The value of nurse mentoring relationships: Les-sons learnt from a work-based resilience enhancement programme for nurses working in the forensic setting

: This study aimed to evaluate a mentoring programme embedded in a work-based personal resilience enhancement intervention for forensic nurses. This qualitative study formed part of a wider mixed-methods study that aimed to implement and evaluate the intervention. Twenty-four semistructured interviews were carried out with forensic nurse mentees and senior nurse mentors; these explored their experiences of the mentoring programme and any beneﬁts and challenges involved in constructing and maintaining a mentor – mentee relationship. Qualitative data were analysed thematically using the Framework Method. Four key themes relating to the initiation and maintenance of mentor – mentee relationships were identiﬁed: ﬁnding time and space to arrange mentoring sessions; building rapport and developing the relationship; setting expectations of the mentoring relationship and the commitment required; and the impact of the mentoring relationship for both mentees and mentors. Study ﬁndings highlight the beneﬁts of senior nurses mentoring junior staff and provide evidence to support the integration of mentoring programmes within wider work-based resilience enhancement interventions. Effective mentoring can lead to the expansion of professional networks, career development opportunities, increased conﬁdence and competence at problem-solving, and higher levels of resilience, well-being, and self-conﬁdence.


INTRODUCTION
The changing, and often challenging, healthcare needs of growing and ageing populations, alongside fast-paced changes to the structure and provision of care, have resulted in increased pressures on health services internationally (Black 2013, Burmeister et al. 2019, Goyen & Debatin 2009, NHS 2014, Wanless 2002. Increased healthcare demand has been compounded by current and projected shortages in the number of staff required for the delivery of quality care over the next decade, particularly amongst nurses, midwives, and health visitors (Health Workforce Australia 2014; Institute of Medicine 2010; NHS 2017; Unruh & Fottler 2005,). In the United Kingdom (UK), a recent report on National Health Service (NHS) staffing trends highlighted a number of key areas of concern including high levels of staff attrition; decreased applications and retention rates within preregistration nurse training programmes; pressure on international recruitment strategies; worsening staff retention; increased reliance on agency staff; and a lack of investment in ongoing staff training and development (Buchan et al. 2019).
Evidence suggests that increasingly pressurized working conditions, experiences of workplace adversity, and incidents of staff burnout are major contributors to intentions to leave the nursing profession and absenteeism internationally (Buchan et al. 2019;Burmeister et al. 2019;Heinen et al. 2013). In particular, job satisfaction, staffing, team dynamics, stress, managerial style, and supervisory support are all driving factors affecting retention, with younger, less experienced nurses most at risk of leaving (Burmeister et al. 2019;Halter et al. 2017). A recent review found that the experience of stress and burnout of mental health staff is particularly problematic compared to staff in other clinical areas, with consequent knock-on effects on individual well-being, productivity, and patient care (Johnson et al. 2018). In addition, nurses working in forensic settings are often exposed to physical assaults from patients, who also have higher rates of self-harm and suicide attempts than in other clinical areas (Clarke et al. 2011). Forensic inpatients present as challenging and complex cases and can remain on wards for many years, often with little evidence of progress apparent (Davoren et al. 2015). However, despite mental health being identified as a strategic priority for the NHS, the number of mental health nurses rose less than 0.5% between 2017 and 2018, with a reported drop of 2.6% in areas outside of community mental health (Buchan et al. 2019).
It is crucial that attention is sharply focused on developing and implementing staff retention strategies as a means of alleviating the substantial and detrimental consequences of a decreased nursing workforce (Buchan et al. 2019; Health Workforce Australia 2014). The NHS National Retention Strategy was launched in 2017 to decrease nursing turnover rates in all trusts (NHS Improvement 2019); the strategy advocated for investment in workplace interventions and training, and the provision of additional mentoring support for nurses and other healthcare professionals.
Personal resilience can be defined as the ability to respond to challenges and difficulties positively, whilst retaining a sense of control over the environment (Hart et al. 2014;Jackson et al. 2007;McDonald et al. 2012). Building personal resilience has been identified as an essential strategy for coping with work-related stress and responding to and overcoming experiences of workplace adversity, as well as helping to address problems with retention (Craigie et al. 2016;Foster et al. 2018a;Foster et al. 2019;Foster et al. 2018b;Jackson et al. 2007;Slatyer et al. 2017). Moreover, a recent review found that interventions targeted at burnout and improved patient care were effective, with good uptake amongst healthcare staff working in mental health services (Johnson et al. 2018). However, despite increasing evidence to support the potential impact of workplace resilience enhancement interventions for nurses (Craigie et al. 2016;McDonald et al. 2012;Slatyer et al. 2017), there is still a relative paucity of studies examining these within a mental health nursing context (Foster et al. 2018a;Foster et al. 2018b;Foster et al. 2019;Henshall et al. 2020).
A wide body of literature cites the importance of building collegial and external professional relationships and support networks within the wider context of developing personal resilience to workplace adversity (Daly et al. 2004;Jackson et al. 2007;McDonald et al. 2016;Tusaie & Dyer 2004).
The qualitative study reported on in this paper was part of a wider mixed-methods study that aimed to implement and evaluate a work-based personal resilience enhancement intervention for forensic nurses at an NHS Trust in the UK (Henshall et al. 2020). Part of the intervention consisted of a mentoring component whereby forensic nurses were matched with senior nurse mentors with the aim of contributing to the development of their personal resilience. This paper reports on the evaluation of the mentorship component of the intervention, in relation to its impact on the programme outcomes, as well as identifying any key facilitators and barriers to initiating and maintaining a sustainable mentor-mentee relationship within this healthcare context.

