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 T H E NU rS E
M E NTor’S
HA NDBo o K
Supporting Students
in Clinical Practice

Thlrd
EdlTlo
n

DA NNY WA L S H
with contribitions by Julie Dixon,
Fran Maplethorpe,Wendy Leighton,
Clare Sobieraj and Karen Johnston
The Nurse Mentor’s
Handbook
The Nurse Mentor’s
Handbook
Supervising and Assessing
Students in Clinical Practice
THIRD EDITION

Danny Walsh
Open University Press
McGraw-Hill Education
8th Floor, 338 Euston Road
London
England
NW1 3BH

email: [email protected]
world wide web: www.openup.co.uk

and Two Penn Plaza, New York, NY 10121-2289, USA

First published in this 3rd edition 2021

Copyright © Open International Publishing Limited, 2021

All rights reserved. Except for the quotation of short passages for the purposes of
criticism and review, no part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise, without the prior written
permission of the publisher or a licence from the Copyright Licensing Agency
Limited. Details of such licences (for reprographic reproduction) may be obtained
from the Copyright Licensing Agency Ltd of Saffron House, 6–10 Kirby Street,
London EC1N 8TS.

A catalogue record of this book is available from the British Library

ISBN-13: 9780335248612
ISBN-10: 0335248616
eISBN: 9780335248629

Library of Congress Cataloging-in-Publication Data

CIP data applied for

Typeset by Transforma Pvt. Ltd., Chennai, India

Fictitious names of companies, products, people, characters and/or data that may be
used herein (in case studies or in examples) are not intended to represent any real
individual, company, product or event.
Praise page

Out with the old and in with the new! Looking back on my nurse train-
ing I can vividly recall clinical placements where I was mentored by
inspirational, dynamic, enthusiastic, and nurturing mentors. However,
I can equally recall the toxic mentors that ruined clinical placements
and made me question whether I wanted to be a nurse at all! Support-
ing students in clinical practice is a privilege and getting it right is
essential! Danny Walsh’s book demystifies the NMC’s SSSA document
and provides a real insight into the meaning of the word mentorship,
along with practical advice on how to be a practice supervisor.
Mike Parker is an Associate Professor in
Emergency Nursing at the University of York, UK

This is a real-world book that offers practice supervisors and asses-

sors detailed guidance on their new role within the context of the
recent NMC (2018) standards for supervision and assessment of
students. It gives information on the background policy to the stan-
dards and what is expected of nurses who take on these new roles.
The book provides the theoretical base and practical guidance on
facilitating good quality learning experiences for students and on
teaching, assessment and providing evidence of learning. It is the
ideal handbook for nurses since it addresses all the issues that you
are likely to encounter whilst supporting students, with an easy ref-
erence system and great practical examples.
Professor Fiona Irvine - Emeritus Professor
in Nursing, University of Birmingham

A book worth recommending and adopting as a core text for mod-

ules, especially those in teaching, learning and assessment for new
mentors, practice assessors and supervisors. It can be a resource
for nurses returning to study, international students and anyone
involved in clinical guidance/teaching such as practice education
coordinators, facilitators, and nominated persons. It would also be
suitable for lecturers delivering core modules for Diploma, Degree,
Masters and Dissertations.
Leontia Hoy - Course Director - Bsc Hons/
Graduate Diploma/ Post Graduate Diploma–
Specialist Practice, School of Nursing,
Queens University Belfast
Contents

List of figures xi
Acknowledgements xiii

Introduction1
Who is this book for? 1
A brief summary 2
Quotes and narratives 3
Benefits of being a practice supervisor 4
Students’ views 4
Summary5
References5

1 The mentor’s new clothes: the NMC standards for

student supervision and assessment 6
Key points 6
History and context of student supervision 6
SLAiP: the NMC framework to support learning and
assessment in practice 7
NMC review of nurse education 2010 11
The mentor’s new clothes 2018 13
Summary20
Further reading 20
References20

2 Effective practice supervision 22

Key points 22
Motivation, Maslow, and practice supervisors 22
The characteristics and roles of the supervisor/mentor 24
Effective working relationships and the practicalities
of supervision 26
The first day and week 28
Active listening: the basis of effective working relationships 34
Student-centred leadership 39
Summary41
Further reading 41
References41
viiiContents

3 Supervision considerations 43
Key points 43
What can we learn from the clinical supervision
literature?43
Supporting students through clinical supervision 43
Toxic mentoring and supervising (how not to do it!) 49
Practice supervisor SWOT analysis 55
A useful alternative 57
Liaison with higher education institutions 58
The case of the associate nurse: a new role for
health and social care  60
Summary63
Further reading 63
References64

4 The clinical learning environment 66

Key points 66
Creating an environment for learning 66
Factors that enhance a placement experience 68
Factors that detract from a placement experience 72
Learning experiences 74
Learning resources 78
Placement profiles 80
Insight visits 82
Links with the School of Nursing/university 82
Role modelling 82
Structured teaching 83
Mapping of learning opportunities 83
Educational audit 85
SWOT analysis of the placement area 87
Students’ evaluation of placement 88
Physical safety 89
Evidence-based practice 89
Practice supervisor’s evaluation of placement 92
Conclusion: putting it all together 93
Summary94
Further reading 95
References95

5 Teaching and learning theory 96

Key points 96
Teaching and learning theories 97
Behaviourist theories 97
Humanistic theories 99
Contents ix

Cognitive theories 103

Learning styles 107
Criticisms of learning styles 112
Bloom’s taxonomy 113
Summary of key principles of good teaching 116
Summary117
Further reading 117
References118

6 Teaching in practice 119

Key points 119
Theory in practice! 120
Lesson planning 121
Teaching methods and strategies 126
Assessment of learning 140
Student evaluations 140
Conclusion141
Summary142
References142

7 Assessment: theory and practice reality 144

Key points 144
Theory of assessment 147
Cardinal criteria 148
Types of assessment 151
Evaluating learning 155
Factors influencing assessments  155
Assessment in practice 157
Levels of learner  162
Attitude163
Good practice in assessment  164
Summary166
Further reading 166
References166

8 Evidence of learning 168

Key points 168
What is a portfolio? 168
Structure of a portfolio 170
Reflection173
Types of evidence of learning 175
Learning contracts 176
Summary180
References180
xContents

9 Fostering a successful placement 182

Key points 182
Support mechanisms other than the practice supervisor 182
Link tutor/personal tutor 183
Students with disabilities and difficulties  188
Disability189
Dyslexia192
Dyscalculia193
Sickness and stress 193
Workplace harassment 195
Bad practice 195
Supporting the failing student 196
Reasons for failure 196
The error of leniency: why nurses fail to fail students! 197
Providing feedback 199
Avoiding failure and failing with fairness 203
Managing the process of failure 204
Attitude  208
Accountability and responsibility in practice 212
NMC requirements 216
Summary216
Further reading 216
Useful web resources 217
References217

10 Support and development for the practice

supervisor and assessor 219
Key points 219
Practice supervisor’s guide to surviving a placement! 219
The politics of time 221
Maintaining competence 222
Evidence for a portfolio 223
Research227
Revalidation  227
Support for practice supervisors/assessors 227
Common practice supervision/assessment problems 230
Some problems to ponder 235
Ongoing developments 236
Good practice for practice supervisors: a few reminders 238
The future! 239
Summary240
Further reading 241
Useful web resources 241
References241
Index243
Figures

1.1 How it might look! 19

4.1 Role of the nurse spider chart 76
4.2 Sample patient’s journey 78
4.3 Mapping learning experiences 79
4.4 Nursing action research cycle 91
4.5 Simplified nursing action research cycle 91
5.1 The nursing process 108
5.2 The nursing process and Kolb’s learning
cycle combined 109
6.1 The lesson-planning cycle 121
6.2 Example of the construction of a mind map 131
8.1 Student’s reflective cycle 174
Acknowledgements

For this third edition I am hugely indebted to a host of friends and col-
leagues. The advice and contributions of my colleagues Julie Dixon and
Fran Maplethorpe have been invaluable and their contribution on the art of
supervision does much to enhance this volume. I am also grateful to Clare
Sobieraj and Karen Johnston for their general overview of the Nursing and
Midwifery Council (NMC) changes to nurse education and student supervi-
sion. The material relating to nursing associates was written by Wendy
Leighton. My thanks also go to Diane Ramm who has drawn on her consid-
erable experience to write an important section detailing the key principles
of teaching clinical skills, and to Chris Craggs who contributed her insight
with the section relating to students with disability. Many of the mentor/
supervisor and student quotes used within were drawn from various student
evaluations from a range of nursing courses nationally. Many were also sent
to me anonymously, so to persons unknown I am especially grateful. Some
narratives were recollected on request specifically for this book and I am
grateful to these contributors: S. Bettles, A. Hurrell, N. Raybould, Y. Potter,
C. Burrows, Z. Mabandla, G. Helme and I. Trueman. Finally Sylvia Hep-
worth, whose wisdom and experience I called upon many times in the pro-
duction of the second edition, remains a major influence upon this third. I
have been lucky to have had such support from all those listed above – as far
as mentors go, there could be no better.
Introduction

Arguably the most important aspect of nursing and midwifery training is the
clinical placement during which nurses learn and practise their many skills
in the real world. The most important factor underpinning a good placement
is the practice supervisor who works with the student. All nurses have a
duty, through their professional code of conduct, to pass on their knowledge
and to teach students – and this book is a guide to doing just that. The sec-
ond edition of The Nurse Mentor’s Handbook embraced changes in nurse
education and this third edition has had to incorporate some wholesale
changes in pre-registration nurse training and student nurse mentorship
described by the NMC as not just an update but a radical revision. Not least
of these have been changes in terminology and the division of labour: nurse
mentors have been replaced by practice supervisors and practice assessors.
In a sense it is a case of the emperor’s new clothes (or titles) – of which more
in Chapter 1. Among other changes, there have also been new standards of
proficiency for registered nurses and the introduction of nurse associates.

What’s in a word!
While the mentor of old is now cast as a practice supervisor and some-
times practice assessor, the reality will see the same roles and skills being
used by the same nurses under new titles, with little practical difference.
The word mentor is still used in many instances throughout this book,
such as in the examples from practice taken before the new terminology
was in place; indeed, it will take a while for nursing to get used to the new
terminology – not least because the word mentor perfectly describes the
role of the supervisor and assessor in a clinical practice setting.

Who is this book for?

The purpose of the book is to examine and support the role of the nurse
acting as practice supervisor and/or assessor to pre-registration student
nurses in the light of the NMC 2018 Standards for Student Supervision and
Assessment (NMC 2018a). The book is intended primarily for qualified
nurses undertaking the roles of practice supervisor and assessor. However,
it will also be of value to all student nurses themselves, containing as it does
2 The Nurse Mentor’s Handbook

a wealth of guidance and ideas on useful learning experiences to undertake

in practice and how these can be presented as evidence of achievement of
proficiencies. It will also be useful to those undertaking mentorship or
supervision in other related health and social care settings, such as occupa-
tional therapy, physiotherapy and social work. The professional standards
might vary, but, as with midwives, the supervision skills and teaching ele-
ments will be transferable.

