Ask the Experts: When should I engage staff nurses in constructive coaching?

Nurse Leader Insider, December 14, 2017

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By  Patty Kubus, RN, MBA, PhD

Constructive coaching to improve staff nurses' skill level is critical as coaching is one of the most effective ways to change behavior. It is the method by which you support someone through the process of changing ineffective behavior to effective behavior.

If you have built your culture to represent this type of coaching as helpful and supportive, rather than critical and punitive, then it will be viewed in a positive light. People should not be threatened by constructive coaching nor by having a development plan. Everyone needs to have a development plan, even if they are "superstars." Your superstars still need to be continually learning and continually challenged, and everyone needs to be sure they are leveraging their skills and continuing to build on their strengths.

For people to listen to and accept your feedback and coaching, they need to have an open and receptive mind. They cannot be in a fearful state, because they will not be able to hear you (literally) if their bodies are preparing for fight or flight. Setting the tone for constructive coaching scenarios is something to think about before you initiate the discussion.

A culture that supports feedback and coaching will make almost every constructive coaching conversation one that does not make others feel defensive. Your staff will realize that the reason you are taking the time to have this discussion with them is to help them be better professionally, as nurses, teammates, and colleagues, and to help them grow to use their skills to the fullest. The conversation will not have a negative effect; people will not feel they have been chastised. Rather, it will have a positive effect and they will leave feeling a little humbled (no one is perfect) but also empowered. They will now have the tools to perform at a higher level the next time this situation arises. That will give them confidence. How could they not be appreciative about that? The culture you establish and the delivery of this kind of conversation make all the difference.

Examples of behaviors that may require constructive coaching include:

    Incomplete charting
    Taking too long to chart
    Not tending to patients in appropriate time
    Inappropriate attitude and actions toward patients or colleagues
    Bullying others
    Excessive absences
    Lacking skills or awareness of standards
    Failing to achieve goals, objectives, or expectations

The constructive coaching process not only helps you to change these behaviors, but also helps you get to the cause of the behaviors. Reasons for poor performance can include personal issues (domestic violence, family or personal health issues, substance abuse, fatigue, and shift changes) or organizational issues (inadequate training, poor communication of policies or standards, poor role models or preceptors, discomfort with new technology, poor management and support, and bullying). Having this discussion will help you get to the cause of the behavior so that you can create a perfect solution, when necessary. The problem may be more systemic than just this one person.

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