BACKGROUND
Mentoring is widely recognized as a mechanism for providing opportunities for workplace learning for nurses throughout their careers, whether in the form of preregistration nurse education, preceptorship, staff development, or clinical supervision (Nash & Scammel 2010). Despite this, research on the effectiveness of mentorship in clinical nursing practice is still relatively sparse (Gray & Smith 2000).
Involving the intentional matching of experienced senior staff with more junior, less experienced staff, mentoring relationships can be used to solve workplace issues; promote development and increase competence; empower mentees and improve self-confidence; develop professional identities and assist with career advancement; and provide immediate and contextual feedback (Gray & Smith 2000;McDonald et al. 2010, Spouse 1996. A recent review of the effectiveness and application of nursing mentorship programmes found them to be beneficial, with positive impacts on job satisfaction, professional competencies, and staff turnover rates (Zhang et al. 2016). The professional support, guidance, and nurturing offered by a successful mentoring relationship have been identified as one of the most important forms of protection against workplace adversity, helping to combat work-related stress, increase job satisfaction, increase a sense of belonging and purpose, and improve patient care (McDonald et al. 2016). Mentoring relationships have also been found to be mutually beneficial, with positive outcomes for mentors as well as mentees, including the benefits derived from helping other nurses, developing understanding of current challenges facing services, and retaining expertise (Clutterbuck & Lane 2004;McDonald et al. 2010). The development and implementation of successful mentorship programmes have positive, widespread implications for nurse managers and health services.
Previous literature has identified key individual and relational factors contributing to effective mentorship, including consistency between mentors' and mentees' perceptions and expectations of the relationship; acceptable and consistent levels of communication and one-to-one interaction; enthusiasm and accessibility of the mentor; and relevant seniority and previous experience of the mentor (Gray & Smith 2000, Hodges 2009, Jackson et al. 2015, Zhang et al. 2016. Equally, unsuccessful mentoring has the potential to cause adverse effects and dissatisfaction for both mentors and mentees (Green & Jackson 2014). Barriers to effective mentorship that have been identified include the establishment of imbalanced or assigned mentoring relationships that are not matched for personality and other factors; lack of time to commit to the relationship; insufficient mentoring skills or knowledge; and a lack of institutional support (Jackson et al. 2015;Zhang et al. 2016). McDonald et al. (2012) successfully developed and implemented a work-based personal resilience enhancement intervention for nurses and midwives in Australia which involved the engagement of nurse participants in a mentorship programme with senior and retired nurses. The resilience enhancement programme intervention used in this study was modelled on McDonald et al. (2012) intervention (Henshall et al. 2020). The intervention consisted of six, day-long workshops over 12 weeks and incorporated learning objectives such as building hardiness, maintaining a positive outlook, achieving work-life balance, and reflective and critical thinking, and enabling spirituality, together with a mentoring component that involved matching the nurse participants with senior nurse mentors. Each session was facilitated by a member of the project team and an invited cofacilitator. The cofacilitators included senior managers, nurses, medical directors, and chaplains working in the Trust, who were considered experts in the areas of focus for each session. Further details of the programme are reported in a separate paper (Henshall et al. 2020). Analysis of pre-and postprogramme surveys to evaluate the effectiveness of the intervention found that amongst a range of positive changes that mentees experienced due to the programme, the ability to interact with other mentees and mentors throughout the course was particularly beneficial (Henshall et al. 2020). However, a more in-depth exploration of which aspects of the mentorship component of the programme were beneficial, and an examination of the impact of the mentor-mentee relationship on the programme outcomes are required.

