Honing Your Performance Coaching Skills

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Many of the ideas for these blogs come from nurse leader readers. The idea for this blog is from Lindsey Ryan who serves as the MICU manager for Sharp Grossmont Hospital in San Diego, CA. In a blog last week, I had talked about how supportive leaders act like performance coaches. Lindsey asked for more specific direction on how to do this. It is a great question.

Recently during a coaching session, a nurse leader told me that she had once been a professional ice skater and later a coach. She said that these performance coaching skills come in very handy in nursing leadership. She pointed out that when you skate – you constantly receive feedback on your performance. It is the only way to improve. Skating coaches rarely continue to work with skaters who resist feedback. It is part of the culture. A second key lesson she learned with performance coaching in skating is that the best feedback is three-part. The first part is to point out what is being done well and the skater needs to continue. The second part of the feedback is what the skater needs to do to take his/her performance to the next level. The third part is a jointly-developed coaching plan to reach the goal.

Let’s use the example of a new graduate who is having challenges prioritizing her patient care. The nurse manager observes the novice nurse and notes that she is very caring. Her patients seem to love her yet as she plans her care for the day – there is a lack of organization, attention to detail and critical decision making about what should happen next. During the interview process, the manager had discussed with the novice nurse that coaching was part of the unit culture and critical to professional development. She begins her conversation by reminding the novice nurse about the importance of coaching and that it is her intent in this conversation to provide performance coaching to help her to grow professionally.

Part 1 – As I watch you give care to your patients, I am impressed with how you are able to individually meet their needs through your caring actions – a good example of this is …………

Part 2 – A key part of nursing practice is the ability to think critically at the moment about what your key priorities for care need to be given your patient assignments. I have watched that you have struggled with this. A good example of this is ………. To grow professionally and be successful, this is an area that you need to work on.

Part 3 – A key goal that we need to focus on at this point is your ability to more effectively prioritize and organize your care after receiving an assignment.

Once the goal has been established – we can move into a conversation using the GROW Coaching Model. The coaching conversation should include many open-ended questions.

Goal – Prioritize and organize your care after receiving an assignment.

Realities – What are the realities and obstacles that are getting in the way? The manager can ask the novice to talk about what challenges she is experiencing with doing this. The reality is that the new graduate will be expected to care for 5 patients – that won’t change.

Options – This is where the manager can discuss approaches that could be different than the one the novice is currently using. She may suggest that the novice talks to more experienced nurses on strategies they use.

Way Forward – The conversation should end with a plan and a commitment to action. The nurse manager needs to plan to continue to observe and follow-up with the nurse to discuss progress.

One reason that managers struggle with these conversations is that they don’t set the stage for staff to expect them. Many staff will want feedback but only if it is good. Yet, this is not how it works with performance feedback. You will only improve with specific coaching. To begin the performance coaching journey – start with your unit culture and expectations. Make it safe and expected for staff to get feedback.

Read Rose Sherman’s new book – The Nurse Leader Coach: Become the Boss No One Wants to Leave