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New Nurse Mentorship Program

Resources to support participants in the the New Nurse Mentorship Program at Nova Scotia Health.

Introduction

Mentorship from experienced nurses is a cornerstone of successful transition into practice for early-career nurses, improving retention and job satisfaction.

As noted in Health Canada’s Nursing Retention Toolkit (2024), “formal transition programs are an essential tool for supporting new graduates... [and] are vital to ensuring formal support remains available as they bridge the gap between theory and practice.”

Recognizing the challenges that new graduates—Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Internationally Educated Nurses (IENs) — face when entering the workforce, Nova Scotia Health launched the New Nurse Mentorship Program in 2022, as part of a provincial commitment to Action for Health: A Strategic Plan. This program directly aligns with Solution 3: Cultivate Excellence on the Frontlines, specifically the strategy to increase professional development and practice supports through structured mentorship.

Now, three years into implementation, the program continues to grow in reach and impact. This updated guide serves to:

  • Share current mentorship topics and resources.
  • Provide a basic review of topics that may be pertinent. These modules are intended to guide discussion and are not meant to be an all-inclusive list of topics. Other topics may be covered as requested by the mentee.
  • Equip mentors and mentees with tools and resources to support continued professional growth.
  • Serve as a living document that will evolve with the needs of our workforce.

With a continued focus on excellence and collaboration, this program aims to ensure every new nurse in Nova Scotia Health begins their career with confidence, connection, and strong support.

Reference

Health Canada. (2024).Nursing retention toolkit: Improving the working lives of nurses in Canada. https://www.canada.ca/en/health-canada/services/health-care-system/health-human-resources/nursing-retention-toolkit-improving-working-lives-nurses.html

Module 1: Standards of Practice, Scope of Practice and Self-regulation

All nurses in Nova Scotia must follow professional standards to be able to work in the profession. These standards define the legal and professional responsibilities of nurses and outline what the public can expect from any nurse in any workplace in this province (NSCN, 2025).

Professional standards represent the minimum expectations for nursing practice, regardless of the nurse's role or work environment. Standards are approved by the Nova Scotia College of Nursing (NSCN) or are otherwise inherent in the nursing profession (Nursing Act, 2019).

The Nursing Act, grants the NSCN the authority to set standards for the practice and education of its members. These standards are regularly reviewed and revised to ensure that they reflect trends in both nursing and health care in Nova Scotia as well as across Canada (NSCN, 2025).

Standards of practice (SOP) are broad and flexible. This enables nurses to meet them consistently, though how they do this may vary depending on the context of their practice setting (NSCN, 2025).

The purpose of SOPs is to:

  • protect the public by ensuring high-quality nursing care
  • define the scope and boundaries of RN and LPNs practice
  • promote accountability and professional integrity
  • guide RNs and LPNs in making ethical and safe decisions
  • support consistent, evidence-based nursing practice in Nova Scotia

Self-regulation of nurses in Nova Scotia means that the nursing profession governs itself through a regulatory body (NSCN) that sets standards, issues licences, and ensures nurses practice safely and ethically to protect the public.

The goal of this module is to guide new nurses in understanding their standards of practice, scope of practice, and what it means to be a self-regulated professional in Nova Scotia. Nurses must provide care within their scope of practice, their individual scope, and their scope of employment. They are expected to participate in lifelong learning to ensure they continue to meet the criteria for licensure through NSCN.

This section covers the following topics:

  • Standards of practice
  • Nursing care plan
  • Nursing scope of practice
  • Assignment and delegation of tasks
  • Self-regulation and continuing competence
  • Specialty certifications

Standards of Practice

Nursing Care Plan

The Nursing Act requires nurses to ensure that an appropriate nursing care plan (NCP) is in place for every client. The NCP may be a discipline-specific, stand-alone document, or part of a broader interdisciplinary plan of care incorporating knowledge from nursing, health science and other disciplines (NSCN, 2025).

As autonomous practitioners, RNs are responsible for initiating the care plan with collaboration and input from LPNs. The NSCN guideline for the completion of an NCP is located at:

Most hospital units have standardized care plans for common conditions and diseases. Nurses must evaluate and update them for their patients.

Nursing Scope of Practice

Professional Scope

This refers to the legal scope of nursing practice as defined by the Nursing Act.

Individual Scope

The individual nurse’s scope of practice is typically narrower than the full professional scope, but individuals may have specialized, in-depth knowledge and competence in a specific area of practice. In other words, it includes the unique 'tools in your toolkit' that a nurse brings to their role.

Scope of Employment

The scope of employment describes the nurse’s role within the employment setting. It is defined by the employer through job descriptions, policies, guidelines, and context specific education.

As a professional, you must always practice within your professional scope first and foremost.

In clinical practice, it is essential to ensure that the appropriate healthcare professional is performing the appropriate task at the appropriate time. To guide this decision-making, refer to the Three-Factor Framework, which supports safe, effective, and client-centered care by evaluating:

  • Client factors 
  • Nurse factors 
  • Environmental factors 

Assignment and Delegation of Tasks

Nurses are responsible for providing ongoing guidance and supervision to Unregulated Care Providers (UCPs). This responsibility is based on three factors:

  • Client needs or complexity
  • The UCP's level of experience
  • The predictability of the patient's outcome

The NSCN outlines the difference between assignment and delegation of tasks to UCPs.

Assignment

  • Allocation of duties to individuals whose scope of practice or scope of employment authorizes performance of these duties.
  • UCPs are responsible for outcomes and can provide interventions independently.

Delegation

  • Delegation involves tasks that fall outside the UCP’s scope of practice and employment.
  • The nurse is responsible and accountable for identifying the need to delegate and providing education to the UCP.
  • Delegation usually applies to a specific client within a specific context. There must be no risk to the client.
  • The nurse must determine the right client, the right care provider, and ensure that the right information is provided, and the right monitoring is in place to achieve the right outcome.
  • Nurses cannot delegate to clients, family members, or other self-regulated professionals. They can teach others about the care and interventions that the client needs.

