Clinical Editor's Corner: Kern

What Does It Mean to Be a Mentor in the Cath Lab?

Morton J. Kern, MD

Morton J. Kern, MD

At the 2018 American College of Cardiology Scientific Sessions (ACC.18), March 10-12 in Orlando, I was honored to be invited to a session for fellows-in-training (FITs) to address the topic of mentorship. The session was entitled, “’Successful Mentorship’: Preparing tomorrow’s leaders today”, and was chaired by Drs. Anthony DeMaria and Dr. Poonam Velagapudi, with a faculty panel including Drs. Ajay J. Kirtane, Martin Leon, and Athena Poppas, with FIT members Drs. Tanush Gupta and Emily Lau. 

We were asked to share our views and advice on what it means to be a mentor, how mentees should identify mentors, and other aspects of mentorship. In everyone’s career life, including the nursing and technical staff in the cath lab, mentors take on a multitude of roles during the training periods and early work life, and continue to have an impact well into the future years of the daily experiences in the lab. A successful working life is often the combined results of the mentee’s intrinsic capabilities and the application of a mentor’s advice and counsel, even if this information remains with the mentee in only a subliminal way.  

At the FIT session, the fellows mentioned the difficulty and importance of finding a good mentor early and having a successful mentor-mentee relationship. We discussed what it meant to be a mentor and the responsibilities of having a mentor. The question about where and how to find the right mentor was raised. In forming the relationship, it is important to define the roles of a mentee/mentor even in an informal way and to understand the expectations from each person. It was clear that each topic presented had a spectrum of views and opinion on how to best find, develop, and nurture both mentors and mentees for career success. I thought I’d share these views, as they also apply to the cath lab experience, where each staff member knowingly or unknowingly takes on a mentor/mentee role, especially as new members come to the lab, and senior members move into more administration and education.  

Who is a Mentor?

A mentor is anyone who can share knowledge with a less-knowledgeable person and further, more than just teaching, is someone who can provide the mentee with insights, counsel, and life lessons beyond just the technical tasks. Age is not necessarily a requirement. A younger person can be a mentor for an older individual as they share new experiences. This relationship must include several features that make one a good mentor (Table 1) and a good mentee (Table 2, Figure 1). 

Do You Need a Mentor in the Cath Lab?

Of course, we all do (including me, thanks, Dr. Seto). A mentor is needed in every career path where the individual wishes to progress, grow, advance, and succeed. We know the cath lab fellows-in-training depend on the attending physician to mentor and teach them in the performance of the procedures, but so do the nurses and staff. It is important to recognize that the same attendings who are working with the fellows are (or should be) mentors to the entire cath lab staff while they are in charge of the procedure. Being the captain of the ship (i.e., the lab) carries the responsibilities of not only ensuring the smooth and correct operations of fellows, nurses, technologists, and students, but also making sure that every person has an understanding of their role and carries out their tasks with professionalism.  

There is little room for unprofessional or “unmentored” behavior in the lab. The captain is both leader and educator, whether he/she knows this or not, and whether he/she takes this role or not. The nurse or tech in charge as second mate to the captain is also responsible for the lab and takes (or should take) the role of mentor to the entire staff, and at times, the fellows-in-training, who also look to the nursing and technical staff to educate them on how the lab works and what they must learn to grow into an independent operator. 

I can remember as a first-year fellow in the cath lab in Boston how Melba, our chief tech in charge of hemodynamic recording, instructed me on how things were going to be done, and gently but firmly admonishing me (and all fellows at the table) with a sharp “hands off the transducers” (while I’m recording). Violating the routine of hemodynamic recording and the acquisition of good tracings was a supreme ‘no-no’. I respected this approach and learned a lot from being a mentee. By the time I was a senior fellow, I shared this knowledge with my younger co-fellows, becoming a mentor of sorts, but none escaped the Melba hemodynamic recording lesson. It was very meaningful to see the evolution of a mentee to mentor. I’m sure all of us have had similar experiences, some more painful than others, while we learned our trade. 

What Makes a Good Mentor?

Certain attributes make for good mentors. A mentor should be willing to share their wisdom, knowledge and skills. It is because of his or her expertise that we look to such an individual to guide us. A mentor should be a good role model and demonstrate a positive attitude toward the work, goals, and chosen career path. A skeptic, nay-sayer, or curmudgeon makes for a poor mentor. The mentor should take a personal interest in the success of those he or she teaches. He or she should have enthusiasm for the field and value the concept of life-long learning. While this sounds more formal that it need be, life-long learning is what we do when we seek to know more about our work in the cath lab and more about how to make life in the cath lab better. A good mentor will provide guidance and constructive feedback. Being able to give feedback is truly challenging and to give constructive feedback can be difficult when the mentees’ activities need focus and maybe redirection. A good mentor should be respected by others in all levels of the organization. A mentor sets and meets ongoing personal and professional goals.

What Makes a Good Mentee?

A good mentee assumes responsibility for their own learning and develops trust with the mentor, being respectful of their time. Mentees should set realistic expectations with their mentor and be prepared, perhaps with an agenda for each meeting. A mentee should be open about their needs. Remember that the relationship is a two-way street and the mentee should provide feedback to the mentor. 

For example, at the VA in Long Beach, one of our pharmacists sought me out to see if I would mentor her in becoming more of a teacher and researcher. I was impressed at the drive of this woman, having already established her career, published a few papers, and received a small grant. She wanted to know if I would help her become more academic. How could I say no? This was a very direct way of finding a mentor, and because of her clear direction and goals, we set up a regular time over the month to meet. I asked her to set some goals, timelines, and ways that she thinks she might achieve these goals. Our second and subsequent meetings focused on transforming her main research on medication dosing for spinal cord injury patients’ renal function into a large VA grant. We also discussed what background reading might be helpful, and what collaborators she might need for success. This formalized mentor/mentee relationship was helpful to both of us to develop new views of our lives.  

(NB: Obviously, all of us who are parents are already mentors to our children, to whom we likely will retain the title of perpetual mentor, and over time we should embrace the reversal of our roles, becoming their mentees. But, guess what? We get to do it all over again when grandchildren appear. Just something to think about.) 

Finally, I wanted to share one of my keys to successful communication with the FITs (Figure 2). I showed a picture of my talking dog, Riley (Figure 2) and reminded the FIT group that brevity, clarity, and wit will make the exchange of ideas fun, productive, and tolerable to those with busy schedules.  

The Bottom Line

I recommend to everyone, that when given an opportunity, they become a mentor. 

Disclosure: Dr. Kern is a consultant for Abiomed, Merit Medical, Abbott Vascular, Philips Volcano, ACIST Medical, Opsens Inc., and Heartflow Inc.