The purpose of this course is to help formal and informal leader to become successful in coaching and mentoring staff.
At the completion of this activity, the healthcare professional will be able to:
Connor and Pokora have given a useful definition that emphasizes the similarities between coaching and mentoring.1 They say: “Coaching and mentoring are learning relationships which help people to take charge of their own development, to release their potential and to achieve results which they value.”
A mentor counsels or guides. A coach instructs or trains. Mentoring is long in duration and focuses on career development by guiding and nurturing a protégé/mentee. A mentor is someone who walks beside the protégé while guiding them in career development. A mentor may at times instruct a protégé/mentee or train them as needed. The mentor passes on valuable skills, knowledge and insights to help the mentee develop their own career. The mentee can become more confident and self-supporting.
Mentees can also develop a clearer sense of what they want in their own personal careers. This clearer sense helps them to create a greater self-awareness and visualize the world, and themselves, as others do. In most organizations, entrance to middle-top management positions is not determined by just competence. It depends on acceptance by those who are in the most key and influential positions.
Many organizations realize the benefits of having a mentoring program. Confident and satisfied employees steer organizations forward; this expands the organizations’ skills base, building effective, strong teams and enhances Succession Planning.
There are two main types of mentoring:
Coaching is a skill of attaining results by developing people to their maximum positive, productive ability. It is a collaborative relationship undertaken between a coach and a willing individual. Coaching is time-limited versus mentoring. Coaching uses conversations and skill to help clients learn to lead while achieving their goals. Coaches develop people by communicating effectively and challenging an employee to think and grow on their own. A coach is someone who walks behind the client and pushes and encourages the client to stretch. Effective Coaches deliver results!
A mentor has expertise in the areas of self-presentation, positioning, and connecting the essential aspects of helping the protégé/mentee to be promoted. To assist individuals to make it to the top, a mentor who is accepted by top management is essential. A mentor takes a personal interest in the mentee/protégé. To some degree beyond just being a co-worker or professional. Mentors offer their knowledge, expertise and advice to those with less experience. By leveraging their unique knowledge and skills, mentors guide mentees in the right direction. The support is based on the mentor’s own experiences and learnings, which make them more reliable figures in the eyes of the mentee.
A key aspect of an effective mentor is one who is willing to share their skills and knowledge with mentees and inform mentees that they have had to face many of the same challenges. This positive can-do attitude helps to inspire trust and confidence. Mentees then feel at ease discussing their professional goals, concerns, and challenges.
A mentor does the following2:
Ben is a Registered Nurse (RN) who started out as a Nursing Assistant (NA) and then went on to become a Licensed Practical Nurse (LPN). He completed an LPN to RN bridge program about three years ago.
Michelle is a nursing shift supervisor. She recognized Ben's clinical and leadership potential when he was an NA and has acted as his mentor for years. Michelle was instrumental in encouraging Ben to return to school. She helped Ben see the benefits for furthering his education and assisted him in identifying schools, financial resources, and was influential in getting Ben's schedule changed to accommodate classes. Michelle had multiple conversations with Ben to assist him in transitioning from an LPN role to the RN role.
Now that Ben has been an RN for three years, Michelle influenced Ben's Nurse Manager to train Ben as a relief charge nurse. Michelle recommended that Ben ask to take the charge nurse position and leadership continuing education courses as they become available. In a year or two, if Ben is successful as a relief charge nurse and is still interested in leadership, Michelle will assist him to find and recommend him for a full-time charge nurse position.
Chuck Reynolds defined coaching in the following manner3:
“Like a stagecoach of an earlier era, which picked people up and transported them to their destination, coaching is a practice and methodology for taking people from where they are, to a destination that they need or want to arrive at in terms of achievement.”
Jim Collins stated the following4:
“Lead with questions, not answers. Leading from good to great does not mean coming up with answers and motivating everyone to follow your messianic vision. It means having the humility to grasp the fact that you do not yet understand enough to have all the answers and to ask questions that will lead you to the best possible insights.”