Study design
This study formed part of a larger mixed-methods study consisting of quantitative pre-and postprogramme intervention surveys and qualitative interviews (Henshall et al. 2020). Here, we report on findings from the qualitative interview component, which pertain to the mentee/mentor relationship.

Setting, access, and recruitment
The study was undertaken at a mental health and community NHS Trust in the south-west of England. Ethical approval for the study was obtained from the Faculty of Health and Life Sciences Research Ethics Committee at the university sponsoring the research study (FREC 2017/21).
Study participants were recruited to the resilience enhancement programme using convenience sampling.
All nonagency, band 5 and 6 nurses registered with the UK Nursing and Midwifery Council, who worked on the forensic inpatient wards at the participating trust, were deemed eligible and were invited to participate in the intervention (n = 80). These nurses were provided with a participant information leaflet (PIL), which provided information about the study, by the Head of Nursing and Forensics' ward manager and were given permission to attend the programme during their working hours. Working and retired senior nurses with experience of working at band 7 or above in the trust were recruited as programme mentors by the research and clinical teams. However, senior nurses who were working in forensics were not invited to be mentors, on the basis that mentees might not wish to disclose sensitive work-related issues to a member of their own senior management team. Eligible senior nurses were provided with a PIL to explain the study purpose and were asked to contact the research team if they were willing to participate as a mentor.
Mentee and mentor study participants were divided into two sequential cohorts, to avoid the groups becoming too large to facilitate. In the first session of each cohort, nurse participants (mentees) and mentors were matched via a three-minute 'speed dating' session, in which each mentee asked each mentor three questions about themselves (questions could relate to personal or professional experiences of the mentors). At the end of the 'speed dating' session, each mentee listed their top three preferred mentors and, where possible, the session facilitators then matched the mentors to the mentees' preferences. This was done to promote mentee autonomy, as well as taking into account individuals' personalities, aspirations, and expectations, all of which have been highlighted as important components of the matching process in successful mentoring relationships (Jackson et al. 2015). The purpose of the mentee-mentor relationship within the programme was to provide mentees with an additional support mechanism in which they could work towards mutually agreed personal and professional goals (McDonald et al. 2013).

Data collection
Semistructured interviews were conducted with mentees and mentors following completion of the 12-week resilience enhancement programme. Prior to the interviews being undertaken, participants were asked to provide written informed consent. Mentees and mentors were also asked to complete a brief demographic form as part of the wider resilience enhancement programme evaluation. The interviews were carried out either face to face at the participating trust or over the telephone depending on participant's preference.
Semistructured interviews were used to explore in depth the experiences of the mentees and mentors and to understand the benefits and challenges of constructing and maintaining the mentor-mentee relationship. A topic guide was used to guide the interviews with mentees and included questions specific to the mentormentee relationship such as: 'Can you describe your relationship with your mentor?' And 'How useful do you feel this relationship has been?'. A separate topic guide was used with mentors and contained additional questions such as: 'What form of contact have you used and why?' 'How likely is it that you will remain in contact with your mentee after the 12 week programme?' And 'What has been the best/most difficult thing about this mentor/mentee relationship?'. Interviews were digitally recorded and transcribed by a local transcription company. Data were deidentified at the point of transcription.

