“Professional nurse coaching can be defined as a purposeful, results-oriented, relationship-centered interaction with clients for the purpose of promoting goal achievement” (Dossey).
The critical role of Nurse coaching in practice is increasingly recognized, and in 2013, the American Holistic Nurses Credentialing Corporation began a nationally recognized Nurse Coaching Certification program. Today, there are many formally recognized programs specifically related to healthcare coaching, usually associated with healthcare/well-being support of patients.
Preceptor as coach: It is critical that all of us recognize the importance of coaching skills required of a Preceptor. Have you thought of yourself as a coach? Have you taught coaching skills to your preceptors and do they get the credit they deserve for having achieved these skills? Do you have a way to evaluate the coaching expertise and needs of your preceptors? These are important questions to address.
Preceptorship is a time-limited partnership between new and veteran nurses that supports the new nurse as they move from dependent to independent levels of safe practice and integrate into the culture of the unit. In other words, it is a purposeful, results-oriented, relationship-centered interaction with the defined purpose of supporting the learning and confidence of the new nurse.
As with any coaching, the relationship is central; the relationship must cultivate a connection that is grounded in mutual respect, safety and trust.
The four pillars of a healthy supportive coaching relationship include:
Mindful presence. This involves giving full attentiveness during interactions with acceptance and non-judgmental communication. Presence is achieved through centering attention inward and intending to be attentive and connected. In a busy clinical setting, it is important to prepare for this by a simple moment of silence and naming your intention to yourself. You can further develop this capacity by practicing simple mindfulness-based centering meditation.
Authentic communication. Open honest communication that honors both people is essential. Coaching communication begins with deep listening and awareness of body language. Curious inquiry and reflective questioning encourages self-discovery by the preceptor which is such an essential aspect of deep learning. If you need to give constructive feedback, be frank, honest and direct – speaking from center.
Self-awareness. Both preceptor and preceptee are most effective when they practice self-awareness. One goal of precepting is to facilitate self-awareness and self-direction of the preceptee through self-care and self-reflection. Nurturing your own well-being is critical to your ability to remain present, listen deeply, and help the new person to successfully direct and evaluate their own learning. Thus it is important for both preceptor coach and preceptee to engage in self-reflection, silence, journaling, or meditating to develop self-awareness.
Sacred space. The preceptee should always feel that the relationship is sacred and that the space created is physically and emotionally safe with clear boundaries. In a busy clinical setting, you can achieve this sense of safety by designating a specific time and place for your goal setting and evaluation sessions. Enter this space with intention and start with a short centering exercise. In a precepting situation, not all communications can be held as confidential; thus It is important that you clarify what information if any may need to be shared and with whom (Lawson).
Transition into practice requires personal transformation as the new nurse moves through a process of change and “arrives” on the other side. The process can be uncomfortable. Preceptor coaching helps the young nurse through this journey to the rewards of discovery, wisdom and creating the story of who they are becoming.
Sources: Kreitzer & Koithan (2014). Intewgrative Nursing. New York: Oxford University Press.; Dossey & Luck, (2016) “Nurse Coaching” in Dossey & Keegan, Holistic nursing: a handbook for practice (7th). Burlington, MA, Jones and Bartlett.