NURS 236A

Module 5

Phyllis M. Connolly PhD, APRN, BC, CS

 

Professional Competency: Coaching and Mentoring

 

Nursing�s responsibility is awesome�in patient care and also in creating a new society�and the nurses who will lead this movement are nursing administrators who have embraced the values of caring and will bravely move the philosophy of caring into the dominate place in health care systems and in society.� (Nyberg, 1998, p. 209)

 

Purpose

You will have two weeks to complete this module. You will explore the important role of professional competency in the nursing profession and specifically as a nurse administrator/manager.Various definitions of competency and its relationship to caring and the role the administrator/manager will be explored. Teaching and learning theories will be reviewed as they relate to the concepts of mentoring and coaching for yourself and for those you lead. Evaluation of the impact of organizational learning will be discussed. Furthermore, this module will help you prepare your self-evaluation for your midterm evaluation.

 

Learning Outcomes

After completing this module, you will be able to:

 

    • Define competency and caring
    • Discuss the sources for identifying and mandating competencies
    • Describe the competency-mastery connection
    • Recognize the stages of Bennner�s (1984) novice to expert
    • Describe the similarities and differences between mentoring and coaching.
    • Explore the relationship between �Caring� and coaching and mentoring
    • Recognize the need to utilize mentors and coaches in developing your managerial competencies
    • Review teaching and learning theories and models used to facilitate competency
    • Identify tools to assess learning styles
    • Identify the steps in coaching
    • Discuss the evaluation of organizational learning.

 

Required Learning Activities

 

Complete by November 15 at 5:00PM (You have two weeks for the work in this module; please note responses to Question # 1 needs to be posted by November 8 at 5:00PM)

    1. Read (all articles are available in full text through SJSU electronic CINHAL data base, http://libaccess.sjsu.edu:2409/ovidweb.cgi. You will need to log into the library and CINHAL to access the articles which follow:

 

a. Tornabeni, J. (2001). The competency game: My take on what it really takes to lead. Nursing Administration Quarterly, 25(4), 1-14.

 

b. Kruger, J. & Dunning, D. (1999). Unskilled and unaware of it: How difficulties in recognizing one�s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology, 77(6), 1121 � 1134. This article can be accessed directly at http://www.apa.org/journals/psp/psp7761121.html

 

c. Lewis, M. Caring and competency. JONA, 4(2), 36 �43.

 

e. Meretoja, R., & Leino-Kilpi, H. (2001). Instruments for evaluating nurse competence. Journal of Nursing Administration, 31(7/8), 346 � 352.

 

f. George, V. Farrell, M., & Brukwitzki, G. (2002). Performance competencies of the chief nurse executive in an organized deliverysystem. Nursing Administration Quarterly, 26(3), 34 � 43.

 

g. McCallum, M., Curran-Smith, J., Wojnar, D., & Williamson, S. (2002). Evaluating the impact of organizational learning initiatives. Journal for Nurses in Staff Development, 18(4), 177 �183.

 

h.       Hansen, D. Matt-Hensrud, N., Holland, D., Severson, M. (2000). Development of a discharge planning mentorship program. Journal for Nurses in Staff Development, 16(1), 11 � 16.

 

i.         Feldman, D. (2001). Career coaching: What HR professionals and managers need to know. Human Resource Planning, 24(2), 26 35.

 

j.        Kondrat, B. (2001). Operating room nurse managers-competence and beyond. AORN Journal, 73(6), 1116, 1119, 1121 �1124, 1126-1127, 1129 �1130.

 

k. Knouse, S. Virtual mentors: Mentoring on the internet. Journal of employment

counseling, 38(4), 162 � 169.

 

l.         Nyberg, J. (1998), Chapter 11, The Organization and Practice of Nursing in A caring approach in nursing administration (Nyberg, J. 1998). Course Textbook, also available as an electronic book at SJSU Library

 

2.      Post on the Discussion Board (for November 9) By November 8, 5:00 PM.Identify one managerial competency that you need to develop and a plan to increase and measure your competency. Support your work based on the assigned readings, provide your citations.

 

  1. Post on the Discussion Board (for November 16) By November 15, 5:00 PM Describe one example of coaching that either you were able to use either in your current management position or during your practicum experience. Support your work from the assigned readings, provide your citations.

 

  1. Post on the Discussion Board (for November 16) By November 15, 5:00 PM. Describe one clinical example, that supports one of the �predictions� cited by Kruger and Dunning (1999).

 

 

�Mini-Lecture

�The new leader is a partner�

 

�You are responsible for your own learning. I am responsible for supporting, facilitating & learning with you.