Self-regulation/Continuing Competencies

The healthcare system is constantly evolving to improve the quality of patient care. Nurses must commit to continuous learning and stay informed about emerging trends and best practices.

Nurses should complete self-assessment to ensure they are meeting the requirements of their regulatory body.

Nurses must complete a professional growth plan (linked below). A nurse may be audited by the NSCN at any time during their practice to ensure continuing competence.

Entry-level Competencies. Nova Scotia College of Nursing

The NSCN portal for nurses includes the following self-assessment tools for RNs and LPNs:

Nursing Certification

The Canadian Nurses Association provides a list of nursing specialties that nurses may apply for to become an expert in their specialty of care. Obtaining certification:

  • Must be supported by the nurse’s manager.
  • Is based upon the number of hours of experience that the nurse has in the specialty area.
  • Supports a nurse’s ongoing competence and dedication to lifelong learning.

Patient Profile:

Name: Mrs. J.S.

Age: 58

Diagnosis: Type 2 Diabetes Mellitus, Hypertension

Admission Reason: Elevated blood glucose levels and hypertensive urgency

Situation:

Mrs. J.S. was admitted to the medical-surgical unit with complaints of frequent urination, excessive thirst, and blurred vision. Her blood glucose was 17 mmol/L, and her blood pressure was 180/110 mmHg on admission. She has a history of non-compliance with medication and diet.

RN Scope of Practice in This Case

Assessment:

  • Perform a thorough physical and neurological assessment, including:
    • checking vital signs
    • blood glucose monitoring
    • assessing signs of diabetic complications (e.g. peripheral neuropathy, skin breakdown).
  • Review Mrs. J.S.'s medication list and notes any gaps in adherence.
  • Assess Mrs. J.S.'s diet at home prior to admission.

Planning:

  • Collaborate with the healthcare team (physician, dietitian, diabetes educator) to develop an individualized care plan focusing on glycemic control, blood pressure management, and patient education.
  • Plan nursing interventions such as scheduled blood glucose checks, medication administration, and dietary adjustments.

Implementation:

  • Administer prescribed insulin as per the sliding scale protocol.
  • Provide patient education on insulin administration techniques, hypoglycemia recognition, and importance of medication adherence.
  • Implement dietary recommendations by coordinating with the hospital nutritionist and reinforcing dietary restrictions.
  • Monitor for potential complications like hypoglycemia or hypertensive crisis.

Evaluation:

  • Evaluate Mrs. J.S.'s blood glucose readings, vital signs, and response to medications daily.
  • Assess patient understanding through teach-back methods.
  • Communicate with the interdisciplinary team regarding the patient’s progress and adjusts care plans accordingly.

Outcome:

With RN-led monitoring and education, Mrs. J.S.'s blood glucose stabilized to 7.4 mmol/L and her blood pressure reduced to 140/85 mmHg by discharge. She verbalized understanding of medication adherence, diet, and follow-up appointments, demonstrating readiness for discharge.

Key Points on RN Scope of Practice:

  • The RN performed comprehensive assessments, administered medications, monitored patient responses, and provided education, all within the legal and ethical boundaries of nursing practice.
  • The RN did not prescribe medications or make independent medical diagnoses, respecting physician authority and collaborative care principles.
  • The RN’s role emphasized patient safety, advocacy, and coordination of care.

Module 2: Self-Care

You cannot keep giving to others if you do not give to yourself first. This is like pouring water from a pitcher without ever filling it, eventually it will run dry.
Leslie K. Lobell, (2007)

“Self-care is any deliberate activity that we engage in to improve our physical, mental, or spiritual well-being. It is important for workers in every field, but especially for nurses, who spend their working hours caring for others. Self-care reduces stress, replenishes a nurse’s capacity to provide compassion and empathy, and helps improve the quality of care"(Purdue Global, 2025).

  • To provide guidance to recognize the holistic signs—including physical, psychological, emotional, and spiritual indicators—and contributing factors of stress, exhaustion, fatigue, burnout, and apathy.
  • To recognize the need to implement self-care practices daily, at or away from work, and not just as something to do when burnout sets in.
  • To assist nurses in identifying various methods of coping and managing stress and what self-care supports and interventions are available.
  1. Harmful effects of neglecting self-care may include some of the following (this is not an exhaustive list):
    • Inability to cope
    • Indigestion
    • Anxiety and depression
    • Irritability and mood swings
    • Negative impact on workplace performance
  2. Mentor’s role in assisting to identify signs and symptoms of burnout/stress/fatigue etc.:
    • Behavioral changes (appetite, sleep, isolating, nervous habits)
    • Social changes (lacking motivation, feelings of social rejection)
    • Psychological/emotional changes (difficulty concentrating, burnout, emotional exhaustion)
    • Long-term consequences (heart and gastrointestinal diseases, diabetes, mental health disorders)
  3. Some ideas for self-care:
    • Time management (day-to-day schedule)
    • Breaks (essential to take breaks away from the work environment)
    • Hydration and nutritious eating (helps to maintain energy and mood)
    • Mindfulness and/or meditation (helps to focus and relax)
    • Physical activity (yoga, walking, biking)
    • Connecting with colleagues (can reduce feelings of isolation)
    • Good sleep hygiene (create a relaxing bedtime routine)
    • Keeping a gratitude journal
    • Setting boundaries (learning to say no to extra shifts beyond capacity)

Some helpful resources:

RM - The link to the Sharepoint site (TEND tools) that you wanted me to add does not work for me. Will it work for all mentors?

Case Study #1

This case study highlights the challenges nurses may face when experiencing emotional exhaustion and decreased fitness to practice.