A brief summary

Chapter 1 ‘The mentor’s new clothes’ discusses the policy context and recent
changes arising out of the NMC’s (2018a) Standards for Student Supervi-
sion and Assessment which sets out the roles and requirements for practice
supervisors and assessors. The history and politics of mentorship are also
examined for valuable lessons to be learnt.
Chapter 2 ‘Effective practice supervision’ examines the role of the super
visor, trying to capture the essence of what it takes to be a good supervisor.
It examines some key principles – including effective working relationships
and communication – and offers much practical advice on how to make a
student feel valued and the placement successful.
Chapter 3 ‘Supervision considerations’ examines the literature around clin-
ical supervision to see how it informs practice supervision. It looks at the
concept of ‘toxic’ mentoring or supervision and how to audit your supervi-
sion skills. It also looks at the introduction of a new level of nurse associate
and examines their own needs in relation to supervision.
Chapter 4 ‘The clinical learning environment’ examines the qualities of a
good learning environment as well as what detracts from it. In any learning
environment, many factors affect the learning that takes place, for good and
for bad. Readers are asked to reflect upon their own experiences here in
order to explore key issues. The chapter also covers the key aspects of pro-
ficiency mapping and how this can be achieved, and explores the range of
potential learning opportunities in the clinical environment. Furthermore, it
introduces a range of strategies that can help improve the learning environ-
ment. An emphasis is placed upon evidence-based practice and the role action
research can play.
Chapter 5 ‘Teaching and learning theory’ explores the major educational
theories, examining them for their usefulness and practical application.
Behaviourist, cognitive and humanist approaches to learning and teaching
are explored alongside the concepts of andragogy and pedagogy. The chapter
also examines the concept of learning styles and the work of Kolb, Bloom,
and Honey and Mumford, among others.
Chapter 6 ‘Teaching in practice’ looks at the teaching cycle, planning for
teaching, and lesson planning. The chapter outlines the practicalities and
skills of delivering teaching in the practice setting and examines the various
Introduction 3

teaching methods and resources that are available, giving the practice
supervisor a range of strategies to choose from. It also looks at assessment
of learning.
Chapter 7 ‘Assessment: theory and practice reality’ focuses upon assessment,
examining the process and the theory behind it. From definitions and aims
of assessment, it goes on to discuss the cardinal criteria for assessment –
such as validity and reliability. From a practical point of view, a range of
assessment methods are examined which can be used to assess clinical pro-
ficiency, again giving the practice supervisor and assessor a range of strat-
egies to choose from.
Chapter 8 ‘Evidence of learning’ looks at the range of evidence which can
go towards demonstrating the student’s achievement of their proficiencies.
The role of portfolios which many students and qualified nurses have to
keep is examined. It also highlights the importance of reflection.
Chapter 9 ‘Fostering a successful placement’ provides a summary of good
practice in relation to supporting students generally. It also looks at the
ways in which mentors can help students with disabilities such as dyslexia
and dyscalculia, and support students under stress. The chapter also exam-
ines the work of Kathleen Duffy and others who identified that mentors were
‘failing to fail’ students for various reasons. The evidence and implications
are examined in detail before outlining a strategy for fair and objective sup-
port for a failing student. The implications for professional (and other)
accountability are made clear. Particular emphasis is placed upon the diffi-
cult area of assessing a student’s ‘attitude’. The chapter outlines good prac-
tice guidelines for practice supervisors and assessors and suggests ways in
which the supervisor can help the student get the best out of their placement.
Chapter 10 ‘Support and development for the practice supervisor and
assessor’ provides a range of strategies relating to how practice supervisors
can be supported. The chapter also looks at the evidence nurses could gen-
erate in relation to updating and building a portfolio of ongoing proficiency.
There is also an examination of commonly encountered placement problems
giving suggested strategies for dealing with them.

Quotes and narratives

The chapter themes are illustrated in part by quotes and narratives from
students in training, supervisors and previous mentors. These are real com-
ments and describe the students’ raw concerns. It is the kind of feedback
straight from the horse’s mouth that we should all be gathering and acting
upon. The importance of the role of practice supervisors in pre-registration
nurse education cannot be underestimated, a point reiterated and evidenced
throughout this book and one that these quotes highlight. Many of the quotes
from nurses are from recent times when they were still called mentors, and
I have kept that term for these quotes rather than change it to the new title
of practice supervisors.
4 The Nurse Mentor’s Handbook

Benefits of being a practice supervisor

As nurses, we have a professional duty towards students as set out in the

NMC Code paragraph 9.4 ‘Support students’ and colleagues’ learning to help
them develop their professional competence and confidence’ and 20.8 ‘Act as
a role model of professional behaviour for students’ (NMC 2018b). Becoming
a practice supervisor is a role nurses should wish to embrace, as it is by no
means just one-way traffic. Here are just a few of the tangible reasons for
becoming one:
• Increased job satisfaction
• Increased professional role
• Involvement with the higher education provider
• Being updated by and learning from the students
• Developing teaching skills
• Adding to personal profile/CV
• Supervision skills useful in other areas – such as management
• Gratitude of the students, and increased self-esteem
• Opportunity to impact upon curriculum and nurse training
• Maintaining the standards of your own profession
• Helping to protect the public

Students’ views

Here are a selection of student reflections suggesting that good practice

supervisors/mentors are highly valued.

Second-year student on medical ward

What stood out for me was working closely with motivated mentors who
were willing to share the wealth of their knowledge despite the pressures
of their hectic shifts.

Third-year student on surgical ward

Every member of the team was approachable and helpful. I was made to
feel valued at all times. Nothing was too much trouble for my mentor and
associate mentor.
(continued)
Introduction 5

Third-year student on emergency assessment unit

Very welcoming staff made the placement very enjoyable. I have gained
valuable knowledge and skills from excellent mentors. They put lots of
effort into the teaching despite the busy workload.

First-year student on medical acute placement

They gave me plenty of opportunity to take part in clinical skills and I
didn’t feel pressured to contribute if I felt I couldn’t do it. Everyone tried
to make me feel welcome and get the best experience I could.

Third-year student on forensic mental health placement

I think what makes a good supervisor is one that takes an interest in their
students’ learning and gets them involved. Somebody you can look up to
in terms of practice and say to yourself ‘I want to be like that’. Somebody
who can tell you what you don’t do well in such a way as to make it not
feel like a criticism but an opportunity. I’ve been very lucky.

First-year mental health student

This placement was a remarkable experience and the credit is due to my
mentor.

Summary
• This introduction has hinted at both the diversity and importance of
the role of the practice supervisor, and this will become even more
apparent in the following chapters.
• It is well documented that nurses who support students are pivotal
in ensuring a student nurse has a good placement experience, and
this view is supported by the students quoted in this book.

References
Nursing and Midwifery Council (NMC) (2018a) Realising Professionalism: Part 2:
Standards for Student Supervision and Assessment. London: NMC.
Nursing and Midwifery Council (NMC) (2018b) The Code: Professional Standards of
Practice and Behaviour for Nurses, Midwives and Nursing Associates. London:
NMC.
 The mentor’s new
1 clothes: the NMC
standards for student
supervision and
assessment

Key points
• The history and politics of nurse education can inform current prac-
tice
• Good collaboration between education and practice remains crucial
to nurse education
• The old mentor role is now split into those of practice supervisor and
practice assessor
• Nurse education can now be more multidisciplinary
• Practice learning is the responsibility of every registered nurse

The aim of this book is to explore the nature and role of supervising and
assessing student nurses in practice. Gone is the old title and role of mentor,
having been replaced by the roles of practice supervisor and practice asses-
sor. To understand how we have arrived here, it is useful to look back briefly
at the history and context in which the current situation has developed.

History and context of student supervision

In 1999, the Department of Health (DoH) published a strategy for nursing

entitled Making a Difference (DoH 1999). The document was critical of the
abilities of newly trained nurses on the previous Project 2000 curriculum,
saying that evidence suggested that in recent years students completing
training had not been equipped at the point of qualification with the full
range of clinical skills they needed. The strategy also heavily stressed the
importance of practice placements in nurse education, stating a determination
to enhance the status of those who provide practice-based training – i.e. the
mentors. The Department of Health wanted to ensure that nurses were ‘fit
for purpose’, having the necessary skills, knowledge, and ability to provide
The NMC standards for student supervision and assessment 7

the best care. During the same year, the UK Central Council for Nursing,
Midwifery and Health Visiting (UKCC) published its review of nurse educa-
tion entitled Fitness for Practice (UKCC 1999). Essentially, this document
stressed the need to emphasise the role of the mentor/teacher in the practice
setting and reiterated the belief that practice experience was crucial to
nurse education. The report also acknowledged the need for higher education
institutions (HEIs) and health service providers to formalise the preparation
of mentors for nurses in training. The other significant change was the
accreditation of 50 per cent given to the achievement of clinical practice
outcomes, thus raising the status of the clinical aspect of training and under-
lining the need for credible mentor preparation programmes.
Subsequent reports such as Placements in Focus (ENB/DoH 2001) confirmed
this message. Partnership between the National Health Service (NHS) and
HEIs was stressed, and both became responsible for providing and support-
ing clinical placements. The partnership between the clinical areas and the
HEIs is crucial because, as Hand (2006) points out, skill without knowledge
fosters unsafe practice and knowledge without skill fosters incompetence.

How robust do you consider the partnership between your own clinical
area and the university and how could this be improved upon?

SLAiP: the NMC framework to support learning and assessment in

practice

The NMC document Standards to Support Learning and Assessment in

Practice (NMC 2006) gave us the mentor standards describing the outcomes
nurses must attain to become mentors to student nurses.
The framework also identifies eight domains for achieving mentorship:
• Establishing effective working relationships
• Facilitation of learning
• Assessment and accountability
• Evaluation of learning
• Creating an environment for learning
• Context of practice
• Evidence-based practice
• Leadership
The domains were a revision of those previously published by the NMC in
2004 as Standards for the Preparation of Teachers of Nurses, Midwives and
Specialist Community Public Health Nurses. The 2004 standard of ‘Role
8 The Nurse Mentor’s Handbook

modelling’ was replaced with the domain of ‘Leadership’. They were also
modified slightly in 2008 in the second edition of Standards to Support
Learning and Assessment in Practice (NMC 2008).
These mentor domains (or standards as they were called) represented the
competencies and outcomes for mentors, with each domain broken down
into several outcomes:

Establish effective working relationships

• Demonstrate an understanding of factors that influence how students
integrate into practice
• Provide ongoing and constructive support to facilitate transition from
one learning environment to another
• Have effective professional and interprofessional working relation-
ships to support learning for entry to the register

Facilitation of learning
• Use knowledge of the student’s stage of learning to select appropriate
learning opportunities to meet their individual needs
• Facilitate selection of appropriate learning strategies to integrate
learning from practice and academic experiences
• Support students in critically reflecting upon their learning experiences
in order to enhance future learning

Assessment and accountability

• Foster professional growth, personal development, and accountability
through support of students in practice
• Demonstrate a breadth of understanding of assessment strategies
and the ability to contribute to the total assessment process as part
of the teaching team
• Provide constructive feedback to students and assist them in identify-
ing future learning needs and actions. Manage failing students so they
may either enhance their performance and capabilities for safe and
effective practice, or be able to understand their failure and the impli-
cations of this for their future
• Be accountable for confirming that students have met, or not met, the
NMC competencies in practice. As a sign-off mentor, confirm that stu-
dents have met, or not met, the NMC standards of competence in
practice and are capable of safe and effective practice
(continued)
The NMC standards for student supervision and assessment 9

Evaluation of learning
• Contribute to evaluation of student learning and assessment experi-
ences – proposing aspects for change as a result of such evaluation
• Participate in self- and peer evaluation to facilitate personal develop-
ment, and contribute to the development of others

Creating an environment for learning

• Support students to identify both learning needs and experiences that
are appropriate to their level of learning
• Use a range of learning experiences, involving patients, clients, carers,
and the professional team, to meet the defined learning needs
• Identify aspects of the learning environment that could be enhanced,
negotiating with others to make appropriate changes
• Act as a resource to facilitate personal and professional developments
of others

Context of practice
• Contribute to the development of an environment in which effective
practice is fostered, implemented, evaluated, and disseminated
• Set and maintain professional boundaries that are sufficiently flexible
for providing interprofessional care
• Initiate and respond to practice developments to ensure safe and
effective care is achieved and an effective learning environment is
maintained

Evidence-based practice
• Identify and apply research- and evidence-based practice to their area
of practice
• Contribute to strategies to increase or review the evidence base used
to support practice
• Support students in applying an evidence base to their own practice

Leadership
• Plan a series of learning experiences that will meet students’ defined
learning needs
• Be an advocate for students to support them accessing learning
opportunities that meet their individual needs – involving a range of
other professionals, patients, clients, and carers
(continued)
10 The Nurse Mentor’s Handbook

• Prioritise work to accommodate support of students within their

practice
• Provide feedback about the effectiveness of learning and assessment
in practice

While the landscape and terminology have changed, these domains and their
outcomes remain very relevant to the new practice supervisors and asses-
sors because essentially the skills and knowledge required have not changed.
The document Standards to Support Learning and Assessment in Practice
(NMC 2006) introduced what was often referred to as the student ‘passport’.
This is a record of each placement in a book/file that is taken from placement
to placement. From 2007 it became known as the ‘Ongoing Achievement
Record’ (OAR) and has recently morphed into a PAD or Practice Assessment
Document.

