Nurse coaching
Nurse coaching is a professional nursing practice in which registered nurses integrate evidence-based coaching techniques, behavior-change methodologies, and holistic frameworks to support individuals, families, and communities in achieving sustainable health and well-being. Nurse coaches use presence, deep listening, and reflective dialogue to help clients identify goals, strengthen self-awareness, and facilitate behavioral and lifestyle change within the scope of professional nursing practice.[1]
History and development
The origins of nurse coaching trace to the late twentieth-century holistic nursing movement, which emphasized the integration of body, mind, and spirit in patient care. The American Holistic Nurses Association (AHNA) and the American Nurses Association (ANA) jointly advanced the field by publishing The Art and Science of Nurse Coaching: The Provider’s Guide to Coaching Scope and Competencies in 2013, establishing standards for education, ethics, and professional competencies.[2]
The formalization of nurse coaching as a specialty is closely associated with Barbara Dossey, a nurse theorist, author, and co-founder of the nurse-coach movement. Dossey co-developed the original nurse-coach competencies and later helped launch the American Holistic Nurses Credentialing Corporation (AHNCC) board-certification program.[3] Her work bridged caring-science theory and holistic practice, establishing nurse coaching as a recognized domain of professional nursing.
The AHNCC introduced national certifications in 2012—the Board-Certified Nurse Coach (NC-BC®) and Health & Wellness Nurse Coach (HWNC-BC®)—which were accredited by the American Board for Specialty Nursing Recognition (ABSNC) and recognized by the American Nurses Credentialing Center (ANCC).[4] Throughout the 2010s and 2020s, nurse coaching expanded into hospitals, outpatient settings, community health organizations, corporate wellness programs, and private practice. Integrative reviews identify nurse coaching as a strategy that improves role effectiveness, communication, leadership, and organizational culture in healthcare systems.[5]
Theory and frameworks
Nurse coaching is grounded in nursing theory, behavior-change science, and humanistic psychology. Foundational influences include Jean Watson’s Theory of Transpersonal Caring, the Transtheoretical Model of Change, and motivational interviewing techniques.
A mid-range nursing theory, the Theory of Integrative Nurse Coaching (TINC), articulates nurse coaching as a process of awareness, choice, and transformation supporting self-healing and wellness. The model emphasizes the nurse-client partnership, mindfulness, and integrative modalities that align personal values with health goals.[6]
Barbara Dossey’s caring-science framework and integrative perspective have also shaped nurse coaching theory. In her text Holistic Nursing: A Handbook for Practice, Dossey situates coaching within the nurse’s ethical commitment to caring, self-development, and global healing.[7]
Education and credentialing
Education programs preparing nurses for the nurse-coach role combine core nursing knowledge with communication, motivational interviewing, presence, self-reflection, and integrative health.
The AHNCC administers the Nurse Coach Board Certification (NC-BC) and Health and Wellness Nurse Coach Board Certification (HWNC-BC), both accredited by the American Board of Nursing Specialties.[8] Eligibility requires active RN or APRN licensure, completion of an approved educational program, a minimum number of supervised coaching practice hours, and successful completion of a competency-based examination.[9]
Universities, professional organizations, and continuing-education providers offer nurse-coach preparation programs. Some are rooted in holistic and integrative frameworks, while others focus on lifestyle medicine, chronic disease management, or organizational leadership. Most are eligible for continuing nursing education (CNE) contact hours through ANCC-accredited providers.
Practice and settings
Nurse coaches practice in diverse environments, including hospitals, primary care, public health, integrative medicine clinics, corporate wellness, and private practice. They facilitate health promotion, lifestyle modification, chronic disease management, and resilience for patients and healthcare staff.
In acute care and ambulatory settings, nurse coaching has been linked to improved patient adherence, self-management behaviors, and quality-of-life outcomes.[10] Within organizations such as the U.S. Department of Veterans Affairs, nurse coaches participate in the Whole Health model, emphasizing personal empowerment and integrative care.[11]
In leadership and workforce applications, coaching has been shown to enhance communication, teamwork, and nurse engagement.[12]
Distinction from health and wellness coaching
Although nurse coaching shares principles with health and wellness coaching, the fields differ in scope, regulation, and theoretical foundation.