 

The issues regarding competency are most frequently addressed by the national nursing organization, the American Nurses Association. There is agreement among nursing professionals that competence is a key component to assuring quality of nursing interventions and outcomes. Furthermore, one major responsibility for nurse administrators is to ensure staff nurse competence (Meretoja & Leino-Kilpi, 2002).The American Nurses (ANA) 2001 Code of Ethics asserts that individuals must assume responsibility and accountability and maintain competence. Moreover, it asserts that the profession must continue developing its body of knowledge and improve nursing standards.In addition to the ANA Code of Ethics the ANA develops standards of practice for general nursing as well as specialty areas, each Standard specifies measurement criteria which identify performance expectations

http://nursingworld.org/ethics/code/ethicscode150.htm . Provision 5.2states:

 

Though it has consequences for others, maintenance of competence and ongoing professional growth involves the control of one�s self respect, self-esteem, professional status, and meaningfulness of work�Evaluation of one�s own performance, coupled with peer review, is a means by which nursing practice can be held to the highest standards (ANA, 2001).

 

Lifelong learning through continuing education, networking with professional colleagues, self-study, professional reading, certifications and seeking advanced degrees are suggested to meet the provisions in 5.2 (ANA, 2001).

 

Additionally, The National Council of State Boards of Nursing define competency as the application of knowledge and the interpersonal, decision-making, and psychomotor skills expected for the nurse�s practice role (National Council of State Boards of Nursing, 1996). State Nurse Practice Acts for example the Nursing Practice Act of California (1997)�� http://www.rn.ca.gov/npa/title16.htm#1443.5 defines Standards of Competent Performance (1443.5) � a registered nurse shall be considered competent when he/she consistently demonstrates the ability to transfer scientific knowledge from social, biological and physical sciences in applying the nursing process� .�

 

Advanced nursing practice competencies are defined both by ANA and specialty organizations such as the National Association of Clinical Nurse Specialist (CNS). In their publication Statement on Clinical Nurse Specialist Practice and Education (1998) core CNS practice competencies are defined: The graduate degree demonstrates the achievement of those competencies. In addition to the ANA Scope and Standards for Nurse Administrators (2004) specific performance competencies for nurse administrators have been identified in several studies (George, V., Farrell, M., &Brukwitzki, G. 2002; Kondrat, B, 2001). The results of the studies about managerial competencies indicated that communication, advocacy, valuing staff, and competence in decision-making were most important. Kondrat (2002) reported that competencies in human and leadership categories were higher than categories in financial management, conceptual, and technical categories. Tornabeni (2001) identifies six core competencies needed to manage an integrated health system as conceptual, technical, managerial/clinical, interpersonal/collaborative, political, commercial, and governance (p. 1).You should reflect on the work of these authors and compare them to those prescribed by ANA (2004) as well as your own practice and experiences.

 

Others involved in defining competencies include JCAHO, and employing organizations, which may set up competencies such as advanced life support, patient safety for use of restraints, intravenous therapy and/or wound care. Most of these go beyond basic competencies with a goal of providing quality care, protecting the organization from liability and/or meeting licensing regulations.

 

Clearly, there are a number of approaches and organizations that are prescribing and defining competency. Lewis (2002) states, �that caring in its proactive prospective role, is essential for nursing competency, with its goal of good patient care� (p. 41) and he argues, as does Nyberg (1998) that there is strong relationship between caring and competency. An excellent literature review of definitions of competency is found in Lewis (2002) with agreement that the areas include critical thinking, interpersonal skills, and technical skills. Most authors cite interpersonal skills, which are critical to demonstrating caring, as the most important. This appears consistent with the results of patient satisfaction studies in which low scores have been found in the area of emotional support for patients, that is patients wanted more emotional support.

 

How do we assess competency and how can it be increased?Meretoja and Leino-Kilppi (2001) have identified and evaluated the current available tools, which may be used to assess practicing nurses. Their work confirms the problem of definitions of competence as well as confusion between competence and performance. The findings are valuable and include an evaluation of the reliability and validity of the various tools. Many of the instruments are self-assessments. Kruger and Dunning (1999) claim that people tend to over estimate their abilities and that this becomes a problem in their ability to realize it (http://www.apa.org/journals/psp/psp7761121.html). The authors� claim that novices have poorer metacognitive skills than do experts. They make four specific predictions about the links between competence, metacognitive ability, and inflated self-assessment, which have implications for interventions. Perhaps the most important is that the incompetent gain insight about their deficiencies by making them more competent. Based on my own 40 years in nursing practice, my practice and experiences are consistent with the findings of the authors.

