288 JNK JURNAL NERS DAN KEBIDANAN (JOURNAL OF NERS AND MIDWIFERY) http://jnk.phb.ac.id/index.php/jnk Literature Review: The Support Needs of The Nurse Mentors in Their Mentoring Role Sisinyana Hannah Khunou1, Kholofelo Lorraine Matlhaba2 1,2Department of Health Studies, University of South Africa, South Africa Article Information Abstract In order to develop effective mentoring programme, it is important to identify the needs of the nurse mentors. A lot has been documented about the needs of the nurse mentees, however, there is a dearth of recent literature finding the support needs of the nurse mentors. The aim of this integrative review was to synthesize the literature on the support needs of the nurse mentors in their mentoring role. The search was steered across Cumulative Index to Nursing and Allied Health Literature; Direct of Open Access Journals; Google Scholar, PubMed/MEDLINE, Science Direct, and SCOPUS, in order to identify challenges and support that need to provide to the nurse mentors in their mentoring role. The Medical Subject Headings according to National Library of Medicine was used to search for the key concepts. Key search concepts were entered into the query box on the main PubMed page and searched. The search details page was check to determine how PubMed processed the search. The same concepts were used on the database to search for the articles which were included in this review. Seven subthemes, twenty categories were identified and classified into two main themes: Challenges to effective mentoring; Support needed by the nurse mentors. The review identifies challenges faced by nurse mentors and concludes that they need support. This study suggests that policy makers should make a concerted effort by availing resources for mentoring role. Workshops to equip mentors and collaboration between different stakeholders might help to enhance the support of the nurse mentors. Future research should analyse collaboration in support of the nurse mentors in their mentoring role. History Article: Received, 25/03/2023 Accepted, 17/07/2023 Published, 30/08/2023 Keywords: mentoring role, mentorship, nurse mentors, support needs © 2023 Journal of Ners and Midwifery Correspondence Address: University of South Africa - South Africa, South Africa P-ISSN : 2355-052X Email : khunosh@unisa.ac.za E-ISSN : 2548-3811 DOI: This is an Open Access article under the CC BY-SA license (http://creativecommons.org/licenses/by-sa/4.0/) http://jnk.phb.ac.id/index.php/jnk mailto:khunosh@unisa.ac.za Khunou, Matlhaba, Literature Review: The Support Needs of The Nurse Mentors in Their … 289 INTRODUCTION Transition from being a student to practice as a newly qualified nurse, has been proven to be a nerve- racking experience journey (Duchscher, 2009; Chen et al., 2021). To that effect, studies has recommended mentorship and support of the newly qualified nurse in order to alleviate the transitional shock (Chen et al., 2021). Mentorship is described as a reciprocally valuable relationship between a more experienced person (mentor) and a less experienced person (protégé/Mentee), where the primary focus is professional development of the mentee (Scott & Smith, 2008). Notably, without the mentor, it would be impossible to ensure adequate and effective mentoring and support of the newly qualified nurse as a mentee. Indeed, mentors form a crucial aspect in the mentoring of the newly qualified nurses. Hence, it is important to consider their support needs in persuing the mentoring role. Mentoring has benefits to the mentor and the mentee. Some of the mentor‘s benefits entail recognition, career and psychological developments (Khunou, 2018; Lapointe & Vandenberghe, 2017). The benefits of mentoring for the mentees include skills and knowledge development, being a competent prosperous professional, collaboration and professional visibility (Cross et al., 2019). In order to realise these positive outcomes, there should be an effective reciprocal mutual relationship between the mentor and the mentee (Moran and Banks, 2016). Even though the relation is mutual, the mentor shoulders the most responsibility by taking the lead and directing the complete mentoring process (Hale, 2018). The valuable contribution of the nurse mentor is well documented. In support, Moran and Banks (2016) revealed that mentors form a crucial aspect in the supervision and mentoring of novice nurses. Pivotal responsibilities include the teaching and learning of students as well as the assessment of the students’ competency (Moran & Banks, 2016). It is also