To help people get “unstuck” in their search for a life of health and balance, many healthcare practitioners, including nurses, are seeking out education to become health and wellness coaches. As a Certified Wellness Coach myself for the last 3 years, I’ve found it rewarding and energizing. I feel that I am using my nursing skills of assessment and teaching more than I ever have and am able to help people get past the barriers that keep them stuck and unable to achieve the kind of life they need and deserve. As a coach, I assess the client’s readiness for change and where their life is out of balance. I use motivational interviewing by asking questions that will help the client look at their current state of wellness and the consequences to their life of their present state of being. I hold them accountable, but remain nonjudgmental, use intuitive listening, and guide them through the process of change. Together, we work as a team as the client moves toward the future, achieves their personal best and realizes goals with long lasting results.
There are a number of programs popping up around the country designed to train and prepare health coaches, one of which is found at the Center for Spirituality and Healing at the University of Minnesota. Karen L. Lawson, MD, is Program Director for the Health Coaching track, Certificate in Complementary Therapies and Healing Practices. I interviewed Karen about her program to learn more about the opportunities available for nurses as health coaches in today’s environment.
What is the role of the health coach?
Karen stated that the health coach works on a face-to-face basis or on the phone. The time together is about deep and authentic listening, self empowerment and creating a safe space so people can manifest change. The initial evaluation is done in about 30-60 minutes and the frequency of follow-up sessions is determined by client needs, not the coach agenda. The health coach may talk to the client weekly, or they may only talk monthly as the client progresses in achieving goals. Health coaching is very mind, body and spirit oriented. Coaches are not spiritual directors, nutritionists, or therapists, but need to have a knowledge of resources, know their limits and boundaries, and coordinate resources. In other words, the process must be very client powered.
Would health coaching and holistic nursing be a “good fit”?
Absolutely! The competencies utilized by a health coach include:
- Assessment
- Asking questions to call the client to action
- Being non-judgmental
- Listening
- Clarifying to understand what the client says
- Using your intuition
- Holding the client accountable
- Being present
- Helping the client bring up emotions that are blocking behavior and
encouraging emotions that help move the client past the barriers
Thus, for holistic nurses, health coaching would be a natural addition to their work. The approach and skills used by a health coach are very mind, body, and spirit oriented, and the process focuses on helping the individual heal through self-empowerment, knowledge, and balance. Holistic nurses come from the same paradigm and would find health coaching an excellent addition to their practice. Incorporating an assessment of the client’s readiness for change, asking the right questions, understanding that the process of change must be client directed, and staying focused actually saves the nurse time and enhances the effectiveness of the interaction. In addition, the coaching approach increases the possibility of adherence to medical plans and helps the nurse feel good about what they are able to accomplish without feeling overwhelmed.
What are the liability and acceptance issues?
Health coaching is currently unregulated and each state has very different guidelines for health and wellness coaches. The State of Illinois Board of Nursing, for example, “suggests” that nurse coaches have a medical release for each client and that they should not discuss or recommend the use of supplements. Karen felt that there is a need for dialogue about professional roles and a client bill of rights. Decisions about the legality of certain activities are generally based on whether it falls within the scope of the nurse practice act.
Karen also mentioned that there are some very innovative things happening in the Midwest and she was amazed at how much interest there is now in complementary health therapies. While some healthcare professionals are hesitant to spend time talking to patients about wellness because they may not feel that anyone is listening, the health coach can actually help get past this barrier. Health coaches could conduct surveys to find out what patient needs are evident (diet, weight, exercise, etc.), what kinds of information patients would like to know, and conduct pilot study groups using health coaching to show evidence of its effectiveness. This process would help provide evidence to physicians that not only do educational needs exist, but patients are willing to listen, and can learn, when provided in an effective format.
What is the philosophy and guidelines of University of Minnesota’s Center for Spirituality and Healing Health Coaching Track?
The Health Coaching track was developed about 6 years ago and focuses on training health coaches to work in a multitude of practice settings and delivery models (e.g., hospitals, clinics, health educational facilities, private practice, corporations and schools). The program philosophy states that, while they work in collaboration with practitioners in all disciplines and there may be some overlap in skills, they do not duplicate the role of others. Instead, health coaches focus on health and holism, and have a very broad range of training and capabilities and a vision of integration. The UM program is designed for individuals who have a bachelor’s degree and a health care background, but they do not need to be a licensed practitioner. According to program guidelines, the program consists of “four semesters structured to prepare a wide variety of students to be skilled and knowledgeable companions for individuals on their path to greater health and healing.”
Courses are delivered in a blended format with the weekly content and assignments done online and the practice and application of the skills learned done via two on-site weekends per semester. The 18 semester credit program must be completed in four years. Upon completion of the program, students will receive a Certificate in Complementary Therapies & Healing Practices: Health Coaching from the University of Minnesota.
The AHNA-ANA Holistic Nursing: Scope and Standards of Practice lists health teaching and promotion as one of the standards of holistic nursing by which the nurse “employs strategies to promote holistic health/ wellness and a safe environment” (p.48, Standard 5B). Health coaching is just one of the many ways holistic nurses can fulfill this standard and enhance their nursing practice. I, for one, believe that coaching not only helps clients achieve health and happiness, but it can also help nurses become more effective in what they do, thereby increasing the nurse’s positive feelings about themselves and their jobs, and saving time.