Previous mentor preparation programmes

The NMC requirements under SLAiP for nurse mentorship courses
declared that they should:
• be at a minimum of Level 2, otherwise known as diploma level or HE
intermediate level
• be a minimum of ten days in length, of which five days are protected
learning time
• include learning in both practice and academic settings
• have a work-based learning component as a key feature. This often
entailed acting as an associate mentor or undertaking tasks related
to student learning in the workplace as directed by the course
locally.
In reality there were many variations of this course nationally, it being
interpreted locally and creatively in many different ways. However,
another reality in many areas suggests that nurses often struggled to
secure their ten days training, often only managing five and making up
the rest in their own time. For managers, releasing staff is difficult at the
best of times, and the course was seen in the light of its predecessor,
which in many areas was interpreted as a three-day course. The NMC
had not previously defined a specific mentor course, and previous men-
tor preparation programmes were approved as part of pre-registration
and specialist practice qualification programmes, producing much
national variation.
The NMC standards for student supervision and assessment 11

With the onset of the new 2018 standards for student supervision and assess-
ment, the requirements for a mentorship course have radically altered and
shortened. The new requirements are explored in more detail below, but one
can argue that the new approach is a watering down of the supervision and
assessment (mentorship) training and represents a worrying devaluation of
the role. Cynically, it can also be seen as a neat way of addressing the wor-
rying lack of good mentors which dogged the old system by replacing a
limited pool of well-trained mentors with a readily available plethora of less
well-prepared, if nonetheless dedicated, practice supervisors.

NMC review of nurse education 2010

The revised Standards for Pre-registration Nursing Education (NMC 2010)

were born out of a consultation exercise commissioned by the NMC entitled
Nursing: Towards 2015 (Longley et al. 2007). The new standards ushered in
an all-degree profession arguing that this was necessary for the future and
to ‘enable new nurses to work more closely and effectively with other pro-
fessionals’ (NMC 2010, p. 8). The review also attempted to clarify the nature
of the concept of ‘due regard’, stating that other registered healthcare pro-
fessionals who have been suitably prepared can supervise and contribute
towards the assessment of nursing students. The new 2018 standards move
this on further in a welcome expansion and flexibility towards who can sup-
port and assess nursing students.

The politics of mentorship!

Many nursing workplaces are stressful and nurses are faced with con-
stant challenges, including lack of time, organisational reform, new tech-
nology, an increasingly aware and challenging patient group, high public
expectations, bed shortages, cost-saving measures, and increasing
non-nursing and administration duties. To this list we must add the almost
constant staff shortages that are the source of most care failings for
which nurses are sometimes erroneously blamed. On such a ward, the
picture to an outsider might be one of unremitting chaos. Yet in the face
of this chaos high standards of care remain and the fact that the above
factors do not often undermine the quality of nursing care, is testimony
to the professionalism of today’s nurses. It can be argued that they are
the glue that holds the NHS together.
This scenario also masks the unofficial training that accompanies such a
shift, whereby students witness thinking in action, intuitional decision-
making, and creative individualised care in the face of daunting con-
straints. Many examples of learning opportunities could be described if
one just sat and watched a shift, noting all that the nurse did on a clipboard.
(continued)
12 The Nurse Mentor’s Handbook

Alongside skilled physical and psychological care tasks are managerial

and decision-making skills, assertive and confident practice. Such
nurses can see beyond the chaos and achieve Benner’s (2001) intuition.
Merely being with these nurses is an important learning experience for
students. Much key learning takes place almost by osmosis with the stu-
dent soaking up styles of nursing, ways of reacting and dealing with
complex situations amid uncertainty and pressure. Such experience is
as beneficial as structured learning and the use of reflection can help to
make sense of it.
When students describe how they learnt to become a nurse, they usually
cite key role models whom they have witnessed regularly in such situa-
tions. It is the skill of the mentor in allowing the student to participate
according to their ability and level in such dynamic and chaotic scenar-
ios that gives the students the opportunity to build personal and profes-
sional competence.
The 2012 NHS London examination of nurse mentorship (Robinson et al.
2012) cites Pulsford and co-workers (2002), reminding us that mentors in
this study wanted more support from trust managers and more time for
mentoring activity, specifically help with managing multiple demands
upon their time. This is still the case and serves as a timely reminder that
if nursing shortages increase and mentorship is not given time, we may
well lose the most important, albeit chaotic, learning experience that stu-
dents get. The profession must monitor very carefully whether the new
approach to mentoring student nurses overcomes or exacerbates these
problems. The title ‘practice supervisor’ is quite succinct, but it doesn’t do
justice to the diversity of roles involved or the range of knowledge and
skills required to undertake it. That mentors did not get any ‘time out’ for
‘mentoring’ a student has been hard to reconcile with the requirements of
the role. Compared with other professions, before the dawn of the new
practice supervisor era, nurses were the poor relations. In their Stand­
ards and Guidance for Mentors document (AODP 2006), the Association
of Operating Department Practitioners recommends that mentors have
four hours a week protected time per student. This is to allow them ‘suffi-
cient time to provide regular supervision, including assessment and feed-
back’. Social workers receive enhanced payments for mentoring
students. Occupational therapists are in the same boat as nurses. Their
Code of Ethics and Professional Conduct (College of Occupational Ther-
apists 2005) asks that they make a commitment to the education of stu-
dents in the workplace, having a ‘professional responsibility to provide
educational opportunities for occupational therapy students’ (5.5). For
this role, like nurses, there was no protected time or any extra remuner-
ation – they simply had to try and put aside time for a weekly supervision
session with their student. The NMC Standards to Support Learning and
Assessment in Practice (2006) state that mentors ‘will need time, when
(continued)
The NMC standards for student supervision and assessment 13

undertaking work with a student, to be able to explain, question, assess

performance and provide feedback to the student in a meaningful way’
(NMC 2006, p. 30). The document goes on to state as an NMC requirement
that sign-off mentors should be allowed one hour a week per student.
Given the professional responsibility involved here, this was derisory.
The document had little to offer non-sign-off mentors who had to balance
their clinical and managerial duties with mentoring students.
In 2009, the NMC began a review of pre-registration nurse education with
the aim of developing a teaching, learning, and assessment framework
suitable for the future of an all-degree profession. As part of this process,
a practice educator facilitator workshop identified ten priority areas of
concern, one of which was mentorship. It raised the question, should all
nurses be mentors? An acknowledgement perhaps that a significant
number of nurses have far too little time to be effective mentors, but it
also acknowledged a lack of funding for mentorship and, most tellingly,
lamented the lack of value attributed to the status of mentors. The nurs-
ing professional body should recognise the importance of mentoring by
introducing protected time, if not financial reward, for undertaking the
role. The theory side of training has been elevated to degree status, but
the practice side of training is arguably more deserving of elevation and
status, and this can be achieved in part by recognising and giving real
value to the role of the mentor. But the NMC have not chosen to do this;
they have instead changed the name to practice supervisor and said that
all nurses must be supervisors in an attempt to spread the mentoring
load.

The mentor’s new clothes 2018

Clare Sobieraj and Karen Johnston

In 2018, the Nursing and Midwifery Council – following intensive scrutiny
and consultation – published two new sets of standards. The first, Future
Nurse: Standards of Proficiency for Registered Nurses (NMC 2018a) focuses
on the knowledge, skills and attributes student nurses need to attain in train-
ing to become registered nurses. The second, Realising Professionalism,
sets out expectations regarding the provision of all pre- and post-registration
NMC-approved nursing and midwifery education programmes. Realising
Professionalism was set out in three parts.
• Part 1 Standards Framework for Nursing and Midwifery Education
(NMC 2018b)
• Part 2 Standards for Student Supervision and Assessment (NMC 2018c)
• Part 3 Standards for Pre-registration Nursing Programmes (NMC
2018d)
14 The Nurse Mentor’s Handbook

This book focuses upon Part 2: The Standards for Student Supervision and
Assessment (NMC 2018c) as these are the standards which superseded the
Standards to Support Learning and Assessment in Practice (SLAiP, NMC
2008) which outlined the requirements of the well-established mentor role,
for supporting and assessing student nurses within the practice learning
environment.

Background

The NMC have historically defined the term ‘mentor’ as a registered nurse
who has met the approved preparation and standards and who facilitates
learning and supervises and assesses students in a practice setting (NMC
2008). In preparation for this dual role, prospective mentors with a mini-
mum of one year’s experience and a period of preceptorship after registra-
tion were required to undergo an NMC-approved preparation course, to
demonstrate achievement of the eight NMC Standards to Support Learn-
ing and Assessment in Practice, as described earlier (SLAiP, NMC 2008).
Recorded on a maintained register, mentors in practice then worked with,
guided and supported, the student throughout their placement, assessing
them through various means, including direct observation in practice,
reflective discussions, question and answer sessions, reflective writing
and assessment of a range of clinical and essential skills through continu-
ous, formative and summative means. Both written and verbal feedback
from other team members, such as clinical and practice educators and the
interprofessional team, were implicit within this model. It was a require-
ment that the supernumerary student would spend 40 per cent of their
placement time with a qualified mentor who would work closely with them
and simultaneously oversee and assess the student at defined points, while
giving constructive feedback and support aligned to required compe-
tences and experience. Furthermore, there was a sign-off mentor role,
who having met further requirements stipulated by the NMC, was required
to ‘sign off’ final placement nursing students to assure the required level
of competence had been met for entry onto the register. By and large the
model worked well, but there were some problems with this approach –
most notably time limitations and role pressures for already hard-working
pressurised nurses. The management of challenging or failing students
was also highlighted by many, notably Duffy (Duffy 2003). Not all nurses
were mentors, so workloads could become unevenly spread with no remis-
sion from nursing duties to offset the time pressures of mentoring stu-
dents. The lengthy mentorship course of up to ten days also contributed to
a diminution in the supply of mentors. The 2018 Standards for Student
Supervision and Assessment (NMC 2018c) set out to address these issues
and outline the new approach to nurse mentorship. They set out new
expectations for the learning support, supervision and assessment of stu-
dents in the practice environment, and replace the mentor and sign-off
mentor role with those of practice supervisor, practice assessor and aca-
demic assessor.
The NMC standards for student supervision and assessment 15

The Standards for Student Supervision and Assessment (NMC 2018c) are
divided into three headings:
1. Effective practice learning
2. Supervision of students
3. Assessment of students and confirmation of proficiency

Effective practice learning

This reiterates the need for students to remain supernumerary. It says that all
NMC registrants should now be involved in practice learning. It also states that
the practice supervisor is encouraged to utilise interprofessional learning in
order to meet specific programme and proficiency requirements for the individ-
ual needs of students, tailored to their stage of learning. The perspective of users
and carers is essential to modern healthcare, and students should be encouraged
to follow the patient’s journey in a supportive and flexible learning environment
which encompasses a range of settings and other professionals, as appropriate.
The students themselves are to be regarded as active participants, included and
involved in their own learning, in order to enjoy experiences specific to their
stage of learning and to achieve outcomes relevant to their programme.

Supervision of students

There is now a clear division and separation between the role of practice
supervisor, who works with the student and facilitates their learning, and that
of the practice assessor, whose role is to assess the student in practice and
determine achievement of proficiencies as stipulated in the student’s practice
assessment document. This is a clear move towards improving the objectivity
of the assessment process as the ‘teacher’ (practice supervisor) and assessor
are no longer the same person. Following this, the academic assessor from
the approved education institution (AEI) must determine whether proficiency
and programme outcomes are met in order to confirm progression.