Robin, once outgoing and engaged, begins to isolate. They show signs of burnout such as irritability, sleep disturbances, and unhealthy coping mechanisms. Their colleagues' concern prompts a moment of self-reflection, helping Robin acknowledge that they are not doing well. By seeking help and implementing self-care strategies, Robin begins to recover and reconnect with both their work and colleagues. This case study emphasizes the professional responsibility nurses have to maintain their physical, psychological, and emotional well-being as part of meeting professional standards. It encourages all nurses to reflect regularly on their well-being and take proactive steps to sustain their fitness to practice.

Discussion points:

  • Identify some early signs of burnout.
  • What are some professional responsibilities for fitness to practice?
  • What external and internal barriers may prevent nurses from seeking help when needed? e.g. External: stigma, workplace expectations; Internal: guilt, denial.

Strategies for Resolution:

  • Peer support: Encourage regular check-ins or buddy systems among staff.
  • Debriefing sessions: Encourage emotional processing after difficult shifts.
  • Mentorship: Connect Robin with a mentor who emphasizes work-life balance.
  • Positive workplace culture: Normalize open conversations about mental health and burnout.

Case Study #2

Anupa, a new-to-Nova Scotia registered nurse, is overwhelmed by her workload and constantly doubts her abilities. She avoids asking for help due to fear of seeming incompetent. Recently, she has been having trouble sleeping and feels anxious before each shift.

Discussion Points:

  • What could Anupa do to build confidence and manage stress?
  • What role do peers and mentors play in self-care?
  • How can workplaces destigmatize mental health support?

Strategies for Resolution:

  • Suggest that Anupa shares her feelings of lack of confidence and anxiety with a supportive preceptor, mentor or peer (depending on where she is in her transition to practice) for guidance and reassurance.
  • Encourage open dialogue and normalize discussions around anxiety or imposter syndrome.
  • Suggest mindfulness apps, stress management training, support groups, or other Nova Scotia Health resources.
  • Promote awareness regarding the idea that asking questions is recognized as a strength. They are not alone!

Lobell, L.(2007). Taking care of you: Self-care for health professionals. In Making the Most of Your Career in Nursing (pp. 203-212).

Purdue Global. (2025). The importance of self-care for nurses and how to put a plan in place. Student Resources Blog: Nursing. https://www.purdueglobal.edu/blog/nursing/self-care-for-nurses/

Module 3: Communication, Collaboration and Caring

Effective communication, collaboration, and caring are foundational to professional nursing practice. These skills require openness, curiosity, and genuine interest. Communication involves three critical components: the sender, the message, and the receiver (Ernstmeyer & Christman, 2021).

While all are important, the message itself is often the least significant. More crucial is how the nurse—both the sender and the recipient—employs emotional intelligence, including emotional regulation, validation and distress tolerance. Mastery of these skills enhances patient care and collaboration.

This module explores the essential nursing competencies of communicating clearly, collaborating efficiently with multidisciplinary teams, and demonstrating caring behaviours to promote positive patient outcomes.

  • 5Ws:
    • Who: Nurses, healthcare team members, patients, and families.
    • What: Effective communication, teamwork, and caring practices.
    • Where: Healthcare settings such as hospitals, clinics, community centers, and long-term care facilities.
    • When: Throughout all stages of patient care, from admission to discharge and follow-up.
    • Why: To ensure patient safety, enhance care quality, reduce errors, and foster therapeutic relationships.
    • How: Through verbal/non-verbal communication, interprofessional meetings, care planning, and empathetic patient interactions.

By the end of this module, learners will be able to:

  • Demonstrate effective communication techniques in nursing practice.
  • Apply collaboration skills to work effectively within interdisciplinary teams.
  • Incorporate caring principles to support patient-centred care.
  • Reflect the mission, vision, and values of Nova Scotia Health in all interactions.
  • Support the overall mentorship program goal of fostering competent, compassionate nursing professionals.
  • The role of communication in patient safety and care quality.
  • Barriers to effective communication and strategies to overcome them.
  • Principles of collaboration and teamwork in nursing.
  • Interprofessional communication and conflict resolution.
  • The concept of caring: theories and applications in nursing.
  • Cultural sensitivity and empathy in communication and care.
  • Impact of technology on communication and collaboration in healthcare.

Articles and Book Chapters

Videos

Guidelines

Websites

Scenario 1:

A nurse is caring for a post-operative patient who expresses anxiety about their recovery plan. The nurse must use communication skills to reassure the patient, collaborate with the surgical team to clarify care instructions, and demonstrate caring through active listening and empathy.

Discussion prompts:

  • How can the nurse ensure clear communication with the patient and the team?
  • What collaboration strategies could improve patient outcomes in this case?
  • In what ways can caring behaviours impact the patient's experience?

Scenario 2:

During a busy shift, a nurse notices a conflict between a physician and a respiratory therapist about a patient’s treatment plan. The nurse must mediate effectively, communicate concerns, and promote collaboration to resolve the issue while maintaining caring for the patient.

Discussion prompts:

  • What communication techniques can the nurse use to mediate this conflict?
  • How does collaboration affect team dynamics and patient care?
  • Why is maintaining a caring attitude important even in stressful situations?

Ernstmeyer, K., & Christman, E. (Eds.). (2021). Chapter 2: Communication. In Nursing Fundamentals. Open RN. https://www.ncbi.nlm.nih.gov/books/NBK591817/.

Module 6: Time Management

Time management for nurses is the effective planning, prioritization, and execution of tasks and responsibilities to ensure safe, efficient, and high-quality patient care. It involves organizing work shifts, managing multiple patients, handling documentation, coordinating with healthcare teams, and adapting to unexpected situations—all while maintaining professionalism and minimizing stress (ChatGPT 2025).

