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In most professions, it is well understood that new graduates are only beginning their integration of the complexity of knowledge, skills, and know-how that will ultimately allow them to practice to the full scope of their capacity. Close engagement with more senior professional mentors is recognized as requisite to achieving their full potential. However, all too often in these modern times, formal mentorship only appears in the specific contexts of preregistration nursing students and very new graduates.

When I was a neophyte nurse in the 1970s, we took it for granted that there would always be a clearly designated system of increasingly senior nurse leaders to look to for guidance and support in developing our competence and confidence when confronted with new situations in the practice context. I always had a head nurse, often a nursing team leader, and, when guidance was needed beyond that, I had access to a charge nurse or even a director of nursing. It felt like I was supported within a web of nursing expertise and authority that was at close range should anything go wrong. And I have vivid memories of the many lessons I learned through the wisdom of each of those mentors. In other systems and settings, such mentors might have held titles such as nursing care manager, matron, nursing sister, or superintendent of nursing. But they were all clearly visible and accessible by virtue of title and scope as one of our own, and holding some responsibility and authority for the systems of nursing care that ensured our patients were always as well served as possible.

As our healthcare systems have been restructured and re-engineered to adapt to conditions and constraints, many of these nursing leadership roles disappeared and were replaced by more generic positions such as service director, program leader, manager, or administrator. Sometimes the people holding those positions were nurses; often they were not. Simultaneously, positions for nurse leaders within the highest echelon of health system administration, such as Director of Nursing or Vice-President of Nursing, have often been reconfigured as interdisciplinary roles, such as Professional Practice Lead, or Director of Clinical Service. Thus, while individual nurses may still occupy significant roles within leadership teams within our systems, they are often in roles that are no longer specific to nursing, meaning that any efforts they may wish to take to actively address systems of nursing care place them at risk of not being equally attentive to the needs of the allied health disciplines. The evolving fashions in health administration have systematically disadvantaged the kinds of workplaces and care settings within which organic nursing leadership and mentorship systems used to thrive.

The evolving global nursing shortage—made more acute by the burnout of the profession during the COVID-19 pandemic—and the disregard at policy tables for nursing perspectives that the pandemic conditions exposed—means that the mentorship crisis is of urgent proportion. By some miracle, young people still compete to enter the profession, and schools of nursing continue to produce excellent graduates; nevertheless, we see increasing accounts across the globe of the difficulty retaining these new nurses (Almost & Mildon, 2022; Voss et al., 2022). Despite their being our hope for the future of health care globally, we are not yet succeeding on a wide scale to convince policy makers and health administrators that their care and feeding is a wise investment. And where we do get that message across, the efforts that we make at orientation programs and reasonable work scheduling systems mean nothing if we have not addressed the systemic barriers to their developing over time into full-grown, proud and confident professionals.

In these dangerous times for our profession, it becomes increasingly important to join forces in the re-establishment of “systems of nursing” within those facilities that rely on a healthy and productive nursing workforce (Cummings et al., 2018; Sigma Theta Tau International, 2018). Rebuilding effective systems of mentorship into the structures within which we deliver health care will necessarily require that we push back against the prevailing organizational philosophies that seek to “break down silos,” challenge “health provider self-interest,” and uncritically advance an ideology of the inherent value of “interprofessional care” (Kim et al., 2006; King & Shaw, 2022; Suter et al., 2009). While nurses certainly do understand the wider motivations that may have fueled these dominant models of health care administration in recent decades, they have found it very difficult to advance an awareness of the unintended consequences of these ideologies for the profession of nursing and the health of the nursing workforce.

I believe we need to name and acknowledge the disruption of nursing mentorship systems as a serious threat to societal health writ large. Solutions such as asking nursing schools to pack more into curricula before students graduate, or extending new grad orientation programs may reflect “baby steps” forward, but are fundamentally inadequate as functional solutions. We need to make it clear to everyone involved in health and health system planning that every nurse needs access to nurses at more senior ranks (or experience levels) in a meaningful way, not simply for the initial months of practice but continually throughout a career (Hoover et al., 2020). We are not task-enacters, interchangeable units of labor who can be moved around the playing field. We are professionals within an increasingly complex profession for which the societal need is only increasing. Doctors and lawyers would never permit a system that simply threw their new graduates into the fray without support and asked them to swim unaccompanied. We somehow missed the boat when all of this re-engineering was taking place, presuming that having a few people “with a nursing background” in senior leadership positions might be sufficient, and failed to appreciate the pernicious ideology underlying the supposed “efficiency and accountability measures” that our system administrators and policy makers were so keen to advance.

In the spirit of not wasting a perfectly good crisis, it seems a very good time to explain to everyone who needs to understand this that a profession such as nursing must have a built in, meaningful, continuous, and effective professional leadership and mentorship system, and without one, patients and health outcomes suffer (Fitzpatrick, 2017; Wong et al., 2013; World Health Organization, 2020). In addition to a convincing narrative, we need strong evidence and the policy advocacy to message both in a manner that will be heard. And although we dearly love our interprofessional colleagues and respect the insights that our operational leaders might possess, we must remain firm on the principle that only nursing can mentor nursing excellence as it gradually unfolds throughout a career.