Data analysis
Interview data were analysed by a member of the research team (ZD) and were guided and managed using the Framework Method, whereby data are coded thematically and then charted into a framework matrix (Gale et al. 2013). Microsoft Excel was used to create the framework and capture the breadth of data from the interviews. Data were analysed using a predominantly inductive approach; however, an overarching and broad deductive framework was constructed using the core components of the interview topic guide (Henshall et al. 2020) Interview data that pertained to the mentor/mentee relationship were analysed thematically whereby themes from the raw data were identified before being linked together to identify relationships and any overarching themes, which were then charted into the framework matrix. To support this process and ensure analytic rigour, themes and a summary of findings were discussed at three team meetings between the researchers and the programme coordinators. In addition, following initial data analysis and charting, themes were discussed at three additional meetings with the research team (ZD, CH), including a member (DJ) who had been involved in the workplace resilience enhancement intervention in Australia (McDonald et al. 2012) on which the current programme was modelled. This allowed the findings to be considered within an international context, taking into account cultural and societal perspectives, differences and variations in healthcare systems, and the impact this might have on the formation and longevity of nurse mentor-mentee relationships. To ensure accurate and complete reporting, the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) guideline was adhered to (Ogrinc et al. 2016).

Participants
Twenty-nine nurse mentees and twenty-two senior nurse mentors took part in cohorts 1 and 2 of the programme. Demographic data for these cohorts are presented in Table 1. Mentees were predominantly band 5 and 6 nurses with less than 10 years working in the profession. The majority were female and aged 30-49 years. Senior nurse mentors were all currently working and were mostly in band 8 positions with more than ten years of working experience in the profession. Most mentors were female and aged 40 years or above.
Twelve nurse mentees and twelve senior nurse mentors from cohorts 1 and 2 agreed to take part in the semistructured interviews. Mentees and mentors interviewed were spread evenly across the two cohorts 1 (n = 6; n = 5) and 2 (n = 6; n = 7), although a small number of cohort 2 mentors were also involved in cohort 1 (n = 3). One mentor interviewed from cohort 2 withdrew from the programme prior to its beginning, due to a change in their role. The majority of mentees (n = 9) and mentors (n = 9) interviewed were female.

Main findings
Facilitators and barriers to the development of successful mentor-mentee relationships in the context of a workplace resilience enhancement programme were explored. Four key themes relating to the initiation and maintenance of mentor-mentee relationships were identified: finding time and space; building rapport; setting expectations; and impact.

