In the past few years, nurses have faced unprecedented challenges. Staff shortages, the emotional toll of working during a pandemic, and compensation struggles are just some of the factors that have contributed to a more complicated, demanding environment for nurses.
It’s no wonder, then, that more than one-third of nurses say they plan to leave the field by the end of 2022. As a response to high burnout and attrition rates, we’ve seen great discussion on how nurses can increase their resilience. This is an important starting point, but we’re still facing a bigger challenge: reimagining the healthcare system. After all, when you’re working in a broken system, your own personal resilience can only go so far.
Our Individual Resilience Can’t Erase Moral Injury
In a recent interview with the Institute for Healthcare Improvement, Wendy Dean, MD discussed the relationship between resilience and moral injury. She notes that nurses often face moral injury, that is, recognizing a need, but being unable to act on or fulfill that need due to system constraints outside one’s personal control.
That inability to act often goes against not only our personal beliefs as nurses but also the nursing code of ethics. Moral injury can be amplified when we as nurses feel betrayed by the same system that’s meant to protect and promote the health of our patients. And this betrayal goes against the core of our nursing practice: caring.
At the Integrative Nurse Coach® Academy, we often see nurses who are deeply committed to delivering high-quality care, but they’ve also fought hard for everything they needed to fulfill that promise. They’re exhausted, frustrated, and feeling helpless. They may have developed distrust in leadership, knowing that decisions get made without shared governance, and without their best interests in mind.
If this sounds familiar, you’re certainly not alone. Maybe you, too, are seeking new beginnings, considering retirement, or ready to leave the profession.
So the question remains: How do we foster individual resilience for nurses–and fix the healthcare industry to avoid chronic moral injury at the same time? Both require a planned, focused journey.
The Role of Integrative Nurse Coaches in Reimagining the Healthcare System
Integrative nurse coaching has emerged as a proven framework to re-energize nurses and to help hospitals recognize nurses as valuable members of the healthcare team. A recent qualitative study of Integrative Nurse Coach® Certificate Program graduates revealed four key themes:
- Development of self
- Enriched self-care
- A call-to-action for facilitating the healthcare paradigm shift
- Incorporating Integrative Nurse Coaching into practice
The study highlights what most of us in the profession already instinctively know: nurses are very interested in propelling a transformation in healthcare. They want to contribute to a healthcare system that’s focused on health promotion and well-being. Furthermore, nurses’ education, training, and experience all make them uniquely qualified to act as essential leaders in this transformation.
How Hospitals Are Recognizing Integrative Nurse Coaching
More healthcare organizations have moved to incorporate Integrative Nurse Coaching as a professional practice model, which is built on a theoretical foundation, such as the Theory of Integrative Nurse Coaching, and the six common components:
- Leadership
- Nurses’ independent and collaborative practice
- Environment
- Nurse development and reward
- Research and innovation
- Patient outcomes
Integrative Nurse Coaching as a professional practice model might appear in different ways. For example, healthcare organizations might introduce concepts of Integrative Nurse Coaching during new-hire orientation. They may also have board-certified nurse coaches on the hospital floors as preceptors and managers, where they can mentor other nurses, integrate nurse coach skills into practice, and encourage self-development.
The result? A win-win-win for nurses, patients, and healthcare organizations:
- Improved nurse satisfaction, along with reduced attrition rates (especially at the 24-month mark)
- Improved patient outcomes. It’s a win-win-win for healthcare organizations, nurses, and patients.
- Support for the Magnet Journey; the ANCC Practice Accreditation Program with new nurse residencies; and the RN & APRN fellowships to transition experienced nurses to master new clinical skills programs
Aligning Integrative Nurse Coach® practice will create a shared purpose and vision for health & wellness promotion across the organization and heal our nursing profession.
Karen Avino is the Executive Director of Education for the Integrative Nurse Coach® Academy and the International Nurse Coach Associationproviding online and onsite continuing education programs for nurses. As a consultant, Karen helps healthcare organizations create optimal healing environments and integrate holistic nursing into practice. Karen taught Holistic Nursing and Integrative Health for 20 years in online and on campus classes at the University of Delaware. She received the Faculty Senate Excellence in Academic Advising and Mentoring Award. She also received the Delaware Excellence in Nursing Practice Award as Nurse Educator. She has over 40 years of experience in Maternal-Child Health, Administration, Community Health, Holistic Nursing and Nurse Coach practice. She is board certified as both an Advanced Holistic Nurse and a Health & Wellness Nurse Coach. Karen is a Reiki Master, Stress Management Instructor, HeartMath, and Clinical Meditation and Imagery Practitioner. Karen is a Director-At-Large board member of the American Holistic Nurses Association and a founding leader of the Delaware Chapter (DEAHNA). She is an author and editor of Holistic Nursing: A Handbook for Practice (2016, 2021) and Core Curriculum for Holistic Nursing (2014). Karen is a Peer Reviewer for the Journal of Nursing Scholarship and Holistic Nursing Practice journals. She is an international and national speaker on holistic and integrative topics.
