Where Do Nurse Coaches Fit in Your Clinic?

I have always had a passion for helping clients achieve their best health and well-being, and that is why I am becoming a Board-Certified Nurse Coach (NC-BC).

As the healthcare system is transitioning from coping with chronic disease management to focusing more on preventative medicine, there is a lot of attention being given to the leadership of nurses. Nurse Coaching values holism and takes a whole body, mind, emotional, and spiritual approach towards promoting health and wellbeing in all societies.

Who is a Nurse Coach and What Do They Do?

The Nurse Coach can range from a registered nurse with an associate degree and 4 years of full-time experience to an Advanced Practice Registered Nurse. The RN brings her/his expertise as a nurse along with the training obtained through an accredited coaching program then becomes Board-Certified. I like to call it an enhancement of traditional nursing. Nurse Coaches (NC to be used interchangeably) are non-judgmental, great listeners, health partners, and advocators. They promote the best quality of life for the individual by facilitating change. A Nurse Coach (NC) works with clients individually or in groups and is trained to use motivational strategies and communication techniques to partner with the client and create self-developed goals based on her/his desire for change. The NCs hold clients accountable by following up with the individuals according to the plan. Clients are usually very receptive to this as it tends to motivate them.

Nurse Coaches (NCs) do NOT "fix" a problem or weakness. With the permission of the client, they may give recommendations, educate, and provide resources to help pave a road to better health and wellbeing. Ultimately, the client creates SMART goals with the guidance of the NC. As noted by the AHNCC, SMART goals are Specific, Measurable, Attainable, Realistic, and can be accomplished in a certain time frame.

According to Dossey, Hess, et. al, 2013¹, "Nurse coaching is a skilled, purposeful, results-oriented and structured client interaction that is provided by Registered Nurses for the purpose of promoting the achievement of client goals.”

What a Nurse Coach Means for a Busy Clinic

The last couple of years has taken a toll on practices across the United States and throughout the world. Staffing shortages related to burn-out, availability of work-from-positions, and career abandonment have created a deficit in clinics and other facilities. The Nurse Coach is trained to help improve staff retention and provide guidance in achieving better health and overall wellness. She/he might coach a peer or peer group that is struggling with burn-out or perhaps want to work towards a healthier lifestyle.

Clients also benefit greatly from having a nurse coach in the clinic where they receive care. How many times was the clinic where you work so busy that the client received a handout about their new diagnosis of diabetes, informed labs were ordered, and a new prescription was called into their pharmacy? It doesn't seem like they had any say in what was going on. This is what a nurse coach is born to do. She/he will sit down with the client and provide education about the diagnosis and go over the medication benefits and potential side effects. The NC will listen to the client's concerns and guide the client to develop SMART goals to ultimately improve overall health and well-being. The client is always treated as the expert in her/his own health. It's no secret that people tend to do better when they have a trusted person in their corner providing the encouragement to keep going.

Advocate to Employ Nurse Coaches

A Nurse Coach just makes sense in a busy clinic. The following is just a small list of reasons to advocate for coaches in today's healthcare:

• The internet is flooded with information that promises to "change your life overnight" and people are buying into the social media craze. This type of instant gratification is costing clients big money. Who knows if they are getting accurate qualified information! That is why it is so important for healthcare personnel to get involved and provide coaching under safe and proven methods. Nurse Coaches are great for this position.
• Nurse Coaches save the Clinician's time. A Provider has approximately 15 minutes per visit with each client to address multiple topics and make a plan-of-care. That includes reviewing the chart either before or during the appointment. Clients often feel "herded through like cattle", confused and frustrated because they did not understand what their Provider told them, or just not feeling heard at all. The Provider might feel the pressure of time constraints, not being able to provide the quality of care they envisioned early on in their career or poor work-life balance due to working long hours to catch up on tasks. An NC bridges the gap between the clinician and the client. She/he can work with clients to ensure they understand the plan of care and agree or disagree. The NC can help clients become active participants in their care through gained knowledge of skills and confidence so they may reach their self-identified goals. This not only saves the Provider time, but also improves client outcomes with an anticipated reduction in recurring hospitalizations.
• NCs provide continuity by connecting with clients in the office and between visits. This is especially helpful when a Clinician is on vacation or works part-time.
• Adding a Nurse Coach to the practice can increase the number of clients the Provider can see each day by delegating teaching and coaching tasks, thus saving time, and increasing revenue. This is a great benefit for those who are in private practice.
• And soon Nurse Coaching may be billable. The AMA recently approved a Category III CPT code, (a temporary code used for data collection), to go into effect in July 2022. This will allow the RN, NC-BC coaching outcomes to be tracked over an approximate 5-year period with a goal of obtaining a billable Category I CPT code.

Are You Interested in Becoming a Nurse Coach in Your Clinic?

As a nurse, you already possess many of the skills needed and you have already coached in some way. Depending on where you work, you may have provided diabetic education and asked the client how confident they feel giving insulin injections or asked them how they feel about this new diagnosis.

If you are interested in becoming a Nurse Coach in your clinic, put some feelers out. Is there interest at your current job? Is it financially feasible for more staff if needed or will you maintain RN duties in addition to coaching? Does your place of employment offer tuition reimbursement?

Look for accredited programs. You are not required to be certified to practice as a coach, but it will be an asset in your career as a Nurse Coach.

 Why Get Certified?

• Provides validation of competence and shows you are an expert in the field of coaching
• You receive recognition of your certification and can add NC-BC to your credentials
• With the paradigm shift in healthcare, an NC-BC credential supports career and professional growth
• Clients and Providers alike trust the credibility of nurses

Conclusion

The Nurse Coach is a valued asset for any clinic or facility. Clients, Staff, and Providers all benefit from the leadership of the NC. Clients optimize health and wellness through the guidance and accountability of the NC. Staff has someone on their team to coach when needed. Providers save time, increase revenue, and improve continuity with the help of a Nurse Coach. Although this is not everything an NC does, every clinic will have different needs based on the type of practice.

References/Resources:

¹Professional Nurse Coaching: Advances in National and Global Healthcare Transformation

American Holistic Nurses Association (ahna.org): Nurse Coaching

American Holistic Nurses Credentialing Corporation (ahncc.org): Nurse Coach

Health Coaching for Patients With Chronic Illness