Coaching is not just giving advice, teaching, or directing – it is a collaboration in which the coach acts like a midwife: supporting, encouraging and helping the client through the experience while acknowledging the client as the expert and the person “making it happen.5”
The role as a coach is to develop the most critical asset of the organization its PEOPLE.6 This acronym stands for:
P Philosophy: Core values and beliefs are the foundations of success
E Establish Standards: Guides behavior and establishes a basis for measurement of effectiveness
O Objective driven: Fulfilling the company Mission by taking ownership
P Paradigm shifting: A new way of thinking about an old problem. Think outside the box
L Let them know you care: Show employees they are valued and appreciated
E Encourage and build belief: Share belief in client's ability to be successful and capable
The most critical step as a coach is to create a climate of trust and learning. These should be an explicit commitment to confidentiality. This step enables the client to feel safe to learn, to make mistakes, and to take risks. Without trust, there can be no successful outcome. The CARE + 5 Model is a good coaching tool. This model included the following:
C create a climate of learning and trust
A appreciate client by seeing their perspective
R respond by providing developmental feedback
E empower staff and help them to develop actions for improvement
The + 5 model is:
The productivity of a coach is apparent when the client develops new actions and practices to achieve goals. The coach must always remember that coaching is not about the coach but it is about the client and each client is an individual. Coaching involves the following7:
Harry Firestone stated, “It is only as we develop others that we permanently succeed.8”
Becoming an effective coach according to Chick Waddell requires knowledge, practice, and application involving phases6:
During One on One Coaching, the assessment phase involves observation of coachee’s performance. An expected standard of what is expected relates to the quantity of work, quality of work, effective use of time and/or cost effectiveness. In the end, does the coachee have the skills to complete what is expected effectively?
The coach needs to ask him/herself four questions.
Once the above questions are asked, it is the Coaches' responsibility to provide the support, the know-how, the ideas, and the tools to help the coachee accomplish his/her tasks.
The second phase of the one-on-one coaching involves regularly meeting with the coachee to get and give feedback identifying ways to improve performance. This meeting is done in a non-threatening environment where learning can occur. A coaching objective is needed to prevent wasting the time of both parties. This process is used by Shirley in our case study.
Shirley is a charge nurse who has worked in the organization over twenty years. She realized that the staff all had the same common mission and goal of providing safe, quality, medical care to all of their patients in a timely manner, and to inform the physician of any changes that could impact their patient's outcome. As a leader and seasoned nurse, Shirley helps staff understand the reason change is important in meeting patient and staff needs and in being in compliance with the company's mission and values. Shirley has coached many staff members and helps those she coaches to deliver results, to act on their own, and to assist others to lead themselves.
Shirley is Ben's coach helping him to learn the charge nurse job. In the first phase as a coach Shirley conducts an assessment of Ben. To be an effective coach Shirley has to listen, to discuss and question; to clarify Ben's sense of purpose, core values and beliefs, and has to identify gaps between Ben's vision and reality while providing the encouragement and motivation which will instill confidence. She notes the quality of his work, the quantity of work, and his use of time and cost effectiveness. Shirley evaluates how Ben handles the staff and how he is careful to show respect for everyone while being the charge nurse, and that he delegates the workload fairly.
In the second phase as a coach, Shirley is concerned with action and implementation. Shirley and Ben create a productive plan using the ACTION model6:
A Agree on the problem or challenge
C Commit to a mutual goal
T Teach and train
I Initiate an action plan
N Negotiate follow-up
Shirley provides the support, some ideas, know-how, and tools to help Ben accomplish his job as a charge nurse. She educates Ben on current policies and procedures, employee compensation, equal opportunity guidelines, the requirements that the Nurse Manager has of the charge nurses in making assignments and completing the workload, and meeting Joint Commission requirements. Shirley helps Ben know when to ask for the additional assistance of the Nursing Supervisor.
She provides developmental feedback to Ben and is knowledgeable about the difference between performance appraisal and developmental feedback.Performance appraisal deals with feedback for actions completed in the past. Developmental feedback looks at the future. Both go hand in hand and performance appraisal feedback can turn into coaching opportunities.
When she gives Ben feedback, Shirley has to be fair, honest and direct, while maintaining a trusting relationship. She knows that when giving feedback it was important to think first about how to say, and what needs to be said using the proper voice intonation while maintaining eye contact and demonstrating concern. She has to remember to see things through Ben's eyes. Her feedback has to be individually customized. Shirley has to be specific when describing actions/performance while maintaining and building Ben's self-esteem. Mistakes become learning opportunities, not disciplinary issues.