 

The challenge for you as a professional nurse and nurse administrator is how to measure and maintain your own competency as well as those under your supervision. Certainly, your recognize your professional obligation to lifelong learning and Tornabeni (2001) and other authors offer specific maps to achieving and maintaining competency. The other areas that must be integrated are theories and approaches for teaching and learning which facilitate personal and professional growth. You may want to review the description of learning styles, if so go to (Felder & Soloman) http://www.ncsu.edu/effective_teaching/ILSdir/styles.htm. You may also want to go and evaluate the tools for use for assessing your learning and employee learning styles by going to the following sites:

 

Teaching and learning theories and strategies can be reviewed and explored at the following sites:

 

Resource

URL

Visible Knowledge Project:

http://crossroads.georgetown.edu/vkp/resources/glossary/

From Novice to Expert

http://books.nap.edu/html/howpeople1/ch2.html

 

Problem Based Learning

http://crossroads.georgetown.edu/vkp/resources/glossary/problembased.htm

 

Inquiry Based Learning

http://www.thirteen.org/edonline/concept2class/month6/

 

Center for Teaching and Learning Resources

http://wings.buffalo.edu/vpaa/ctlr/files/teaching_learning.htm

 

Theories of Learning

http://commhum.mccneb.edu/PHILOS/learntheo.htm

 

In Module 3, Nursing in the New Millennium, for this course mentoring was discussed as a component of the paradigm shift in effective leadership and it is also a method of teaching and coaching for both you as well as your employees. You may want to review the module and the Power Point, �Management and Leadership in a Managed Care Environment.� In this Module we will explore the concept of coaching, primarily as one of the administrator/manager�s tool to increase staff competencies and promote their potential. Knouse (2001) describes the use of the internet for mentoring and in fact the use of our Chat Room for clinical supervision is yet another example of how the internet is being used for both mentoring and coaching. Hansen et al. (2000) provide an example of a using mentoring to improve discharge planning.It is important that you understand the various theories, and principles of teaching and learning as well as styles of learning in order to provide effective coaching. One definition of coaching found at http://www.coachingnetwork.org.uk/ResourceCentre/WhatAreCoachingAndMentoring.htm states that:

 

coaching is a process that enables learning and development to occur and thus performance to improve. To be a successful a coach requires a knowledge and understanding of process as well as the variety of styles, skills, and techniques that are appropriate to the context in which the coaching takes place.

 

It is important to understand that coaching does not attempt to resolve deeper individual problems, which cause serious performance problems such as, poor motivation, low self-esteem and personal upheaval. Rather coaching focuses on performance, and here and now issues, by setting goals and achieving results within specific time frames. With that in mind and with some steps outlined by Sullivan and Decker (2001) and my years of practice, the following steps are provided for you as a possible guideline for using coaching as a method for developing competencies among staff.

 

 

Steps for Successful Coaching 

(Sullivan & Decker, 2001; Connolly, 2003).

 

 

1. Prepare for the session

Schedule time and place that gives you and the employee the appropriate environment and time to complete the session. Do not meet in the employee lounge.

 

2. Time

Depending on the performance that needs to be developed this may vary from 5 minutes to an hour. One hour would be the maximum for any one session. If additional time is needed more sessions should be scheduled.

 

3. Keep the appointment time

Do not cancel or change a scheduled session unless there is an extremely important reason. Inform the person yourself.If this is necessary reschedule by first checking with the employee on the next best time for her or him.

 

3. Establish the performance goal

The specific performance goal should be clear; the person may need to eliminate or improve a performance or develop a new performance behavior.

 

4. State the targeted performance in behavioral terms

 

Example, �Fall risk assessments were not completed on your patients.�

 

5. Connect the problem to outcomes for patient care, unit functioning, or the person�s self-interest

Example, Fall risk assessments are a standard practice for this unit. �Failure to complete the assessments may lead to unnecessary injuries for our patients.� Avoid threatening language.

 

6. Explore reasons for the problem

You must be listening and willing to hear the employee�s reasons. Use Covey�s (1990) Habit 5, Seek first to understand, then to be understood, the principle of empathic communication. If the explanation is a lack of knowledge regarding the standard than the session may be brief.However, it would be at this point that you must assess the employee�s education and skill in completing the Fall risk assessment. If education is necessary than you must be aware of all the resources for learning within your organization.

 

7. Ask for suggestions and discuss ideas to solve the problem

Most times employees do know how to solve the problem and their participation in the solution are more likely to result in commitment to the solution. Again, listening to the employee is critical.

