum and more generally, in other nursing and

midwifery practice settings.

Acknowledgements

The authors thank Research Services at the IWK Health

Centre for providing funding for this project through an IWKCategory A Research Grant, thesis supervisors, Dr Lisa

Goldberg and Dr Joan Evans and thesis committee members,

Professor Denise Sommerfeld, Dr Sue Campbell and Glenda

Carson. A special thanks to the exceptional nurses who

participated in the study, the richness of your stories and your

honesty and raw passion for perinatal practice and nurse-to-

nurse mentoring made this work possible.

Contributions

Study design: AR, LG, JE; data collection and analysis: AR,

LG and manuscript preparation: AR.

References

Almada P, Carafoli K, Flattery JB, French DA & McNamara M

(2004) Improving the retention rate of newly graduated nurses.

Journal for Nurses Staff Development20, 268273.

Andrews M & Wallis M (1999) Mentorship in nursing: a literature

review. Journal of Advanced Nursing29, 201207.

Asselin ME (2001) Knowledge utilization among experienced staff

nurses. Journal for Nurses Staff Development17, 115124.

Barbour RS (2001) Checklists for improving rigour in qualitative

research: a case of the tail wagging the dog? British MedicalJournal322, 11151117.

Benner P (1984) From Novice to Expert: Excellence and Power in

Clinical Nursing Practice. Addison-Wesley, Menlo Park, CA.

Benner P & Wrubel J (1989) The Primacy of Care. Addison-Wesley,

Menlo Park, CA.

Bergum V (2003) Relational pedagogy. Embodiment, improvisation

and interdependence. Nursing Philosophy4, 121128.

Bergum V & Dossetor J (2003) Relational Ethics: The Full Meaning

of Respect. University Publishing Group, Hagerstown, MD.

Borchardt C (2005) Creating nursing passion through a supportive

professional practice environment. Nurse Leader3, 3135.

Boswell S, Lowry LW & Wilhoit K (2004) New nurses perceptions

of nursing practice and quality patient care. Journal of Nursing

Care Quality19, 7681.

Byrne M (2001) Sampling for qualitative research. Association of

Operating Room Nurses Journal73, 494498.

Code L (1991) What can she know? Feminist Theory and the

Construction of Knowledge. Cornell University Press, Ithaca,NY.

Coyne IT (1997) Sampling in qualitative research. Purposeful and

theoretical sampling; merging or clear boundaries? Journal of

Advanced Nursing26, 623630.

DeMarco R & Knauf D (1994) Method Traingulation and critical

social theory: toward reflexive management and education. Paper

presented at the 5th Annual and International Critical and Feminist

Nursing Conference, Bothwell, Washington.

Doane GA (2002) Beyond behavioral skills to human-involved pro-

cesses: relational nursing practice and interpretive pedagogy.

Journal of Nurse Education 41, 400404.

Eaton E, Henderson A & Winch S (2007) Enhancing nurses capacity

to facilitate learning in nursing students: effective dissemination

and uptake of best practice guidelines. International Journal of

Nursing Practice13, 316320.

Fakude LP & Bruce JC (2003) Journaling: a quasi-experimental

study of student nurses reflective learning ability. Curationis 26,

4955.

Faron S & Poeltler D (2007) Growing our own: inspiring growth and

increasing retention through mentoring. Nursing for Womens

Health11, 139143.

Farrell GA (2001) From tall poppies to squashed weeds: why dont

nurses pull together more? Journal of Advanced Nursing 35,

2633.

Fox VJ, Rothrock JC & Skelton M (1992) The mentoring relation-

ship. Association of peri-Operative Registered Nurses Journal56,

858867.Gadow S (1988) Covenant without cure: letting go and holding on in

chronic illness.National League for Nursing Publication15-2237,

514.

Gadow S (1999) Relational narrative: the postmodern turn in nursing

ethics. Scholarly Inquiry for Nursing Practice 131, 5770.

Goldberg L (2002) Rethinking the birthing body: Cartesian dual-

ism and perinatal nursing. Journal of Advanced Nursing 375,

446451.

Goldberg L (2004) The perinatal nursing relation: in search of a

woman-centred experience. Unpublished Doctoral Thesis, Univer-

sity of Alberta, Edmonton, Alberta.

Goldberg LS (2005) Introductory engagement within the perinatal

nursing relationship. Nursing Ethics 12, 401413.

Goldberg LS (2008) Embodied trust within the perinatal nursing

relationship. Midwifery24, 7482.

Goldberg L, Ryan A & Sawchyn J (2009) Feminist and queer phe-

nomenology: a framework for perinatal nursing practice, research

and education for advancing lesbian health. Health Care for

Women International30, 536549.

Greene MT & Puetzer M (2002) The value of mentoring: a strategic

approach to retention and recruitment. Journal of Nursing Care

Quality17, 6370.

A Ryanet al.



9/10

Groah LK (1996) Mentoring is the greatest gift that perioperative

nurses can give to each other. Association of peri-Operative Reg-

istered Nurses Journal64, 868870.

Grosz E (1994) Volatile Bodies: Toward a Corporeal Feminism.

Indiana University Press, Indianapolis, IN.

