Liz Westcott

The Role of Coaching in Nurse Manager Development.

Aims and objectives

Aim

     To explore the role that coaching is playing in the development of nurse managers.

Objectives of the study

1.To critically evaluate literature relevant to nurse manager development and the current role of

coaching in nurse manager development programmes, in healthcare management and in first-line manager development

2. To explore empirically how coaching is used in nurse manager development on a national scale

Objectives continued

3. To explore empirically the experiences of nurse

managers who have received coaching

4. To present a multi-faceted analysis of the use of coaching in the development of nurse managers

5. To advance the theoretical understanding of the coaching context and to develop practical recommendations to inform policy and practice for future developmental programmes

Why Nurse Managers?• 1st line managers • Role found throughout the world• Can be in acute hospitals and in the community• Nurses in this role have responsibility for the quality of

care undertaken by their staff (Lee and Cummings, 2008; Currie, 2013; Fenton and Phillips, 2013) Including giving and supervising direct patient care, performance reviews, staff rotas, finance management, recruitment and measuring quality indicators.

• In addition, the role is a pivotal link between education and management (Ashworth, 2010; Leah and Fenton, 2012).

New Angle

Current literature The nurse managers role is

considered to be the cornerstone

of the patient experience and the maintenance of nursing standards (Prime Minister’s Commission on the Future of Nursing and Midwifery 2010, Royal College of Nursing 2009, Johnson 2007).

The development of management and leadership skills in nurse managers are seen as essential to improve patient care and delivery of change (Fielden et al 2009).

However, little is known about what is being offered nationally to this group of staff and how the existing provision of support and development is working for those who receive it.

The challenges of the emergent manager as a first line manager are not isolated to health care managers and the problems associated with managing

people, budgets, and delivery strategic aims

are well documented

(Hill 1992, Nehles et al 2006, Lennox 2012).

In the UK, the value of coaching staff in the NHS has been reported by Alimo-Metcalfe & Lawler (2001), Sinclair et al (2008) and Woodhead (2011).

Coaching undertaken at NHS Exec level but not lower down the scale.

It appears that there are no empirical studies solely investigating coaching in nurse manager development in the UK.

Research Design and Methodology

Mixed methods study

Pragmatist Paradigm

Data collected from Qualitative interviews and Quantitative survey

Adapted from Leech and Onwuegbuzie (2007, p. 269).

For this study, a hybrid of the embedded design from Cresswell and Piano-Clark (2007) was chosen, similar to the partially mixed methods concurrent design with dominant status of Leech and Onwuegbuzie (2007).

The triangulation design allowed for both qualitative and quantitative components to be given equal weighting - very similar to the fully mixed methods design of Leech and Onwuegbuzie (2007).

The embedded design was judged most suitable because it is typified by having one more dominant method with the other data set providing a supportive role.

Data CollectionDesign

1. Qualitative semi structured interviews with Nurse Managers, Directors of Nursing and Coaches

2. Quantitative Survey of Directors of Nursing to develop a contextual view of nurse manager development in the UK and what role coaching is currently playing in this

Findings

They do say results will vary!!

Used Johari Window   Don’t ever think outside the box!!What the NM and others see

What others see of the NM

What only the NM knows

What no one sees

What the Nurse Manager and others see

The importance of the first line managers adopting a coaching style of management. The NMs reported that being introduced to coaching enabled them to more fully utilise a coaching style of management in their role

The need for NM development but the current lack of consistency in this provision

Coaching helps with difficult decision making and 360-degree line management

Improved project management results from coaching

Improved team leadership results of coaching

The value of a coaching style in clinical supervision to develop skills and performance

The value of a coaching style in mentoring to aid development.

There is a continuum between coaching, mentoring and clinical supervision

What others see of the Nurse manager

Coaching leads to transformation of the NM and their team

Coaching needs to be accessible to all NMs and can be introduced as part of a development programme

NMs desire to be excellent managers and how coaching can facilitate this

‘Return on investment’ can be seen as improved quality of patient care

The added value that a nurse as a manager brings to a management role in terms of reflection ability and the natural caring style that comes from being a nurse

Organisations other than health care could learn from the caring side of nursing as a useful asset and is reflected in the value of using a coaching style of management

Using a coaching style isn’t being a soft manager but is getting the best out of staff

What only the Nurse manager knows

Coaching improves and maximises resilience and self-efficacy

Coaching can help in the very difficult transition to NM role

Improved self-confidence in NMs following coaching

Improved self-understanding following coaching

Line manager should not be the NM’s coach but should have a coaching style of management

Coaching can help the NM understand themselves and their colleagues

What no one sees

Unrecognized, ‘by-product’ link, between support for coaching NMs – transformative leadership – improved patient care

Coaching can help in a shift to problem focused coping

Coaching can help with moving from vulnerability to resilience

The coaching style of leadership that seems to afford staff better management is closely aligned to the caring side of nursing

Insight gained from coaching allowed NMs to be able to enhance their caring nature to most effect

The following three areas seems to be intertwined: coaching style of management, organisational coaching culture and the NM receiving coaching

Key recommendations

Continue to support management and leadership programmes for nurse managers and include 360’ feedback and personality tests such as Myers Briggs

Include coaching sessions in leadership and development programmes to introduce nurse managers to coaching if they haven’t used it already

Advise nurse managers to have coaching when take on the new role and when they move into any subsequent role.

Ensure that formalised coaching is not undertaken by the nurse managers’ line manager but is a senior staff member removed from the nurse manager or a person from outside the organisation.

 

Advise nurse managers to seek coaching if a major project is to be undertaken by them  

Coaches for nurse managers need to understand the context of the NHS or at least health care and the accountability and code of conduct that nurse managers have to work within as managers of nurses

Encourage nurse managers to use a coaching style of management with their direct reports and peers

 

Ensure that any coaches used for nurse managers have undergone training and undertake supervision

 

Identification of the differences between coaching, mentoring and clinical supervision and develop a clear framework to show this.

 

Advise all health care organisations to engender a coaching culture in their staff.

Thank you

References

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