Scope and regulation. Nurse coaching is practiced by licensed nurses and is governed by the ANA Code of Ethics and state Nurse Practice Acts. Health and wellness coaching, in contrast, is generally unregulated and open to individuals from varied educational backgrounds.
Education and credentialing. Nurse-coach certification (NC-BC, HWNC-BC) requires nursing licensure and supervised coaching experience. Wellness coaches may pursue credentials through the NBHWC or other organizations that do not require nursing licensure.
Philosophical orientation. Nurse coaching emphasizes the therapeutic nurse-client relationship as a healing partnership within nursing’s metaparadigm of person, health, environment, and caring. Wellness coaching typically focuses on behavior change and goal attainment without the nursing theoretical or ethical framework.
Legal and ethical accountability. Nurse coaches are accountable to state licensing boards and professional standards, while wellness coaches operate under voluntary ethical guidelines or organizational codes of conduct.
Research and evidence base
The evidence base for nurse coaching has grown over the past decade, moving from descriptive reports to integrative reviews and theory analyses that examine both patient and workforce outcomes.
Integrative and systematic reviews. A 2021 systematic review in BMC Nursing synthesized 17 studies on health coaching delivered by registered nurses. It found that nurse-delivered coaching most commonly targeted chronic illness self-care (often via telephone/online formats) and reported benefits such as reduced distress and fatigue; the authors also noted mixed results for lifestyle change and called for standardization of intervention dose and training.[13] An integrative review in Nursing Open (2023) reported that coaching in nursing is associated with improved role effectiveness, communication, and leadership development, while highlighting ongoing conceptual and measurement heterogeneity across studies.[14]
Theory development and application. A peer-reviewed analysis of the Theory of Integrative Nurse Coaching (TINC) in the Journal of Holistic Nursing (2022; epub 2021) concluded that TINC is a well-constructed mid-range nursing theory that aligns with caring science and supports application across settings; the authors noted the need for more empirical testing at scale.[15]
Implementation in health systems. Within the U.S. Department of Veterans Affairs, “Whole Health” initiatives formally incorporate health/wellness coaching roles that include nurses in interprofessional teams; publicly available VA materials describe scope, delivery modes (in-person/telehealth), and program growth across facilities.[16] [17] A 2023 National Academies report also discusses coaching within Whole Health system redesign, with implications for workforce roles and patient-centred outcomes. [18]
Scope and limitations of the evidence. Across reviews, authors report promising associations with patient self-management, distress reduction, and professional development; however, they consistently note small samples, varied coaching frameworks/duration, and inconsistent outcomes reporting. Future research recommendations include consensus on core components and measures, along with multi-site, adequately powered trials to determine effectiveness and cost-effectiveness.[19] [20]
See also
- Holistic nursing
- Health coaching
- Lifestyle medicine
- Motivational interviewing
- Nurse education
- Nursing theory
- Barbara Dossey
References
- ↑ Berman, A.; Chicca, J. (2021). "Nurse coaching: Advancing holistic practice and health behavior change". BMC Nursing. 20 (1): 112. doi:10.1186/s12912-021-00594-3. PMC 8108347 Check
|pmc=value (help). PMID 33966641 Check|pmid=value (help). - ↑ Dossey, B.M.; Luck, S.; Schaub, B. (2013). The Art and Science of Nurse Coaching: The Provider's Guide to Coaching Scope and Competencies. Silver Spring, MD: American Nurses Association. Search this book on
- ↑ Dossey, B.M. (2019). "The future of nurse coaching: Expanding impact and evidence". Journal of Holistic Nursing. 37 (1): 6–12. doi:10.1177/0898010118820160 (inactive 12 November 2025).
- ↑ "AHNCC Certification Programs". American Holistic Nurses Credentialing Corporation. Retrieved 2025-11-12.