Finding time and space
Finding appropriate times and locations for mentoring sessions was highlighted by both mentees and mentors as a potential barrier to developing a successful relationship. In particular, finding mutually agreeable times that were compatible with the programme's timetable and mentees' shift patterns without being in conflict with the programme's goal of promoting work-life balance was identified as a challenge. Few mentor-mentee partnerships met off-site or outside of working/programme days, despite being encouraged to do so; however, meeting just before or after shift/programme times, or during scheduled breaks, was common.
They felt that they couldn't ask for more time from their wards during a shift, so we met around the beginning of a late shift or we met on the lunch break of the course sessions, which was helpful. (Mentor A, Cohorts 1 and 2) We weren't allocated protected time to meet with our mentors. We were meant to do that in our own time. And one of the things about personal resilience, which we kept going back to, is having that work-life balance, making time for you, not staying late. And yet, I was trying to stay late or come in early to meet with my mentor, which seemed counterproductive (Mentee A, Similarly, finding a suitable venue for mentoring sessions, particularly when mentee-mentor partnerships were based at different sites, was seen as problematic, as were overcoming barriers to communication such as the lack of access to email on forensic wards, which made planning meetings difficult.
The biggest challenge was the distance between us.
(Mentor A, Cohorts 1 and 2) Whilst the provision of additional protected time was highlighted as a possible solution, several mentees and mentors acknowledged the need for flexibility from both parties in finding suitable times and spaces to meet.
I think at some level you have to make that sacrifice when you are mentoring somebody and I think that the mentee equally has to make some sacrifice of some sort. Because for me it meant that I had to work or to stay behind work for extra time to see her. And equally for her, she had to stay behind to see me. So, it was kind of a sacrifice which was agreeable between the two of us (Mentor C, Cohort 1) Building rapport Finding opportunities to build and develop personal connections between mentees and mentors was viewed as important for initiating and maintaining this relationship. Mentor-mentee partnerships used a mix of communication channels to stay in contact, and the importance of planned, regular communication was acknowledged. Having time to build the mentor-mentee relationship was also viewed as an important facilitator. Many mentees and mentors felt they were able to foster positive, rewarding relationships during the 12-week programme, but some felt this was not enough time.
I think it was a nice exchange but I don't think we had enough time to discuss things in depth.
(Mentor D, Cohorts 1 and 2) I think that it takes a little while to build up that relationship. You can't just say, this is my mentor. It's about finding someone you click with and things and someone that you can benefit from. And I think that we needed longer to find our flow and to find what was going to be helpful for both of us (Mentee A, Cohort 1) It was acknowledged that taking a flexible approach to the content and structure of mentoring sessions was conducive to the aim of establishing shared personal and professional goals, as well as creating an environment in which an open and constructive relationship could be established.
What's happened so far is when we've met we've checked in with each other and where we're up to and then that's dictated what we've talked about. And that sort of gains an open bond so that we can talk about whatever the person wants to talk about, gives them the freedom to set the agenda (Mentor F, Cohort 1)

Setting expectations
Setting clear and realistic expectations of the outcomes, steps involved, and commitment required from both mentees and mentors for the mentoring component of the programme was raised as an important factor contributing to the overall success of the mentor-mentee relationship.
When your diary's packed from eight in the morning to seven at night and you just are in this chaos of emails and texts and failed meetings, failed telephone calls, it does feel like, hang on a minute. This is exactly what I mean about having a relationship that's organised. We know when it's going to happen and we both commit to it and off we go (Mentor G, Cohort 1) Whilst some mentors felt well prepared for their involvement in the programme, others would have liked additional, more timely, information and training. Similarly, both mentors and mentees suggested that the mentees would have benefited from further guidance on the role of the mentor and the expectations held of the mentees in this context, particularly around the issue of communication.
I don't know how much of a blueprint was put down about what they could reasonably expect from a mentor relationship?
(Mentor H, Cohorts 1 and 2) We don't really have any context of what this relationship is supposed to be, so I didn't really know what angle I was supposed to be coming at it from. I don't think the mentors did either, to be honest. I think it would have helped if there was some sort of framework for a dialogue (Mentee C, Cohort 1) There also appeared to be some confusion, particularly on the part of the mentors, about what was expected by the programme facilitators with regard to the continuation of the mentor-mentee relationship beyond the life of the programme.
At the celebration event I think a number of us talked about that. About where's the end? And is it okay to keep going? Or should there be an acknowledged end?
(Mentor G, Cohort 1) We haven't met since the course finished, which was something that they said we could do if we wanted to. But I kind of got the feeling from [my mentor] that she'd signed up to be part of this pilot and that she wouldn't be (Mentee A, Cohort 1)

