A Research Paper created by Carmen Philippe-Welton
(Career and Spirituality Life Coaching, CANADA)
In Nursing, it is a common career trajectory to work as a clinician for several years and develop expertise before moving into other areas of practice, be it within clinical practice as Clinical Nurse Specialist, Faculty Educator, administration as department or committee Chair, or engage in Research. This paper will highlight the value of Coaching to assist Registered Nurses (RN; nurses) with their career aspirations and leadership transformations.
In Canada, a nurse’s role is to prevent illness, mitigate illness and assist people in a meaningful death. As a client directed caring practice, nurses contribute to the health of the nation within a highly regulated and public health care system. The College of Registered Nurses of British Columbia states, “Nursing combines science with art. The science comes from knowledge gained through education and ongoing professional development. The art is developed through experience and the provision of nursing services to meet the various needs of clients and their families. . . nurses commit to keeping their knowledge and skills current.
As lifelong learners, nurses ‘continually assess and improve their practice’ through specialized study. It is vital for nurses to continuously deepen their professional knowledge and practices to maintain an ever satisfying career. Usually, nurses progress in their careers through 1:1 mentoring and ongoing professional competency development courses. According to Donner & Wheeler, 2009, ‘Mentoring is a longer term relationship in which someone with more experience and wisdom (mentor) supports and encourages another (mentee/protégé) as that individual grows and develops professionally and personally.’ (p.9). While a discussion of mentoring is beyond the scope of this paper, it is important to note that Coaching may be used concurrently.
Nurses utilize many resources throughout their careers. They may draw from legal and ethical resources, scholarship specialty areas, professional development resources, qualitative research paradigms, including the use of the visual arts. Coaching benefits nurses as they journey through their careers since it is congruent with the principles of Adult Learning Theory, Expressive Visual Arts and Transformative Learning Theory through non-punitive empowering processes unlike National or Provincial Regulatory Body Competency and Licensure requirements.
According to the International Coaching Federation and the International Nursing Association, coaching is defined as “an ongoing partnership that helps clients produce fulfilling results in their personal and professional lives.” (Donner, G., Wheeler, M.M., 2009, p. 16) and represents a ‘… collaborative relationship undertaken between a coach and a willing individual, the client… time-limited and focused and uses conversations to help clients achieve their goals. Learning starts when the coaching conversation begins and new actions and new practices are always the final stage of a successful coaching conversation . . . [is] a key competency for leaders, managers, educators, researchers and practitioners . . . directed at enhancing professional development, career commitment and practice . . . to help them increase enjoyment of and satisfaction with their current roles. (Donner, G., Wheeler, M.M., 2009, p. 9)
Coaching is future focused. While positive feelings/emotions may be a natural outcome of coaching, the primary focus is on creating actionable strategies for achieving specific goals in one’s work or personal life. The emphases in a coaching relationship are on action, accountability, and follow through.
Within nursing, coaching programs have been instituted (a) to smooth the transition from an educational to an employment setting (Nelson et al. 2004: Grealish 2000; Hom 2003) and maintain retention and succession planning; (b) to improve manager interactions with staff (Lachman 2000); (c) for educator development (Eisen 2001; Waddell 2005); and (d) to provide executive coaching for nursing leaders (Savage 2001). Using a “unit coach” to assist new nurses in the post- orientation period is a strategy that affirms and continues the development of professional competencies such as critical thinking (Nelson et al. 2004) … Executive coaching for nursing leaders is usually provided by external professional coaches who facilitate the development of specific skills required for success in the leadership role (Donner, G., Wheeler, M.M., 2009, p. 27). Coaching then benefits recently graduated and advance practice nurses throughout their career.
Coaching supports leadership transition and succession planning in an era when there is a nursing shortage. Thousands of RNs will be retiring within the next 10 years with too few nurses to replace them. A report released by the ‘Canadian Nurses Association, Tested Solutions for Eliminating Canada’s Registered Nurse Shortage’ indicated that ‘…the shortage of registered nurses who provide direct, clinical care to Canadians will climb from the equivalent of nearly 11,000 full-time nurses in 2007 to almost 60,000 Full Time Employees in 2022. Solutions for eliminating the shortage focus on: retention; increased productivity through elimination of non-nursing tasks, and reducing levels of absenteeism, increasing enrollment and reducing attrition rates in entry-to-practice programs.
Coaching can also function as a valuable enrichment opportunity for nurses in their current roles or as an introduction to a new career path within nursing. (Douglas Noel Adams, p 31 as cited in (Donner, G., Wheeler, M.M., 2009, p. 31). RNs invited to begin a more complex nurse position in administration, how to manage the different and increased workload and maintain a healthy life-work balance. Coaching effectively in every area of nursing practice be it Administration, Clinical Practice, Teaching and Research. For example, nursing careers often progress over many years from clinician to teaching to program designer and evaluator, to teacher, mentor and coach. Such changes contribute to retention of experienced nurses in the profession. The development of coaching skills presents tremendous opportunity for nurses to meet the challenges of retention, professional development and quality care. (Donner, G., Wheeler, M.M., 2009, p. 31)
Coaches facilitate the growth and development of the client’s self-efficacy (an estimate of the client’s own capacity to perform a certain task) by supporting, encouraging and challenging the client to expand their ability to achieve their goal(s). The outcome of the work the coach and client do together is action and learning. Action moves the client forward and learning creates new ways of being. (Donner, G., Wheeler, M.M., 2009, 18).
