coaching method in NURSING by ICN part 1

Part one:
AboUT CoACHinG



Most people don’t need advice. They just need support and discipline in doing what they already know works.

Marianne Williamson

What is Coaching?

Coaching is a collaborative relationship undertaken between a coach and a willing individual, the client. It is time-limited and focused and uses conversations to help clients achieve their goals. It demands skill on the part of the coach in facilitating mean- ingful conversations and letting the client “lead.” Learning starts when the coaching conversation begins and new actions and new practices are always the final stage of a successful coaching conversation.

Coaching is not giving advice, not teaching, and not directing — it is a collaboration in which the coach acts like a midwife: sup- porting, encouraging and helping the client through the experience while acknowledg- ing the client as the expert and the person “making it happen” (Donner & Wheeler
2005). To facilitate these coaching conversa- tions, a coach must have the ability to listen, discuss and question; to clarify core values, beliefs and sense of purpose; to identify gaps between a client’s vision and reality; and to encourage, motivate and instill confidence.

Coaching is a key competency for lead- ers, managers, educators, researchers and practitioners. Coaching helps nurses engage in conversations and relationships that are directed at enhancing profession- al development, career commitment and practice. Individuals act as coaches or are coached to advance their career oppor- tunities and practice. They may also use coaching to help them increase enjoyment of and satisfaction with their current roles.

Sometimes the terms coaching and mentor- ing are used interchangeably, but coaching is

not the same as mentoring. Both are inde- pendent but related by the communication strategies that are often used to promote professional development and facilitate re- tention. Understanding their differences will help individuals and organisations ensure that they choose the right strategy for the right purpose. Thus, although coaching and mentoring are aligned, they are independent concepts and strategies. What unites them is that both are founded upon mutual trust, respect and excellent communication skills. While they are not interchangeable, a nurse may have or be both a coach and a mentor, or an organisation may employ both strategies.

To help you better differentiate between the two terms, remember:
• Coaching is a collaborative relationship, undertaken between a skilled facilitator (coach) and a willing individual (client). It is time limited and focused and uses conversation to help clients (individuals or groups) achieve their goals.

• Mentoring is a longer term relationship in which someone with more experience and wisdom (mentor) supports and en- courages another (mentee/protégé) as that individual grows and develops pro- fessionally and personally. While you may use coaching skills as a mentor, you do not need to be a mentor to be a coach.

Trends in Coaching

There are some trends, both in method and application, that are emerging in coaching that have possibilities for nurses and nurs- ing. Individual, group and team coaching are relatively new to nursing. To capitalize on this potential, we need a variety of methods and designs for programmes that prepare coaches, along with rigorous evaluation processes.

Coaching, whether provided in person, by phone or over the Internet, has traditionally been seen as a one-on-one activity. Group



Part one: about coaching • 9





coaching is a newer method that is gaining momentum. It brings individuals together in a group to present their individual issues and work together with a facilitator, the coach, to develop individual plans to resolve those is- sues. For example, new nurse recruits may meet as a group with a coach and discuss their individual challenges in navigating and adapting to their new workplace. In team coaching, the team, rather than the individ- ual, is the client. The issue to be discussed and resolved is the team’s issue, not the indi- vidual’s. The same process applies as with a group; however, the team develops the plan.

In addition to trends in methods of coach- ing, there are also untapped opportunities with regard to different application areas for coaching. Four areas for future development in nursing are peer, health and interprofes- sional coaching and succession planning. Let’s take a closer look at each.

• Peer Coaching

Peer coaching can be used to help nurses advance their careers and increase their job satisfaction. Organisations continue to look for ways to retain senior nurses and provide opportunities for junior nurses and to offer practical help and support to all nurses. Pro- viding opportunities for a nurse coach to as- sist a colleague working on a clinical or pro- fessional issue is one way an employer can recognize the expertise and commitment of that nurse and provide support to other nurs- es. Peer coaching can also be used to en- able staff to have conversations about their careers and career possibilities. These kinds of conversations help contribute to a work environment that is career-sensitive and sup- ports the career aspirations of employees.

New recruits or beginning practitioners are valuable yet vulnerable resources within the organisation and as such require special at- tention. Peer coaching can enhance retention by providing new employees with the skills and savvy they need to navigate through the organisation and negotiate successfully with their colleagues. Peer coaching can be deliv- ered in an individual or group format to sup- port these new recruits.


