Title : ED connections: Strengthening new nurses through mentorship and improving outcomes
Abstract:
Orientation for nurses new to the Emergency Department (ED) typically relies on preceptors who focus on direct clinical instruction and competency validation during the onboarding period. However, the high-acuity, fast-paced ED environment can limit opportunities for additional mentorship, professional development, and support beyond clinical training. Recognizing this gap, the ED Service Line Council identified an opportunity to further support nurses transitioning into the ED. Clinical nurses proposed the Mentoring Enhanced Education Program (MEEP), a structured three-month mentoring initiative designed to build trust, confidentiality, and professional networking between experienced ED nurses and new staff. The goal of MEEP was to supplement traditional preceptor-based orientation and enhance new nurse confidence, engagement, and retention. MEEP was developed to provide mentorship distinct from the preceptor role. Experienced ED nurses volunteer as mentors and guide new nurses outside of their scheduled shifts, supporting their professional development and helping them acclimate to both the organizational culture and the demands of the ED environment. The program offers ED-specific mentorship and bridges gaps that may occur during preceptor-led training by creating dedicated time for discussion, reflection, and growth. Mentor-mentee pairs meet one-on-one throughout the three-month program to address key topics such as the role of the ED nurse, patient satisfaction, and coping with the emotional impact of emergency care. Clinical discussions include common ED scenarios such as sepsis, cardiac arrest, and stroke, while additional focus is placed on interpersonal skill development, including conflict resolution, communication with providers, time management, prioritization, and confidence building. Program content is guided by pre-surveys used to identify knowledge gaps and tailor mentorship discussions. Mentor-mentee pairings are completed during ED Service Line Council meetings based on personality and experience level, with input from council members. Participants receive resource packets and educational presentations reviewing essential ED processes, practices, and policies. Communication between mentors and mentees occurs through various platforms, including one-on-one meetings, texting, and email, allowing for consistent check-ins and support. Post-program surveys are completed by mentees to evaluate program effectiveness. Since implementation, 28 nurses have completed the MEEP program, which has become a core component of ED mentoring. Participants reported increased confidence in managing high-acuity patients, delegation, and communication. Mentees expressed feeling more supported, while mentors reported enhanced leadership skills, stronger peer relationships, and reinforced clinical expertise. Improvements were also reflected in organizational metrics. The 2025 Healthy Work Environment Assessment Tool demonstrated “Moderate Healthy” scores in Skilled Communication (4.41) and True Collaboration (4.37). Employee engagement survey results improved, with the ED score for “I have the tools and resources I need to do my job well” increasing from 3.49 in 2024 to 3.57 in 2025. The score for “I would stay with this organization if offered a similar position elsewhere” increased from 3.71 to 3.84. Additionally, ED RN turnover declined from 13.27% in 2023 to 12.73% in 2024 and further to 7.81% in 2025. MEEP demonstrates that a structured mentoring initiative can enhance nurse development beyond traditional orientation. The program strengthens mentorship, teamwork, professional growth, and retention in a high-acuity setting. This adaptable model can be replicated across healthcare organizations seeking to promote resilience, competence, and a culture of continuous learning for nurses transitioning into emergency care roles.
