Career Sphere

The Nurse Executive’s Coaching Manual

Editor’s Note: Below are a series of excerpts from a new book: The Nurse Executive’s Coaching Manual courtesy of Sigma Theta Tau International. All rights reserved. Visit www.nursingknowledge.org/STTIbooks to purchase or learn more about the book.

With the incredibly changing and challenging environment of health care, today’s nurse leaders are required more than ever to consistently think about developing others and sustaining a committed and engaged workforce. Of the hundreds of coaching books available, this one is targeted specifically for current and aspiring nurse leaders who are interested in integrating the coaching approach into their leadership practice and creating a coaching culture in their organizations. Based on our experience with leaders and organizations we’ve had the pleasure to serve, those leaders who have worked with a professional coach and then learned how to coach others are clearly more effective in creating cultures of accountability and orchestrating cohesive action on many fronts.

Some coaching includes giving feedback and developing performance goals, but it is much more than that. Coaching is a learning and development strategy to enhance individual and organizational performance, support succession planning, and help leaders make successful transitions. Coaching promotes self- discovery and innovation, elements that can lead to breakthrough thinking and new ways of operating within our health care organizations. Whether they are implementing an initiative related to National Patient Safety Goals, American Nurses Credentialing Center (ANCC) Magnet Recognition, new TJC (The Joint Commission) standards, an electronic medical record implementation, or American Nurses Association (ANA) Healthy Work Environments, nurse leaders are responsible for ensuring team member talents are used fully and high-performing members are retained. Coaching is a catalyst that can unleash the talent of your team members.

In the past, the work of providing leadership development and coaching was reserved for professional coaches and organizational development practitioners. Now leaders at all levels are being asked to use the coaching approach with team members. Both the American Organization of Nurse Executives and the National Center for Healthcare Leadership directly and indirectly identify coaching as an essential component of executive practice. Integrating coaching into your leadership practice extends your reach and impact.

Coaching is not therapy

Please note that coaching is not therapy or counseling or the advanced stage of a disciplinary process. A coach doesn’t rescue, fix, demand, or threaten. A coach creates a safe context for new thinking, exploring, and testing. A coach stimulates learning and inspires achievement.

Applying the coaching approach

You can use the coaching approach in a variety of situations, including:


  • Developmental planning, for a high-potential nurse director being groomed for a chief nurse position in your system.
  • Performance improvement, where a gap such as poor listening skills might derail a leader’s success.
  • Individual and team coaching, to accelerate the adoption of change and sustain results for key initiatives.

During times of transition, coaching can be particularly valuable. Whether the transition includes promotion, stretch assignments, or other new challenges, leaders benefit from focused coaching to achieve a new level of performance and to “hit the ground running.”

You can find countless openings for coaching. Anytime you work one-on-one with team members to ask about their concerns, provide feedback, generate new perspectives, discuss upcoming challenges, and identify plans for professional development, you face an opportunity for coaching.

Some examples include the following:

  • Use the coaching approach to support a manager preparing for a capital equipment meeting with physicians or a director who is presenting patient safety results to the board of directors for the first time.
  • Use the coaching approach to engage front-line staff in learning conversations that enable them to develop professional practice and shared leadership/governance competencies.
  • Coach nurse managers to guide team members to shift their thinking and behavior so they envision and create more effective care delivery systems and embrace evidence-based practice guidelines and healthier work environments. Coaching can provide opportunities for exploring resistance to new ideas and rehearsing new skills.
  • Coach leaders to work effectively with the generational and cultural differences present in our increasingly diverse workforce.
  • Use coaching to build the strengths of your leadership team in areas such as interpersonal dynamics, communication, conflict management, strategic thinking, emotional intelligence, and work/life balance. Leaders who have been coached well manage their responsibilities with flexibility and adaptability, a necessary quality in the uncertain times ahead.

You might be thinking, “It sounds great, but I don’t have the time.” But wait—integrating coaching into your leadership practice can help you produce the desired long-term outcomes by spending less time “firefighting” crisis situations and redirecting your attention to strategic thinking and relationship building. If you spend time coaching others, they then can generate their own solutions and act on them, and in turn begin to coach their peers. Although coaching requires an investment of time, the rewards outweigh the time spent. As nurse leaders look for ways to increase productivity, team member satisfaction, clinical effectiveness, and patient experience, learning to coach others can serve you well.

Thoughts on coaching

In this final part of the book, the authors talk about

  • Assessing your current level of coaching competency
  • Working with a professional coach
  • Seeking resources for additional study

As you coach others, you need to have a parallel focus on your self-development. Even if you use video, your observations are limited because you are relying on your frame of reference, and that perspective might not match an objective assessment of your performance. This reason is why most professional athletes and top performers have an ongoing relationship with a coach. Good professional coaches also have coaches, so they can continually grow and experience for themselves the process of being coached. We hope our book has inspired you to take the journey and make coaching common practice for you.

As a coach, you need the personal maturity, relevant experience, and coaching expertise necessary to quickly grasp a team member’s situation, challenge assumptions and choices, and bring credible, fresh ideas to the conversation. Otherwise, you face the danger that your views are going to be less helpful or insightful than those of the person you are coaching. In other words, if a team member wants coaching on managing conflict and you avoid conflict at all costs, you are not going to be an effective coach for her. You must build your own competence in the areas in which you are coaching others.

By personal maturity we mean that a coach is fully developed (and always developing) in four domains: mind, emotion, body, and spirit.

  • In the cognitive domain, we assess an aspiring coach’s willingness to face reality, recognition of patterns and themes, curiosity, and capacity for creative and systems thinking.
  • In the emotional domain, we assess a coach’s ability to initiate and sustain relationships, tolerate internal conflict, hold clear boundaries, demonstrate compassion, and express feelings directly.
  • In the body domain, we assess well-being and vitality, how the aspiring coach carries herself, and how she responds to sensory experiences.
  • In the spiritual domain, we assess a coach’s ability to articulate his purpose and values, learn from experience, express gratitude, demonstrate joy in living, and stay connected to a source of inspiration.

Committed team members want authentic leaders who have a clear sense of purpose, who role model what they espouse, and who inspire their followers to act with high standards. We challenge you to think about how you want “to be” as a leader, as opposed to what you want “to do.”

Try it Yourself

Pour a cup of tea, put your feet up, and reflect on your leadership and coaching style.

  • What do you stand for as a leader? How do you communicate this?
  • What values underlie your leadership actions? How do you communicate them?
    Do you give mixed messages?
  • How do you demonstrate your personal commitment to feedback, coaching, and learning?
  • Are you willing to share your thoughts and engage in conversations as a way to learn about yourself and others?
  • How do you step back periodically to reflect on work processes, actions, and results?

Kimberly McNally is an executive coach and consultant who works with leaders and teams in healthcare, nonprofit, and public education organizations. She draws on 30 years of nursing and health care experience in diverse governance, leadership, education, and clinical positions. She has provided coaching to nursing leaders, senior executives, physicians, executive directors, managers, educators, boards, and professional associations.

Liz Cunningham is an executive coach, consultant, and speaker who is committed to assisting others in building teams that leave a “fingerprint to be proud of.” An expert on the human side of business, Liz has successfully worked side-by-side with leaders for 25 years, tapping into their organization’s collective wisdom, determining values-based strategies, and inspiring people to take action. She integrates leadership, change, culture, communication, and professional development.

Visit www.nursingknowledge.org/STTIbooks to purchase or learn more about their book: The Nurse Executive’s Coaching Manual.

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