Before giving feedback, Shirley connects and shows appreciation of Ben and his hard work. The feedback is given to encourage development and growth which helps to build a trusting relationship. Shirley demonstrates good intentions and is gentle and supportive of Ben's role as a charge nurse. She praises his strengths and ability to strengthen the healthcare team.
Shirley gives immediate feedback and discusses different ways of handling situations. When Shirley provides developmental feedback she remembers that no one was perfect, everyone including herself needs feedback to allow for growth to occur.
Feedback is vital in helping the client connect, appreciate, respond and become empowered. If there is no feedback, people’s performance could become less effective and never reach their potential. Providing Developmental Feedback is crucial and what makes it difficult at times is:
Shirley asks Ben to identify strengths. What is working? What is not working well? What would you have done differently? Shirley listens to what is not working and allows Ben to self-identify what might have been done differently. She is encouraging Self Discovery. Once these questions are answered, Shirley adds her own feedback. She uses examples of Ben's actions/performance, observes Ben's reactions both verbal and non-verbal and helps him to develop self-esteem. She gives him examples on how to improve and to stretch to accomplish his goals.
As a productive coach, Shirley also helps to empower staff to create actions for improvement. Ben is interested in learning the coaching role and assists Shirley. They both help to “empower” the staff to create actions for improvement. Shirley asks the staff specific questions which would enable all to become owners of the process. The staff has to6:
1. Establish Goals/Focus
In the first process, Shirley asks the staff what they want to change and why there needs to be a change. Shirley may point out a problem the staff was not aware existed. Once this is accomplished, what resources do they need to accomplish the desired results? When establishing goals the healthcare team needs to focus. Goals help the healthcare team to focus on what needs to take place, prioritize what needs to be completed first, develop an agenda, determine important goals and timeframes to accomplish goals. The healthcare team will have established their goals and will have an end in mind. A practical timeframe can easily be scheduled to accomplish their goals.
2. Promote Discovery
In the second process, Shirley asks more questions which encouraged the staff to discover possibilities or other options which would help them to achieve goals. They discuss both the positive and negative outcomes of specific actions. She listens to staff and paraphrases what is said. Shirley shares past experiences with staff and her perspective. She brainstorms with staff, and together they consider workable options.
3. Action Plan
In the third process, Shirley helps the staff to determine a workable plan and course of action. She asks questions related to: What needs to happen next? With whom do they need to talk to? When do they plan to do this? How do they plan to achieve this? Specific assignments and accountability are established along with guidelines for staff to follow.
Shirley helps staff develop a concrete, workable, and viable plan and helps them begin to feel empowered to act while adapting to change. The staff begins to take ownership and feel accountable as a team member.?
4. Authorize and Empower
Shirley and staff work together to identify potential barriers and solutions to remove these barriers. Resources are identified both human and material. Shirley maintains her trusting relationship with staff as she shares her circle of influence.
5. Recap, Review, Restate
Shirley asks staff to recap, review, and restate the action plan. In this phase, the staff focuses on their desired results. They answer questions related to What, Where, Why, How, When and then establish the next meeting time. The staff discusses the resources available, barriers needing to be eliminated, who would be accountable for each phase and what they would be doing, and the consequences of accomplishing their goal both positive and negative.
Shirley assists staff and suggests that they put in writing this complete process with the beginning date and estimated completion date. She also wants the staff to have ownership and the individual who is to accomplish each process is also listed in writing. She praises the team for all their efforts and for being willing to make change a positive.
Shirley felt she had done a good job and implemented the coaching process effectively. Now she would talk to her coach and would be asked: What worked well? What did not work well? What could have been done differently?
In summary, a Coaches' feedback should be kept simple and should do the following:
A key to coaching is to remember the importance of good communication. As Chick Waddell states “developing people involves effectively communicating and challenging an employee to think and grow on their own.6” Understanding the perspective and style of other people makes communicating and coaching effective.