emphasised that mentors, play an essential role in retaining of the newly qualified nurses. Besides skills development, Zhang et al. (2019) reiterate that mentors also provide psychological support thus enhance job satisfaction amongst the novice nurses. It is apparent that the mentor is the cornerstone of the mentoring process. Mentors need to be motivated and supported in order to be committed in the mentoring of the novices. According to Roseghini and Olson (2015), mentors who are competent, knowledgeable and motivated are likely to provide a positive mentoring and feedback. It is further revealed that there is the need for the organization to support and acknowledge the mentor’s role (Wissemann et al., 2022). It is clear from the literature that the mentors need to be adequately supported. In order for the nurse mentor to be supported, it is imperative to get a clear evidence to understand their support needs. The purpose of this review was to synthesize the evidence available on the support needs of the nurse mentors in mentoring role. The review aimed to address the following research question: “What are the challenges and the support needed by the nurse mentors in their mentoring role?” Mentoring plays an important role in the transition from students to graduate nurses whether in form of formal or informal relationship between the experienced nurses as the mentors and novice nurses as mentees. Dirks (2021), suggest that mentoring relationships in critical care provide the ongoing interactions, coaching, teaching, and role modelling to facilitate the nurses' progression into the profession. In agreement, Voss et al. (2022) suggest that the collaborative knowledge sharing between the mentor and mentee fosters better support, resilience, increased motivation, and overall job satisfaction. Therefore, experienced nurses as mentors are needed to provide guidance as well as sharing their clinical experiences with the intention to assist the novice nurses gain confidence in their professional roles as well as assisting them to adapt to the working environment. However, it is evident that nurse mentors find it challenging to execute their roles due to multiple factors including lack of support (Wissemann et al., 2022; Oluchina & Gitonga 2016; Ntho et al., 2020). Therefore, this review aimed to provide evidence on the support needs of the nurse mentors in mentoring role from the existing literature and to make recommendations. METHOD An integrative literature was used to address the question on support needs of the nurse mentors in their mentoring role. Integrative review determines current knowledge about a specific topic because it is carried out to identify, analyse and synthesize results of independent studies on the same subject (Whittemore & Knafl, 2005). The justifications fundamental to the selection of this approach were as follows: 1) This approach allowed the consolidation of different research findings which applied various designs and methodologies to establish the gaps on the support of mentors in the mentoring role; 2) the methodical appraisal and 290 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 288-301 blend of the vast literature enhanced the review rigor (Whittemore & Knafl, 2005). The support needs of the nurse mentor in the mentoring role are multidimensional, therefore an integrative literature review was the most suitable method to contemplate the existing evidence. The research question underpinning this integrative review was: What are the support needs of the nurse mentors in the mentoring role? This integrative review encompassed research articles published between 2013 and 2023. The search focused on the following electronic databases: Google scholar, Medline Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), PsychINFO, Science direct, Pub Med and EBSCOhost.The Medical Subject Headings (MESH) according to National Library of Medicine was used to search for the key concepts as illustrated in Table 1 below. Key search concepts were entered into the query box on the main PubMed page and searched. The search details page was check to determine how PubMed processed the search. The same concepts were used on the database to search for the articles which were included in this review. Table 1: Search strategy Steps Search terms 1 "Mentor”; mentors”; “mentorship”; preceptor”; “supervision” 2 "Need”; health services needs and demand"Needs 3 “Mentoring”; “Coaching”; “preceptorship”; “supervision”; “clinical supervision”; 4 “mentor’s