Roles and responsibilities of the supervisor role

The maintenance of public protection and the provision of safe and effective
care remain of paramount importance for the NMC, and it is the practice
supervisor’s role to safeguard this. In general, the practice supervisor should
facilitate and identify learning opportunities for the student based upon
their individual needs and the stage of learning the student is at. Such super-
vision should aim to promote independent learning and can decrease as pro-
ficiency and confidence develop.
All NMC-registered nurses, midwives and nursing associates can be included
in the supervisory role; they are no longer required to be on the same part of
the register or within the same field. As role models, practice supervisors
16 The Nurse Mentor’s Handbook

should practise effectively, in line with their code of conduct, and support
the student to meet their proficiencies and programme outcomes.
Apart from nurses, one major change is that any registered health and social
care professional may take on the role of supervisor to students and provide
ongoing support and guidance for the duration or part of the placement.
This role might be undertaken by occupational therapists, physiotherapists,
nursing associates, social workers, paramedics and potentially pharmacists
and doctors as registered professionals – essentially any professional within
the multidisciplinary team. A significant outcome of this change may be that
capacity for student nurses in placement could well increase, with a wider
professional workforce responsible for supervision rather than one individ-
ual in one profession. Another benefit may be the potential for movement
around services and agencies as part of neighbourhood teams, and primary
care networks with more flexible working across boundaries. These other
registered health and social care professionals are also tasked with training
their own profession, and may not feasibly have capacity to extend this to
nursing students. However, adopting a more interprofessional workforce
approach to training should lead to the development of more knowledgeable
practitioners who are able to more readily understand each other’s roles and
liaise more effectively across team and profession boundaries. Such poor
interprofessional and inter-team communication has often been cited as a
key factor in many recent tragedies where care has failed.
Effective record-keeping on behalf of the supervisor will be essential, while
direct observations and reflective discussions and other resources – for
example, fellow professionals, patients and service users’ views – can be
drawn on to inform decisions. Supervisors will provide feedback to the prac-
tice assessor and ascertain the achievement of clinical skills. As supervisors
can change over the course of a week, a ‘go to’ professional may manage
and oversee learning opportunities to ensure a diverse and relevant range of
skills and proficiencies are observed, attempted, practised and assessed.
The NMC (2018c) state that a nominated person in each practice setting
should be identified to actively support students and address their concerns.
Thus, in case of difficulty, the students will have an identified ‘go to’ person.
This will be locally managed by practice partners with the support of their
approved education institute partner. The supervisor also contributes
through both written and verbal feedback to the student’s overall assess-
ment of proficiency and achievement of programme outcomes, and so must
have a good understanding of these through effective preparation and sup-
port. Liaison and meeting with the practice assessor are also essential to
discuss direct observations, progress, and the development of skills. Super-
visors should seek support from assessors when raising concerns. Once
effectively prepared, supervisors can also take on an assessor role but can-
not supervise and assess the same student, in order to enhance objectivity.
Many aspects of a student’s placement will look much the same and remain
unchanged, they will still need an induction to the placement, an initial inter-
view, mid-point and final interviews. Indeed, the skills and practicalities of
supervising and assessing remain pretty much as they were under the title
The NMC standards for student supervision and assessment 17

of mentorship. Role modelling used to be a staple of good mentorship, and

the new approach from the NMC reiterates the importance of this, stating
that supervisors serve as role models for safe and effective practice.

Preparation and support for the supervisor role

The preparation and support for the practice supervisor and assessor role
are no longer NMC-approved but determined through collaboration between
the practice partner and the student’s approved education institution, who
are accountable for the local delivery and management of approved pro-
grammes, thus allowing innovative approaches to be developed. The super-
visor role requires knowledge and understanding of the proficiencies and
programme outcomes, and preparation for this is important for potential
non-nursing supervising professionals. Coordination and ongoing support
for the role will therefore be essential to ensure that safe and effective prac-
tice learning take place. There must be opportunities to discuss feedback
with assessors and others, and raise concerns to ensure that fitness to prac-
tise is upheld. This new flexible approach has developed without the require-
ment for an NMC-approved preparation course. The NMC do, however, need
to be satisfied that preparation of supervisors is adequate and that support
for them is in place as part of their approval processes.

Some issues
The preparation for the role of supervisor is now the remit of the AEI in
coordination with the employing organisation, and so could theoretically
vary widely between providers. Such variation could be in the depth and
level of supervisor training, and preparation from face-to-face, university,
in-house-led or online courses – this is a far cry from the previous restric-
tions of the NMC under SLAiP, which involved the administrative burden of
managing a database and checks on mentor status, annual updates and tri-
ennial review, not to mention the ten-day mandatory training.
Questions may also arise as to whether the student’s professional identity
will be maintained in the absence of a registered nurse as their supervisor. It
is possible that student nurses may access placements where no registered
nurse is employed, and is conceivable that over two placements they may be
supervised solely by the other professions.
Much like the old system of mentorship, the new practice supervisors will
need to ensure that their managers allow them sufficient time to supervise
students in a useful and meaningful way.

Assessment of students and confirmation of proficiency

The 2018 NMC standards for student supervision and assessment state that
responsibility for the development of an effective, objective, robust and evi-
denced-based approach to the assessment process lies in the collaboration
of partners, AEIs and employing organisations. To support this, the NMC
18 The Nurse Mentor’s Handbook

have clearly defined practice and academic assessor roles to ensure that
timely assessments facilitate confirmation of proficiency and student
achievement of competence.

The practice assessor

The practice assessor does not work with the student on a daily basis but is
involved purely for the purposes of objective assessment. They liaise closely
with practice supervisors, observe a clinical episode of care, attend inter-
views, provide constructive feedback, and liaise with the new role of aca-
demic assessor from the AEI. The practice assessor is required to possess
current knowledge and expertise within their field of practice and have
in-depth knowledge of proficiencies and programme outcomes, as well as an
understanding of the students’ learning in theory. Individual students are
required to be allocated to an assigned practice assessor for each practice
placement area and to an academic assessor for each part of the programme.
These assessors are required to be registered nurses or midwives to assess
midwifery students, while student nursing associates can be assigned to a
registered nurse or associate. The NMC stipulate that the practice assessor
should have ‘equivalent experience for the student’s field of practice’. This is
quite vague, but it means that the assessor should have work experience and
knowledge to understand and assess what the student is trying to achieve.
Liaison with the academic assessor will be integral to the new system so that
recommendations for progression for each part of the programme can be
made. The practice assessor requires the opportunity to periodically observe
the student in practice, and must conduct assessments to confirm student
achievements of proficiencies and programme outcomes for practice learn-
ing. They will not supervise the student while on placement, but will observe
them periodically as part of the assessment. Heavy reliance on feedback
from supervisors will therefore be integral to the success of this method.
Practice assessors should confirm and challenge achievement of outcomes
with the student and support supervisors when raising concerns.
It is feasible a failing student may go unnoticed in this new more flexible
learning environment, but this can be mitigated through effective recording
in the practice assessment document and good communication between
supervisors and assessors.

Preparation and support for the practice assessor role

The effective preparation of practice assessors new to student assessment,
and for those existing mentors already holding mentor qualifications
approved by the NMC, again falls within the remit of local providers to
devise appropriate programmes in response to need and demand. While no
longer to be regulated by the NMC, there are responsibilities to ensure that
preparation includes development around the assessment process, effective
interpersonal communication skills, the provision of constructive feedback
and the undertaking of objective and evidence-based assessments.
Systems are required to provide ongoing support and continued profes-
sional development for the supervisor and assessor roles. Such roles could
The NMC standards for student supervision and assessment 19

be similar to the link tutor or practice educator role currently in place.

Knowledge and understanding of practice assessment documents will there-
fore be essential for all members involved in the student’s assessment in order
to assure public safety, as well as the student’s demonstration of values,
leadership, confidence and proficiency.

Academic assessor roles and responsibilities

The academic assessor should be a suitably prepared academic able to col-
late and confirm student performance and their achievement of proficiencies
and programme outcomes. To achieve this, they must work in partnership
with the nominated practice assessor to confirm that the student may pro­
gress to the next part of the programme. Effective communication channels
between practice and education must therefore be developed to discuss stu-
dent progression for theory and practice. With regard to the management of
failing students, they must raise and respond to concerns regarding student
conduct, competence and achievement. Like their practice colleagues, the
academic assessor must also be effectively prepared and supported in this
role, holding relevant qualifications, while possessing appropriate knowledge
of the proficiencies and programme outcome, demonstrating effective inter-
personal communication skills and the ability to conduct objective assess-
ments with the provision of constructive feedback (Figure 1.1).

Comment
Most of the SLAiP (NMC 2008) mentor standards remain very relevant to
effective student learning and achievement. For example, ‘Establishing effec-
tive working relationships’; ‘Creating an environment for learning’; ‘Context
of practice’ and ‘Leadership’. It is important to retain those aspects which

Assuming three placements that year with several practice supervisors in each:

Practice supervisor 1

Placement 1 Practice supervisor 2 Practice assessor 1

Practice supervisor 3

Practice supervisor 4

Placement 2 Practice supervisor 5 Practice assessor 2 Academic assessor

Practice supervisor 6

Practice supervisor 7

Placement 3 Practice supervisor 8 Practice assessor 3

Practice assessor 9

NB: the student may have the same practice assessor for a series of placements.

Figure 1.1 How it might look!

20 The Nurse Mentor’s Handbook

added value to facilitating students and in which student nurses felt valued
and invested in, leading to increased recruitment and retention (McCabe and
Sambrook 2013). There is a new opportunity for the development of lead
roles in practice to actively support the student experience and encourage
feedback, self-reflection and evaluation, as well as placement evaluation.
Academics should therefore still form effective links to the practice area,
address and discuss concerns, and support the management of challenging
or failing students within the role of academic assessor in order to confirm
achievement with the student’s nominated practice assessor.

Summary
This chapter has:
• Examined the history and politics of nurse mentorship
• Outlined the new roles of practice supervisor and assessor
• Stressed the increasing importance of having robust links between
placement areas and the approved education institutions providing
the nurse education

Further reading
Nursing and Midwifery Council (NMC) (2004) Standards for the Preparation of
Teachers of Nurses, Midwives and Specialist Community Public Health
Nurses. London: NMC.
www.practicebasedlearning.org
This website ‘aims to enhance the quality of student experiences whilst on prac-
tice, i.e. work-based placement. It covers much ground and has a very useful
resource section. It has sections which will be useful to all aspects of mentor-
ship and supervision and which relate to many chapters in this book.