Wanda is a Nursing Supervisor and is considering being a Mentor or Coach. She needed to know what it took to be an effective coach or mentor. She realized that this entailed “knowing “ones’ self.” Viney, R and Harris, D stated in their article on Coaching and Mentoring that there are specific qualities that are needed by a coach or mentor.9 These include the following:
One of the challenges in the healthcare work environment is working with people of various generations. Understanding the values, work ethics, and conflicts of each generation can improve communication and productivity. The different values of each age group should be considered in resolving differences and negotiating tangibles such as work schedules, hours, tasks, and equipment.
It is important to be aware of the generation gap. However, today the new “Z” generation of Mentors and Mentees has a different role than their counterparts of the past. This new “Z” generation no longer looks to the Mentor to lead the relationship, and the Mentee must drive the relationship and become responsible for the outcome of the development that takes place in the Mentor/Mentee relationship.
Nothing in the Mentor and Mentee relationship states that the Mentor must be older, but the Mentor should have the experience, knowledge and or skills in a specific area and if not has a resource person he/she can ask for direction to gain what is lacking. The Mentor may have a higher job grade level or title than the Mentee, and this could be an asset to the Mentee.
The most valuable asset in the Mentor and Mentee relationship is that both individuals work together and listen and communicate with each other; this helps to develop each other and uses creativity in problem-solving. Each individual learns from each other and thus can make presentations more innovative and interesting. The Mentee can learn the ability to understand the audience and culture of the organization and how to focus future presentations so that they are well understood and received. Thus, the key to success in the Mentor and Mentee relationship today is “knowledge sharing!” Being aware of what generation the mentor and mentee are from and what they value is vital in forming a constructive relationship.
After understanding the requirements and time needed to develop a positive relationship with her Mentee, Wanda decided she needed to continue her schooling first. Time had to be devoted to her Mentee if she was to be an effective and positive role model. She declined this position and planned on being a Mentor in the future.
The generations are grouped by year of birth:
The following tables describe generalized characteristics, values and methods for coaching and communicating with each generation.11, 12
|Generation||Values||Methods for Coaching and Communicating|
|Slang names: Beatnik, Dunce|
Movies: Wizard of OZ
Gone with the Wind
Music: Elvis Presley, Benny Goodman
Hair styles: ducktail, flat top
Clothing: Saddle shoes, poodle skirts
TV: Phil Silvers
Late night: Jack Par
Dances: two-step, jitterbug, swing
Generational happenings: doubleheader, outer space, air raids, Sunday drives, the great depression
|Follows directions without asking why|
One company for life: loyal to the organization
Work hard and get ahead
Inflexible/resistant to change
Respectful of gender
|Respect strong sense of loyalty|
Explain changes needed-with time frames (likes the norm)
Reward systems are not necessary.
Respect their “cost conscious” mindset
Respect their silence: personal issues should not be discussed at work
Reared with a strong commitment to manners and respect of establishment and genders
Strong need for “hierarchy” and bureaucracy- they built in
Give them a longer time frame to make decisions
|Generation||Values||Methods for Coaching and Communicating|
|Slang names: Hippie, Yuppie, Nerd|
Movies: Ben Hur, Ten Commandments, James Bond
Music: Beatles, Beach Boys
Hair styles: afro, shag
Clothing: mini skirt, bell bottoms, hot pants
TV: leave it to Beaver
Lake Night: Johnny Carson
Dances: twist, rock'n roll, disco
Generational happenings: Super Bowl, inner space, drive in movies
|60 hour work week|
Self absorbed/self fulfillment
Value leadership skills
Lives are meaningful
Do not like conflict
|Nurture and develop: provide continuing education|
Make sure when using teams they are productive
Support need for long term relationships
Need to answer the “why” and give them structure as to “how”
Negotiate the need for change
Support casual Fridays and their need to simplify their lives
Know they are willing to “put in the time”
Stress dynamic/create a “make a difference” environment
|Generation||Values||Methods for Coaching and Communicating|
|Slang names: head bangers, geeks|
Movies: Pulp Fiction, Terminator
Music: Cindy Lauper, Madonna, MC Hammer, Garth Brooks
Hair styles: skin heads, spiral perms
Clothing: name brand, vinyl jackets
Late Night: Jay Leno
Dances: line dancing, Macarena, running man
Generational happenings: Dream Team, cyberspace, computers, fear of AIDS Chameleon-like
|Change is constant|
Highly adaptable to diversity, new people and groups