Time management is a skill that comes with practice, experience, and learning how to organize. It involves:

  • Managing and completing workload during a nursing shift, including prioritizing tasks by organizing the day into work blocks, using resources efficiently, and recognizing time-sensitive tasks.
  • Critical thinking about what needs to be done first and in what order.
  • Setting priorities, planning the workload, setting goals, and tracking completion. Goals can be short- and long-term.
  • 5Ws (who, what, where, when, why) +how
    • Who: The nurse along with interprofessional team.
    • What: Efficient quality patient care and completion of work within the shift.
    • When: Prior to the shift and during the period of the shift. After the shift. (e.g. Is my uniform ready? Do I have my ID tag, Have I planned my meals?)
    • Why: New nurses without exception report struggling with time management and workload. Being organized allows for better patient care, efficiency, greater overall work satisfaction, as well as personal satisfaction, while decreasing feelings of stress, overwhelm and burn-out. (Murray et al., 2019)
    • How: Learn and apply strategies for organization, review and revision of plan during the day as priorities change.

To learn strategies for organizing and completing workload in a timely fashion.

  • Time sheets
  • Decision matrix
  • Asking for assistance
  • Setting priorities
  • Good workplace habits
  • Cluster care
  • Adapting to unpredictability, change and chaos
  • Setting boundaries
  • Self-care is part of time management

Get the Mentees to come up with ideas on what is important, urgent, critical. This may vary depending on where they work.

Discussion points:

  • How do you structure your day? For example:
    • arriving early for shift
    • preparing the night before
    • planning the day and organizing tasks
The Decision Matrix What must be done right now? i.e. Urgent What can be delayed? i.e. Less urgent but still important
Important
  • Deteriorating patient Glucometer checks on insulin dependent patient.
  • Re-start IV
  • Wound dressings
Less Important
  • Rounding
  • Patient hygiene
  • Ambulation
  • Routine vital signs
  • Checking emails
  • Returning a call from a patient's family
  • Completing a SIMS form
  • Learning to ask for help when needed
  • Flexibility (You can't control chaos; there will be multiple interruptions.)
  • Organization (To avoid multiple trips; keeping bedsides tidy, etc.)
  • Be efficient (No shortcuts.)
  • Self-care is part of time management
  • Patient safety

Scenario 1:

Jasmine is a new graduate nurse on an acute medical floor. She has six patients assigned to her today; she had to pick up a patient as the unit is short staffed due to a sick call. It is 9 am, the meds have been given, and it is break time but she doesn’t feel she can go. One patient is a newly diagnosed diabetic and will be going home as soon as the diabetic teaching is completed today. An 80-year-old woman was admitted last night with pneumonia and is on IV Abx. This patient is having diarrhea, and although usually continent, she can’t get to the toilet and is wearing adult briefs. Jasmine has just gotten another patient up in their chair so they can eat breakfast and given them their morning AC breakfast insulin. Now a physician is asking her to get that patient back to bed. Jasmine feels overwhelmed and not “a good nurse.”

  • What should be the priorities?
  • How can she ask for help? And for which tasks?
  • What is urgent right now?

Scenario 2:

Matt graduated six months ago and works on a surgical floor. He feels he still isn’t organized and able to get off work on time. Today he couldn’t find a parking spot and got on the unit just before the shift started. While he is admitting a patient back from the OR, a code blue is called on the unit. It doesn’t involve one of his patients, but he is asked to “cover” the floor while the code was happening. While he is covering for four extra patients, a family member of one of those patients begins asking when he could talk to the surgeon about his mother. Matt doesn’t have time to talk to the family member and doesn’t know the patient. The call bells are continuously ringing. Two patients who just had hip fracture repairs need the toilet now and also need PRN pain meds. Matt is now one hour late giving the noon meds and he needs to do a NPWT dressing, which he is slow at doing and has only done once before. Because of the code, he has skipped lunch. He feels his preceptorship was cut short and he doesn’t get help from the other nurses. Even when he is busy and they are sitting at the nurse station, they don’t offer to help.

  • What are the priorities?
  • How could Matt have better prepared for this day?
  • What should he do next?

Ausmed.(2024, January 25). A guide to time management in healthcare. https://www.ausmed.com/learn/articles/time-management-for-nurses.

Murray, M., Sundin, D., Cope, V. (2019). New graduate nurses' understanding and attitudes about patient safety upon transition to practice. Journal of Clinical Nursing, 28 (13–14), 2543–2552. https://doi.org/10.1111/jocn.14839.

Regis College. (2023, May 4). Nurse Time Management: Tips and Techniques for Nurses and Nursing Students. https://www.ausmed.com/learn/articles/time-management-for-nurses

Module 8: Imposter Syndrome

Persistent feelings of incompetence despite evidence of success are defined as imposter syndrome (Cuncic, 2023).

When discussing imposter syndrome, mentors can:

  • Begin with a quote for reflection:
    • "Transition does not require that you reject or deny the importance of your old life, just that you let go of it. (William Bridges Associates, n.d.)
  • Highlight that transition is an emotional, psychological, and professional journey.
  • Introduce the concept of imposter syndrome, which affects up to 70% of professionals and is particularly prevalent during role transitions.
  • Emphasize that experiencing self-doubt does not indicate incompetence but is a normal response to change.

Provide a structured, supportive membership framework that helps nurses transitioning into new roles (e.g. new graduate nurses) to:

  • Understand and manage imposter syndrome
  • Build confidence
  • Successfully integrate into their new professional identity

Understanding Role Transition

  • Who experiences role transition in nursing? (New graduates, nurses transitioning to other positions)
  • What are the common challenges faced during role transitions? (Feelings of incompetence, overwhelming expectations, fear of failure)
  • When do nurses typically feel the effects of role transition? (First independent patient assignment, transition to new specialized roles)
  • Where should mentorship support be focused during role transitions? (Clinical settings, professional development, peer support)
  • Why do role transitions lead to feelings of vulnerability? How does this relate to imposter syndrome?
  • How can the mentor guide the mentee through emotional and clinical changes associated with role transition?

