Academic Progression, Baccalaureate Nursing Students, Coaching, Transition Shock



  1. Knowlton, Mary


Abstract: Regionally Increasing Baccalaureate Nurses (RIBN) is a unique articulation program in North Carolina. The fourth year of RIBN is challenging; students are enrolled as full-time university students while starting part-time employment as new graduate nurses. The aim of this descriptive pilot study was to explore the anticipated and actual stressors related to the fourth year experience and evaluate the impact of monthly coaching sessions. Key stressors identified were academic workload, professional awareness/role transition/workforce adjustment, time management, and obligations to support individuals. The monthly coaching sessions were beneficial in providing a means of debriefing and reframing life events.


Article Content

Nationally, academic institutions are exploring new educational pathways for associate degree registered nurses to obtain the baccalaureate nursing degree (BSN). The Regionally Increasing Baccalaureate Nurses (RIBN) program is a North Carolina statewide initiative led by the Foundation for Nursing Excellence in which students are dually accepted and enrolled in a community college and a university nursing program; they earn both an associate degree and BSN in four years. The RIBN program provides a seamless educational pathway that combines the resources of the community college and university to educate more students at the baccalaureate level.


The RIBN educational design culminates in a challenging fourth-year experience. Students take a higher academic course load during years 1 to 3; then, during year 4, they start working part-time as new graduate RNs while simultaneously completing full-time (12 credit hours) university-level coursework.


The aim of this study was to identify anticipated and actual stressors during the fourth year of the RIBN program and analyze the perceived impact of monthly coaching sessions as a student support initiative for the first cohort of six students. By understanding the stressors experienced by students in this educational pathway, faculty can plan interventions that will facilitate student success and program completion for future RIBN cohorts.



Coaching has shown benefits in both academic and workplace settings. Coaching is relationship based, with the coach actively listening to the coachee's concerns; asking relevant, thought-provoking questions; and providing feedback that results in empowerment for the coachee to reach desired goals (Berriman, 2007; Serio, 2014; Taylor & Boyatzis, 2012). In the educational setting, coaching was shown to improve retention and completion rates in a study of more than 13,000 college students (Bettinger & Baker, 2014). In a mixed-methods study of 24 single mothers in the second and third year of college, coaching increased self-efficacy, well-being, coping capabilities, and feelings of resiliency (Bar & St. Rosh-Ha'Ayin, 2014). The premise is that coaching helps the individual identify and re-frame stressors to minimize the negative emotions that arise from stressful situations. Coaching encourages goal-oriented management of stressors using a supportive relationship (Berriman, 2007).


Knowles' theory of andragogy guides this study by supporting the foundational constructs of coaching - that of person-centered attention that addresses the immediate needs of the individual (Cox, 2015). Coaching nurtures self-direction and provides an environment that values past experiences while directing the individual toward self-selected goals at the time they are needed.



Written consent was obtained from participants following university institutional review board approval. The participants were given investigator-created written surveys at the beginning and end of the academic year with questions about anticipated/actual stressors, assessment of stress levels, and the anticipated/actual benefits of monthly coaching sessions. (See Supplemental Digital Content, A short group interview session followed survey completion to explore and clarify answers to questions on the written survey. This design allowed documentation of events as they occurred, supporting this descriptive study approach (Polit & Beck, 2012).


Eight monthly coaching sessions, conducted by a social work graduate student, were held during the course of the academic year. Face-to-face group sessions took place over the lunch hour on days that classes were scheduled on the university campus. Some coaching sessions were structured, addressing topics related to self-care, stress management, and empowerment; others were dictated by the needs of the participants as stressful situations arose.


A content analysis approach was used to analyze the fully transcribed written survey and interview responses. Two reviewers independently evaluated the transcripts and sorted all remarks into emerging categories. Categories were compared for congruency, followed by discussion of similarities and differences and further refinement until agreement was reached.



Participants included all six students in the first cohort of this educational model. Five of the six individuals were women; ages ranged from 22 to 44 years. Using a 0 to 10 scale, students reported an average stress level of 5.5 (range 3 to 8) at the beginning of the fourth year and anticipated their stress would be 7.25 (range 6 to 8) during the academic year. At the end of the year, they reported their average stress over the year to be 6.5 (range 5 to 8).


The four categories that emerged as stressors were 1) academic workload, 2) professional awareness/role transition/workforce adjustment, 3) time management, and 4) obligations to family/friends. Stress was associated with higher educational expectations and academic workload requirements. Most participants discussed aspects of professional role transition that were challenging. One student remarked: "You hit that shell shock of 'why do I want to be a nurse?' and going through that and being in school full-time. It is very overwhelming. You just get down."