Electronic wizards-truly computer literate
Work with ambiguity
Want to make an impact
Need access to information
Often question the boss
Need trust and respect
Want contribution noted and valued
|Demonstrate expert management techniques|
Train and orient
Set specific standards
Give them instructions and information, then let them be creative
Support their balanced lifestyles
Make work fun
Provide access to technology
Develop a reward system
Support non-traditional work settings and hours
|Generation||Values||Methods for Coaching and Communicating|
|Slang names: skaters|
Movies: Beauty and the Beast, Aladdin, Harry Potter, World of Warcraft
Music: Brittany Spears, pop culture
Cloths: name brand, Goth
TV: Beavis & Butthead
Digital technologies: internet, online gaming, texting, email
Achievers, trophy seekers
Culturally liberal-reject attitude of Baby Boomers
Lives with parents longer
Needs to feel valued
Changes jobs frequently and even careers seeking self-fulfillment in the workplace
They value their time, which takes precedence
They look for flexibility that allows a balance between work, family and personal time
Want jobs that fit their lifestyle
|Fluent in today's technologies|
Possess great business acumen and a firmer grasp of money matters
Outspoken, bold thinkers, with a strong sense of self worth
Need constant feedback on accomplishments
Requires appealing incentives to join the work force with constant rewards
Also known as Post-Millennials, theiGeneration, or the Homeland Generation, Generation "Z" is the demographic cohort following the “Y” generation.
There are no precise dates for when this cohort starts or ends; demographers and researchers typically use starting birth years ranging from the mid-1990s to early 2000s and ending birth years ranging from the late 2000s to early 2010s.
Generation “Z” is led by today’s teens and tweens. Generation “Z” individuals are more aware, self-reliant, driven, pragmatic, savvy and have become demanding customers. They have specific tastes and personal preferences. They are most influenced by online video bloggers, and “real People,” with whom they can relate. They prefer “real People” instead of actors advertising products.
Tim Elmore, an author who writes about Growing Leaders, describes the six defining characteristic of Generation “Z” which is our newest generation. The six characteristics that growing leaders need to be aware of are the following13:
In this generation, individuals may be well-adjusted, fairly happy, but not giddy as compared to Generation “Y” people. These individuals are more realistic, not idealistic, and jaded by the tough economy, terrorism, and increased complexities of life at home, in our communities, in our nation, and worldwide.
These individuals after seeing or hearing of individuals or possibly their siblings get in trouble for posting controversial material on social media don’t want to be tracked down. Because of this, Apps such as Whisper and Snapchat have increased in growth in the past few years. Facebook, on the other hand, has decreased in volume.
These individuals want more out of life and know hard work is required. They want to set the pace and build successful businesses.
Money represents success and being conservative can help in building a strong financial base. Vacations may be planned on-line after being researched for the best “bang for their bucks!” Many worry about the future and think having a lot of money represents success.
This generation constantly multi-tasks and may be on their iPhones, tablets, iPods, or using more than three computer screens at a time. When communicating, they tend not to look at you, but at their phones or other things in the room. When in class, instead of looking at the speaker they may be sending messages, looking at new information, or ordering supplies on the phone.
Mr. Elmore13 states, “Generation Z has communicated enough with marketing researchers and academics to reveal that they experience: 4D Thinking. Because their minds are streaming in so many directions, they’ve become post-moderns who are hyperaware of their surroundings.”
Surveys indicated that the “Z” generation is addicted to technology. They prefer shopping online for everything from equipment, food, housing, etc. and having their goods delivered. They also prefer interacting using social media websites for a significant portion of their socializing.
Some reliable coaching techniques needed to be effective include the following:
Tenna is an experienced Chief of a Medical Surgical Unit including the Intensive Care Unit and Step down Unit. She manages approximately 70 employees and oversees the Nurse Managers and Assistant Nurse Managers along with the In- House Nursing Supervisors. She was born with common sense and the ability to listen first and after thinking through what is truly being said responds effectively.
A situation occurred when staffing was limited due to staff calling in, and the Nursing Supervisor responded to a CODE (patient went into Respiratory and Cardiac arrest) on one of her Medical Surgical Units.