Hagell E (1989) Nursing knowledge: womens knowledge. A socio-

logical perspective. Journal of Advanced Nursing14, 226223.

Hartrick G (1997) Relational capacity: the foundation for interper-

sonal nursing practice.Journal of Advanced Nursing26, 523528.Haynor PM (1994) The coaching, precepting and mentoring roles of

the leader within an organizational setting. Holistic Nursing

Practice9, 3140.

Hom EM (2003) Coaching and mentoring new graduates entering

perinatal nursing practice. Journal of Perinatal & Neonatal

Nursing17, 3549.

Hurst S & Koplin-Baucum S (2003) Role acquisition, socialization

and retention: unique aspects of a mentoring program. Journal of

Nurses Staff Development19, 176180.

Im E (2002) A feminist critique of research on womens work and

health. Health Care for Women International21, 105119.

Kirkham M (2000) The MidwifeMother Relationship. Macmillan,

London.

Kruger D (1988) An Introduction to Phenomenological Psychology,

2nd edn. Juta & Co. Ltd, Cape Town.

Lundgren I & Berg M (2007) Central concepts in the midwife-

woman relationship. Scandinavian Journal of Caring Sciences 21,

220228.

Maggs-Rapport F (2000) Combining methodological approaches in

research: ethnography and interpretive phenomenology.Journal of

Advanced Nursing31, 219225.

van Manen M (1997)Researching Lived Experience: Human Science

for an Action Sensitive Pedagogy, 2nd edn. The Alton Press,

London, Canada.

Mangone N, King J, Croft T & Church J (2005) Group debriefing: an

approach to psychosocial supportfor newgraduate registered nurses

and trainee enrolled nurses.Contemporary Nurse20, 248257.McKinley MG (2004) Mentoring matters: creating, connecting,

empowering.AACN Clinical Issues: Advanced Practice in Acute &

Critical Care 15, 205214.

Merleau-Ponty M (1945/1962) The Phenomenology of Perception

(C. Smith, Trans.). Routledge and Kegan Paul, London.

Mills J, Francis K & Bonner A (2007) Live my work: rural nurses and

their multiple perspectives of self. Journal of Advanced Nursing59,

583590.

Moerer-Urdahl T & Creswell J (2004) Using transcendental phe-

nomenology to explore the Ripple Effect in a leadership men-

toring program. International Journal of Qualitative Methods 3,

Available at: http://www.ualberta.ca/~iiqm/backissues/3_2/pdf/

moerercreswell.pdf (accessed June 24 2008).

Murphy M, Petryshen P & Read N (2004) Retaining and transferring

nursing knowledge through a hospital internship program. Nursing

Leadership 17, 6068.

Neuhauser PC (2002) Building a high-retention culture in healthcare:

fifteen ways to get good people to stay. Journal of Nursing

Administration32, 470478.

Newman MA (1997) Experiencing the whole. ANS: Advances in

Nursing Science 20, 3439.

Parse RR (2002) Transforming healthcare with a unitary view of thehuman. Nursing Science Quarterly15, 4650.

Pask E (2003) Self-sacrifice, self-transcedence and nurses profes-

sional self. Nursing Philosophy6, 247254.

Perry PA (1994) Feminist empiricism as a method for inquiry

in nursing. Western Journal of Nursing Research 16, 480

494.

Pollio HR, Henley TB & Thompson CJ (1997) The Phenome-

nology of Everyday Life. Cambridge University Press, New

York.

Routledge FS (2007) Exploring the use of feminist philosophy within

nursing research to enhance post-positivist methodologies in the

study of cardiovascular health.Nursing Philosophy8, 278290.

Sandelowski M (1995) Sample size in qualitative research. Research

in Nursing & Health 18, 179183.

Santucci J (2004) Facilitating the transition into nursing practice:

concepts and strategies for mentoring new graduates. Journal of

Nurses Staff Development20, 274284.

Scott J (1990) Domination and the Art of Resistance. Hidden

Transcripts. Yale University Press, New Haven, CT.

Scott ES (2005) Peer-to-peer mentoring: teaching collegiality.Nurse

Education30, 5256.

Smith LS, McAllister LE & Snype Crawford C (2001) Mentoring

benefits and issues for public health nurses.Public Health Nursing

18, 101107.

Staden H (1998) Alertness to the needs of others: a study of the

emotional labour of caring. Journal of Advanced Nursing27, 147

156.Thomas SP (2005) Through the lens of Merleau-Ponty: advancing the

phenomenological approach to nursing research. Nursing Philos-

ophy 6, 6376.

Tourigny L & Pulich M (2005) A critical examination of formal and

informal mentoring among nurses. Health Care Management24,

6876.

Villeneuve M & MacDonald J (2006) Toward 2020: Visions for

Nursing. Canadian Nurses Association, Ottawa, ON.

Wilde MH (1999) Why embodiment now? ANS: Advances in

Nursing Science 22, 2538.

Young IM (1990)Throwing Like a Girl and Other Essays in Feminist

Philosophy and Social Theory. Indiana University Press, Bloo-

mington.




10/10

This document is a scanned copy of a printed document. No warranty is given about the accuracy of the copy.

Users should refer to the original published version of the material.

Documents

Wise Woman Mentor