experiences”; “attitudes”; “perspectives”; “view”; “perceptions”; “feelings”; “opinions” 5 “Role” 6 1 and 2 and 3 and 4 and 5 Inclusion and exclusion criteria were further applied to make sure that appropriate and relevant articles were reviewed. Studies were included if they met the following criteria: (a) scholarly works published in peer-reviewed journals; (b) written in English; (c) timeframe between 2013 and 2023 (d) study participants were nurse managers/ registered nurses; (e) inclusion of search term or keywords. Any research work and articles involving other nurses and other health care professionals were excluded. Furthermore, the exclusion applied to pilot studies reports, literature reviews, and editorial letters, as well as conference reports. The most relevant articles were determined with the application of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). This process resulted in 16 articles, which met the criteria for review inclusion (Fig. 1 and Table 2). Figure 1. PRISMA Flow Diagram of integrative review (adapted from Moher et al, 2009) Articles identified from databases (n =980) Duplicate articles removed (n =300) Ineligible articles (n = 500) Articles screened by title and abstracts (n = 180) Articles excluded (n =110) Full text articles assessed for eligibility (n = 70) Articles excluded because of the exclusion criteria (n = 54 Studies included in review (n = 16) Id e n ti fi c a ti o n S c r e e n in g In c lu d e d Khunou, Matlhaba, Literature Review: The Support Needs of The Nurse Mentors in Their … 291 Critical appraisal The critical appraisal skills programme checklist (CASP) was used to critically appraise the quantitative, qualitative and mixed method studies (CASP, 2018). The two authors collaborated in reading, reaffirmation, proof reading and evaluation of the reserved articles. The extensive reading of the articles sought to assure the quality of the articles and ensure that they met the inclusion criteria. Simultaneously, this process included adequate data extraction as per Critical Appraisal Skills Programme methodological assessment tools (CASP, 2018). The quality and rigor of the articles was based on the author(s), year, country, title, and methods sample and data quality. The quality of the study was scored as A = High quality; B = Good quality and C = Low quality. Table 2 illustrate the CASP for quantitative and mixed method studies and the qualitative studies respectively. From this 16 studies that met the quality appraisal criteria were retained: qualitative (n = 8); mixed method (n = 5); quantitative (n = 3) studies. Data analysis In the data analysis stage, data were organised, categorized and summarised into an incorporated conclusion about the research problem under study (Whittemore & Knafl, 2005). In this review, a matrix was developed that outlined (1) The characteristics of the study population; (2) Challenges to effective mentoring; 3) Support needed by the nurse mentors. Content from the articles were then extracted populating the matrix. The results were then integrated and analysed using a constant comparative method to organise and categorise the data. Review presentation stage At this stage, data is presented elucidating the specifics from each data source in support of the final conclusions from the review (Whittemore & Knafl, 2005). In this review, studies were synthesized under the following subheadings: 1) Author; 2) Year of publication; 3) Country, 4) study design, 5) Study sample and 6) Findings (Table 2). Final summary of the findings is then presented in Themes; Sub-themes and Categories for better clarity of the support needs of the nurse mentors in the mentoring role.as illustrated in Table 3. 292 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 288-301 Table 2: Characteristics of studies including the quality (A = High quality; B = Good quality; C = Low quality) No Author/s; year; country; Title Methods Sample size Quality appraisal Results 1. Bennett & McGowan (2014) UK Assessment matters—mentors need support in their role Qualitative Nurse mentors (n =35). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Changing roles and responsibilities, time to mentor. 2. Broadbent et al. (2014)(AUSTRALIA) Supporting bachelor of nursing students within the clinical environment: Perspectives of preceptors Mixed method Nurse mentors (n =34). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Lack of a qualification in preceptoring resource provision and communication concerning. Difficult to manage time and resolve role conflict. 