Understanding Transition Models

  • Bridges Transition Model (William Bridges Associates, n.d.)
    • Ending: Letting go of the previous role and identity
    • Neutral Zone: The phase of uncertainty, vulnerability, and emotional realignment
    • New Beginning: Establishment of the new role, renewed confidence
  • Benner's Novice to Expert Framework (Benner, 1982)
    • Helps contextualize the emotional journal and competency levels from novice to expert, recognizing that role change can shift a proficient nurse temporarily back to novice behaviours.

Identifying and Addressing Imposter Syndrome

  • Define imposter syndrome and contributing factors:
    • Perfectionism
    • Early experiences
    • Minority status
    • Systemic stressors
  • Explore symptoms:
    • Self-doubt
    • Fear of failure
    • Over-preparing
    • Burnout
  • Discuss the role of self-awareness and emotional validation in managing these symptoms
  • Validate mentee's emotions and experiences
  • Actively listen and share personal stories of vulnerability
  • Reinforce competence with evidence (e.g. past competencies, positive patient outcomes)
  • Introduce coping strategies and learning opportunities without judgement

Practical Tools and Strategies

Includes:

  • "Break the silence"
  • "Focus on the positive"
  • "Visualize success"
  • "Fake it 'til you make it".
  • Peer support and storytelling: Normalize the shared experience of imposter syndrome.
  • Reflection journals: Encourage nurses to write about their challenges and growth.
  • Feedback loops: Create spaces for constructive feedback and praise.
  • Healthy unit culture: Emphasize the importance.
  • Toxic cultures: Outline the impact (e.g. 'Nurses eat their young') and strategies for change.
  • Leadership: Highlight the role of leadership in modelling vulnerability and resistance.

Self-assessment checklist

Reflection

EAP Program

Phone: 1-800-461-5558

Overcoming Imposter Syndrome

Scenario

A newly graduated nurse begins work on a busy medical-surgical unit. Although they excelled academically and during clinical rotations, they feel overwhelmed, question their decisions, and hesitate to ask for help. The unit culture is fast-paced, and while most colleagues are supportive, the new nurse struggles with feeling like a burden. Their preceptor recognizes the signs of imposter syndrome and introduces a mentorship program. Over several months, through structured reflection, regular feedback, and supportive dialogue, the new nurse gains confidence, builds competence, and begins mentoring a peer by the end of their first year.

Discussion Prompts:

  • Where did the transition falter?

The transition faltered primarily due to the overwhelming feelings of imposter syndrome that the newly graduated nurse experienced. Despite excelling academically and in clinical rotations, the nurse struggled with self-doubt, hesitancy to ask for help, and the fear of being a burden to colleagues in a fast-paced unit. These feelings can be common among new nurses and can severely impact their confidence and decision-making. The fast-paced environment and high expectations placed on them without sufficient emotional support or guidance initially contributed to stress and self-questioning, which led to feelings of incompetence, despite having the requisite knowledge and skills.

  • What strategies helped?

Several strategies played a key role in supporting the nurse’s transition and helping them overcome imposter syndrome:

  1. Mentorship Program: The preceptor recognized the signs of imposter syndrome early on and introduced a mentorship program to provide the nurse with the emotional support and guidance they needed. This offered a structured and safe space to address feelings of inadequacy.
  2. Regular Reflection: Through structured reflection, the nurse had the opportunity to examine their actions, recognize their strengths, and identify areas for growth. Reflection helped them shift their focus from self-doubt to tangible progress and learning.
  3. Feedback and Validation: Consistent feedback from peers and supervisors helped build confidence. Positive reinforcement and constructive criticism allowed the nurse to improve while validating their abilities.
  4. Peer Support: The mentorship allowed the nurse to see that other colleagues, who were once in the same position, had successfully navigated similar challenges. Peer feedback and team collaboration helped them feel like a valued member of the unit.
  5. Building Competence Gradually: Over time, as the nurse became more comfortable with their clinical skills, they gradually took on more responsibility, which reinforced their professional competence. The feeling of accomplishment helped diminish the imposter feelings.
  • How did mentorship change the outcome?

Mentorship was a turning point in the nurse's transition and significantly changed the outcome. Initially, the nurse felt isolated and overwhelmed by the responsibility, but through mentorship, they were able to:

  1. Acknowledge and address imposter syndrome: The mentor helped the nurse understand that feeling inadequate or overwhelmed was normal, and these feelings didn’t reflect their actual competence. This recognition made the nurse feel less isolated in their struggles.
  2. Build confidence: Through consistent guidance, feedback, and encouragement, the nurse became more self-assured in their decisions and actions. The mentor’s support helped the nurse see their strengths, rather than focusing on their weaknesses.
  3. Develop a support system: Having a mentor allowed the nurse to have someone to turn to with questions or concerns, reducing the fear of being seen as a 'burden'. This sense of support and connection was crucial to their emotional well-being.
  4. Guide professional growth: As the nurse gained competence, the mentor encouraged them to take on more complex tasks, which helped develop leadership and critical thinking skills. This made the nurse feel more comfortable in the role and prepared them to eventually mentor others.
  5. Transition to mentoring: The successful mentorship experience empowered the nurse to eventually become a mentor themselves, reinforcing their sense of mastery and professional identity. They transitioned from mentee to mentor by the end of the first year, which allowed them to internalize their growth and realize their capability.

