Mélanie Lavoie-Tremblay, Ingram School of Nursing, McGill University Montréal, spoke at the first international conference entitled “Countering Staff Shortage Among Health Professions – Together for a Healthy Health Care System”. The conference was organised by the Competence Network Health Workforce (CNHW) which implements strategies to combat workforce shortages in healthcare

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Interview: Bettina Nägeli

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Interviewer: Why are you concerned about entry to the profession by registered nurses?

Mélanie Lavoie: I was once a registered nurse myself, and my entry into practice was stressful. I experienced a gulf between what I had learned during my education and training, and my working life. This gulf is still in place today – in the literature we call it a “reality shock”.

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I: What does this “reality shock” mean for the next generation of nurses?

M. L.: New entrants expect to be given support when they start a new post, that they will have time to get used to their work and become integrated into the team. Instead, the workload for nurses in Canada is severe. From their very first day, young people have a full caseload and are given responsibility; it is not unusual for them to have a night shift in their first week. They are not yet experienced experts and all this leads to mental stress. Newcomers to the profession are therefore often presented with more than they can cope with, and leave the profession after only a short time.

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I: Do today’s students – for the most part members of Generation Y – have special expectations of the working environment?

M. L.: We know from studies that it is important to Generation Y[1] to be well-informed and receive regular feedback. These young people also see the workplace as a social place where they are part of a group. And last but not least, younger employees expect challenges in the workplace to help them grow – in a healthy way – and closely associated development prospects.

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I: You have developed a pilot programme, in which experienced registered nurses working in a clinical setting come together for two-hour study sessions with Bachelor’s degree students from a university in Montréal, twice during the final year of study and once after the students have entered the profession. What is the content of these discussions?

M. L.: The aim is to strengthen the new entrants to the profession, giving them a platform to help them gain a deeper insight into this challenging phase and ultimately reinforce the likelihood of them remaining in the profession. The first meeting of the groups[2] is concerned with stress management. The mentors work with the students to increase the ways in which they deal with the workload, prioritise, put forward professional arguments, and take care of themselves. During the second round, the groups discuss the organisational culture in a hospital, the expectations of various roles, and how the new professionals can obtain feedback and respond to it. In the third group meeting, around three months after they start work, the participants exchange experiences on their early days and evaluate the programme.

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I: Was it difficult to get professional nurses to come forward as mentors?

M. L.: That was what we feared to begin with – after all, it is an unpaid activity and the professionals must prepare themselves to train the students. But we found a great willingness on the part of professionals to support new entrants. We were pleasantly surprised.

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I: What has the programme achieved?

M. L.: We have carried out a survey to obtain data on the effectiveness of the programme[3]. The results of the survey show that the new graduates have gained in self-confidence, have learned to obtain feedback, reduced their stress levels and increased their motivation. The mentors have also reported the experience to be enriching, and have been made more aware of the needs of their younger colleagues, as well as improving their teaching skills. 80% of those questioned would recommend the programme to others. However, it is still too early to judge whether the programme will affect the retention in the profession.

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I: It isn’t new for students to have access to practical experience during their education. What makes your programme innovative?

M. L.: Of course nursing studies are practically based. Many other healthcare institutions have developed introductory programmes. But by involving experienced professionals, this programme means that the practical, real-world aspect of the studies is of particularly high quality, raising the linking of university and practical healthcare, of training and professional working life, to a new level. Students can experience first-hand, in a personal setting, what they can expect in their working lives and how to deal with the challenges. This improves both training and practice. And ultimately, it is the aim of both sides to give the best possible care to their patients.

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[1] Birth years 1982 to 1995.

[2] Each group consists of a male and female mentor and no more than six students.

[3] 12 mentors and 18 entrants to the profession took part in the survey.