References
Association of Operating Department Practitioners (AODP) (2006) Qualifications
Framework for Mentors Supporting Learners in Practice: Standards and guidance
for mentors and practice placements in support of pre-registration diploma of
higher education in operating department practice provision. Wilmslow: Associa-
tion of Operating Department Practitioners.
Benner, P. (2001) From Novice to Expert: Excellence and power in clinical nursing
practice, commemorative edn. Upper Saddle River, NJ: Prentice-Hall Health.
College of Occupational Therapists (2005). Code of Ethics and Professional Conduct.
London: College of Occupational Therapists.
Department of Health (DoH) (1999) Making a Difference. London: Department of
Health.
The NMC standards for student supervision and assessment 21

Duffy, K. (2003) Failing Students: A qualitative study of the factors that influence the
decisions regarding assessment of students’ competence in practice. Glasgow:
Caledonian Nursing and Midwifery Research Centre. Available at: http://science.
ulster.ac.uk/nursing/mentorship/docs/nursing/oct11/failingstudents.pdf [accessed 2
March 2014].
ENB/Department of Health (ENB/DoH) (2001) Placements in Focus: Guidance for
education in practice for health care professions. London: English National Board
for Nursing, Midwifery and Health Visiting/Department of Health.
Hand, H. (2006) Promoting effective teaching and learning in the practice setting,
Nursing Standard, 20(39): 55–63.
Longley, M., Shaw, C. and Dolan, G. (2007) Nursing: Towards 2015. Pontypridd:
Welsh Institute of Health and Social Care.
McCabe, T. and Sambrook, S. (2013) Psychological contracts and commitment
amongst nurses and nurse managers: a discourse, International Journal of Nur­
sing Studies, 50(7): 954–67.
Nursing and Midwifery Council (NMC) (2004) Standards for the Preparation of
Teachers of Nurses, Midwives and Specialist Community Public Health Nurses.
London: NMC.
Nursing and Midwifery Council (NMC) (2006) Standards to Support Learning and
Assessment in Practice: NMC standards for mentors, practice teachers and teach-
ers. London: NMC.
Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning and
Assessment in Practice: NMC standards for mentors, practice teachers and teach-
ers, 2nd edn. London: NMC.
Nursing and Midwifery Council (NMC) (2010) Standards for Pre-registration Nursing
Education. London: NMC. Available at: http://standards.nmc-uk.org/PublishedDoc-
uments/Standards%20for%20pre-registration%20nursing%20education%2016082010.
pdf [accessed 20 December 2019].
Nursing and Midwifery Council (NMC) (2018a) Future Nurse: Standards of profi-
ciency for registered nurses. London: NMC.
Nursing and Midwifery Council (NMC) (2018b) Realising Professionalism: Part 1:
Standards Framework for Nursing and Midwifery Education. London: NMC.
Nursing and Midwifery Council (NMC) (2018c) Realising Professionalism: Part 2:
Standards for Student Supervision and Assessment. London: NMC.
Nursing and Midwifery Council (NMC) (2018d) Realising Professionalism: Part 3:
Standards for Pre-registration Nursing Programmes. London: NMC.
Pulsford, D., Boit, K. and Owen, S. (2002) Are mentors ready to make a difference? A
survey of mentors’ attitudes towards nurse education, Nurse Education Today,
22(6): 439–46.
Robinson, S., Cornish, J., Driscoll, C., Knutton, S., Corben, V. and Stevenson, T. (2012)
Sustaining and Managing the Delivery of Student Nurse Mentorship: Roles,
resources, standards and debates – short report, an NHS London ‘Readiness for
Work’ project. London: National Nursing Research Unit, King’s College London.
UKCC (1999) Fitness for Practice. London: UK Central Council for Nursing, Midwifery
and Health Visiting.
 Effective practice
2 supervision

Key points
• A good practice supervisor is a motivator
• There are many aspects to the role of the practice supervisor
• An effective working relationship is the backbone of good practice
supervision
• A student’s welcome and induction are crucial in setting the tone for the
placement
• Active listening is a key skill in forming effective working relationships
• Leadership and managerial skills are key aspects of practice supervision

Motivation, Maslow, and practice supervisors

The motivational theory of Abraham Maslow (1987) is described later in

relation to learning and teaching theory. However, it is useful here to look at
it from the practical point of view of a student on placement. In identifying
an order in which we usually meet basic human needs, Maslow gives us a
clue as to how to appreciate and account for the needs of our students.
According to Maslow, some higher-order needs cannot be met until certain
lower-order needs have been met. Physiological needs must be met first fol-
lowed by the needs for security and safety, belonging, self-esteem, and finally
self-actualisation. Because of this, we also need to see students as people
who have lives, and therefore other needs, outside of nursing.

Physiological needs

At a basic level, students will not be able to get the best out of their place-
ment if they are not eating enough and it should be recognised that some
students live within limited means. Most universities will have student hard-
ship funds and support mechanisms for financial needs, and the practice
supervisor can involve the link tutor to help the student explore these. The
student may also have problems with accommodation, or lack of sleep due to
life stress and/or the pressure of study; indeed, many students balance their
Effective practice supervision 23

full-time nursing course with paid work elsewhere. Add to this mix a ‘healthy!’
social life and it is easy to see why a student might be too tired to get the
most out of the experiences the placement provides. A number of students
will, of course, invert Maslow’s hierarchy, with the need to ‘belong’ and
‘party’ taking precedence over the basics such as eating. That’s life, but prac-
tice supervisors may occasionally need to remind students about their pro-
fessional responsibilities. Similarly, many students are mature and have
family responsibilities. Ward teams need to take account of these human
stresses and strains and be realistic in their expectations and supportive, but
also be assertive and offer guidance where a student is consistently falling
short of expectations. An open and frank discussion should ensue and a way
forward agreed. The student can be pointed in the direction of other support
mechanisms if appropriate, and the practice supervisor may also involve the
university link tutor should it become necessary.

Security and belonging needs

The need to feel secure on placement can be met by reducing anxieties,

especially early on in a placement. A good orientation programme will do
this with the student being met and seen early on by their supervisors and
inducted and introduced to others within the team. It is also important for
students to feel well supported when they are asked to perform tasks with
which they are unfamiliar or which are particularly demanding. By being
aware of the student’s level and ability, the practice supervisor will ensure
the student is adequately supported and their anxieties addressed. It also
helps if students are not alone on placement but have peers they can chat to
and work with. Sometimes on short placements it can be difficult to achieve
a real sense of belonging, but a good practice supervisor can help to make a
student feel they are valued and can make a useful contribution, by giving
them time, seeking their opinion, and making sure they are involved.

Self-esteem

This need will likely only be met if the above ones have been met first. The
practice supervisor can help the student here to gain a sense of being involved,
valued, wanted, and of making a positive contribution. Being given frequent
positive feedback and being included in the social as well as the working life
of the clinical team will foster this even more.

Self-actualisation

Self-actualisation is a vague concept and often ill defined. It has been

described as the achievement of ambitions and goals in professional or per-
sonal life. Others describe it as fulfilling one’s potential. It is difficult for a
practice supervisor to promise this, but for many students the road to this
24 The Nurse Mentor’s Handbook

goal can be via the personal and professional achievements made on the
journey through a successful placement and nurse training.

The characteristics and roles of the supervisor/mentor

According to Homer’s Odyssey (circa 800 bc), Mentor was the name of the
person Odysseus asked to look after his son while he was away. The word
‘mentor’ now means a guardian, advisor, teacher.
According to the NMC (2006), the responsibilities of nursing mentors included:

• Organising and coordinating student learning activities in practice

• Supervising students in learning situations
• Providing constructive feedback
• Setting and monitoring objectives
• Assessing students’ skills, attitudes, and behaviours
• Providing evidence of student achievement
• Liaising with others about student performance
• Identifying concerns
• Agreeing action about concerns

Gopee (2008), among others, cites the work of Darling (1984) and others
who together have suggested the following roles and characteristics of a
mentor – these now equally apply to the practice supervisor:

• Role model Always under scrutiny and always upholding

high standards and professionalism. Well
respected by their peers and someone who the
student ‘looks up to’ and holds in high regard.
This is a powerful position of influence.
• Energiser 
Motivating, inspiring, and enthusiastic. Seeks
to use every situation as an opportunity to
teach.
• Envisioner 
Keen to embrace change and improve care,
and to encourage the student to see beyond
the present and seek improvements in care.
• Investor 
Gives freely of their time, knowledge, and
experience. Delegates responsibility to the stu-
dent.
• Supporter 
Available and willing to listen; encouraging.
Humanistic and empathic in approach. Takes
account of the student’s anxieties and needs.
Effective practice supervision 25

• Standard prodder Questioning, seeking to improve standards.

Demonstrates up-to-date knowledge. Matches
student tasks to their level.
• Teacher–coach 
Passes on skills and competence, guides, sets
up learning experiences, allows time for prac-
tice. Encourages personal and professional
development. Provides and organises a range
of learning opportunities. Willing to share
knowledge.
• Feedback giver Gives constructive feedback, identifies future
learning. Skilled questioner and facilitator of
reflection. Assessor.
• Eye-opener 
Shows student the wider picture beyond the
team – e.g. politics, management, research.
• Door-opener 
Points out and brokers other learning opportu-
nities and resources, such as the wider multi-
disciplinary team.
• Ideas bouncer Helps student reflect and generate new
ideas, open to discussion and exploration of
the literature.
• Problem solver Helps student develop problem-solving skills.
Supportive when a student is struggling.
• Career counsellor Gives guidance upon future directions and
possibilities.
• Challenger 
Helps student develop critically and encour-
ages them to question and challenge views and
prevailing norms.

Other desirable qualities of a practice supervisor include:

Assertive Knowledgeable
Confident Competent
Approachable Honest
Empathic A good listener
Experienced Trustworthy
Patient Accessible
Creative Kind
Consistent Fair
Non-judgemental Respected by peers

The list of qualities is endless and a good supervisor is many different things
to many different people, but from the above list it is clear that they are a
dedicated professional with a real desire to further the profession of nursing
by giving their time and energy to passing on their knowledge, skills, attitude,
and intuition to others.
26 The Nurse Mentor’s Handbook

Trainee mentor describing the diversity of their role

I hadn’t realised until I actually sat and watched a mentor and worked
with them just exactly what it entailed. From the welcoming and inducting of
the student, identifying their needs, setting up learning experiences,
action planning, setting aside time to discuss things with them, assessing
them and a whole lot more besides.

Effective working relationships and the practicalities of supervision

The foundation for being a good practice supervisor is in building a good

working relationship with the student. Achieving this one initial, important
goal will solidly underpin every other aspect of supervision and do much to
reduce the usual anxieties of the student on a new placement. The contem-
porary scenario of the nurse in a short-staffed and busy clinical area trying
to balance the needs of patients, managers, and others with those of a stu-
dent means that time is at a premium. As such, any time spent with the stu-
dent must be very well used. For this to be the case, it is imperative that good
working relationships are achieved as quickly as possible. There are two
major facets to this: the first is managing the student’s first day and week in
a productive and welcoming way; the second is the supervisor’s use of good
communication skills and ‘active listening’.

Increased anxiety reduces learning (Moscaritolo 2009)

Why is this quote important?

Pre-placement visits

Both the student and the clinical placement staff should be aware of who is
going where before the placement starts. A good student will contact the
clinical team in advance of the placement to check what time they should
turn up, and whether there is any uniform policy or other protocols they
should be aware of. Similarly, a good ward team will encourage the student
to make a preliminary visit just to be given the above information and to say
‘hello’. It can help enormously to reduce anxiety on a first day if the student
already knows one or two faces. The supervisor(s) should be allocated well
in advance of the student arriving, and they should be allocated on the basis
that they can spend an adequate amount of time with the student. On a
pre-placement visit, the student can be introduced to supervisors and have a
quick chat and any pre-placement reading can be handed out together with
Effective practice supervision 27

the placement information pack, outlining learning opportunities and ward

information, shift pattern, dress code, and so on. Off-duty rotas can be planned
together and a pre-placement visit can also be the forum for any negotia-
tion over study days and childcare needs, for example, so that the anxiety
over these can be managed prior to the placement. A good welcoming pre-
placement visit can begin the process of socialisation into the team and its
culture and can give the student an early sense of belonging.

Pre-placement pack
Often given out prior to a student beginning a placement, this pack
will include much of the material included in the induction. If you don’t
already have a pre-placement protocol and student pack, consider what
should be included in one. Think back to your own experiences in the
early days of placements and generate a list of useful information and
things that could be achieved on such a visit.

Student quotes
A common feature of student feedback was that of their mentor going on
holiday shortly after they have begun the placement. These kinds of
eventualities can easily be foreseen and thus avoided with effective
pre-planning.

Third-year mental health field student on mental health

adolescent unit
Although my mentor was supportive and knowledgeable, she was on
annual leave for the crucial first two weeks of the placement, then she
had further holidays and spent much of the time on nights. I felt quite
isolated.

First-year adult field student on first placement

(acute admissions)
I arranged and visited the unit prior to commencement of the placement.
This helped to alleviate uncertainties into what awaits you and helps in
building relationships prior to the dreaded ‘first day at work’ feeling. On
the starting day, I was one hour late due to unforeseen circumstances,
then I got asked by the nurse, ‘What are you doing here?’ My mentor was
unaware that he was mentoring me and due to his holiday arrangements
and night shifts I only saw him for three days over the next five weeks.
28 The Nurse Mentor’s Handbook

The first day and week

Newly qualified mentor

Looking back on my own placements, I can remember how nerve-wracking
it is when you start a new placement. Being made to feel welcome made
all the difference. I make sure that all the students are greeted with a
smile – it sets the tone for the entire placement.