Mentorship shifted the trajectory of the nurse’s journey from self-doubt to self-empowerment. Initially, imposter syndrome was a barrier to success and well-being, but the structured, supportive environment created by the mentorship program allowed the nurse to:

  1. Feel seen and validated: By having a mentor who acknowledged the emotional and professional struggles they were facing, the nurse felt seen and validated, reducing the fear of being “discovered” as a fraud.
  2. Create a growth mindset: The mentor helped the nurse understand that growth takes time and that mistakes are a part of learning. This mindset shift was key in overcoming the paralysis that imposter syndrome often causes.
  3. Foster a collaborative learning environment: Through mentorship, the nurse learned that asking for help and collaborating with others is a sign of strength, not weakness. They no longer feared being seen as incompetent but embraced the idea of lifelong learning.
  4. Develop leadership skills: The mentorship helped the nurse build the confidence to take on a mentorship role themselves by the end of the first year. They moved from feeling like an outsider to becoming a mentor for their peers, which reinforced their own competence and professional identity.

In summary, mentorship directly impacted the nurse’s ability to overcome imposter syndrome by offering emotional support, guiding their reflection and professional development, and providing a framework for transition. It helped transform the nurse from someone struggling with self-doubt to a confident and capable professional who could support others in their journey.

Benner P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402–407.

Cuncic, A. (2025, September 29). Is imposter syndrome holding you back from living your best life? Verywell Mind. https://www.verywellmind.com/imposter-syndrome-and-social-anxiety-disorder-4156469

William Bridges Associates. (n.d.). Bridges Transition Model. https://wmbridges.com/about/what-is-transition/

Young, V. (n.d.). 10 Steps You Can Use to Overcome Impostor Syndrome. Impostor Syndrome Institute. https://impostorsyndrome.com/articles/10-steps-overcome-impostor/

Module 9: Professional Presence

Professional presence is the foundation of nursing care. It is defined by the Nova Scotia College of Nurses (NSCN) as “the demonstration of respect, confidence, integrity, optimism, passion and empathy in accordance with professional standards, guidelines and codes of ethics. It includes a nurse’s verbal and nonverbal communications and the ability to articulate a positive role and professional image, including the use of one’s name and title during patient interactions. The demonstration of professional presence leads to trusting relationships with clients, families, communities and other health care team members” (NSCN, 2018).

Professional presence is the embodiment of values, behaviours and actions that convey a nurse’s commitment to safe, competent, compassionate and ethical care (NSCN, 2018).

A nurse’s professional presence influences public perception of nursing and can inspire respect and trust in the profession (OpenAI, 2025). Professional presence is also often used interchangeably with “professionalism.”

For novice nurses, demonstrating professional presence is a learned skill, which can be gained throughout formal education. It can also be developed during clinical experiences, by observing professional behaviours of experienced nurses, through mentorship, and within interactions with patients and their families (OpenAI, 2025). Time, support and practice are required for new graduates to understand and develop the skills and traits that underlie a consistent professional presence in nursing.

  • Define professional presence in the workplace with the mentee
  • Identify components of professional presence: why, where, when, what and how
  • Recognize that mentorship can reinforce the concepts of professional presence with new graduates who may be more focused on tasks/skills/time management   
  • Reflect on how to ensure one is displaying professional presence in patient interactions (case studies)
  • Why do nurses need professional presence and with whom?

Professional presence is essential for humanized care (Guillaumie, Boiral, Desgroseilliers Vonarx & Roy, 2022) and building therapeutic relationships. Being fully present helps nurses notice subtle health changes, builds trust and encourages patients to share sensitive information.

  • When and where?

Professional presence should be demonstrated at all times - before, during, and after care -  whether in person, on the phone, or virtually. Nurses should introduce themselves with their name and professional title and use respectful verbal and non-verbal communication in all settings.

The integration of smartphones and tablets into everyday provision of care has many benefits for patients but can cause distraction that may negatively impact the nurse's ability to provide both care and patient safety (CNPS, 2025).

  • What does it look like?

Professional presence includes a clean uniform, a professional demeanor, and behaviours like active listening, empathy, respect, and cultural competence (NSCN, 2022). It reflects integrity and a commitment to protecting patient dignity and addressing their holistic needs.

  • How to demonstrate it?
    • Appearance & behavior: Maintain appropriate hygiene, a calm demeanor, and a caring attitude.
    • Communication: Use clear, respectful language and active listening.
    • Respect for diversity: Show cultural humility and deliver culturally competent care.
    • Professional interactions: with healthcare team members. Acknowledge contributions of all members of the staff.

 Professional Presence Practice Guideline

Nova Scotia College of Nursing, 2019

Consider the following patient scenarios:

Scenario 1:

Mabel is visiting her mother Joan in the hospital for the first time since her admission. She comes into the room and finds her mother slumped in bed looking anxious, with a medicine cup of pills and a cup of water sitting in front of her, along with her barely touched meal. Mabel attempts to give her mother her pills but her mother does not want to swallow them without knowing what they are. Mabel asks her mother who her nurse is so she can get some assistance, but her mother doesn’t know her nurse’s name and says she does not know when the pills were left there. She is worried about when she will be discharged home and starts to cry. A woman comes into the room and puts some clean linen on another bed and hurries away before either Mabel or Joan can speak with her. When Mabel tries to find someone on the unit to ask who her mother’s nurse is, she sees a group of individuals at the front desk in scrubs laughing, and another in the hallway looking down at a cell phone. She doesn’t know who the nurses are or who to ask for help.

  • What do you imagine happened in this situation?
  • What components of professional presence are lacking in this scenario?
  • What would you do if you witnessed this scenario unfold in the workplace?

Scenario 2:

George is the nurse looking after Joan. He announces his presence, using his full name and professional title. George smiles, makes eye contact with Joan, and bends down to speak with her. He lets her know what medications he is bringing her and asks Joan if she has any questions. He verifies her identity before administering the medication. George listens to Joan’s concerns, makes notes to ask the doctor and assures Joan he will speak with her and her daughter again to review any other questions. Before leaving Joan’s care area, George updates her bedside patient care board with the date, his name and relevant communication details for the care team.

  • What does the nurse do to display professional presence in this scenario?