10 • Part one: about coaching

• Health Coaching

Health coaching can be a useful strategy for nurses who want to help patients achieve their goals. Patients increasingly want to take charge of their own health and their own health futures, and health coaching enables nurses to use a focused form of communi- cation in delivering patient-centred care. Presently, there are very limited examples of health coaching in the literature. Howev- er, the approach seems a natural fit for the nurse-client relationship where the clients articulate their needs and the nurse-coach asks questions that will help move the cli- ent forward. Coaching clients and patients is another application that holds promise for expanding nursing practice.

• Interprofessional Coaching

There is an increasing emphasis on advanc- ing interprofessional education and practice. The ultimate goal is to have nurses, physi- cians and other health care professionals working together in teams to provide com- prehensive care. Working together effec- tively requires more than knowledge about teams and team work; it requires readiness for an interprofessional team to be created and sustained. A coach can facilitate the development of the team as members work on their relationships and also provide a fo- rum for their ongoing reflection and action. Because nurses recognize the benefits of cooperation, they can take a leadership role in mobilizing the interprofessional team and ensuring the team achieves its objectives.

• Succession Planning

Finally, coaching can be used to support suc- cession planning programmes. Demograph- ics, changing definitions of work-life balance, and the impending retirement of significant numbers of leaders over the next five years are major challenges for nursing around the globe. Leadership succession planning pro- grammes are becoming a key component of many organisations’ long-term human resources strategies. Individual and group coaching, mentorship and internship/job shar- ing are generally built into these programmes.





Coaching is used to ascertain individual ca- reer aspirations, clarify learning and personal development goals, and support new leaders in transition.

The Client

The only attributes required to be a client, i.e. engaging in a coaching relationship, is a willingness to question who you are and what you are doing and an openness to exploring possibilities for your future that almost always mean change. In a coaching relationship, it is the client who asks the coach to show possi- bilities the client cannot see, that are beyond the horizon of possibilities of who the client is right now, and it is the client who chooses the focus of the coaching conversation.

Client requests may be for, but are not lim- ited to, assistance with such issues as performance, career or lifestyle. Clients need to come willingly to the coaching conversa- tion, and their self-identified need for change is the catalyst for moving forward. As in any change process, the client has to identify his or her intentions before behaviour modifica- tion will occur.

When Might You Need a Coach?
There are times in our professional lives when we are not sure what our next step should be. That’s when we can benefit from a coaching conversation. We know what we want to ac- complish, but our self-limiting perceptions get in the way of realizing our personal vi- sion. These inner voices plant the seeds of self-doubt and fear, and whisper “you can’t do that” or “what if.” It takes courage to say, “I don’t know what to do next,” but once you acknowledge it, the possibilities for moving forward are limitless.

Most of us know what we want to do and be
— all we need is a safe place and support to achieve our goals. Knowing when to seek the services of a coach is as important as knowing how to select one. A coach can help you face your fears, stretch your capacity and move forward.

The following are a list of situations for which the services of a coach might be helpful. Can

you see yourself in one of these situations? Check the one(s) that apply to your present state.

•Are you at the very beginning of your career and need help in navigating the work environment, clarifying your priori- ties and learning how to adapt to new situations?

•Are you a mid-career nurse looking for work-life balance who needs help decid- ing whether to take on new responsibili- ties and/or shed old ones?

•Are you a late-career nurse beginning to consider how to reduce your workload so it is more manageable, or are you contem- plating how to prepare for retirement?

•Are you experiencing career/life stress, i.e. you have a number of competing interests/demands/priorities and need help sorting them out in order to move forward?

•Are you thinking about your career in an organised and systematic way but feel stuck, uncertain of your next steps and/ or have some career questions that need exploring?

•Are you a nurse leader who requires support in developing and achieving your role-specific professional goals?

If you answered “yes” to any one of these situations, consider using the services of a coach.

Articulating Your Needs
Having a clear purpose is critical to all phases of the coaching relationship and also guides in the evaluation of the coaching relationship on an ongoing basis. Your purpose needs to be accompanied by a strong determination to produce a desired result. Your determina- tion is what will help ensure your success in achieving your goals.

Two questions that will help you develop a clearly articulated purpose for engaging a coach are:


Part one: about coaching • 11





1. What do I need/want? For example, “I need help with making a career move.”
2. What is it that has made me decide that a using a coach can help me with what I need/want? For example, “I need to discover what is getting in the way of me moving forward and accomplishing my career goals and why I can’t do this by myself.”

