Learning the Role of Integrative Nurse Coach™ Integrative Nurse Coach™ Academy Graduate...
“I think it (Nurse Coaching) gave me new ears to hear what my client’s goal was— and, you know, maybe bend them to my will a little bit (laughter)— and have them voice that goal and what they really want to work on. It made my work in cancer survivorship much more meaningful and accessible to my patients after getting my Nurse Coach certification.” Leslie Heron
Nurse Practitioner, Nurse Entrepreneur and Co-Founder of Green Labyrinth Small Rural Retreat Center in Northwest WA State
Leslie Heron has over 30 years of nursing, family practice and nurse coaching experience. She works with individuals, community and professional groups, in clinics, classrooms, at conferences, through retreats and on-line. Currently she does much of her work in the field of Cancer Survivorship and healthcare provider Wellness.
Leslie lives in the Mount Baker foothills in Northwest Washington State. She co-founded the Green Labyrinth, a rural retreat center with a mission to provide sacred sanctuary for family and professional caregivers addressing grief, loss and burnout.
Welcome, everyone, to Integrative Nurse Coaches in ACTION! This is Nicole Vienneau, your host, and today we are thrilled to invite Leslie Heron, Nurse Practitioner and Nurse Entrepreneur and co-founder of Green Labyrinth— a small, rural retreat center in northwest Washington state. Welcome, Leslie.
Thank you, Nicole. Thanks for inviting me.
So we are coming together today to talk about everything Integrative Nurse Coaching. The things you’re doing in your life to inspire your communities and your network and all the fun things that are going on in your world.
So I’m hoping we can take a quick dive, historically, to talk about how you decided to become a Nurse.
Oh my goodness, okay. So back in the dark ages, a long, long time ago, and faraway, I had always wanted to be a teacher. And when I went to college, in the late 70s to early 80s, I started off doing all my pre-reqs to transfer to the university and get my teaching degree, and right about that time there seems to have been a glut of teachers. And it was the first time in the history of University of Washington that they actually did not accept an incoming class of teachers in their transfer program.
And right about that time, there were no Nurses, and so there was a pocket of money, as scholarship money, to go to Nursing school. And I was at a community college, and a broke young person, and had had great experiences with my very, very favorite grandmother who had unfortunately passed away from cancer.
But I had been so impressed with the Nurses that took care of her, that I thought, well, I could be a Nurse and then, you know, work as a Nurse and then go back to school and become a teacher later. And the rest is history. So I ended up with my RN degree.
And I have to say that my favorite thing about Nursing continues to be— you know, what, 37 years later— educating patients and helping them feel that they know what to do with their health and their healthcare and things. And so I actually feel I got the best of both worlds. I got to be a Nurse and I still get to be a teacher.
So it all worked out in the end.
Fantastic. Yeah, you get to use your love of teaching coupled with helping people figure out what’s important to them with their health and wellness.
Yeah, and I have to say that in my Nursing career, I’ve done home hospice, I’ve done hospital work, I worked public health for years, I mean, I’ve done so many different things. And then primary care and then cancer survivorship— just so many different avenues that I’ve taken in my Nursing career, and all of them really require partnering with patients and educating them on why something might work well for them, or educating them on, I don’t know, you know, like, why do you want to take your blood pressure medication or even finding out: what does your lifestyle look like?
And does even doing what we’re talking about— you know, going to physical therapy three times a week— make any sense for you? And so maybe not, because you’ve got to work six days a week or something like that, and can’t take time off. So then educating patients on how to do their own self-care at home or things.
So yeah, I feel like the love for education. And then that has fed into my Nurse Coaching, as well, of really partnering with patients on what are their goals? And then how can I be present to help them meet those goals is so much about, you know, listening, educating, awareness. It all flows, it’s kind of cool.
It is very cool, especially because I know exactly what you’re talking about.
Tell us a little about your story in relation to how you discovered Nurse Coaching.
