"Sometimes the student guides the master"
The reason I became a nurse was to work with people with chronic health conditions supporting them from a primary and secondary prevention perspective. With a background in exercise science combined with my training as a registered healthcare professional I am able to support each individual in a holistic manner taking into account not only lifestyle risk factors but also medical considerations.
Coaching enables nurses to support patients. A well informed and engaged person is essential to successfully manage and treat any health condition autonomously.
Health coaching is something that can be delivered by every professional during any contact with a patient, making every contact count.
Effective communication is essentially the core of coaching. There are many levels to the coaching process but fundamentally we should all be communicating with our patients to help them improve their health. This can simply be during a drug round by giving a brief explanation as to what each drug is for, moving onto asking the patient what each drug is for. Delivering education promoting confidence to become autonomous in a safe environment. This simple task will go a long way to improving their health literacy and start them on a discovery learning path.
By practicing patient centred coaching we will be able to develop patient self-efficacy through enhancing knowledge, decision making, and also informing behavioural change from a completely subjective perspective, what matters most to them.
But, the efficacy of nurse as a coach can be dependent on their ability to understand the patients frame of reference. This is where a good understanding and experience of coaching processes will come into play, which can go beyond the common use of the intrinsic skills such that motivational interviewing utilises for example.
Now MI is important and a very useful tool, but it is essential to have the skills to bring in other dimensions of coaching which will aid nurses, and other HCPs, in building rapport and finding a common ground with their patients. This will hopefully lead to a positive environment where the coaching is not forcing or directing the patient but they are working in partnership, where the patient guides the nurse.
The development of autonomy relies on education. It needs to equip the patient with the knowledge and competence to manage their own health, both acutely and lifelong. They need to be taught the fundamentals of exercise, nutrition, medications, risk factors etc. to achieve this. Any coaching programme should focus on this and is a good time to support them developing confidence, alongside knowledge.
Empowering the patient to manage their own health is the main outcome we want. We need to ascertain ASAP the level of competence that each patient has in their autonomy to manage their condition.