Finding a Coach
Now that you have a purpose for a coach- ing conversation, you will need to find a coach. Since coaching is a relationship built on mutual trust, the coach must be some- one whose expertise and method you value and trust. Some health care organisations include coaching services as part of their human resources offerings. Professional or- ganisations may have coaches available for members, and some community organisa- tions have coaches. Of course, many self- employed coaches also provide coaching on a fee for service basis and also may be on a centralized roster, such as with the Interna- tional Coach Federation (ICF) as part of their Coach Referral Service.

Just as in any other relationships, the fit be- tween you and the coach is critical. So, use your network, get some referrals, and then search out a few potential coaches and learn as much as you can about them before you make a decision. Be an informed consumer. Here are some questions to consider asking a potential coach:

1. What are your qualifications, experi- ence and expertise?
2. Do you use a formal coaching agree- ment with your clients? May I see a sample?
3. Do you incorporate a feedback and evaluation process into your practice?
4. Can you provide references?
5. What are your fees?

As with any purchased service, you need to know the fee range and what you are will- ing to pay. Remember to inquire about the services of your professional association or a nonprofit agency such as the YMCA/YWCA;

they may provide a similar service and at a lower cost. Many coaches will provide a short complimentary conversation (usually about
20–30 minutes) to assist both you and the coach to determine whether the “fit” is there, i.e. whether the two of you have the poten- tial for a successful relationship. Once you begin the coaching relationship, the length of the conversations, the number of times you need to meet or talk and the outcomes are the product of your collaboration with the coach and often form part of a written or ver- bal coaching agreement (see Part Two).

Dealing With Difficult Coaching Situations Coaching is something you ask for to help you develop and implement your vision and goals. But once you begin the coaching rela- tionship, situations may arise that make you wonder if this is the right coach for you.

Example: You and your coach have had three coaching conversations. You are getting the feeling that the coach is someone who likes to move things along at a pace that is faster than your way of approaching problems and situations, which tends to be slower and more methodical. You also acknowledge when this has occurred in other relationships, you have tended not to say anything and felt frustrated later. So what will you do?

1. You should discuss the situation with the coach and explore the options for improving the relationship. Ideally, you and the coach established a coaching agreement that in- cluded a conversation about how you both would handle the situation if the “fit” between the two of you was no longer there. Now is the time to refer back to that agreement.

2. If you did not have that discussion when you began the relationship, then you will need to initiate it when you first feel uncom- fortable. You could begin the discussion by saying: “I want to talk to you about how I am feeling. I am concerned that you are expect- ing me to move toward my goals more quick- ly than I am comfortable. Can we talk about this and find a way to go forward?”

3. If you didn’t have an agreement and you feel the coach is not sensitive to your con-



12 • Part one: about coaching





cerns even after having a discussion, you should consider ending the relationship and seeking another coach. You can broach the subject by saying: “I’ve been doing a lot of thinking about our coaching relationship and the difference in our styles and I real- ize I am not comfortable with the progress I

2. What are four coaching opportunities for future development in health care?

am making. I would like to end our relation-
ship and move forward in another direction.” Remember, you are in charge of your own

experience.

The Coach

There are different stages in our careers when we look for enrichment opportunities. For many nurses, informal coaching roles form part of their day-to-day activities, whether talking with colleagues about their career vi- sions or with clients about their visions for

3. How do I determine when I might need a
coach?







4. I would find a coach by:

their health. Having a coaching conversation
with either a colleague or client is an oppor- tunity to listen to what may be stopping them from realizing their visions. If coaching is of interest to you, consider participating in a

coach training programme that will not only increase your skills but also broaden your own career possibilities. You may also want to consider the long-term value of participat- ing in an accredited coaching programme

5. One strategy to dealing with a difficult
coaching situation would be:

that would provide you with a recognized credential (see Part Four). What is important is that, if you become a coach, you should be
as well prepared as possible.


Now that you understand the fundamentals of coaching and how it can be used, it is time for you to learn more about the coaching re- lationship itself, i.e. the “how to” of coaching.

Exercise ─ “About Coaching”

6. Describe how being a coach can be an
enriching career opportunity.

Before moving on to Part Two, take a few
moments to review and complete these written exercises:


1. Coaching and mentoring are not the same thing. How are they different?
___________________________
___________________________
___________________________
___________________________

Check your answers with those in the back
of this workbook. How did you do? Do you need to go back and reread Part One?

Are you are ready to move on to Part Two, The Coaching Conversation?





Part one: about coaching • 13