Oh my goodness, well, I’ll drop a couple names in here and Nurse Coaches far and wide probably know a couple of these names. But I have to say that I had a— I still have— a really dear Nursing friend, and the two of us have known each other for years and years, and she reached out to me and said, “I am a house mom and help out with cancer retreats at Harmony Hill”, which is in Union, Washington, and she said, “I think you’d be a great house mom, you should come volunteer with me to do that.”
And so I went out to Harmony Hill, and helped out as a house mom, and met Gretchen Schodde, who’s the founder there. And I also had connected with Gretchen by phone, because I was working in cancer survivorship, and I had connected with her by phone saying, like, “I keep getting these flyers about Harmony Hill, and what is it about?”
And so we talked by phone. Then I went out there and Gretchen has this amazing thing where she says, “Sit down, have a cup of tea with me,” and she started telling me about Nurse Coaching and the INCA program. So, Amy, who was the other Nurse who was with me at the time; the two of us are sitting there having tea with Gretchen and the next thing I knew, I was like, “You know what? This Nurse Coaching thing sounds amazing.” And I wanted to sign up for the program.
And I have to say that I went back to my worksite, which was full-time cancer survivorship in a major cancer research center, and I pitched it to my bosses, and they said, “I really don’t see how coaching will make your job description any different than what you’re already doing as a Nurse Practitioner, so we’re not going to bankroll any of this.”
And I actually went above their heads, and I went to the department heads and pitched it, and thank goodness the person I talked to was a cancer survivor herself, and she said, “I totally could have used a coach in my cancer survivorship.” And so, she got it, and so they helped pay for my program. And I have to say that then I spent the next five years, in my cancer survivorship role, I think giving much— I don’t know if I want to say better care— but much broader and more inclusive care to my cancer survivors as a coach.
And I’ll explain that I— as a Nurse Practitioner in primary care for 19 years, I’ve always been good at educating and partnering with my patients, I think, I pride myself on that— but it was prescriptive, you know? What do I need to do for your ear infection? Or how do we get you on board with more exercise or something like that. But it was very prescriptive. And even at first, with my cancer survivorship, it was like that.
And after going through the Nurse Coach program and becoming certified in that, I feel that I truly understood the partnering with the patient and letting them set the goal. Maybe my goal was for them to become more fit and take off 20 pounds so that they would be at decreased risk for cancer, let’s say. And instead, it was like, what is their goal?
Maybe their goal was really being more mindful, or being less anxious, or being able to sleep better so that they felt more rested, so that then they could even consider an exercise program or improved fitness or better diet.
And so I think it gave me new ears to hear what my client’s goal was— and, you know, maybe bend them to my will a little bit— but to be able to have them be able to voice that goal and what they really wanted to work on. And I think it made, especially my work in cancer survivorship, so much more meaningful and accessible to my patients after getting my Nurse Coach certification.
I wonder if you could elaborate a little bit more on the differences that you spoke of, when you spoke of prescriptive versus really listening and hearing what the patient wants to do. For our listeners who are not really sure of those differences, could you describe that a little bit more?
Sure. Gosh, give me an example. Do you want to do it, I don’t know, about changing blood pressure? What do you want?
Yeah, let’s do someone coming in with high blood pressure.
Okay. So let’s imagine.
I’ll give us a hypothetical patient, maybe a 50 year old person who works full time, let’s say, in retail. Okay, a 50 year old woman who works in retail and she’s running with these high blood pressure numbers.
And I think before my Nurse Coaching, I would probably sit down and say, “Wow, Martha” —we’ll give her a name— “Martha, your blood pressure numbers are continuing to be high. I know that you’re up on your feet all day at work and moving around because you’re working in retail, so I know you’re getting some exercise. How’s it going with limiting salt in your diet? And making good, you know, some healthy food choices? And are you, let’s say, taking that one blood pressure medication every morning, like we talked about?”