3. Chan et al. (2019) (HONG KONG) Understanding the needs of nurse preceptors in acute hospital care setting: A mixed-method study Sequential mixed method approach Nurse mentors (n =10 –Qual; 260 – Quan). Aim ,objectives described Methods suitable Results consistent Implications described Quality=High (A) Training on critical thinking, prioritising, teaching techniques, conflict management. Tension with their dual roles and strained relationships with co-workers 4. Fernandez et al. (2018) (AUSTRALIA) Exploring the experiences of neophyte nurse mentors: A qualitative study. Qualitative Nurse mentors (n =6). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Readiness for mentoring, ;Venturing into the unknown, Frustrations of mentoring; Reciprocal professional relationship. 5. Frankenberger et al. (2021)(USA) Experience of burnout among paediatric inpatient nurse preceptors. Qualitative Nurse preceptors (n =8). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Feeling the Responsibility” reflected the cognitive stain of precepting. “An Obligation to the Role 6. Jokelainen et al. (2013) (UK) Finnish and British mentors' conceptions of facilitating nursing students' placement learning and professional development. Qualitative Nurse mentors (n = 39). Aim, objectives described; Methods suitable; Results consistent; Implications described Quality=High (A) Mentors are required to have effective communication and evaluation skills, should therefore be supported through mandatory mentor preparation programmes. Khunou, Matlhaba, Literature Review: The Support Needs of The Nurse Mentors in Their … 293 No Author/s; year; country; Title Methods Sample size Quality appraisal Results 7. Kramer et al. (2021) (USA) The Art of Nurse Mentoring: A Framework of Support Qualitative Nurse mentors (n =42). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Barriers: time, patients/patience, competition, knowledge deficit regarding mentor verses preceptor roles, lack of incentives, receptiveness 8. Macey et al. (2021) (AUSTRALIA) ICU nurse preceptors’ perceptions of benefits, rewards, supports and commitment to the preceptor role: a mixed- methods study Mixed-method design Preceptors (n =113). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Supports as barriers and enablers to successful preceptorship were discussed in terms of peer and leadership support, role preparation, role conflict 9. MacLaren (2018) (UK) Supporting nurse mentor development: An exploration of developmental constellations in nursing mentorship practice Qualitative Nurse mentors (n =3) Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Findings suggest that dyadic forms of supervisory mentorship may not offer the range of skills and attributes that developing mentors require. 10. McIntosh et al. (2013)(UK) Mentors' perceptions and experiences of supporting student nurses in practice Mixed-method approach Nurse mentors (n =61) Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Mentors need to be supported with clinical skills, integrating into the team. Mentors were aware of their roles and responsibilities in supporting students 11. Mikkonen et al. (2021) (UK) Mentors' competence in mentoring nursing students in clinical practice: Detecting profiles to enhance mentoring practices. Quantitative Nurse mentors (n =1604). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Significantly different values (p < .001) across all seven areas of mentoring competence. 12. Mubeezi et al. (2017) (UGANDA) Mentoring student nurses in Uganda: A phenomenological study of mentors’ perceptions of their own knowledge and skills Qualitative research method Nurse mentors (n =5). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) The paper reports on the nature of the relationship between mentor and students, the teaching approaches used and the challenges of the role. 294 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 288-301 No Author/s; year; country; Title Methods Sample size Quality appraisal Results 13. Panzavecchia et al. (2014) (UK) Are preceptors adequately prepared for their role in supporting newly qualified staff? Qualitative Preceptors (n =30). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Lack of preparation for their role, expectations of limitations and difficulties associated with being a preceptor. 14. Rooke (2014) (UK) An evaluation of nursing and midwifery sign off mentors, new mentors and nurse lecturers' understanding of the sign off mentor role Quantitative Nurse mentors (n=114). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Introduction of sign off mentors positively; offering a more robust mechanism for ensuring students were competent, and offered an increased level of support for students 15. Staykova et al. (2013) (USA) Empowering Nursing Preceptors to Mentoring Undergraduate Senior Students in Acute Care Settings Mixed method study Preceptors (n =28). . Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) The mentorship experience for preceptors would be enhanced by incorporating the needs and preferences of the preceptors into their training and resource materials. 16. Tuomikoski et al. (2018) (UK) The competence of nurse mentors in mentoring students in clinical practice–A cross-sectional study Quantitative Nurse Mentors (n = 576). Aim , objectives described Methods suitable Results consistent Implications described Quality=High (A) Reflection during mentoring and identifying a student's need for mentoring the highest, whereas student- centred evaluation and supporting a student's learning process were rated lowest. Khunou, Matlhaba, Literature Review: The Support Needs of The Nurse Mentors in Their … 295 RESULTS Sixteen (16) studies published between the years 2013 to 2023 met the inclusion criteria, which entailed qualitative (n=8), quantitative (n =3), and mixed methods (n =5) as indicated in Table 2. The qualitative studies were exploratory and descriptive in nature (Bennett & McGowan, 2014; Fernandez et al., 2018, Frankenberger et al., 2021, Jokelainen et al., 2013;Kramer et al., 2021; Mubeezi & Gidman, 2017; Panzavecchia & Pearce, 2014). The studies which applied the mixed method design were as follows: (Broadbent et al., 2014; Chan et al., 2019; Macey et al., 2021; McIntosh et al., 2014; Staykova et al., 2013). Quantitative studies applied the cross-sectional descriptive designs and included: (Mikkonen et al., 2022; Rooke, 2014; Tuomikoski et al., 2018). These results are depicted in Table 3. Thirteen out of the sixteen reviewed studies, revealed that mentors were faced with numerous challenges in their mentoring roles (Bennett & McGowan, 2014; Broadbent et al., 2014; Chan et al., 2019; Clark & Casey, 2016; Frankenberger et al., 2021, Jokelainen et al., 2013; Kramer et al., 2021; Macey et al., 2021; Mikkonen et al., 2022; Mubeezi & Gidman, 2017; Panzavecchia & Pearce, 2014; Tuomikoski et al., 2018; Rooke 2014). This theme is supported by the following subthemes, namely: Knowledge gap, inadequate support, undefined roles and Organisational challenges. The reviewed studies highlighted that the nurse mentors need to be supported specifically with regard to these important aspects: 1) Conducive mentoring environment; 2) Capacity building regarding the mentoring role; 3) Adequate support for the mentoring role (Chan et al., 2019, Jokelainen et al., 2013; Kramer et al., 2021; Macey et al., 2021; McIntosh et al., 2014; Mikkonen et al., 2022; Rooke, 2014). Overwhelmingly, the support of the nurse mentor has been posited by seven studies (Chan et al., 2019; Kramer et al., 2021; MacLaren 2018; Macey et al., 2021; McIntosh et al., 2014; Mikkonen et al., 2022; Mubeezi & Gidman, 2017). Recognition and clarity of the role were highlighted as an important strategy to support the nurse mentors (Chan et al., 2019; MacLaren 2018; Mikkonen et al., 2022). Table 3 depicts the themes, subthemes and categories identified from the reviewed articles. Table 3: Themes, subthemes and categories of the integrative review Themes Subthemes Categories 1. Challenges to effective mentoring Knowledge gap • Lack of knowledge and skills • Inadequate preparedness for the role • Lack of confidence • Challenges in assessment Inadequate support • Lack of managerial support • Poor interpersonal relationships • Ineffective communication Undefined roles • Lack of recognition • Role confusion Organisational challenges • Shortage of resources and mentors • Inadequate time • Work overload 2. Support needed by the nurse mentors Conducive mentoring environment • Adequate mentoring resources • Collaboration between the stakeholders • Availability of mentoring guidelines Capacity building regarding the mentoring role • Training and development • Adequate mentoring preparation Adequate support of the mentor • Recognition and clarity of the role • Protected time for mentoring • Managerial and peer support 296 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 288-301 DISCUSSION The purpose of this integrative literature review was to synthesize the evidence available on the support needs of the nurse mentors in mentoring role. The sixteen reviewed studies revealed the two main themes, namely: 