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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?
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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 Collection
Design
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
What others
and others see 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 selfefficacy
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
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