And maybe Martha’s like, “Oh my gosh, but I’m so busy at work and I have my grandkids on my other day off, and I’m usually just grabbing something that I can throw in the microwave to eat. So I don’t think I’m doing so great with my salt intake but, you know, I am pretty good about taking my blood pressure medicine every day. But I have to say, even though I’m up on my feet at work, I don’t do any other exercise.”
And I’d be like, “Well, you know, what are the chances… blah, blah, blah,” and then I might add another blood pressure medication; a second one on top of it. Because really, I’m seeing that she’s perhaps not that motivated to do more than she’s already doing, and her life is pretty busy, and she’s kind of got a set idea of: this is what I’m going to do, this is how I do it.
And so I’m going to be like, “Well, okay, I’d love you to work on these things. Might we send you off to a nutritionist?” “No, I don’t have time…” you know, whatever. And it’s like, “Okay, well then let’s add a second blood pressure medicine, because taking your medicine is something you actually can accomplish, right?”
So then, if we reset that with a Nurse Coaching mindset, I might sit down and say the same thing: “Hey, Martha, it looks like the blood pressure numbers aren’t really coming into what we’d love to see them. That’s putting you maybe at increased risk for stroke or heart attack or things like that, whatever. What do you think is working?”
And she might say, “Well, I’m taking my medicine every day, I’m good at that.” And I’d be like, “Wow, that’s amazing. You know, giving you more medication might be an option but I’m wondering if there’s something else that you feel that you’d like to add in, other than another pill, that you’d like to work toward to get your blood pressure down.
Some of the things we’ve talked about before— maybe changing your diet a little bit, getting a little more exercise, stress reduction, getting better sleep at night, a lot of different things that can impact blood pressure. So is there something that you’d really like to do?”
And maybe she says, “Well, you know, I have my grandkids on the weekend and I feel like I’m kind of a boring grandma. Maybe getting to the park with them more?” And then I could explore that. “Well, what would that look like? Are you close to a park? Would you drive to the park? Or is it close enough that you might be able to walk?” “Well, you know, actually, it’s a couple blocks, we could walk to the park, I haven’t thought about that.”
And so really kind of teasing out a little bit more like, “Wow, do you feel like you’d be a cooler grandma if the kids came over and they knew that they could walk to the park with you, and play, and other things? You know, what about other things that you could do with them? Do they like to bicycle? Do they like to shoot baskets?”
And so kind of a little bit more of that give and take, where she is really now going like, “Wow, I could be the coolest grandma ever because we could actually go out to the park and ride bikes together and blah, blah, blah.” And it’s like, “Well, when do you think you could start that?” “You know, I could start that this weekend!” “Okay, well, when do you want to follow up and see how that’s going and see if that’s making an impact on your blood pressure?”
So I think that exploration piece and then, also, instead of going like, “Well, I guess you’re not going to do anything about this, we better just give you another pill.” You know, it’s like, “Well, how do you want to go about this? What might seem engaging?” And come out at that tact. So I think those are kind of the two. As opposed to like, “Let me just write you a prescription and tell you what I want you to do,” a little bit of like, “what would you like to prescribe yourself? And how can I talk you through that to come up with a plan?”
Yes, yes, instead of telling her what to do, now Martha has her own plan and she’s come up with the solutions, because she’s the only one who knows her unique life.
So when you think of the prescriptive kind of view, which was our first scenario, and then shifting it to the second scenario of the Nurse Coach approach, how does that impact you in your practice?
You know, at first I would have said, “Oh, that sounds like it’s going to take a lot longer.” I can just write your prescription, send you out the door, right? But I’ve found, after doing this now— I’ve been a Nurse Coach now for six years, I guess, now— and I don’t think it takes longer, actually.
And I also think, when I was in my more institutional workday role, I think the other thing that I found that was astounding is how much more buy-in I got. So I wasn’t seeing people back and back and back to kind of batter through the same concern over and over again— “Well, that didn’t work. Well, that didn’t work. Well, now that didn’t work. Now, I’m so discouraged that it’s not working.”
