Because nurse coaching is becoming an increasingly popular and important role, JCN is pleased to initiate a feature column on this topic. This first column defines professional nurse coaching, identifies places nurse coaches work, presents coaching fundamentals, and differentiates nurse coaching from other types of coaching and counseling. Subsequent columns will delve into training and skills nurse coaches obtain. Appreciative inquiry, motivational interviewing, and use of the holistic caring process will be explained along with interventions nurse coaches utilize.
A PROFESSIONAL ROLE
According to Southard et al. (2021), authors of the second edition of The Art & Science of Nurse Coaching, the professional nurse coach is "a registered nurse who integrates coaching competencies into any setting or specialty area of practice to facilitate a process of change or development that assists individuals or groups to realize their potential" (p. 7). According to Hess et al. (2013), authors of the first edition of this book, the definition of professional nurse coaching is "a skilled, purposeful, results-oriented, and structured relationship and person-centered interaction with a healthcare consumer that is provided by a baccalaureate-prepared or advanced practice registered nurse for the purpose of promoting achievement of a person's goals" (p. 7). Components of the nurse coach role are derived from Nightingale's legacy, nursing theories, nursing history, and social sciences. Holistic nursing theories and the philosophy of whole person care are foundational. Nurse coaching focuses on strengths in place of weaknesses to allow clients' inner knowing to identify barriers to create better health (Southard et al., 2021).
EMPLOYMENT SETTINGS
Where do nurse coaches work? Some work in consultation or private practice. Nurse coaches may be employed in acute care settings, assisting with nursing staff retention. Coaches may collaborate with other health professionals to enhance clients' well-being or work for insurance companies to lessen disease management costs (American Holistic Nurses Association [AHNA], 2022). Nurse coaching can be a primary role, or the skills can be used by registered nurses, advanced practice nurses, nurse educators, administrators, and nurse entrepreneurs. One survey revealed that nurse coaches had a 70.7% job satisfaction rate, and 84.8% had improved their own health (Ross et al., 2018). Boosting nurse satisfaction should improve the nursing shortage. The nurse coach professional practice model of care is in alignment with Magnet status achievement criteria and American Nurses Credentialing Center Practice Transition Accreditation Program criteria for transitioning nurses to new roles (Avino et al., 2021).
COACHING POPULARITY
This specialty role has come into its own as healthcare leaders sought ways to create more person-centered care. The need for culturally congruent care to empower individuals and populations grew while the need for value-based care arose from high healthcare costs. Positive outcomes, patient participation in care, and patient satisfaction gained increasing value (Southard et al., 2021). Nurse coaching became an ideal fit to improve person-centered healthcare, enhance quality outcomes, and coordinate care. Nurse coaches focus on well-being and health promotion, acting as change agents and leaders in this innovative role that supports the Triple/Quadruple Aim of the Institute for Healthcare Improvement (Southard et al., 2021).
According to the AHNA (2022, para 5),
Nurse coaches work with the whole person using principles and modalities that integrate body-mind-emotion-spirit-environment to promote health, wellness, and wellbeing while they facilitate their client's growth and healing. Nurse coaches are supportive and encouraging, building on the client's strengths rather than attempting to correct weaknesses. Nurse coaches provide guidance and resources to the client who is the expert on their own needs and choices.
BOARD CERTIFICATION OPPORTUNITIES
The AHNA promotes nurse coaching. The American Holistic Nurses Credentialing Corporation (AHNCC) is the only entity that administers examinations for holistic nurse coaching certification. In 2012, the AHNCC developed the nurse coach (NC-BC) board certification as well as the health and wellness nurse coach (HWNC-BC) certification. Importantly, the American Medical Association Current Procedural Terminology (CPT), effective July 1, 2022, allows board-certified nurse coaches (NC-BC) and health and wellness nurses coaches (HWNC-BC) to use Category III codes to document nurse coaching. The CPT 5-digit codes for medical services provide standardization in documenting and billing (Fontaine, 2022). This landmark ability to utilize CPT codes will increase opportunities to bill for nurse coaching services.
COACHING VERSUS COUNSELING
As nurse coaching is a new role, it is useful to differentiate it from other types of counseling, mentoring, and consulting. Coaching is considered creative partnering with clients to develop their professional and personal potential. Coaches may give advice and offer solutions or options, but the client is considered the expert. A counselor is trained to diagnose and assist clients with dysfunction and emotional issues. Counselors focus on strength-based approaches with more of a present focus (AHNA, 2022). Counselors include licensed professional counselors (LPC), licensed clinical social workers (LCSW), licensed marriage and family therapists (LMFT), licensed mental health counselors (LMHC), and psychologists (PsyD or PhD) (Buckley, 2022).
Numerous other types of counselors exist as well (Psychology School Guide, n.d.). A mentor is distinct, considered a trusted advisor or guide, and even a subject matter expert. Consultants are considered professional or technical experts who guide change with advice rather than having the answers come from the client, as in coaching (AHNA, 2022).
Many coach roles do not require a nursing degree. The popular life coach role focuses on helping clients improve careers and relationships. Life coaches assist clients to be goal-focused, identify life obstacles, and develop strategies to deal with these impediments (Cherry, 2022).
Other coaches include the health coach, who guides clients to establish sustainable lifestyle changes. A holistic health coach uses a body and mind approach to facilitate client change in areas such as spirituality, nutrition, physical fitness, and relationships. The wellness health coach works to help the client achieve a balanced lifestyle inclusive of social, physical, emotional, spiritual, intellectual, and occupational well-being. According to the AHNA (2022), health coaches are licensed or credentialed, whereas wellness coaches are not required to be licensed or certified. The box included here lists exemplars of other coaching roles (Functional Diagnostic Nutrition, 2022).
JESUS AS A COACH
Some consider Jesus a coach. Switzer (2009) gave excellent examples of Jesus as a coach, noting he asked many probing questions, a coaching style. Toh (2020) detailed how Jesus acted as a coach and gave examples of several ways Jesus used coaching principles, including developing trust with his disciples and asking questions to create insights, foster learning, and challenge others. As a rabbi and teacher, Jesus used special skills that coaches can emulate.
Selected Coaching Roles
Spiritual coach
Business coach
Leadership coach
Career coach
Sports coach
Organizational coach
Mental health coach
Personal development coach
Couples coach