by Susan Luck, RN, BS, MS, HNC, CCN

With a renewed focus on prevention and wellness in healthcare reform, it has been proposed that health coaches play a major role in patient and consumer education. If the goals of wellness coaches are to improve health outcomes and reduce health costs for individuals, employers, insurance companies, and the nation, it is essential that coaches are equipped to guide all sectors in health promotion strategies that support behavioral and lifestyle changes. Below is a holistic nursing perspective on how to accomplish this.

As a practitioner, and holistic nurse educator, I have been exploring the meaning of this emerging role to understand the skills needed to navigate the complexities of health issues confronting individuals today on many levels; economically, nutritionally, environmentally, socially, culturally, emotionally, and spiritually.

After searching many websites to gather information on health coaching, I found that there is neither a clear definition nor credential for who can become a health coach; a position that certainly encompasses many roles, skills, and responsibilities that can impact one’s immediate health decisions and future goals. A general definition found on several coach websites included: “The objective of a Health Coach is of assisting you to achieve your personal wellness goals. Health Coaching utilizes effective behavioral psychology principles to assist people to make lifestyle changes. Health Coaching is a new paradigm for assisting people to become masters of their Wellness”. As practitioners, we know that changing unhealthy behaviors to promote wellness (and prevent damaging complications from chronic diseases) is complex and requires knowledge and special skills.

From a holistic perspective, effective health coaches need to have the ability to understand the use of conventional medical treatments along with integrative strategies to effectively guide individuals toward healthy behaviors and achieve desired outcomes. Often overwhelmed with navigating the complex system of medical treatment options and protocols, a coach often serves as an advocate assisting one through the medical maze. The ability to communicate with allopathic physicians and CAM practitioners and coordinate care appears to be part of a comprehensive coaching model for supporting the whole person. The professional skills of nurses could be a perfect fit for in this new emerging trend.

Nurses speak both the language of medicine and of healing. Holistic nursing is a nationally recognized and credentialed specialty within the nursing profession, and offers new opportunities to draw upon the knowledge and skills of these nurses to assist individuals in their health and healing process. Nurses hold a unique position to be a bridge in the emerging integrative healthcare paradigm. Inherent in nursing education and nursing practice is the emphasis on both health and disease management. As patient educators, advocates, and coaches, nurses provide guidance, support, and motivation while offering tools and strategies for effective actions leading to healthier behaviors. In interviewing nurse wellness coaches, they describe a key part of their role as communicating and coordinating care with other providers, educating on CAM modalities, and assisting in navigating the complex medical system.  Often, mistrust and fear can impact health decisions and permeate cultural perceptions of our current medical model. Nurses have been identified as the most trusted profession according to public polls, year after year.  Research shows that a holistic nursing presence is a healing moment, providing comfort, support, and lowers the stress response. Combined with teaching stress reduction techniques, a nurse wellness coach facilitates lifestyle changes and healthier behaviors.

Health outcomes research has shown that these directions in both intervention and preventive care strategies, has proven to be most beneficial following hospitalization and in avoiding being re hospitalized according to employers and health insurance companies in the U.S. where Registered Nurses are being utilized as health coaches and care managers. Although this is not a new career path for nurses, it is one that is growing as trends in health care are placing an emphasis on prevention and individual, family, and community education programs.

Today, with approximately 2.4 million nurses in the U.S. working in all sectors of healthcare, many with years of experience, skills, and knowledge, they are seeking new directions and meaningful employment options. Many nurses are leaving medicine, disenchanted with the modern technological focus, and seeking to reconnect to their roots in the healing arts and the carative tradition. Nurse Coaches can be integrated into diverse health care settings to provide skilled preventive health strategies, healing modalities, and substantive coaching skills in a person centered model.

Utilizing the skills of holistic nurses as wellness coaches presents an opportunity to move our vision forward for creating an integrative health care paradigm for the nation.