 

8. A written plan describing the steps to be taken to solve the problem should be developed

If the problem is minor than an oral agreement on the solution maybe all that is needed. If not agreement on the developed steps should be achieved before the session is ended.

 

9. Follow up meeting should be scheduled to provide performance feedback

The meeting should be scheduled before the coaching session ends at a mutually convenient time.

 

Note: Personal problems. The manager should not ask the employee if she/he has personal problems. 

Employees may disclose that personal problems have contributed to the work problem. The nurse manager needs to demonstrate concern and willingness to assist the employee to obtain help.The additional resources should be identified for the employee.

 

It is important to evaluate the efforts, which are made to improve organizational learning, and McCallum et al. (2002) provide an evaluation model, which you may find useful.

 

 

 

 

References

 

American Nurses Association. (2000).A new code of ethics for nurses. American Journal of Nursing, 100(7), 69 �71.

 

American Nurses Association. (2004). Scope and standards for nurse administrators(2nd ed.).ANA:Washington, DC.

 

Angelini, D. J. (1995). Mentoring in the career development of hospital staff nurses:Models and strategies. Journal of Professional Nursing, 11(2), 89 - 97.

 

Ashton, J. T. (1996). Establishing a team-based coaching process. Contemporary Nurse,  4(1), 6.

 

Bell, C. R. (1996). Managers as Mentors: Building partnerships for learning. San �� Francisco: Berrett-Koehler Publishers.

 

Benner, P. (19984). From novice to expert. Menlo Park, CA: Addison-Wesley.

 

Campbell-Heider, N. (1986). Do nurses need mentors? Image, 18(3), 110 - 113.

 

George, V., Farrell, M., Brukwitzki,. G. (2002). Performance competencies of the chief nurse executive in an organized delivery system. Nursing Administration Quarterly, 26(3), 34 � 43.

 

���������� Feldman, D. (2001). Career coaching: What HR professionals and managers need to know. Human Resource Planning, 24(2), 26 35.

 

Hansen, D. Matt-Hensrud, N., Holland, D., Severson, M. (2000). Development of a  discharge planning mentorship program. Journal for Nurses in Staff Development, 16(1), 11 � 16.

 

Haynor, P. M. (1994). The coaching, precepting, and mentoring roles of the leader within an organizational setting. Holistic Nursing Practice, 9(1), 31 - 40.

 

Johns, C. (2003). Clinical supervision as a model for clinical leadership. Journal of Nursing Management, 11(1), 25 � 34.

 

Kondrat, B., (2001). Operating room nurse managers-Competence and beyond. AORN, 73(6), 1116, 1119, 1121-1124, 1126-1127, 1129-1130

 

Knouse, S. (2001). Virtual mentors: Mentoring on the internet. Journal of employment counseling, 38(4), 162 � 169.

 

Kruger, J. & Dunning, D. (1999). Unskilled and unaware of it: How difficulties in recognizing one�s own incompetence lead to inflated self-assessments. Journal of Personality and Social Psychology, 77(6), 1121 � 1134. 

 

Lewis, M. Caring and competency. JONA, 4(2), 36 �43.

 

McCallum, M., Curran-Smith, J., Wojnar, D., & Williamson, S. (2002). Evaluating the learning initiatives. Journal for Nurses in Staff Development, 18(4), 177 �183.

 

Meretoja, R., & Leino-Kilpi, H. (2002). Instruments for evaluating nurse competence.Journal of Nursing Administration, 31(7/8), 346 � 352.

 

National Council of State Boards of Nursing (1996). Definition of Competence and Standards for Competence. Chicago: National Council of State Boards of Nursing.

 

Nyberg, J. (1998). ). A caring approach in nursing administration. eBook ISBN 0585042446, Niwot, CO: University Press of Colorado. On reserve in SJSU library.

 

Nyberg, J. (1998). A caring approach in nursing administration. Niwot, CO: University Press of Colorado.

 

Pearson, L. (2001). The incompetent expert. Nurse Practitioner, 26(8), 8, 11.

 

Sullivan, E., & Decker, P. (2001). Effective leadership and management in nursing (5th ed.) Upper Saddle River, NJ: Prentice Hall.

 

Tornabeni, J. (2001). The competency game: My take on what it really takes to lead. Nursing Administration Quarterly, 25(4), 1-14.

 

Wickman, F., & Sjodin, T. (1996). Mentoring. Chicago: Irwin.

 

 

Last Modified: Jan 14, 2015