So you’d have kind of a whole series of visits where you’re working on the same thing, which when you added up that time, that’s more time. And so I think that one of the ways that it has impacted me is to really realize that when you and your patient are both working on the same goal together, and you’re accomplishing things, it actually does take less time overall.
So I think that there’s that impact, in that I felt more successful and that I’ve actually felt like I could work on the next issue or the next issue with someone, instead of, like, keep circling back to that same one that we don’t seem to get over the bump on. So that feeling of success, feeling really connected, and understanding my patient more, which I personally find satisfying. It’s much more satisfying, career wise, for me.
And then I also think, in this sense it may be a little funny, but it’s kind of nice to not really be in control. I don’t know if I’m saying that right. Because, you know, it takes a lot of pressure and brain work to always be in charge of everything and be driving the bus all the time.
And it kind of has a little bit more of a sense of ease, really, to step back and say, “Well, what direction do you want to drive the bus? And I’ll help you, I’ll say ‘turn left here’, but I don’t have to be the one reading the map all the time.” And so there’s a little bit of ease, not that you don’t have to still be aware and do a good job and all that other kind of stuff, but there’s a little more ease to it.
Yes, and who doesn’t want more ease in your work, right? Yes. And I’m sure with your patients and your clients, I mean, you as a respected Nurse, for you to ask them what they think is important or what they’d like to do, it shifts the relationship to a partnership, versus a prescription of: you must do this, because this is how we do it. And so your relationships become more authentic, I would imagine.
I think you’re right there. I think that’s a great word, that authenticity, indeed. And it’s interesting, I was thinking that, you know, I feel like 19 years of primary care, my patients… I actually have always had pretty good luck, I would say, at people mostly doing what I prescribed. Mostly. Within reason, I suppose.
But I feel that that partnership, that buy-in piece, where someone’s working on something that they want to work on, and maybe it is like, “Oh, I really want to become a distance runner.” And then they end up discovering they have a bum knee and so maybe that distance running thing isn’t going to happen. But instead of that, they can alter their goal a little bit: “Well, maybe I could go to the gym, or maybe I could do yoga, or ride the exercise bike.” You know, something like that.
But we’re working with their goal, and what’s working for them, and then if they kind of hit a wall with that, well, what did work with that, what didn’t work so well with that? How do we take the win part and adapt that? And so that authenticity and all of that, I’ve been pretty astounded with just how much even more buy-in, more success, more, I don’t know… such great changes in people’s health can happen when they get to drive the bus, as opposed to when I’m telling them where to go, which works, but it just works so much easier when we’re working with their goals.
And so I love that authenticity piece, I think it becomes authentic for them instead of what I’m telling them to do.
And who doesn’t like choice? I’d rather choice than, you know, a directive. “You must do” versus “what would you like to do?”
When my kids were little, you know, it wasn’t the thing of like, “Do you want to put on your socks?” But, “Do you want to have your blue socks or your yellow socks on?” You know? Right? So I do think there is a little bit of that flavor in the coaching, too. It’s like, “Do you want to do nothing? Or do you want to do something?” It’s like, “Which something do you want to do?”
I love that explanation. Right, right. But in the end, it does come down to their choice. Yeah, wonderful, wonderful.
So in your journey through your life— you know, Nurse Practitioner, very stressful job working with clients who are surviving cancer, and through creating your own entrepreneurial aspects— how do you keep all of this together?
Oh, now there’s an assumption there, Nicole! (laughter) I love it. You know, it’s interesting, there was some magical thinking that went into jumping ship from the workday world to becoming an entrepreneur and having my own clinical, or not my own clinical practice but my own coaching practice, and deciding that we were going to start this small rural retreat center.