全文翻译（仅供参考）

在大多数职业中，众所周知，新毕业生才刚刚开始整合知识，技能和诀窍的复杂性，最终将使他们能够充分发挥自己的能力。与更资深的专业导师密切接触被认为是充分发挥其潜力的必要条件。然而，在这些现代化的时代，正式的导师制往往只出现在注册前的护理专业学生和刚毕业的学生的特定背景下。

20世纪70年代，当我还是一名新手护士时，我们想当然地认为，当我们面对实践环境中的新情况时，总会有一个明确指定的越来越高级的护士领导系统，以寻求指导和支持，从而发展我们的能力和信心。我总是有一个 护士长 ，通常是护理团队的领导者，当需要指导时，我可以接触护士长，甚至是护理主任。感觉就像我在一个护理专业知识和权威的网络中得到了支持，如果有任何问题，这个网络就在近距离内。我对通过这些导师的智慧所学到的许多教训记忆犹新。在其他系统和环境中，这样的导师可能拥有诸如护理经理、护士长、护士长或护理主管之类的头衔。但他们都是清晰可见的，并凭借标题和范围作为我们自己的一个，并持有一定的责任和权力的护理系统，确保我们的病人总是尽可能好的服务。

由于我们的医疗保健系统已被重组和重新设计，以适应条件和限制，许多这些护理领导角色消失，取而代之的是更通用的职位，如 业务主管 ， 项目负责人 ， 经理 ，或 管理河有时担任这些职位的人是护士;但往往不是这样。同时，卫生系统管理最高层的护士领导职位，如 护理部主任 或 护理副总裁 ，经常被重新配置为跨学科角色，例如 专业实践主管 ，或 临床服务总监.因此，虽然个别护士可能仍然占据我们的系统内的领导团队中的重要角色，他们往往是在角色，不再是特定的护理，这意味着他们可能希望采取的任何努力，积极解决护理系统的地方，他们在风险不同等关注的需要专职医疗学科。卫生管理的不断发展的时尚系统地不利的工作场所和护理环境中，有机护理领导和指导系统曾经蓬勃发展的种类。

不断演变的全球护理短缺--COVID-19大流行期间职业倦怠使其更加严重--以及政策制定者对大流行条件暴露出的护理观点的忽视--意味着导师制危机迫在眉睫。由于某种奇迹，年轻人仍然竞相进入这个行业，护理学校继续培养出优秀的毕业生; 然而，我们看到地球仪越来越多的人难以留住这些新护士（几乎& 米尔登 2022; Voss等人，& nbsp; 2022 ）.尽管他们是我们对全球卫生保健未来的希望，但我们还没有大规模地成功说服政策制定者和卫生管理人员，他们的护理和喂养是一项明智的投资。在我们确实传达了这一信息的地方，如果我们没有解决他们随着时间的推移成长为成熟，自豪和自信的专业人士的系统性障碍，我们在定向计划和合理的工作安排系统方面所做的努力就毫无意义。

在这些危险的时候，我们的职业，它变得越来越重要，以联合起来，在重建“系统的护理”的设施，依赖于一个健康和生产力的护理劳动力（Cummings等，& nbsp; 2018 Sigma Theta Tau International， 2018 ）.在我们提供医疗保健的结构中重建有效的指导体系，必然要求我们抵制流行的组织哲学，这些哲学寻求“打破筒仓”，挑战“医疗服务提供者的自我利益”，并不加批判地推进“跨专业护理”固有价值的意识形态（Kim等人，& nbsp; 2006 ;国王& 肖 2022 ; Suter et al.，& nbsp; 2009 ）.虽然护士当然知道更广泛的动机，可能助长了这些主导模式的医疗保健管理在最近几十年，他们发现很难提前意识到这些意识形态的护理专业和护理人员的健康的意想不到的后果。

我认为，我们需要命名和承认护理指导系统的破坏是对社会健康的严重威胁。解决方案，如要求护士学校在学生毕业前将更多的课程纳入课程，或延长新的毕业生入学培训计划，可能反映了“婴儿步骤”的进步，但从根本上说，作为功能性解决方案是不够的。我们需要让参与卫生和卫生系统规划的每个人都清楚，每个护士都需要以有意义的方式获得更高级别（或经验水平）的护士，不仅仅是在最初的几个月的实践中，而是在整个职业生涯中不断（Hoover et al.，& nbsp; 2020 ）.我们不是任务制定者，不是可以在运动场上移动的可互换的劳动单位。我们是一个日益复杂的行业中的专业人士，社会需求只会增加。医生和律师永远不会允许一个系统，简单地把他们的新毕业生在没有支持的情况下投入战斗，并要求他们独自游泳。在进行所有这些重新设计的时候，我们不知何故错过了机会，认为在高级领导职位上有几个“有护理背景”的人可能就足够了，并且没有意识到我们的系统管理人员和政策制定者如此热衷于推进所谓的“效率和问责制措施”背后的有害意识形态。

本着不浪费一次完美的危机的精神，现在似乎是一个非常好的时机，向所有需要理解这一点的人解释，像护理这样的职业必须有一个内置的、有意义的、持续的、有效的专业领导和导师制度，没有一个，病人和健康结果都会受到影响（菲茨帕特里克， 2017 ; Wong等人，以及nbsp; 2013 ;世界卫生组织， 2020 ）.除了令人信服的叙述外，我们还需要强有力的证据和政策宣传，以便以一种能够被听到的方式传达信息。虽然我们非常爱我们的跨专业的同事和尊重的见解，我们的业务领导人可能拥有，我们必须保持坚定的原则，只有护理可以指导 护理在整个职业生涯中逐渐展现卓越。