Canadian Nurses Protective Society. (n.d.) InfoLAW: Mobile devices in the workplace. https://cnps.ca/article/mobile-devices-in-the-workplace/

Cao, H., Song, Y., Wu, Y., Du, Y., He, X., Chen, Y., Wang, Q., & Yang, H. (2023). What is nursing professionalism? A concept analysis. BMC Nursing, 22(1), 34. https://doi.org/10.1186/s12912-022-01161-0

College of Registered Nurses of Saskatchewan. (n.d.). Electronic distraction in health care. https://www.crns.ca/nursing-practice/nursing-practice-resources/rn-manager-tool/electronic-distractions/

Guillaumie, L., Boiral, O., Desgroseilliers, V., Vonarx, N., & Roy, B. (2022). Empowering nurses to provide humanized care in Canadian hospital care units: A qualitative study. Holistic Nursing Practice, 36(5), 311–326. https://doi.org/10.1097/HNP.0000000000000418

Nova Scotia College of Nursing. (2018). A guideline for Nurses: Professional Presence. https://www.nscn.ca/sites/default/files/documents/resources/ProfessionalPresence.pdf

Nova Scotia College of Nursing. (2022). Position Statement: Cultural Safety and Humility. https://www.nscn.ca/sites/default/files/documents/resources/Cultural-Safety-and-Humility.pdf

Module 10: Incivility

"A significant percentage of nurses leave their first job due to the negative behaviors of their coworkers, and bullying is likely to exacerbate the growing nurse shortage. A bullying culture contributes to a poor nurse work environment, increased risk to patients, patient satisfaction scores, and greater nurse turnover, which costs the average hospital $4 million to $7 million a year. Addressing nurse bullying begins with acknowledging the problem, raising awareness, mitigating contributing factors, and creating and enforcing a strong antibullying policy. Nurses and stakeholders also must actively work to change the culture and understand that bullying has no place in the nursing profession or anywhere else in health care"(Edmonson & Zelonka, 2019, p. 274).

The phrase “nurses eat their young” has long been used by nurses in the profession to describe a culture of hostility toward newer staff. Incivility refers to disrespectful behaviour and it can be a form of bullying. Kathleen Bartholomew describes it as “the overt and covert behaviours that we use to put people in their place as humans" (TedxTalks, 2016).

Incivility is often underreported - only about 25% to 60% report experiencing it (RNAO, 2019; Atashzadeh Shoorideh, Moosavi, & Balouchi, 2021). A report from Alberta found that, due to poor treatment by co-workers, “'60 percent of new graduates will leave their first positions within six months’ and 50 percent of that number will actually quit the nursing profession" (Hubbard, 2014).

Incivility can occur within nursing units and can happen to any nurse. It can come from colleagues, and other members of the healthcare team, as well as from patients or family members. It can occur during working hours or extend to interactions on social media. Incivility can be subtle or overt, but in all forms, it negatively impacts the nurse who experiences it.

Nova Scotia Health is committed to ensuring a respectful workplace for everyone. The Respectful Workplace Policy is designed to support and maintain a safe and inclusive environment where everyone is treated with dignity. It describes incivility as disrespectful behaviour.

The goal of this module is to provide education and guidance to nurses about strategies to use when they witness or are the victim of incivility/bullying on their unit. It includes references that describe incivility and its impact within the healthcare environment.

The following points will be discussed:

  • Theoretical frameworks related to incivility in nursing
  • Impact of incivility on patient outcomes
  • Signs of bullying/incivility, both overt & covert
  • Solutions and interventions

Theoretical frameworks related to incivility in nursing

Lateral Violence Theory

  • Describes negative behaviours among peers of the same hierarchical level, such as bullying, exclusion, or undermining. Studies indicate that 46 to 100% of nurses have experienced this during their careers (Snively & Vaughn, 2023).
  • Explains how nurses can perpetuate incivility to cope with workplace stress or assert dominance. It usually occurs when the nurse believes that they are superior to other members of the team (Snively & Vaughn, 2023)

Social Learning Theory

  • Suggests that uncivil behaviours are learned by observing others, meaning toxic behaviours can become normalized if not addressed.
  • Highlights the importance of role models and leadership in shaping respectful workplace culture.

(Sutton, 2021)

Transactional Model of Stress and Coping

  • Examines how individuals perceive and respond to stressors such as incivility.
  • The nurses' strategies (e.g., seeking manager support) influence their resilience and well-being.

(Faubian, 2025)

(ChatGPT, July 2025)

Impact of incivility on patient outcomes

  • Communication Breakdown: When nurses are excluded or ignored, important patient information may not be shared effectively, increasing the risk of errors.
  • Decreased Collaboration: Team dysfunction reduces coordination of care, affecting timeliness and quality of interventions.
  • Increased Nurse Burnout: Incivility contributes to emotional exhaustion and job dissatisfaction, which correlates with higher turnover and understaffing.
  • Patient Safety Risks: Studies show that units with high levels of incivility have higher rates of adverse events like medication errors, falls, and infections.
  • Lower Patient Satisfaction: Patients can perceive the negative atmosphere, reducing their trust and comfort with care providers

Signs of bullying/incivility

Overt (obvious, direct, and visible behaviours)

  • Verbal abuse (e.g. yelling, insults, name-calling)
  • Threats or intimidation
  • Public humiliation or ridicule (e.g. jokes or unwelcome remarks)
  • Physical aggression (e.g. pushing, hitting—rare but possible)
  • Open refusal to cooperate or follow orders
  • Open criticism or blaming in front of others
  • Taking credit for someone else’s work

Covert (subtle, hidden, or indirect behaviours)

  • Ignoring or excluding someone deliberately (e.g. silent treatment)
  • Gossiping or spreading rumors behind someone’s back
  • Withholding important information or resources
  • Sabotaging someone’s work quietly (e.g., not completing a task that affects another)
  • Undermining decisions or authority subtly
  • Giving impossible deadlines or unfair workloads
  • Eye-rolling, sighing, or non-verbal gestures that show disdain
  • Setting someone up to fail without obvious confrontation