Responding to the situation included the Intensive Care Unit Nurse, Respiratory Therapist, ER Nurse, ER Technician, Hospitalist, patients’ nurse, and two Medical-Surgical Nurses along with the Nursing Supervisor. The patient was intubated, placed on life-saving drips, and needed to be transferred to a higher level treatment facility. After the CODE, the only Intensive Care Unit Nurse had to return to her unit to take over her critically ill patient. The ER staff had to return to the ER. The Medical-Surgical Nurses were not ACLS Intensive Care Nurses. The Nursing Supervisor with the ER staff transported the patient to the ER to await transport via ambulance since this would be about 20 minutes and the patient needed to be monitored closely and critical IV drips regulated based on the patient’s condition.
After the situation had occurred, the Nursing Supervisor was told that policy had not been followed and the patient should have remained on the Medical-Surgical Unit. The Nursing Supervisor said that this could have been detrimental to the patient since he required qualified nursing care until transport.
Tenna gathered the whole story while she was informed of the situation and listened to her Nursing Supervisor. She then asked “What went well?” “What did not go well?” “What would you have done differently based on the circumstances?” The patient survived!
Coaching her Nursing Supervisor, she gave suggestions for deal with this type of situation effectively. The Policy had to be updated, and those involved in this process had to be made aware of what might occur in the future and that changes were necessary.
As an effective Coach, Tenna worked with the Nursing Supervisors, Nurse Managers and those responsible for updating the Policy. They all became aware that this had to be done as soon as possible and set up time frames to accomplish their goal.
Tenna authorized and empowered the Nursing Supervisors to continue evaluating situations on an individual basis, to take appropriate actions and to keep her informed as situations needing her support and input arose.
Once the updated policy was written, Tenna recapped, reviewed and restated what had occurred. She also reviewed the newest changes to policy. At the end of the staff meeting with her Nursing Supervisors, Nurse Managers, and Assistant Nurse Managers she again restated what has been established and new actions and practices to improve safe, patient care and positive outcomes.
The next process Tenna planned is to educate the Nurse Educators who would, in turn, set up meetings to inform staff of the changes in policy based on individual situations. Charge Nurses on the off shifts would be informed by the Nurse Managers and Assistant Nurse Managers if the educators had conflicts in their schedules.
All motivational plans according to Chick Waddell begin with relationship development, starting with praise, recognition, and education. These core elements are6:
A coach is responsible for results and how a team is and stays successful. This success requires a coach to constantly implement new strategies and use effective teaching skills which are constantly updated. The word PROCESS uses to paint a developmental picture of effective training.6
Steven Covey stated, “Seek first to understand, then to be understood!14” Reasons coaches fail can be due to the following:
Coaches should set up a routine to at least quarterly ask themselves the following questions as Chick Waddell mentions in his book, “Coaching 2 Win”.6
Although coaching and mentoring are aligned, they are independent concepts and strategies. What unites them is that both are founded on mutual trust, respect, and excellent communication skills. It is evident that a balance of mentoring and coaching is important to overall leadership success. Coaching helps to develop people by effectively communicating and challenging an employee to stretch, think, and grow on their own. Problems should become growth challenges which can produce positive outcomes. Mentoring helps people by giving ongoing support as long as needed and helps to strengthen each employee on an individual basis so that they too can grow with the organization. It is vital that to develop a workable, cohesive, productive team that coaches and mentors, appreciate and value people, for this strengthens the foundation of businesses not just within the healthcare industry but those outside this industry, nationwide, and worldwide.
Coaching and mentoring for success used with common sense and a positive attitude through daily practices will significantly strengthen the development of our future leaders, our organizations, and the communities we live in.
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This course is applicable for the following professions:
Advanced Registered Nurse Practitioner (ARNP), Certified Nursing Assistant (CNA), Clinical Nurse Specialist (CNS), Home Health Aid (HHA), Licensed Practical Nurse (LPN), Licensed Vocational Nurses (LVN), Physical Therapist (PT), Physical Therapist Assistant (PTA), Registered Nurse (RN), Respiratory Therapist (RT)
Administration & Leadership, CPD: Practice Effectively, CPD: Promote Professionalism and Trust