- ↑ Gallagher, R.; Roberts, S. (2023). "Coaching in nursing: An integrative review of the literature". Journal of Nursing Management. 31 (6): 1234–1247. doi:10.1111/jonm.13844. PMC 9874585 Check
|pmc=value (help). PMID 36194470 Check|pmid=value (help). - ↑ Avino, K.; Wagner, L. (2022). "The Theory of Integrative Nurse Coaching: An analysis and application". Journal of Holistic Nursing. 40 (4): 328–339. doi:10.1177/08980101221094420 (inactive 12 November 2025).
- ↑ Dossey, B.M. (2016). Holistic Nursing: A Handbook for Practice (7th ed.). Burlington, MA: Jones & Bartlett Learning. Search this book on
- ↑ "American Board of Nursing Specialties". American Nurses Association. 14 October 2017. Retrieved 2025-12-02.
- ↑ "AHNCC Nurse Coach Candidate Handbook" (PDF). American Holistic Nurses Credentialing Corporation. Retrieved 2025-11-12.
- ↑ Thompson, H.J.; Watson, N. (2020). "Integrative nurse coaching for chronic illness: A systematic review". Journal of Holistic Nursing. 38 (3): 223–234. doi:10.1177/0898010119891234 (inactive 12 November 2025).
- ↑ Anderson, A. (2020). "Veterans Health Administration's Whole Health model and the role of the nurse coach". Federal Practitioner. 37 (6): 260–267.
- ↑ Dossey, B.M.; Luck, S. (2020). "The evolution of nurse coaching: Integrating caring, coaching, and healing". Global Advances in Health and Medicine. 9: 1–9. doi:10.1177/2164956120952015 (inactive 12 November 2025).
- ↑ Barr, Jennieffer A; Tsai, Lily P (10 May 2021). "Health coaching provided by registered nurses described: a systematic review and narrative synthesis". BMC Nursing. 20 (1). doi:10.1186/s12912-021-00594-3. PMC 8108347 Check
|pmc=value (help). PMID 33966641 Check|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ Richardson, Corianne; Wicking, Kristin; Biedermann, Narelle; Langtree, Tanya (October 2023). "Coaching in nursing: An integrative literature review". Nursing Open. 10 (10): 6635–6649. doi:10.1002/nop2.1925. PMC 10495732 Check
|pmc=value (help). PMID 37365717 Check|pmid=value (help). - ↑ Moore, Amy K; Avino, Karen; McElligott, Deborah (June 2022). "Analysis of the Theory of Integrative Nurse Coaching". Journal of Holistic Nursing. 40 (2): 169–180. doi:10.1177/08980101211006599. PMID 33876977 Check
|pmid=value (help). - ↑ "Whole Health Coaching". U.S. Department of Veterans Affairs. Retrieved 2025-11-12.
- ↑ "Whole Health (overview)". U.S. Department of Veterans Affairs. Retrieved 2025-11-12.
- ↑ "Achieving Whole Health: A New Approach for Veterans and the Nation" (PDF). National Academies of Sciences, Engineering, and Medicine. 2023. Retrieved 2025-11-12.
- ↑ Barr, Jennieffer A; Tsai, Lily P (10 May 2021). "Health coaching provided by registered nurses described: a systematic review and narrative synthesis". BMC Nursing. 20 (1). doi:10.1186/s12912-021-00594-3. PMC 8108347 Check
|pmc=value (help). PMID 33966641 Check|pmid=value (help). Unknown parameter|article-number=ignored (help) - ↑ Richardson, Corianne; Wicking, Kristin; Biedermann, Narelle; Langtree, Tanya (October 2023). "Coaching in nursing: An integrative literature review". Nursing Open. 10 (10): 6635–6649. doi:10.1002/nop2.1925. PMC 10495732 Check
|pmc=value (help). PMID 37365717 Check|pmid=value (help).
External links
- American Holistic Nurses Credentialing Corporation
- American Nurses Association
- Nursology: Theory of Integrative Nurse Coaching
Category:Nursing Category:Nursing specialties Category:Nursing occupations Category:Health care occupations Category:Holistic health Category:Behavioral medicine
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