1) Challenges to effective mentoring; 2) Support needed by the nurse mentors (Table 3). Challenges to effective mentoring Nurse mentors are expected to impart their valuable information and experience to the least knowledgeable novice nurses. It is concerning to note that the majority of the reviewed studies, highlighted the knowledge gap amongst the nurse mentors (Bennett & McGowan, 2014; Chan et al., 2019; Fernandez et al., 2018; Jokelainen et al., 2013; McIntosh et al., 2014; Tuomikoski et al., 2018). Undeniably, this lack of knowledge is demonstrated by unpreparedness for the mentoring role, lack of skills and confidence to mentor and assess the mentees (Bennett & McGowan, 2014; MacLaren, 2018; Mubeezi & Gidman, 2017). Inadequate preparedness and knowledge was perceived as more challenging and exacerbated by lack of managerial support (Panzavecchia & Pearce, 2014). It is clear that this resulted in more frustrations as it meant that the nurse mentors had no option but to blunder around their novices .Furthermore, the lack of confidence in assessment was highlighted as a concerning issue amongst the mentors (Bennett & McGowan, 2014; Rooke, 2014). Notably, the lack of knowledge amongst the nurse mentors could be attributed to the advancements on nursing curricula. Therefore, it is imperative that the nurse mentors should undergo some orientation and workshops in order to keep them in par with the new nursing education developments (Bennett & McGowan, 2014; Khunou, 2019). Mentoring the novice nurse has been found to result in a range of mixed feelings, dismay and frustrations, which necessitate the need for adequate support (Hunt et al., 2016). In this literature review, it came out clear from the eight studies (Broadbent et al., 2014; Chan et al., 2019; MacLaren, 2018; Macey et al., 2021, McIntosh et al., 2014; Mubeezi & Gidman, 2017; Panzavecchia & Pearce, 2014; Rooke, 2014), that the nurse mentors were not supported in their mentoring role. This was perceived as a challenge in that there was ineffective communication and lack of support from the managers (Chan et al., 2019; MacLaren, 2018). The lack of support resulted in the whole mentoring responsibility shouldered by the nurse mentors and this was frustrating. In this regard, the mentors were blamed for the unsatisfactory performance and poor progress of the mentees (Chan et al., 2019). This type of resentment could result in the inadequate mentoring of the mentees and ultimate abandonment of the whole mentorship by the mentors. The nurse managers should demonstrate the support by monitoring the outcome and mediating between the mentoring pair when a need arise (Goodyear & Goodyear, 2018). Five of the studies, (Broadbent et al., 2014; Chan et al., 2019; Frankenberger et al., 2021; Macey et al., 2021; Rooke, 2014) revealed the undefined nurse mentors’ roles as a huge challenge. Most of the studies indicated a thin line between the lack of recognition and role confusion (Chan et al., 2019; Macey et al., 2021; Rooke, 2014). In this instance, the nurse mentors cited role confusion in terms of having to make a choice between ward routine and the needs of the mentees (Rooke, 2014). An expectation that mentoring should be combined with other nursing activities, result in role confusion and a lot of pressure amongst the nurse mentors (Panzavecchia & Pearce, 2014). The lack of recognition of the mentoring role can be perceived as the lack of support. Furthermore, lack of mentoring incentives was perceived as lack of recognition of the role. Recognition can be demonstrated by rewarding the nurse mentors with proper remuneration, continuing educational opportunities and career advancements (Oluchina & Gitonga, 2016). Notably, by recognising and appreciating the role played by the nurse mentors, can assist to motivate them to keep on doing the good work of socialising the nurse mentees into the nursing profession. Nurse mentors requires adequate and efficient organisational non-human and human resources, in order to participate and provide successful mentoring. However, the findings of the current review, revealed otherwise. Shortage of resources, time and work load are identified as factors which hindered nurse mentors to effectively perform their role (Broadbent et al., 2014; Chan et al., 2019; Frankenberger et al., 2021; Kramer et al 2021; Macey et al., 2021; Mubeezi & Gidman, 2017). Agreeably, adequate time is required by the mentor to effectively teach and provide both developmental and psychological support to the mentee. (Bennett & McGowan 