There was some magical thinking that you just put your nose to the grindstone and plug forward and it will kind of magically happen. And actually, what ended up happening is I needed to take a few months of almost, kind of, stepping off the grid entirely and allowing 30 years of healthcare to kind of ground and re-sift. And then being able to pick up the pieces that I wanted to still carry and let go of the pieces that I didn’t want to still carry.
And then, I have to say, I got an extra little bump of time, too, because COVID happened. And so here we were, I was like, “Okay, I’m realizing that I need to take a few months just, kind of, off. Unpack boxes, go through things, figure out who I am now, what I want to do, and almost, I don’t know, do my own recovery from all those years of being in healthcare institutions.
And then I was like, “Okay, we’re ready! We’re going to invite people out here to Green Labyrinth, and we’re going to have small groups out and offer mindfulness, grief, loss, burnout reprieve, a chance to be in nature…” and then COVID hit and nobody could come out.
And so we’ve actually had an additional year of not really having people coming to us, as a retreat center, but more of me having to sift and figure out: well, how do I then offer what I want to offer in a virtual outreach, educational way on Zoom or by phone, and doing my Nurse Coaching, which I had done face-to-face, and then going to a different venue, doing that by phone or by Zoom and does that even work? And the answer is yes.
So when you ask, you know, to get back to your first question of how do you hold all that together? I think I come back over and over again to a quote by Michael Lerner that is: “Move at the speed of guidance.” And so, about the time that I’m stressing out and going, “Oh my gosh, I have so many things on my calendar and there’s so many deadlines,” then noticing that I’m feeling anxious about that, taking some time for some mindfulness, and maybe a walk out in nature for myself, coming back to it, reorganizing, writing it down, and maybe I can even admit defeat a little bit and reach out and say, “Can I move that deadline, you know, can I change that?”
And there’s some things that you can’t change, and so you reorganize and put that as the priority and move something else. But I really find that, for me, I keep coming back, again and again, to the stillness, the stopping, the mindfulness, noticing my own anxiety, and then moving at the speed of guidance and figuring out what’s next, more from an energetic place, maybe, than from a “what’s on the calendar” place. Is that a longer answer than you wanted? Probably!
It’s a lovely answer. And through Nurse Coaching, specifically in the Integrative Nurse Coach™ Academy, there is a beautiful connection to ourselves, to our needs as practitioners, to our own way of being and doing, and our own self-care.
So your view of self-care— I mean, I just heard some wonderful things in there and with moving at the speed of guidance, you know, you’re being guided to that, and you’re listening, you’re hearing that guidance— would you consider that to be self-care?
Oh, I definitely do. I am a mover and shaker, lots-of-things, person. And I always have been that way, I think. And I like to organize, I like to be involved in things. I am not the, you know, quiet, hermit person who goes and just reads books for three months. I feel like I want to interview the author and then I want to go to where they live and then…!
It’s like, “Squirrel!” That’s just who I am, which is great, I’ve accomplished a lot in my life because of that motivation and that curiosity, right? But that self-care piece, that I think I missed for so many years, of stopping and noticing when I’m not getting enough sleep, when I’m not eating well, when I’m feeling anxiety, and somehow or another my answer to that is to take on something else.
Like, if I just do a little bit more, I’ll feel more in control and then maybe I won’t feel as anxious or something like that, you know, there was something that was a little twisty in there. And so then by kind of untwisting that— and I do think that’s the Nurse Coaching perspective around putting your own oxygen mask on first, and being able to stop and notice what’s happening in my body. Are my shoulders tight? Am I breathing shallow? Am I laying in bed at night, problem solving?
And taking notice of that and then saying, “Wow, how can I breathe into that? How can I feel more grounded? What do I need around that?” And maybe that is to leave everything piled up on my desk for half a day and go walk by the river. Or maybe it’s to call a friend, to call a lifeline, and say, “Oh my gosh, how are you?”
Get out of my own head. Ring a bell, read a couple of poems and have a good cry. You know, whatever that is, that slowing down and listening to what your heart says is such a self-care gift. You know, if we could put that in the prescription bottle— take two deep breaths and call me in the morning. Something like that.