The important elements of the first week are building up a rapport with the
student, orientation and induction to the placement, and the all-important
first interview.

Building rapport

Many of the attributes of good supervision discussed above are the key
qualities of a humanistic approach to teaching in the tradition of Carl Rogers
(1994). Rogers felt that providing an appropriate culture or environment would
in itself facilitate and nurture learning. A key element of this approach is
developing a relationship with the student which is respectful of their auton-
omy and in which the supervisor displays the qualities of genuineness, respect,
trust, acceptance, and empathy. According to Rogers, genuineness is about
being your real self rather than presenting a false face or pretending to be
some sort of ideal type. An effective supervisor does not pretend to be per-
fect or that they know all the answers. They are real people who are still
learning themselves but are willing to share what they do know. Good super-
visors are non-judgemental about their students, and thus are able to develop
a relationship based upon trust and acceptance. Only in such an open and
trusting atmosphere can a student really feel at ease and free to ask for help
and to question.

Stupid question?
One sign of a good learning environment and good practice supervisor is
that the student feels able to ask any question no matter how ‘silly’ it
might seem, without fear of being shot down and ridiculed.
There is no such thing as a stupid question, just learning opportunities.

Within such a relationship, the student will feel respected rather than awk-
ward and incompetent. This is especially important in the early stages of
training where many students will be both young and inexperienced in
Effective practice supervision 29

healthcare matters. The supervisor needs to strip away some of the awe in
which they can find themselves shrouded.

Awestruck!
A first-year student on their first placement and who has no previous
healthcare experience is looking quite scared after shadowing you for the
morning. Close to tears, they tell you they don’t think they can do it, that
they’ll never get to be as skilled and professional as you.
What would you say to this student?

Having insight into the student’s needs will allow you to display a degree
of empathic understanding, which will make the student feel more at ease.
A bit of self-disclosure on the supervisor’s part can go a long way here, reas-
suring the student that they were once a novice and that the student will also
become competent. Such empathy can do much for developing the student’s
confidence that they, too, will achieve the same professionalism and stand­
ard as their supervisor.
Displaying and using Rogers’ core conditions as described above will allow
you to build a relationship with the student in which each other’s expectations
can be shared in a trusting and open way.

First-year adult nursing student on mental health placement

I was really quite apprehensive and it must have shown because my
mentor took me to a quiet room and we sat and had a chat about the ward
and what to expect. She just sat and listened, but more importantly took
me seriously.

Consistency on the part of the supervisor is also important in building trust.

The supervisor must do what they say they will and not embark upon a
pattern of excuses for not having time and postponing agreed meetings. In
many respects, finding the time is the hardest part of being a practice super-
visor but it is crucial to do so.
Taking the student as they are is also important and this means that the
supervisor must be non-judgemental and display what Rogers calls uncondi-
tional positive regard. An effective supervisor is capable of being objective
and has an awareness of their own prejudices and preconceptions and will
not allow themselves to be swayed by such.
30 The Nurse Mentor’s Handbook

Wilkes (2006) reminds us that although we should seek to bond with the
student, we must keep the relationship professional. Developing too much of
a social relationship will make it difficult for a supervisor to act profession-
ally and compromise the offering of objective feedback.

Question
What might be the underlying reasons for a student trying to cultivate a
friendship rather than a professional relationship?

Welcome and orientation

Orientation is the gateway to a successful placement (Beskine 2009).

The initial welcome and orientation form a crucial phase in helping the student
get off on the right foot and make the most of their placement. At the outset,
it is useful to share a little of your own experiences of being a student and to
talk a little about yourself, and to ask the student about their experiences so
far and a little about themselves outside of nursing. Gray and Smith (2000)
highlight the importance of the early days of a placement, reporting that a
good orientation experience reduces the dependency of the student upon
the nurse. Ensure the first shift is not too busy and that you have time to
spend with the student. Gray and Smith (2000, p. 1546) cite one student from
their study who made just this point, that if the first shift is a morning shift,
‘you are just going to be used as a pair of hands . . . Whereas if staff roster
you on a back shift they are more willing to give you time for a proper orien-
tation.’ The orientation should include introducing the student to the ward
team and giving them a tour of the area. Essential information should be
provided, including fire and emergency procedures, location of essential
equipment, and security issues.

First-year adult field student on children’s ward

I was made to feel part of the team and felt well supported. The orienta-
tion day was very useful and you became prepared for what to expect from
the department – they taught us some basic skills. I felt much more
confident after this session.
Discovering Diverse Content Through
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The Project Gutenberg eBook of Under the Skin
This ebook is for the use of anyone anywhere in the United States
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Title: Under the Skin

Author: Leslie Perri

Illustrator: Robert Engle

Release date: March 7, 2022 [eBook #67580]

Language: English

Original publication: United States: Royal Publications, Inc

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*** START OF THE PROJECT GUTENBERG EBOOK UNDER THE SKIN

***
UNDER THE SKIN
 By LESLIE PERRI

Illustrated by ENGLE

The road to Ul was paved with danger, difficulty,

and good intentions—and it's an open question
which of the three was most disastrous!

[Transcriber's Note: This etext was produced from

Infinity Science Fiction, June 1956.
Extensive research did not uncover any evidence that
the U.S. copyright on this publication was renewed.]
I ran a story the other day about the arrival on Earth of a Martian
diplomat and his wife. And I okayed a picture of the lady presiding
over a tea at the Martian embassy. I looked at the picture for quite a
while. The lady in her costume, fresh from the Couture Syndicate in
Rio, was a carbon copy of every other woman. What was different
about her was no longer very different. It was sad, and it was
frightening, too.
It took me back to the days when Deborah and I were pioneering in
the gloomy bureau Universal News had set up in Marsport. I
remember the biggest story we ever covered; it was the only one we
never wrote. And I've been waiting for a time when I could break it
because sooner or later you can take the lid off anything. It illustrates
a point I try to make when I can.
In the early days we were frequently involved in Martian difficulties.
It was partly through genuine concern for their welfare; we liked the
Martians without question. But it was also, curiously, motivated by an
almost adolescent eagerness to demonstrate efficiency and speed
and worth to a people who remained friendly and grateful but aloof
and paternally amused by our energies.
This story started as suddenly and simply as most disasters usually
strike on Mars, or anywhere. A news flash was relayed in from an
interior hill community, Faleeng, to our Marsport office. The news
flash to Universal News came almost simultaneously with the official
SOS.
Disaster had struck a small community of Martians in the Ul
Mountains—a mining region, remote and inaccessible to the Martian
land machines. Power failure threatened the colony of 2,000 with
extinction. Intense cold was slowly, inexorably moving in from the
cheerless sandstone hills from which Ul had been carved.
It was top news as it stood, but there was an additional detail that
made it a real 72-point type headline, a screamer. Ul was the seat of
Martian diranium mining operations. And Mars ran on diranium ore
and whatever it was that the Martians did with it.
We didn't know anything about diranium then and the Martians kept
it that way. We had nothing like it and it drew the con boys like a
magnet. But fruitlessly. Ambassador Ferne, a real level guy with the
Martians, made sure nothing like diranium ever left in anyone's carpet
bag. Our relations with the Martians were smooth, as a result. There
was really nothing else we wanted from them.
Except maybe to see what their women looked like, and, oh yes, their
children. No ancient system of purdah was ever stricter. They were
inflexible on the subject. They had not only instituted elaborate
precautions for keeping their women invisible, it was, also, distinctly a
breach of good manners to mention them. We had been given a
rough idea of the methods the Martians employed in rearing children,
but while it excited a lot of psychologist chaps with its novelty, we
were still frustrated and speculative about their female relations. Who
must have been a pretty attractive and exotic lot, to judge by their
men.
But you couldn't, if you were decent, do anything but defer to the
Martians in the matter. They were wonderful people, honest, friendly
and with no ax to grind. They invariably brought out your best
without any seeming effort. They made you examine into your
motives, and the darker nooks and crannies of your far-from-perfect-
soul.
Consequently, the Ul disaster packed a real wallop for us.

When the Martian authorities got the news from Ul they appealed to
Ferne for assistance. The U.F.S. Rocket Auxiliary was the fastest
transportation available on Mars, faster than anything the Martians
had. The Ambassador ordered the rocket fleet to assist in the
immediate evacuation of stricken Ulans to Marsport medical stations.
In addition a team of Martian and Earth Federation technicians
boarded the lead ship, Electra. Equipment, food and medical supplies
were crowded into the remaining ships. And a large fleet of Martian
land machines went into action. The land machines were like
enormous onyx bowling balls, rolling heavily but smoothly on bands
of gripper treads. They would go as far as they could into the hills,
and the clumsy, short-hop Martian wings would make the rest of the
trip to Ul.
Of course the monster maw of public interest on Earth devoured the
first news like a cocktail sandwich and clamored hungrily for more. In
those days news from Mars took priority. The New York bureau of
Universal News was explicit about wanting full coverage—and
pictures.
And this was where Deborah Wayne first came into the picture—
unfortunately. Deborah was a nice girl, a bright girl, and brilliant with
her super-speed, super-sensitive cameras. But I think, now, that the
psychologist who screened her for that career was drunk. She was
supposed to be ready to cope with the rigors and exigencies of the
frontier. But in the showdown she turned out to be a sentimental slob
who all but got us kicked off Mars.
I didn't think about Debby when the news first broke. I might never
have thought of her myself, but the New York bureau did. When their
orders came in on the Spacetron, the message link between Earth
and Marsport, I was alone in our office with Charley Ray of Galactic
News. I read him the tape as it came off the machine.
QUOTE PROSTEVELASKER EXWILSON COLON UNPICKLE
SELF AND SUBQUOTE TALENT UNSUBQUOTE FOR
FULLEST DISASTER COVERAGE WITH PICTURES PERIOD
OFFER WAYNE BONUS IF DANGEROUS PERIOD REQUIRE
LEAD FOR BLUELINE CASTS AND FULLEST UL
BACKGROUNDING END UNQUOTE
"And where do you suppose Debby is?" Charley said. "To think I
could have forgotten her!"
"Debby!" I said. "Pictures!" I was thinking that the insatiable human
glut for horror and tragedy was a pretty sad and unchanging constant
in our Earth civilization.
"They want a real production," I said bitterly. "With a gallon count on
the blood running in the streets."
"And you get paid for counting it accurately," Charley said. "We got
an hour. Feel noble when we're comfortable. And on our way. With
Debby. I won't go without her. Mad about the girl."
"Mad," I agreed. "You'd better call our office and then check with
Ferne's office on which crate we get to ride in. While I try to locate
that two-legged witch."
Kibby came in. He was relief man and almost always shrouded in an
alcoholic fog from which the cleanest, clearest prose emerged. He
nodded at us, noticed we were looking less bored than usual and
picked up the tape for the answer. He groaned. "You mean I have to
work this morning? With this head? Background on Ul! The rockpile
of Mars."
"Yop," I told him. "SOS came in a couple of hours ago to the
communications center. Galactic and Universal got the flash from the
stringer in Faleeng, the nearest point to Ul. Sounds real rough out
there. And interesting. This is the closest we've ever come to their
diranium. But first I have to find Debby."
As I talked, I was looking over a list of stations.
"Ruin my day, altogether," Kibby muttered.
"Try the Celestial. She said she was doing a film on those historic
ruins outside of Marsport. The Celestial's the only dump you can stay
in out there."
I rang up the Celestial. She had left hours ago.
"Great," I groaned. "She could be anywhere."
Charley put a cigarette in his mouth. And in between the calls I made
to different places on the list he told me the seats reserved for the
press, us, were on the Starfish. We were going along with some
crates of blankets and two mine experts, Sam Vechi and his assistant,
Raeburn.
"But no pictures of the mines," Charley said. "Or the mining
equipment. This order is backed up with RA zap guns. Dipple, over
there, was very emphatic. If he didn't know much about anything
else, he knew that. I'm surprised he managed to figure out how we
were going to get to Ul."
Kibby was at the water cooler, his head pressed lovingly against the
cold metal cylinders. "Why are they letting Vechi go along? He's no
humanitarian. His interest on Mars is diranium and they're giving him
a chance to run through it barefoot."
"Pure conjecture," I said, cautiously but not convincingly. I had given
up trying to locate Deborah. "It's a mine area and Vechi is an
engineer. With all that education he should be some help."
Vechi was a hard guy to figure and pretty much on his own for a
member of the small Earth Federation colony. He was more or less
attached to the United Federated States Geological Research
Expedition. But he was a free-lancer, too, and disappeared from
Marsport for months at a time. It gave rise to rumors about his being
an agent on the side for some big mine development syndicate on
Earth. His comings and goings were mysterious but you couldn't pin a
thing on him. Vechi was slippery, smooth and indefinably unpleasant.
But smart.

