Guidance and Coaching in Nursing Care

Guidance and coaching are essential components of work for an advanced practice nurse (APN). Dossey and Hess (2013) state that the purpose of coaching in nursing is “to advocate, identify, and focus on factors that promote health, healthy people, and healthy communities” (p. 10). Thus, a nurse engaged in coaching activities should focus on advocating a healthy lifestyle for the people. According to Hamric, Charlene, Tracy, and O’Grady (2014), guidance is a form of coaching, however, it is more preliminary and less comprehensive. APN and registered nurses (RN) should understand the importance of guidance and coaching to carry out the two in the daily patient care.

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APN has different responsibilities regarding patient care when compared to RN. Thus, the roles in guidance and coaching differ significantly for APN and RN.

The crucial element, in this case, is the approach the nurse takes to the patient. Hamric et al. (2014) state that APR should “raise awareness, contemplate, implement, and sustain a behavior change, manage a health or illness situation, or prepare for transitions, including birth and end of life” (p. 465). The process aims to help patients achieve their goals regarding health. Additionally, an essential aspect for the APN is to ensure that the patient is feeling well both physically and mentally. This should ensure that they make proper decisions regarding their health. APN’s role in coaching and guiding involves advanced communication skills to be able to explain the importance of various choices in one’s healthcare.

The responsibility of the RN is to educate patients on the health issues and improvement opportunities, which is done in the form of teaching. According to Dossey and Hess (2013), the purpose of teaching for the RN is to promote health utilizing “evidence-based strategies with clients and support behavioral and lifestyle changes to enhance growth, overall health, and well-being” (p. 12). Furthermore, the process can be considered as a form of counseling for a patient, as it involves directing the person and advising him or her.

RN can utilize additional materials (such as hangouts) that are given out while having a conversation with a patient. This communication is typically carried out at the patient’s bedside (Hamric et al., 2014). While APN can utilize the same approach, it should be more extensive. APN can provide patients with a more detailed guide to their health assessment. Coaching competency in RN is typically referred to as patient education (Hamric et al., 2014).

In APN, the competency is performed in the form of intervention. Although the objective of both is to help a patient set healthcare goals and implement them in their lifestyle, their methods differ. Thus, guidance and coaching in the APN are more complex processes than teaching and coaching performed by RN.

The teaching and coaching role fit in wellness versus sickness model of care. Wellness medicine’s focus is on a healthy person who does not have any severe condition diagnosed. Perry (2017) states that wellness model utilizes an integrative approach, by considering different aspects that influence one’s health. It can be argued that an essential factor in such case is to maintain the healthy condition.

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The teaching and coaching practice can provide insight and knowledge to patients regarding the vital aspects of their lifestyle, which influences the state of their health. Thus, ANP or RN can explain to the patients the importance of exercising and diet that can help them enhance their health. The approach can help both the patients and medical workers prevent severe illnesses by intervening in advance. Therefore, the teaching and coaching practice is crucial in the wellness model of care.

The sickness model focuses on the illnesses a patient has. Although the main aim in such cases is on providing treatments, teaching and guiding are essential to improve the wellbeing of the person as well. APN or RN should educate the patient about the particular disease, to ensure that he or she is aware of the various aspects of it. Furthermore, APN can guide the patient through the lifestyle change needed to improve the health or to recover from surgical procedures.

It is essential, as it is critical for the patients to be able to return to their everyday life after they were treated for the condition. Additionally, teaching and guiding can be effective in helping patients with chronic diseases to recognize their symptoms and know what to do in specific situations. For example, a patient with diabetes will benefit from knowing how to change their lifestyle correctly, and in which cases to visit the hospital for tests. Therefore, teaching and coaching are essential in the sickness model of care as they help patients learn how to deal with their illnesses.

Overall, guidance and coaching of patients are essential in the nursing practice. However, with APN the process is more complicated than with RN. RN typically utilize the approach of teaching the patients. APN should have more enhanced skills to be able to communicate the importance of healthcare to the patients. The practice of teaching and coaching fits into the models of wellness and sickness as in both cases they help a person to achieve a specific goal.


Dossey, B. M., & Hess, D. (2013). Professional nurse coaching: Advances in national and global healthcare transformation. Global Advances in Health and Medicine, 2(14), 10-16. Web.

Hamric, A. B., Charlene, M. H., Tracy, M. F., & O’Grady, E. T. (2014). Advanced practice nursing: an integrative approach (5th ed.). St Louis, MI: Elsevier.

Perry, C. (2017). Medical model vs. Wellness model. Web.

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