Yeah, I think you’re onto something there, Leslie. Let’s put that in a little bottle, sell that on eBay.
Well, actually, what you’re doing with your practice is exposing people to their own inner workings and own access to the things you’re talking about.
I’m super excited with the things that I’ve been able to do virtually. A lot of the different lectures or classes or educational things that I’ve been able to put out, virtually, I’m so excited that that learning curve happened and I was able to do that. But I’m so excited, eventually, to be able to invite people out here to our property.
You know, when I worked and lived in the city, I would have to make this plan like, oh, if I wanted to go sit by a pond, you know, I could get in my car and drive somewhere and go sit by some water. And now I get to walk out my back door and go sit by a little stream and a pond. Or if I want to look at the mountains, I can look out my window. Or if I do feel like taking a drive, I can drive for 20 minutes and actually be at like the second highest mountain, I think, in the United States.
And so things like that, that I’m hoping that once COVID decides to move on from us all, that we can offer that, in person, here at Green Labyrinths. But until that time, I’m so thrilled to be able to offer that virtually and by phone with people— that reminder that we actually all have within us what we need, if we can figure out how to access that. Now, you know, not everything we need, right? But we know what we need, if we can listen within. But most of us don’t take the time to do that in our busy lives.
Yes. So how can our listeners find you and potentially work with you? Or when you open up Green Labyrinth again, how can they discover you?
Well, we do have a website and if nothing else, they should go to the website to see the pretty pictures. Which is kind of a meditation in itself. I’ll tell a really silly little story: last year, we added solar out on our property to help with sustainability and things, and when we were working on getting our loan to put the solar up, the people at the bank who were working with us on the loan, got back to us and said, “I’ve had everybody in the office look at your website because we just want to go there in our minds.” So if nothing else, do that.
So it’s www.green-labyrinth.com. And on there there’s also email access and phone number access for people to reach out, and I would encourage that route, as far as how to find us. And then if you’re a Facebook person, we also have Green Labyrinth Sanctuary as our Facebook page and that also has contact information with email and phone number, as well, on there.
So what do you see on the horizon?
Well, right at the moment, there are a lot of things in the works around education, and I’m doing quite a bit of lecturing and workshopping with Oncology Nurses. And also, Healing Circles. So another great website I’ll plug is healingcirclesglobal.org. And I’m helping bring healing circles to healthcare institutions, and schools of Nursing, and other healthcare professionals.
And so I’m doing quite a bit of education and outreach with healthcare professionals right now. Some of the things that are in the works are more cancer patient and caregiver supports, and a lot of that is actually going to be through a group called Camp Make-A-Dream, which is out of Montana. So if you haven’t heard of them, that’s another thing to look at. And then I’m really hoping, you know, my big hope is to continue doing more personal coaching, one-on-one with patients.
And then I also do some corporate coaching that, I have to say, with budgets right now, with COVID, have gotten a little skinnier. But I love to do that— helping teams work together better. So I’m putting it out there into the universe, that as COVID lightens up, that maybe more individual coaching, more corporate coaching shows up.
And I just so hope to be able to invite everyone to come out to Green Labyrinth and be able to come— whether it’s for half a day or a full day or once we’re able to have people overnight here again— come and really do either just a personal retreat, where you figure out what you want to do, or asking me to help you with some yoga or journaling or coaching or whatever it is, to come here and heal.
Our mission out here is for family and professional caregivers addressing grief, loss, and burnout— which we do a lot of grief work— but, I don’t know, life just feels big right now, and coming in and taking an opportunity to slow down and be in nature is healing in and of itself.
Absolutely. Well, we will look forward to hearing what transpires for you and Green Labyrinth and, just, Leslie Heron. And thanks so much for joining me today here.
Oh, thank you so much for asking, Nicole. Much gratitude to you. Thank you.
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