2014; Rooke, 2014). Furthermore, lack of time has been associated with workload and shortage of resources (Panzavecchia & Pearce, 2014; Khunou, Matlhaba, Literature Review: The Support Needs of The Nurse Mentors in Their … 297 Khunou, 2023). The assertion is that inadequate time coupled with lack of resources and workload make it impossible for the nurse mentors to give it all when mentoring a novice nurse. Support needed by the nurse mentors To ensure effective mentoring role, several strategies are urgently needed to support the nurse mentors. Based on the results of this integrative literature review, there is a need to provide adequate support to the mentors Table 3 clearly illustrate the challenges which hinder the smooth mentoring role of the nurse mentors. To that effect, the studies advocated for the need of a conducive mentoring environment characterised by adequate mentoring resources, collaboration between the stakeholders and availability of mentoring guidelines (Jokelainen et al., 2013; Kramer et al., 2021; McIntosh et al., 2014). The nurse mentors, should be provided with a favourable conducive environment which has enough and efficient resources (Broadbent et al., 2014). Another study pointed out that inadequacy of mentoring environment impact negatively on the mentoring outcomes (Foolchand & Maritz, 2020). There is a need to ensure that the nurse mentor is provided with resources such as equipment which will be used for facilitation and demonstration of skills, technology for adequate record keeping. Furthermore, the organization should provide policies and guidelines to help mentees to familiarize with the new working environment (Panzavecchia & Pearce, 2014; Fong et al., 2021). In order to be effective, mentoring programs must be created with clear guidelines, established criteria, prescribed education, training, and supportive components (Kramer et al., 2021; Goodyear & Goodyear, 2018). Additionally, collaboration between the stakeholders has been identified as an essential component of the conducive mentoring environment (McIntosh et al., 2014; Tuomikoski et al., 2018). In view of the challenges stipulated in this study, collaboration has the potential to benefit the mentoring partners especially with sharing of resources and exchange of information (Rakhudu et al., 2016). Importantly, collaborating with the nurse educators is likely to address the nurse mentors’ knowledge gap especially with regard to assessments and curriculum issues. In case of the shortage of resources, other team members might support the mentees during the unavailability of the nurse mentor (Mikkonen et al., 2022; Tuomikoski et al., 2018). In order for the nurse mentors to effectively equip the novice nurses, they need to be more knowledgeable and empowered. The results in table 3, revealed that the nurse mentors have inadequate knowledge and skills. As a result, this literature review recommended the capacity building for the nurse mentors (Broadbent et al., 2014; Chan et al., 2019; Frankenberger et al., 2021; MacLaren, 2018; Tuomikoski et al., 2018; Rooke, 2014; Staykova et al., 2013). These considerations suggest that nurse mentors need to be educated on student support, learning process and conducting reflection during mentoring (MacLaren, 2018; Mikkonen et al., 2022, Tuomikoski et al., 2018). In addition, the nurse mentors need to be trained on different teaching strategies as they are expected to be innovative and skilled in empowering their mentees (Chan et al., 2019).Unsurprisingly, the five studies (Bennett & McGowan, 2014; Fernandez et al., 2018; Macey et al., 2021; Mikkonen et al., 2022; Staykova et al., 2013) unanimously suggested that the nurse mentors should be adequately prepared for the mentoring role. This could be related to the fact that some nurse mentors felt oblivious with the mentoring expectations (Fernandez et al., 2018). The submission is that mentees with prepared mentors have constant and effective routines as compared to those with unprepared mentors (Weimer, 2021). Consistently, other studies maintains that the nurse mentors should be recognised by providing them with developmental opportunities, promotions and incentives (Oluchina & Gitonga, 2016). The support of the mentors could also be demonstrated by acknowledging their mentoring role by providing them with ample time to mentor the mentees. The notion is that mentors should be provided with protected time mentoring in a manner that they are recused from other pressures and responsibilities (Rooke, 2014; Clark & Casey, 2016). STUDY