(Ayen, 2023; Edmonson & Zelonka, 2019)

*Note* Incivility/bullying does not include:

  • Appropriate use of management responsibilities
  • Assignment of shifts
  • Performance appraisals
  • Appropriate discipline
  • Occasional grumpiness or lack of friendliness (if it becomes persistent it can be described as incivility)

(Nova Scotia Health Authority, 2017)

Solutions and interventions

  • Treat all Staff, Patients, families, visitors, and others with dignity and respect
  • Develop skills to constructively address offensive or disrespectful behaviour in a professional manner
  • Access resources and supports to address offensive or disrespectful behaviour
  • Follow resolution processes and/or participate in resolution processes
  • Acknowledge their role in incidents of offensive or disrespectful behaviour
  • Hold others accountable for incidents of offensive or disrespectful behaviour
  • Let staff, patients, families, visitors, and others know through their own actions that respectful behaviour is expected.

(Nova Scotia Health Authority, 2017)

All staff are encouraged to bring forward any complaints informally or formally within a reasonable time frame with dates, times and situation. The nurse mentor can play a key role in supporting the nurse by sharing information and strategies to address incivility within their work environment. Using role playing can be a useful strategy for the nurse to gain knowledge and confidence. Discussing de-escalation techniques may be useful for the new nurse during role-playing. The mentor may encourage and support the nurse if they decide to submit a formal complaint about the incivility.

Case Study: Nurse Experiencing Incivility on a Hospital Unit

Background: Jessica is a registered nurse (RN) working on a busy medical-surgical unit in a large urban hospital. She has been in the role for two years and is well-regarded by patients but relatively new compared to many senior staff on the unit.

Situation: Recently, Jessica started noticing subtle but consistent uncivil behaviors from some of her colleagues, particularly from a group of senior nurses. Examples include:

  • Exclusion from informal communication: Jessica is often left out of important shift-change discussions and informal team meetings where key patient care decisions are made.
  • Dismissive attitudes: When Jessica asks questions or seeks advice, some colleagues respond with impatience or sarcasm. For example, during a medication reconciliation, a senior nurse said, "You should know this by now," even though the protocol had recently changed.
  • Gossip and negative talk: Jessica overheard colleagues making derogatory comments about her competence, implying in front of others that she was careless and inexperienced, which affected her confidence.
  • Withholding information: At times, important updates about patients’ conditions or unit policies are not communicated to Jessica, leading to increased stress and the potential for errors.

Impact:  Jessica began feeling isolated and anxious at work. Her job satisfaction declined, and she hesitated to contribute during team discussions. This also affected her performance and increased the risk of patient safety concerns. She considered transferring to another unit or leaving nursing altogether.

Response: Jessica decided to document the incidents and approached her nurse manager for support. The manager acknowledged the problem and arranged a facilitated team meeting focused on professional communication and respect. They also introduced:

  • Incivility awareness training: Workshops on recognizing and addressing incivility.
  • A mentorship program: Pairing newer nurses like Jessica with supportive senior nurses to improve communication and collaboration.

Outcome: Over time, with management intervention and increased awareness, the team culture began to shift. Jessica felt more included and supported. The unit also reported fewer communication breakdowns and improved teamwork.

(Chat GPT, July 2025)

Alsadaan, N., Ramadan, O. M. E., & Alqahtani, M. (2024). From incivility to outcomes: tracing the effects of nursing incivility on nurse well-being, patient engagement, and health outcomes. BMC Nursing, 23(1), 325. https://doi.org/10.1186/s12912-024-01996-9

Atashzadeh Shoorideh, F., Moosavi, S., & Balouchi, A. (2021). Incivility toward nurses: a systematic review and meta-analysis. Journal of Medical Ethics and History of Medicine, 14, 15. https://doi.org/10.18502/jmehm.v14i15.7670

Ayen, M. (2023, February 4). Overt and covert bullying. LinkedIn. https://www.linkedin.com/pulse/overt-covert-bullying-marjorie-ayen.

Edmonson, C., & Zelonka, C. (2019). Our own worst enemies: The nurse bullying epidemic. Nursing Administration Quarterly, 43(3), 274–279. https://doi.org/10.1097/NAQ.0000000000000353

Faubian, D. (2025). What is Transactional Leadership in Nursing? (PLUS, Pros VS. Cons, Characteristics, & How to Become). NursingProcess.org. https://www.nursingprocess.org/transactional-leadership-in-nursing.html

Hubbard, P. (2014). What can be done about horizontal violence? Alberta RN, 69(4), 16-18.

Nova Scotia Health Authority. (2017). Respectful Workplace. Policy #AD-HR-020. https://policy.nshealth.ca/Site_Published/nsha/document_render.aspx?documentRender.IdType=6&documentRender.GenericField=&documentRender.Id=109470

Registered Nurses’ Association of Ontario (RNAO). (2019) Preventing violence, harassment and bullying against health workers. 2nd ed. Toronto (ON). https://rnao.ca/bpg/guidelines/preventing-violence-harassment-and-bullying-against-health-workers.

Snively, E., & Vaughn, N. (2023). What Is Lateral Violence in Nursing? [Blog]. Relias. https://www.relias.com/blog/what-is-lateral-violence-in-nursing

Sutton, J. (2021). What Is Bandura’s Social Learning Theory? 3 Examples. PositivePsychology.com. https://positivepsychology.com/social-learning-theory-bandura/

TEDx Talks. (2016, Jan. 25). TEDxSanJuanIsland - Kathleen Bartholomew- Lessons from Nursing to the World [Video]. YouTube. https://www.youtube.com/watch?v=Qh4HW3yx00w