Health coaching is the skillful use of evidence-based conversations, clinical interventions and strategies to safely and actively engage clients who have chronic conditions or are at moderate to high risk for developing them. Health coaches are licensed or credentialed professionals.

Wellness coaching is a process that challenges clients to develop their inner wisdom, identify their values, and transform their wellness goals into action by facilitating healthy, sustainable behavior change. Wellness coaching draws on principles from positive psychology, appreciative inquiry, motivational interviewing and goal setting. Wellness coaches are not required to be licensed or credentialed health professionals.

Both health and wellness coaches:

• Partner with clients who are seeking self-directed changes
• Promote client health and well-being
• Display a belief in the client’s capacity for change
• Honor the client as an expert on his or her life
• Ensure that all coaching interactions are respectful and non-judgmental

Nurse coaching is a skilled, purposeful, results-oriented and structured client interaction that is provided by Registered Nurses for the purpose of promoting achievement of client goals. (Dossey, Hess, et. al, 2013)

Nurse coaches promote and facilitate the growth, healing and wellbeing of the whole person by using coaching principles and healing modalities that integrate body-mind-emotion-spirit-environment. Nurse coaches are required to have several years of nursing education and experience as a foundation to developing their coaching skills.

Nurse coaches integrate coaching competencies into any setting and specialty area of nursing practice to facilitate a process of change or development that assists individuals and/or groups to actualize their potential.

1. Establish the relationship and assess client’s readiness for change
2. Identify client opportunities and issues
3. Assist client in establishing goals
4. Structure the coaching interaction
5. Empower clients to reach their goals
6. Assist clients in determining the extent to which their goals were achieved

(Adapted from Hess, D., Dossey, B., Southard, M. Luck, S. Schaub, B., & Bark, L. (2013). The art and science of nurse coaching).

Nurse coaches work with the whole person using principles and modalities that integrate body-mind-emotion-spirit-environment to promote health, wellness, and wellbeing while they facilitate their client’s growth and healing. Nurse coaches are supportive and encouraging, building on the client’s strengths rather than attempting to correct weaknesses. Nurse coaches provide guidance and resources to the client who is the expert on their own needs and choices.

Examples of nurse coaching services include helping:

• Hospitals to improve nursing staff retention
• Individuals to improve their overall health and well-being
• Insurance companies to reduce the cost of disease management

Some nurse coaches work in private practice; some collaborate with other health professionals in a group practice, and others are employees. According to surveys, nurse coaches can earn similar or more income than they do working in hospitals.

See the educational programs that offer Nurse Coach training and are endorsed by AHNA.

n the past, each of these professional roles has been distinct:

• Coaching – Coaching is partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential. The coach is the expert at coaching, not necessarily the subject matter expert on the client’s topic of interest.
• Counseling – Counselors are trained to diagnose and help the client with emotional problems, their past, or their dysfunction, while the coach’s role is to assist clients with achieving what they want in the present and future.
• Mentoring – A mentor is a trusted guide, advisor, and subject matter expert who shares their experience while bringing the “mentee” up the ranks. A coach is not necessarily a subject matter expert.
• Consulting – A consultant is an expert who is called on for professional or technical advice. They understand the problem and present solutions. Consulting is different than coaching because with coaching, most of the answers come from the client.

However, in the last few years, these distinctions are becoming blurred.

• Coaches are beginning to offer ideas, solutions, options, and/or advice to their clients like consultants and mentors do.
• Counselors are using more strength-based approaches, with less analysis of the past and more focus on the client’s present, like coaches do.
• Mentors are realizing they are more successful when they incorporate coaching into guiding and supporting their mentees like coaches do.
• Consultants are finding they are more effective in guiding major change when they use a more facilitative style and a less expert-based one like coaches do.

Aware of the need to empower the health and wellness aspects of nursing practice, the American Holistic Nurses Credentialing Corporation (AHNCC) developed the Nurse Coach (NC-BC) and Health and Wellness Nurse Coach (HWNC-BC) certifications in 2012. The American Holistic Nurses Credentialing Corporation (AHNCC) provides the only nationally accredited holistic nurse and nurse coach certification credentials in the USA. Since the AHNCC established the nurse coach certification process, there has been a surge of interest in nurse coaching.

The AHNCC’s Nurse Coach (NC-BC) and Health and Wellness Nurse Coach (HWNC-BC) certifications use the same examination. The difference between the two certifications is:

• Nurses who also hold one of the holistic nursing certifications are awarded the Health and Wellness Nurse Coach (HWNC-BC) credential
• Nurses who do not hold a holistic nursing certification are awarded the Nurse Coach (NC-BC) credential

Reasons for seeking certification are that it:

• Establishes minimum competency standards for the nurse coach practice
• Assures the public that the nurse coach has completed all eligibility requirements
• Recognizes nurses who have met peer reviewed professional standards
• Provides the certified nurse coach with a network of colleagues
• Validates the knowledge and skills necessary for practice as a nurse coach
• Establishes credible identity with consumers, employers, colleagues and surveyors
• Encourages continued personal and professional growth consistent with nurse coaching
• Provides a certificate and validation that documents knowledge and competence in nurse coaching

With a board-certified nurse coach credential (as compared to a plain coach or health coach credential), nurses clearly identify themselves as registered nurses and are recognized as nurse specialists by many programs that are working to integrate holistic and complementary approaches into mainstream healthcare, such as the American Nurses Credentialing Center (ANCC) Magnet and Pathways to Excellence programs in hospitals.

Nurses can study for the AHNCC’s nurse coach certification examination on their own, using the free and paid resources listed on AHNCC’s website, or they can take a prep course if they prefer. Prior to taking the certification examination, applicants are required to have at least 60 hours of coaching experience that has been mentored and/or supervised by a Certified Nurse Coach.

The minimum required nurse coach certification study materials cost around $40 and the cost of the examination is $425. AHNA members receive a $50 discount. Supervision costs vary.

Renewal of Nurse Coach certification is due every 5 years and the following requirements must be met to demonstrate continuing competency: maintenance of an unrestricted RN license; active practice in Nurse Coaching and 100 CNE contact hours or equivalent credits through other professional development activities such as presentations or publishing.

See http://www.AHNCC.org for more details.