Jack Mezirow (1996) defines transformative learning ‘as the process of using prior interpretation to construe a new or revised interpretation of the meaning of one’s experiences in order to guide future action (International Encyclopedia of Adult Education. English, L. London: Palgrave Macmillan, p. 62). According to Kolb’s Experiential Learning Theory (1984), “learning is the process whereby knowledge is created through the transformation of experience. Knowledge results from the combination of grasping experience and transforming it” (p. 41). These views support the coaching principle of changing one’s perspectives in order to actively move forward toward meeting one’s goals.
‘Coaching is an interactive, interpersonal process that supports continuing personal, professional and career development through the acquisition of appropriate skills, actions and abilities that are crucial to professional practice. It offers many benefits to both coaches and those being coached …including improved confidence and autonomy in one’s role, improved job satisfaction and productivity, and the development of new knowledge and skills’ (Donner, G., Wheeler, M.M., International Council of Nurses and Sigma Theta Tau International, 2009, p. 8).
Nurses encounter complex practice situations that hold both ethical and legal dimensions that present or block career progression and satisfaction. As a result, nurses may lose their effectiveness over time. This prevents nurses from being fully present and engaged with their individual clients, client families, Communities of Practice, their students, their peers, and ultimately compromise safety and generates extreme spiritual distress. Coaching influences professional lives of nurses and results in less spiritual distress for them, thus enriching their personal lives and society as a whole.
Nurses experience both the joys and sadness associated with health successes and losses. ‘Coaching recognizes that developing ‘gratitude’ leverages the amount of happiness that clients gain from their achievement of goals’. Nurses are unhappy in jobs that don’t suit their values and more happy and content when working in areas that do (Coaching Influences, ICA, 2012) When happy, nurse clients can live out their life of grace and gratitude. Achieving this is no less than transformative.
Nurses are stressed with trying to balance personal and professional responsibilities and achieve life – work balance. Coaches can listen to nurses, offer their caring presence, pose powerful questions and affirm their hopes and plans for a different future. One key approach related to Transformative Learning used to reframe perspectives is through Visual Arts-based power tools.
Engaging the Visual Arts, such as a text of photographic journal is one coaching method that keeps the process within the coaching realm and out of counseling and mentoring spheres and closely aligned with ICF coaching definition and Standards of Practice. This integration matters because non-linear or technical approaches to change and transformation align with infinitely variable creative discovery processes and applicable in any work setting regardless of client goals of career stage because they do not proceed prescriptively or punitively as national or Provincial Regulatory bodies do when a nurse’s competency is deemed inadequate to protect public safety.
Coaching offers a highly successful way to support nurses’ multiple career changes. It embraces great creative and participatory career planning as an alternative to the traditional, instrumental and technical paradigms of Continuing Competencies associated with Nursing Regulatory bodies. Drawing from Adult and Transformative Learning Theory and using the Visual Arts frees nurses to re-envision, self-determine and enliven their own professional lives and experiences by releasing energies that can then be used to fully engage clients. As nurses’ quality of work life improves through coaching, so too does the health of the nation.
References:
Mezirow, J. (1996). Contemporary paradigms of learning. Adult Education Quarterly, 46, 158-172). In International Encyclopedia of Adult Education. English, L. London: Palgrave Macmillan, p. 62).
Canadian Federation of Nurses Union. Quick Facts on the Canadian Nursing Landscape. Retrieved October 23, 2013
Canadian Nurses Association (2008). Code of ethics for Registered Nurses (Centennial Ed.). Ottawa: Author. Retrieved October 24, 2013
Coaching Influences. International Coach Academy (2012). Retrieved October 23, 2013
Coaching in Nursing: An Introduction Course. G. Donner & M. M. Wheeler. (2009). Publisher: International Council of Nurses/The Honor Society of Nursing, Sigma Theta Tau International. Retrieved October 24, 2013
Coaching World. 2012 ICF Global Coaching Study · Executive Summary. (2012). Retrieved October 23, 2013
College of Registered Nurses of British Columbia, Vancouver: Author. What Nurses Do Retrieved August 9, 2013
Quality Assurance & Continuing Competence
Health Professions Act: Nurses (Registered) and Nurse Practitioners Regulation Copyright (c) Queen's Printer, Victoria, British Columbia, Canada. Health Professions Act [RSBC 1996] CHAPTER 183 Health Professions Act (HPA) Retrieved August 9, 2013