Impact
Despite some clear areas for improvement in both setting up and maintaining the mentoring component of the programme, both mentors and mentees recognized personal and professional benefits to their involvement. For mentees, the mentoring relationship allowed them to explore new ways of dealing with workplace challenges and to build support networks outside of their existing team structures, clinical supervision, and management meetings.
It's a very good relationship. . .They listen, so it's kind of that relationship that I have somebody to talk to (Mentee B, Cohort 1) I got a couple of really good pointers there. Things that were on my mind and concerning me about my own career.
(Mentee C, Cohort 1) Many mentees expressed a desire for the mentormentee relationship to continue beyond the 12-week programme, either as a continuation of the relationship or as a more informal touchpoint within their widening professional networks. I will stay in touch with them, definitely. . .Probably more as a contact point and somebody to go to if there's something that I think they may be able to help with.
(Mentee E, Cohort 2) We spoke quite a bit and it was useful. I met her on the last day again, and we had a really nice conversation. She's offered to meet me again, which is nice. Yes, I plan to take her up on that. (Mentee C, Cohort 1) For mentors, developing one-to-one relationships with nurses working in on inpatient wards in the forensic setting was a means of broadening their own professional network across the trust, providing them with a renewed insight and understanding of the day-to-day challenges facing staff, and the impact of pressures on the health system on clinical practice. I always find that in this job you learn something new every day. . .Listening to where they're coming from and about the pressure. Because obviously I don't work in the hospital environment at the moment and haven't done for four years. So, it's about [understanding] how difficult things are at the moment (Mentor I, Cohort 2) On a more personal level, mentors saw their involvement in the programme as an opportunity to reflect on their own career choices and encounters with workplace adversity. I think I've learnt a lot. . .I can reflect back on how I have gone through my own career. How I've had some difficult moments, and [how] being able to get support from people that I got on well with helped me through those.
(Mentor J, Cohorts 1 and 2) The majority of mentors indicated that they would like to continue to be involved in the mentoring component of the programme, seeing mentoring as an important aspect of their professional responsibilities towards staff development and well-being, providing additional and complementary support and guidance.
It's valuable. I believe in supporting colleagues, always felt that way, that we need to look after each other (Mentor E, Cohorts 1 and 2)