LIMITATIONS The authors acknowledge limitations pertaining to this integrative review. Limitations associated with inconsistent search terminology and indexing problems may yield only about 50% of eligible studies (Whittemore & Knafl, 2005). Furthermore, conducting an integrative review may relate to potential biases as a result of including only published works, utilizing non-exhaustive search methods due to resource restrictions, or having only a single reviewer. Other limitations may be from the employed search strategy used or the inability to generalize review findings (Toronto & Remington, 298 Journal of Ners and Midwifery, Volume 10, Issue 2, August 2023, page 288-301 2020). Even though this is the possible limitation, the authors attempted consistently to use the correct key terms. Furthermore, the inclusion and exclusion criteria was critically applied to ensure that only relevant studies are included. In addition, a thorough description of the systematic steps taken during the literature search to avert the biasness. Even though the two authors worked hand in hand to search the literature, co-checked it for relevancy searched literature, there might be some befitting studies omitted. The review included studies published between 2013 and 2023, of which majority were excluded based on the fact that they did not meet all the inclusion criteria. Majority of the studies included the student nurses as mentees. This suggest a gap in literature review on the support needs of mentors as perceived by the student nurses and mentees. Therefore, the findings of this study cannot be generalised but might inform mentoring guidelines development for nurse managers and researchers. CONCLUSIONS Based on this literature review, it can be concluded that the nurse mentors have challenges in their mentoring role. Inadequate knowledge hinders the nurse mentors to effectively perform their mentoring role. Furthermore, lack of support from peers and managers, characterised by poor communication and interpersonal relationship clearly made it difficult for the nurse mentors to nurture the nurse mentees. Shortage of resources and lack of time, created lot of mentoring missed opportunities to effectively perform the mentor role. Particularly, the nurse mentors did not have enough time to focus on meeting the needs of the mentees. In order to alleviate these challenges, several studies suggested support that should be provided to the nurse mentors. A conducive mentoring environment should be created so that the resources are allocated for mentoring purposes. It can be concluded that by providing adequate support to the nurse mentors, all the mentoring challenges will be averted. SUGGESTIONS • Overall, the findings of this study suggest that the nurse managers and policy makers, should as matter of urgency, develop guidelines and policies which will clearly clarify the mentoring roles of the nurse mentors • The nursing education institutions should be involved in the support and workshop of the nurse mentors to keep them abreast with the new curriculum developments, teaching and assessment strategies. • In order to motivate the nurse mentors the mentoring role should be recognising by some incentives be it financial or promotional opportunities. • Future research should analyse the collaboration in support of the nurse mentors in their mentoring role. ACKNOWLEDGEMENT The authors would like to acknowledge the authors of sources cited and applied in this study. FUNDING The authors declare that the authors did not receive financial support to conduct the research and/or preparation of the article. CONFLICTS OF INTEREST The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article. AUTHOR CONTRIBUTIONS SHK conceptualised the study and searched for the relevant literature. Confirmation and validation of the methods was carried out by the KLM. Both authors analysed the data and contributed to the finalisation and proof reading of the manuscript. REFERENCES Bennett, M., & McGowan, B. (2014). Assessment matters—mentors need support in their role. British journal of nursing, 23(9), 454- 458. https://doi.org/10.12968/bjon.2014.23.9.45 4 Broadbent, M., Moxham, L., Sander, T., Walker, S., & Dwyer, T. (2014). Supporting bachelor of nursing students within the clinical environment: Perspectives of preceptors. Nurse Education in Practice, 14(4), 403-409. https://doi.org/10.1016/j.nepr.2013.12.003 CASP C (2018) CASP qualitative checklist. Critical Appraisal Skills Programme. 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