As a Nurse Coach (NC), Clint promises to:
Use a holistic approach (mind, body, spirit) to partner with clients to assess their lifestyles, address their health concerns, and set short- and long-term goals. Clint will support clients in setting personalized health goals that promote a client-centered vision of health and well-being.
Promote wellness and help individuals realize optimal well-being. Clint will be responsible for developing a nurse coaching relationship with clients to assist them in actively working towards better health by providing support, encouragement, and education. As a Nurse Coach (NC), Clint will provide necessary coaching to support behavior change in an individual or group setting.
Provide opportunities to help clients clarify vision and values, assess readiness to change, determine the focus and set goals, prepare for action, and maintain behavior change.
To assist clients in making change, incorporate skills such as active listening and presence, motivational interviewing, reflection, and SMART goal-setting.
Establish a client-centered relationship that recognizes that the client is the expert in navigating their own lives and provides the structure to serve as a facilitative partner.
Case Study Example:
Joe, a 50 y/o white male, has been recently diagnosed with Type II Diabetes. Joe knows he needs to change and wishes to be healthier but lacks the discipline to get unstuck from his current health condition. Joe lives in a culture that practices an unhealthy lifestyle, including poor food choices and inactivity. Joe lives alone, is obese, and has little social interaction. Joe’s primary care doctor has made numerous attempts to help Joe change his lifestyle by providing education that includes risk factors and lifestyle recommendations with little or no compliance from Joe.
As the nurse coach following the NC process, I will help Joe identify where he is regarding health risks and help him reach a goal that he and his doctor want to achieve.
Consultation:
The consultation is when the NC and the client are introduced. The NC describes the value of nurse coaching and explains the process. The interaction invites the client to determine the value of nurse coaching in their life.
Nurse Coach Process:
Assessment: The first step in the NC process. The NC establishes a relationship with the client, which provides an opportunity to assess the client's need for change and readiness for change and determine the resources available to them to determine if they are a good fit for nurse coaching. The assessment is an ongoing and ever-evolving process during the NC relationship.
Diagnosis: The “exploration” phase is when the NC works with the client to explore possible areas for change. This is established by deeply listening to the client's concerns, reflecting and affirming, and identifying areas of progress and growth. This process sets the stage for the NC to identify the client's goals and measure their progress. NC is a dynamic process; the area that the NC focuses on initially may differ from the issues that arise later. The diagnosis phase is also an ongoing process.
Outcomes Identification: Outcomes refer to the client's goals. The NC helps clients identify the changes they wish to make and supports them in setting goals and taking action steps. The NC does not tell the client what to do but instead elicits change from within the client—their inner knowing. New goals will emerge throughout the NC process and often change as new insights and understanding arise.
Planning:
This phase goes hand in hand with setting goals because the NC strategizes the more specific action steps required to reach the goals, getting down to the “nitty-gritty.” It is like planning a road trip: knowing the destination before planning how to get there. During this phase, the NC plans all the stops that will be made along the way, defines the steps to take, and prepares for obstacles that might hold the client back.
Implementation: In this phase, the coach and client are in the action steps. The client strives toward specific goals while the NC provides support, accountability, and feedback. This phase is ongoing. The NC is responsible for remaining fully present, listening deeply, using nonjudgemental language, asking powerful questions, using direct communication, and integrating holistic communication skills.
Evaluation: In the evaluation phase, the NC and client evaluate the progress made toward reaching the goals and the effectiveness of the coaching itself. Progress is documented. Effective nurse coaching requires the NC to assess the client's progress during the coaching relationship.
Giza, Peter, Heather Lapides. “Chapter 3 The Professional Nurse Coach Role.” Transformative Nurse Coaching - Creating Wellness From The Inside Out, The Nurse Coach Collective, pp. 47–48.