I had just suggested we haul our equipment out of the locker when
the door slid open. Deborah, her red hair half over her eyes as usual,
came in—a blazing little fireball of energy. She was going full blast. I
shrank within myself and wanted to crawl under a desk. If Charley
thought this was enchanting and feminine, he could have it.
Although—she had the throatiest, most electrifying voice I had ever
heard. It was a muted female foghorn with a lovely liquid cold. It
turned my spine to wax even though I got angry the minute she
opened her mouth and used it to say, witheringly, "What's the
matter? How many people have to die before you big shots get
interested? You two wouldn't dream of offering to help even if you
aren't going after the story!"
"I've been trying to get hold of you," I said coldly.
She just looked her contempt. "I've been at rescue headquarters
since 6:00 a.m. You might have tried there. Two thousand people
face death, you know."
"And little Deborah has trundled out her armor and is in there
pitching like mad," I said.
"You hardboiled newsmen," she said, and she was really upset. "You
louses."
"Lice," I said. She had made me feel like a louse. I didn't want it to
show, so I got sly and mean. "Don't you think this trip is too
dangerous for you?"
She had calmed down. She didn't look like Joan of Arc, any more,
just tired and troubled. "No," she said briefly.
"O.K.," I said cheerfully. I was only a little bit sorry to be so mean.
"Then there's no bonus involved."
She buttoned a button on her sleek green workalls. "Louse, in the
singular. Keep your lousy bonus."
Charley gave me a long, disgusted look and left to get his gear.

From the air all of Marsport seemed enclosed in a shimmering

transparent syntho-glass bag. And it was, as were all the other
Martian cities, enclosed in some virtually indestructable sheeting that
rose to heights of 20,000 feet—contracting and expanding in the
extreme temperature changes of the planet. These breathing, nearly
invisible skins sheltered the cities, and within them strange hybrid
species of flora and fauna flourished. The Martians had evolved a way
of life that was tranquil, visually beautiful and civilized—if artificial, by
our standards.
Its very artificiality became, in fact, a new kind of reality. The reality
of a dream that persists, or a fantasy which retains its unbelievable
qualities but becomes actuality. And in this atmosphere we set up our
machines and agencies and extensions of Earth—bursting with the
conceits and importance of having conquered space. And, oddly, we
did not consider it strange that the Martians displayed no interest in
returning our visit.
The spaceport lay outside Marsport, however. When we ventured
beyond the protection of the city shelter we wore the pixie-like
oxygen hoods and adjusted the thermal dials on our workalls. I never
got over being surprised that our technicians on Earth could have
been so clever at keeping us comfortable. You got used to nearly
everything, as a matter of fact, except the psychological sense that
freedom existed within the city shelter—and not in the great
outdoors. You could get agoraphobia on Mars; it was rough outside.
When we arrived at the spaceport it seemed as though every citizen
in the capital city had turned out. The slender Martian men in their
colorful, oddly skirted costumes formed the bulk of the crowd. They
had need of extra oxygen, too, and the tall, transparent cones within
which they breathed glittered like a thousand needles in the early
morning air. Martian women were missing from the crowd, as usual,
and as usual you had a strangely wistful feeling about these
withdrawn people—who were always friendly but never intimate.
Who would not trust you any more than you would mischievous
children with the treasures of their ancient and beautiful civilization.
We rode past the crowds in our vehicle, with an R.A. sergeant
directing us to the Starfish.
It can be said for the Rocket Auxiliary that they worked like beavers
loading the U.F.S. Rocket Fleet. The array of ships was impressive.
The sleek, silver hulls mirrored the pastel, candy colors of a clear
Martian morning. They lay quiescent like glittering feathers on the
broad, red-earth field. Far in the distance, low, brown hills rolled out
to meet the horizon. Small yellow clouds swirled over a section of the
hills—a dust storm into which we would be heading presently.
Our sergeant hopped off the vehicle when we reached the Starfish.
She was a real old dowager, the Starfish, with the broadest beam in
the fleet: even slower, but more uncomfortable, than a ride on a
three-legged Martian ileh, the only beast of burden on the planet.
When we had piled out of the vehicle the first thing I noticed was
Deborah's gear, all neat and ready to be stowed. Then Sam Vechi,
sitting on a fibreboard crate with his legs crossed at precise right
angles. His face in the transparent visor was thin, darkly tanned and
healthier looking than any of ours. And his workalls fitted as though
they had had him in mind when they tailored the original design.
When he got up at our approach I was surprised again by his height.
You remembered him, somehow, as being a small man, which he
wasn't.
The audio cup in my oxygen helmet buzzed a little when he began to
talk, so I adjusted it and picked up the tail end of what he was
saying: "... terrible, this Ul thing, isn't it?" I nodded.
Deborah kept fiddling with her audio adjuster, as though she couldn't
hear, so she wouldn't have to acknowledge Vechi's greeting. She
wasn't good with people she didn't like and she didn't like Vechi.
Charley, who had a bright word for any slob, offered an apology for
our offhandedness. "They have a hate on," he lied blithely. "They
turned off audio so they couldn't hear my arguments for a
reconciliation."
Deborah, who wouldn't let even phony opportunity go by, said nastily,
"I wouldn't give him two minutes or two words more than my
contract calls for."
"And it's a good thing it isn't up for renewal," I said.
Vechi smiled and there was something agreeable about all those
white teeth in that brown face.
I guess it made Deborah uncomfortable to have Vechi agreeable.
"Excuse me," she said. "I want some shots of the mob scene." She
looked at me. "Are you going to wave in a story to Kibby before
takeoff? Lots of color around."
It was a damnfool question. "I do news. You do pictures." I said it
patiently.
"I was only thinking of correlating the two, you crab!" she snapped
and stamped away.
"Real friendly type," Charley growled at me. "Quit riding her. She
knows her job and she does it."
"She knows her job but not her place," I growled back. "She has to
run every show."
"Boy, I bet your ancestors beat the spit out of their women when
they went out after the vote."
"That was the turning point in history," I said. "We have been paying
for it ever since."
Charley grinned. "It ain't such a big price, considering."
He looked around the field. "Well, I'll wave in my story on the takeoff
stuff. There's nothing else for the noon leads."

I watched him leave. And then I looked for Debby—and watched her.
From a distance she looked mighty nice, it was true. She had a funny
way of moving, a little awkwardly like a young animal, but it had its
appeal. And so did her red hair, which was short and curly and never
in place. She was young all over except for her figure which was as
grown up as it had to be. What no one could understand, though,
was why the best looking gal in Marsport hadn't been trapped by any
one guy as yet. And how anyone that good looking could also be
good. So far from home it didn't usually work out that way. The girls
did as they pleased and no one blamed them. It was one of the
rewards for being a sucker and doing a stint on Mars.
It gradually dawned on me, as I watched her, that she wasn't doing
much active picture-taking. Her usual intensity was curiously missing.
She seemed to be thinking about something else as she aimed her
camera, up there on top of the Starfish. I made a mental note of this.
I had learned that when Deborah appeared abstracted there was
usually a damned interesting reason for it.
I fished out my communication gimmick and flicked a button. I got
the control tower, or, more accurately, underground shelter, and the
latest poop. Then I signalled Kibby and dictated a story to him. While
I was talking privately into the 'com. Vechi watched me in a
disinterested way. Raeburn, his assistant, arrived and they wandered
off among the fibreboard crates for a private conversation.
"Paragraph, Kibby," I said into the mouthpiece. "'The vast rocket
terminal at Marsport is soberly alive this morning with preparations
for the giant rescue job awaiting the joint forces of the U.F.S. Rocket
Auxiliary, and the Martian disaster crew....'"
Pundra Doh, the Martian premier, was in the lead ship, Electra. But
there wasn't time for an interview. Thin, electric-blue spits of exhaust
flickered all over the spaceport by the time I had finished dictating.
The high, keening sound of the rockets revving up tore through my
helmet and I shouted at Deborah who was still up there, on top of
the Starfish. My voice in her helmet must have blasted her eardrums.
"Damn you, Steve," she screamed back at me. Then she clicked
another wide-angle shot of the field, sat down suddenly and slid
down the polished tail of the Starfish on her fanny.
It's a wonder her camera survived the descent.
The Starfish shuddered as she lurched along, keeping up with the
rest of the fleet. Her vibration was too heavy to be soporific but
Deborah slept like a baby on a pile of things she had scratched
together. Or at least she seemed to be asleep. Maybe because I was
looking at her she figured it was a good idea to pretend. There was
something wrong with her, something I couldn't put my finger on.
Charley took out a cigarette. He looked at me looking at her. "Why
resist?" he grinned.
"You've got a one-track mind," I said. "What I'm wondering is what
that little witch has up her sleeve. She's behaving like she's done
something—it makes me uneasy."
Charley looked real angry. He flicked an ash meticulously. "You
haven't got a damned thing to gripe about, have you? So, instead of
relaxing, you're imagining enormities she could have committed!
What a jerk. Why don't you admit it to yourself; she attracts you. Like
she does everyone else. Say something nice about her for a change—
you don't impress me."
"She takes good pictures."
Charley laughed, derisively. "I guess you'd like it better if she went
space-crazy, like every other dame does here. She ought to drink
more, beef more, hell around. Maybe you could stand having her
around if you knew she took the guys home with her who would run
at the chance.
"You're just waiting for her to make a slip. So, you can write her off.
But she won't. You might as well save time and admit what
everybody figured a long time ago."
"You through?" I asked.
"Sure."
"I'd still like to know what she's been up to."
I bent forward and started checking my gear. I was so mad my hands
shook. I took out a bottle of hooch and examined it while I calmed
down; it was vintage stuff, not home brew. I put it away again. I
didn't need a drink, really. Deborah! If it wasn't love it was something
just as insidious. I could get real boiled up because of her.
Love, now there was a fancy word! I toyed with it for a minute and
considered it in relation to Deborah. And all I came up with was a
mental picture of her mouth—very soft, with the ingenuous, upward
curve of an eager kid. It didn't solve a damned thing. I closed my
gear pack and looked at the other passengers.
Vechi and his boy, Raeburn, were checking gear, too. They spent a
little time admiring some scientific gadget Raeburn had fished out for
Vechi's approval. Vechi pushed a pointer on a small black dial and
sighted us through it; very cool. When they got through playing, they
leaned back comfortable-like and looked at us.
Since we were newsmen the conversation was bound to be a little
formal.
Vechi must have known he had a doubtful reputation. I guess he
figured we were curious about his berth on the Starfish; how come
he was riding with the press?
Raeburn was a pudgy, balding civil service sycophant. He had little
quick brown eyes, a loose wide mouth filled with an unpleasantly
self-conscious smile—and practically no chin to balance the naked
shine of his brow. He made bad jokes and thought he was quite the
boy.
Since I was never at the head of the class for tact I started the ball
rolling down the center alley. "What's your interest in this trip,
Vechi?" I said.
I heard Charley sigh resignedly.
"I'm a civil engineer," Vechi said. "It seems they need technical
people as well as reporters. Technical people to save as much as they
can and newsmen to dramatize what hasn't been saved."
Score one, and not for us! I grinned at him. "Got any ideas for the
press on what caused the power failure?"
Vechi smiled a gentle, patronizing smile. "Apparently, the Martians
use diranium as a source of atomic power. But since no one knows
the characteristics of diranium it would be difficult to imagine the
type of power installation they employ. It seems evident to me, also,
that we will know as little about diranium, later, as we do now—with
the strong security measures taken to safeguard the secrets of
diranium.
"Furthermore, the Martians have evolved totally different scientific
systems based on materials, limitations and planetary conditions
which are alien to us. Entirely different engineering skills are
required."
"Then what earthly good are our boys going to be?" I asked.
Vechi stretched his legs. Raeburn listened and said nothing. "We have
no way of knowing that Ul station did not sustain a physical
catastrophe—in which case a knowledge of construction, how to
salvage tunnels, buildings, bridges, heating systems and the like will
probably prove useful. We know something of their building
techniques from Marsport."
"Well, you certainly appear to be well qualified," I said as courteously
as possible. But somewhere a dim instinct warned that this was eye-
wash. Why wasn't this joker with the other engineering boys up
front?
"Thank you, Mr. Lasker," he said, equally courteous. End of interview.
I looked at Charley. He looked at me. Then he handed me his bottle.
Trust Charley. "Have a slug, pal," he said cheerfully. "Stop working."
"I will, pal," I said. "Thanks."
It felt good going down and for the first time I realized I had a
hangover from the night before. And the night before that. And then
I saw that Deborah's green eyes were wide open and fixed on me.
I took another slug, over and above Charley's little pained
exclamation. I didn't like the look in those green eyes.
"Hey, Steve," Debby called in that indecent voice of hers. "I want to
talk to you."
"You see, my friend," I said to the owner of the bottle, "she wants to
talk to me."
"That makes you lucky," Charley said. He was very carefully putting
the top back on the bottle.
"So, talk," I said to her.
"No, you come over here for a change."
Then I knew something was wrong. In some crazy way Deborah and
I operated on the same frequency. I could always sense things about
her—and, I knew, she could about me, too. I grunted. I moved
reluctantly. But I went over to her and sat down.
Her face was propped up by an elbow and about six inches from
mine after she had drawn my head down for a real private tete-a-
tete.
"Steve, I've got to talk to you."
She was real, damned pretty that close up. But that wasn't the
reason I got the breathless feeling in my stomach. I wondered how
much this was going to cost Universal. I was thinking in terms of
money at that point.
"All right," I said. "I couldn't hit you even if I wanted to. What did
you do this time?"
"Well. It's not awfully bad and it's not awfully good. It's a delicate
situation. And I need your help."
My alarm grew. "Deborah!" I said warningly.
She drew a deep breath through a small, round red mouth. "I
smuggled someone on board," she said very quietly.
Well, that was interesting. I patted her cheek; I wanted to wring her
neck. "Fascinating," I said lightly. "Let me know how you make out
with customs, or whatever."
I made like I was getting up. She grabbed my collar. "Steve!" she
whispered, agonized about something.
"Mr. Lasker," I said briskly. "I'm your boss, not your friend. Take your
problem to Charley; he's softheaded."
"I'll give Charley an exclusive," she whispered three inches from my
face. "I could tie up the spacetron for the next two days with this
story.
"This is Pundra Doh's wife!"
I sank back on my haunches and stared at her. "You've stowed a
Martian woman on this tub?"
She nodded a small nod, once.
I grabbed her by the shoulders and I guess it wasn't gently.
"The holiest of all holy Martian women, the Premier's woman!"
"Yes, Mr. Lasker."
I was speechless and, I will admit, scared. This was real serious
business. This no newsman on Mars would wade into without a
clearance covered with red seals and blazing with blue ribbons. The
Martians were touchy about their women, and they meant it.
And our doll, our Deborah had done this all by herself. But why? I
asked the burning question even if it was crazy, "You didn't kidnap
her, did you? Just for laughs or something?"
"Steve, please!"
She was scared. I loosened a button on my collar. "Okay, baby, give it
to me. All of it. You realize this constitutes a breach of faith with the
Martians. Not to mention an assault on U.F.S. policy. A lot of people
are going to find their heads on the block if this gets out."
"Well, I don't know about that," Deborah said quietly. "I was asked to
do this. To arrange this trip for Laapet, in exactly this way. And I gave
it a lot of thought before I agreed to do it."
"Laapet? The lady's name?"
She nodded. She backed away a little, down on her elbow again. She
had been upsetting that close; even with everything else charging
through my brain, I noticed it. Had she?
"I was at the Celestial when the first news from Ul broke," Deborah
said. "I was about to go to bed, as a matter of fact, when the Martian
innkeep hammered on my door and told me about the disaster. I
packed my gear right away and got transportation for rescue
headquarters. I figured the biggest picture-wise things would be
happening there. Besides, I wanted to help if I could.
"I hadn't gone very far from the Celestial when my vehicle was
stopped by a Martian."
I listened to her story incredulously. It was eerie and unbelievable.
There in the merciless cold of the white-lighted night desert Deborah
had made the first crossing into the secret, private world of the
Martians.