Time management and organizing complex schedules were a continuous challenge throughout the fourth year. The struggle of working night shifts and weekends also had a significant impact, affecting relationships with friends and family. A participant said: "Switching from night to day schedules left me foggy much of the time and often sleep deprived during the day shift clinicals. This stressor bled into my ability to focus on assignments and course work. More time and energy was required to complete academic work than normal, which took away time from my family life." Another participant stated: "[horizontal ellipsis]that put me working every single weekend and for me that was like misery. Never seeing friends, rarely seeing family. That was difficult."


Participants found the coaching sessions beneficial. A student participant said: "I was able to vent in a 'safe zone.' The coach gave us ideas and helped us come up with strategies to cope with the stress. Sometimes I just felt a hundred times better getting everything out that was stressing me out." Another participant shared: "[The coach] was really good about asking questions. Then hearing the stories from everyone else. It just made you feel better. He asked provoking questions like 'Why did it make you feel that way?' or 'Is this what made you feel this way?' He always had a glass half full thing, which helped you get through the next shift."


Limitations to this study include the sample size and study design. Individual interviews may have elicited richer responses with more explanation of their experiences.



RIBN students reported stress related to role assimilation as a professional nurse as well as stress related to enrollment in a full-time BSN program. The work environment changed for these students from a part-time supplementary job to career-focused employment with obligations and responsibilities. Four participants worked nights, which affected their sleep, social activities, and financial status.


Several participants questioned nursing as a career choice, which is consistent with "transition shock" and common among new graduate nurses (Duchscher, 2009). Having the ability to spend time with family and friends was stress-relieving for participants; being unable to be with friends and family added to their stress. Participants were overwhelmed by the time demands placed on them between employment schedules and academic assignments; many remarked that night shift schedules posed another challenge.


Coaching sessions gave participants the ability to discuss issues with an unbiased person and provided opportunities for peer support. Participants shared that it was nice knowing others were going through the same struggles, something they might not have known without the structured group sessions with the coach. The coach helped them reframe problems by asking thought-provoking questions (Fazel, 2013; Serio, 2014), a practice consistent with the tenets of adult learning theory (Cox, 2015).


As academic institutions seek out pathways to help students achieve higher educational goals in a complex world with competing obligations, educators must be cognizant of the student experience. Recommendations based on the results of this study include finding ways to mitigate stressors identified by students. Coaching support, using graduate students to assist students with stress management, while incorporating education about transition shock could be an effective approach. As this was a pilot descriptive study, future research is needed to explore these and other interventions that can facilitate student success and program completion in highly demanding educational programs.




Bar S. G., & St. Rosh-Ha'Ayin D. (2014). How personal systems coaching increases self-efficacy and well-being for Israeli single mothers. International Journal of Evidence Based Coaching and Mentoring, 12(2), 59-73. [Context Link]


Berriman J. (2007). Can coaching combat stress at work? Occupational Health, 59(1), 27-29. [Context Link]


Bettinger E. P., & Baker R. B. (2014). The effects of student coaching: An evaluation of a randomized experiment in student advising. Educational Evaluation and Policy Analysis, 36(1), 3-19. [Context Link]


Cox E. (2015), Coaching and Adult Learning: Theory and Practice. New Directions for Adult and Continuing Education, (148), 27-38. doi:10.1002/ace.20149 [Context Link]


Duchscher J. E. (2009). Transition shock: The initial stage of role adaptation for newly graduated registered nurses. Journal of Advanced Nursing, 65(5), 1103-1113. doi:10.1111/j.1365-2648.2008.04898 [Context Link]


Fazel P. (2013). Teacher-coach-student coaching model: A vehicle to improve the efficiency of adult institution. Procedia: Social and Behavior Sciences, 97, 284-391. [Context Link]


Polit D. F., & Beck C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice. Philadelphia, PA: Lippincott Williams & Wilkins. [Context Link]


Serio I. J. (2014). Using coaching to create empowered nursing leadership to change lives. Journal of Continuing Education in Nursing, 45(1), 12-13. [Context Link]


Taylor S. N., & Boyatzis R. E. (2012). Looking at stress and learning: Peer coaching with compassion as a possible remedy. Transformative Dialogues: Teaching and Learning Journal, 6(1), 1-14. [Context Link]