DISCUSSION
The findings of this study support existing evidence for the mutually beneficial role of supportive, professional work-based mentoring relationships for nurses outside of existing supervisory and other support structures. Participation in a mentoring relationship embedded in a work-based resilience enhancement programme was beneficial to mentees' professional development, self-confidence, and approach to workplace challenges. These findings reinforce previous studies which have identified the value of work-based resilience interventions for nurses (Craigie et al. 2016;Foster et al. 2018a;Foster et al. 2018b;McDonald et al. 2012;Slatyer et al. 2017). However, a key strength of this study is the addition of a complementary mentoring component which aimed to provide additional support to mentee nurses. To our knowledge, this is the first time this combined approach, promoted by McDonald et al. (2012), has been used within the UK nursing context. Moreover, the study adds to the growing body of research looking at the benefits of resilience enhancement interventions specifically targeted at the mental health nursing workforce. In line with McDonald et al. (2012) findings, the mentors in our study also found the relationship rewarding. It provided them with the time to reflect on their own careers, re-engage with the challenges faced by frontline staff, and gain greater insight into the pressures being placed on staff working at the frontline of service provision. The mentoring relationship was an important part of the overall programme, and a key component in developing and expanding mentees' professional networks by introducing them to experienced senior nurse mentors who were familiar with the healthcare system and the trust, but who were not necessarily from a forensics background and did not currently hold positions within the same clinical teams as mentees (Henshall et al. 2020). The provision of social support to frontline healthcare professionals via open, nurturing professional relationships, including mentoring relationships with senior staff, is crucial to building resilience and feelings of self-worth, which can have a significant impact on staff retention and the delivery of patient care (McDonald et al. 2016, McGee 2006, Tusaie & Dyer 2004. Findings indicated several key factors that contributed to the development of successful mentoring relationships within the context of the resilience enhancement programme, including flexibility and compatibility from both mentees and mentors with regard to work schedules and locations in order to find time and space to arrange mentoring sessions; clear and consistent communication with planned regular contact to allow sufficient time to build a strong mentor-mentee relationship; an open and collaborative relationship that incorporated shared personal and professional goals; and mutually agreed expectations about the outcomes, process, and commitment required from both mentees and mentors. This resonates with existing evidence around the personal, relational, and professional characteristics that comprise effective mentorship (Gray & Smith 2000;Jackson et al. 2015).
In contrast to many other studies in this area with shorter intervention periods (Foster et al. 2018b;Slatyer et al. 2017), our resilience enhancement programme spanned 12 weeks despite involving only six sessions. This was to ensure that mentees and mentors had sufficient time to develop and nurture their relationships and derive maximum benefit from their interactions. However, the length of the mentoring partnerships was substantially shorter than the 6-month minimum described in McDonald et al's. (2010) study. Due to our study's relatively short follow-up period, we are unable to comment on the longevity or success of the mentoring relationships beyond the programme's cessation. However, our findings do demonstrate that a time frame of 12 weeks is sufficient to establish effective mentoring partnerships. This potential for effective mentoring over a relatively short time frame is important as, whilst some participants expressed a desire for continued involvement in current and new mentoring relationships, this may not always be pragmatic or feasible within the current healthcare climate in the UK. Sustaining the mentee relationship beyond a 12-week duration may be beneficial for some partnerships; however, this is not a prerequisite for successful programme outcomes.
In further contrast to McDonald et al's. (2010) study, mentors involved in this programme were all working in senior positions within the same NHS trust as the mentees. The fact that both mentors and mentees were engaged in full-time employment may have impacted on the ability of mentors and mentees to find appropriate times to meet with regular frequency, due to the work pressures both parties were under. However, a clear advantage of utilizing working senior nurses as mentors is their ability to provide mentees with access to wider professional networks that are relevant and up to date and to be able to impart their working knowledge and experience to their mentees to facilitate proactive problem-solving.
Additionally, few mentoring sessions took place at locations off the hospital site, partly for pragmatic reasons but also because of a reluctance from both mentees and mentors to blur the boundaries between their professional and personal lives. Future programmes should carefully consider the impact of practical and logistical factors, such as working hours and workplace location, that may impact on the ability of mentees and mentors to regularly meet. In addition, establishing clear and flexible ground rules at the outset will help ensure that both mentees and mentors are in agreement as to the alignment of these personal and professional boundaries.

Limitations
The study recruited nurses working in the forensic mental health setting. Forensic mental health nurses encounter unique challenges with regard to working practices, routines, and client groups, and as such, the study findings may not be representative of the general nursing population. However, as highlighted, the senior nurse mentors were not from forensic mental health backgrounds, and their fresh and alternative perspectives on workplace-based issues were not limited to the challenges of a specific setting or clinical team. Moreover, findings from the wider study in which these participants were involved indicated that many of the workplace pressures identified centred around factors that are shared by nurses working in most care settings, such as staffing and workload (Henshall et al. 2020).

CONCLUSION
This paper has presented findings from the qualitative component of a mixed-methods study to implement and evaluate a work-based personal resilience enhancement intervention for forensic nurses at an NHS Trust in the UK. The paper reports specifically on the evaluation of the mentorship component of the intervention using qualitative interviews with 24 mentees and mentors who took part in the programme. The findings identify some of the challenges associated with the creation of sustainable and effective professional mentoring networks for staff in the forensic environment within the UK NHS. Together with previous research in this area (Gray & Smith 2000;McDonald et al. 2016;McDonald et al. 2010), the findings from our study highlight the mutually beneficial roles of senior nurses mentoring more junior staff across a range of clinical nursing environments. In particular, the study provides evidence for a mentoring programme integrated within a wider work-based resilience enhancement intervention as an effective means of establishing supportive and effective mentoring relationships.

RELEVANCE FOR CLINICAL PRACTICE
Effective mentoring relationships can lead to increased opportunities for nursing staff through the expansion of their professional networks, career development opportunities, increased confidence and competence at problem-solving, and higher levels of resilience, well-being, and self-confidence. All of these can engender improvements to the clinical environment and clinical practice and contribute to the provision of high-quality patient safety and care.