The man who intercepted her appeared out of the night, without
warning. Tall and slender in a cloak of soft furs, his feet in fine
leather quilted boots, the tall glittering oxygen cone crested with the
phoenix-like emblem of the ruling group—he was regal, and tragic
with uncertainty. He had no taste for his mission but he was urgent.
He frightened Deborah with his intensity but she trusted him. The
way you always trusted the Martians. She left her chauffeur to wait
for her and went with him in his machine. They drove into the desert
for a long while in silence. He did not tell her what to expect, but it
was obviously important and secret. He was without attendants. He
did not even have a driver but operated his own vehicle.
"I could not understand why I had been chosen," Deborah said. "But
I had the feeling that I was very unimportant, in myself."
They came to the rendezvous spot where one of the larger and better
land machines waited—like a black monument rising from the white
sand. Inside, Laapet waited. He had taken her to his sister, Pundra
Doh's wife.
The compartment was luxurious and dimly lit. Laapet sat behind
semi-opaque hangings, shy, frightened and all but invisible. But
desperate. Her two children were in Ul and she was beside herself
with anxiety for them.
Deborah's face was very soft and saddened. I understood something,
suddenly, something I had not come close to before. Laapet was not
a stowaway to Deborah, or a diplomatic catastrophe, but a woman
distraught with concern for her children. If Deborah had any
motivation it was to help this other woman—even if she broke the
iron rules of the Martian code. She was, in that instant, an entire
woman, herself.
And what could you do about it? Forget you were a good guy, too,
someplace in your cynical old fibers? And just berate her for getting
you involved in an absolutely untenable situation—one that would
presently have the Ambassador, himself, running for a bromo fizz?
"So, she wanted to go to Ul. And you were the only woman going
and she trusted you to understand?" I said it as gently as I could.
Maybe Deborah understood that I understood, for once.
Deborah was thoughtful. "I don't understand all of it," she said
slowly. "She was, naturally, not permitted to accompany the Premier.
I'm sure she didn't even ask. If you know anything about the way
they rear their children, here ..." she said expectantly, and I nodded
because I had read a report or two on the subject.
"Well, it seems she had been ill—not physically, but emotionally, I
gather. She was unstable and the children were sent to Ul on a
holiday, to escape her tensions. Since they had been sent to Ul
because of her, she felt it was her fault they were in danger. And
because she knew they would receive no better attention, or be
found more quickly, under the Martian code, she decided to go
herself to make sure they would survive."
"They will not honor her for it," I said. And I was doubtful that
Madame Pundra's stability had returned.
"I am sure they won't," Deborah said bitterly. "But I can understand
that her children are worth more to her than her honor. And maybe
that's an instinct that's common to all mothers regardless of their
origin."
I couldn't argue with her. I didn't say that maybe if Madame Pundra
had been well, emotionally, according to Martian standards, she
wouldn't have done it. What was the point?
The generators of the Starfish hammered through the silence that
hung between us. I had never before been touched emotionally,
myself, by anything Martian. And here, suddenly, I was a hapless
party to a certain tragedy—all the more tragic because it was based
on mores I did not understand entirely, or sympathize with.
"Maybe we can help her avoid dishonor?"
Deborah shrugged. "She will, in any event, confess to having
petitioned us into helping her. The Martians do not dissemble. That
will be enough to condemn her."
I shook myself out of a peculiar gloom. "There may be a way." I said,
but I doubted it. "How did you ever get her on board? And where is
she? And how did she ever hear about you?"
Deborah looked tired. "The plan was to smuggle her aboard in my
portable developing unit; it worked out very smoothly. I don't know
how she heard about me. I wish she hadn't."
"That makes two of us," I muttered. "Deborah?"
Her mouth shook a little. "Yes, Steve, I know." Her voice was a
register lower and all but inaudible. "I'm glad I can count on you, you
louse."
Something pretty incredible was happening to us. In spite of the way
she phrased it she was suddenly not out there striding along manfully
by herself, any more. Nor had she ever been. To have her suddenly
lapse atavistically into a woman instead of a termagent was more
than I could handle. I, who had all but resigned myself to the
inevitable, eventual appeal of one of the moronic but less assertive
ewes of our society! How had Deborah been flushed through the nets
and traps and conditioners of our psychologists—to land, thus, a
compound personality in my lap?
Here, I thought exultantly, is no glitteringly compatible equal with
every brain impulse carefully measured, and every muscle vibrating in
harmony with the males on her level. But a thoroughly mixed-up
female in the romantic tradition of the last century!
"You damned little fake," I said huskily.
"It took you the longest time to figure me out," Deborah sighed. "I
hope you'll treat it as a confidential disclosure or they'll try to cure me
and make me normal."
"Heaven forbid!" I let her voice crawl up and down my spine with a
freedom I'd never allowed before. It made me feel pretty drunk.
I looked at her and her eyes were green and wide. "God, you're
beautiful," I said with the unbidden frankness that comes with any
kind of drunkenness.
"You make me feel that way," she said.
I touched her hand very briefly. "It'll turn out as good as I can
manage."
"I needed you, Steve. I was so afraid you wouldn't be there. I
couldn't be alone with this one. She's going to kill herself, Steve."
"Aren't any of her people interested in helping her? What about her
brother?"
"Another potential suicide, I suppose," Deborah said bitterly. "He's
with Pundra Doh in the lead ship. He will ostensibly take over when
he reaches Ul."
"Well, heaven bless him."

I didn't have to go back and sit next to Charley, but I did. I had a
couple of things to think about and if I'd stayed with Deborah I would
have thought about only one of them.
Charley was half asleep. Raeburn seemed to be asleep. Vechi was
reading. I leaned back and closed my eyes. And still I thought about
only one thing. Deborah. Not thinking, really, feeling. I resented
Pundra Doh's wife for crowding in on that feeling. And for the vague
presentiment I had about Vechi. And Charley's eternally undisturbed
equanimity.
Deborah! I wished we were anywhere but where we were. With this
new thing to explore and understand, I wanted to be near her, alone.
But everything had its price; I had been conditioned successfully
enough to accept that.
There was Laapet, Madame Pundra. And what if her brother did not
materialize when we reached Ul?
I opened my eyes and watched Charley. He was pouring a shot from
his bottle. "Here, pal," he said, "have a medicinal."
I wondered if we would have to tell him about Laapet? Not yet.
"Wait," I told myself reassuringly, "her brother will take the whole
thing off your hands." But I wasn't sure. I had the uneasy feeling that
something would prevent it.
I glanced at Deborah. She was lying on her back, staring at the dome
of the Starfish. She didn't look like she was thinking about us, only.
Charley was tuned in on the same vibration band. He gave me the
answer. "You know," he said quietly, "I've been thinking about Vechi.
I don't like his being on the Starfish."
"Go fight the R.A.," I said sarcastically.
"I don't like other things, too," he went on, ignoring me. "Why hasn't
one of the pilots come out for a smoke, yet? Or a drink—or for some
bright chatter with us educated chaps?"
"Things too dull for you, pal?" I asked routinely. It hadn't penetrated,
yet.
Charley had on his patient expression. "Listen, Brain. While you and
Debby were having your big conference I went to the men's lounge
to gargle my throat. It's a funny thing how cautious the R.A.'s
getting; the door to the control room is locked. I tried it gently. If
they didn't want to come out and talk to us—I thought I'd go talk to
them."
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