The Article: Karsten, M., Baggot, D., Brown, A., & Cahill, M. (2010). Professional coaching as an effective strategy to retaining frontline managers. Journal of Nursing Administration, 40(1): 140-144.

Big Idea: When a large teaching hospital in Denver went through large-scale executive turnover (three CEOs in four years, a new CFO, a new COO, a new VP of Human Resources, and the retirement of the CNO with 40 years with the organization), nearly half of the nurse managers left their positions, as well. Needless to say, every quantifiable outcome for the institution started falling. In an effort to retain the frontline nurse managers, the CNO suggested the organization employ executive coaches for all the managers as the CNO had over 10 years of experience utilizing an executive coach herself. This qualitative pilot study examines the impact of coaching on 12 nurse managers within the organization.

Survey Says!: While there is no quantitative data linking the managerial coaching to improved patient outcomes or nurse satisfaction scores, the qualitative data shows the 12 nurses who participated in the study felt the coaching positively impacted their leadership and their team members. The authors point to several instances within health care in which coaching has, indeed, been linked to improved patient outcomes, though, in the cardiovascular service lines, for example.

Quotable: “Evidence suggests that coaching leads to higher levels of engagement among leaders, enhanced communication skills, improved decision-making skills, motivation to succeed, increased retention, and improved outcomes that ultimately provide a significant return on investment to the organization [references]. [Author] reported that the return on investment for one organization was 529%. In another study, [Author] documented a 6:1 return on investment for those engaged in executive coaching” (p. 141).

Discussing the organizational culture: “Historically, if a leader was asked to utilize a coach, it was due to his/her lack of performance and viewed as punitive. To counter this reaction, the COO/CNO openly discussed her use of a coach and the positive impact that it has had on her career. The COO/CNO shared openly; her belief was that leaders at all levels at all times can benefit from a coach” (p. 141).

So What? I have read about executive coaching in business, but honestly, I have not seen it practiced within the nursing profession. It is a fabulous idea. While the study pilot sample was small, it did reveal positive results, but more quantitative data is needed. Organizations with frontline manager or executive-level turnover issues should consider coaching as an investment in organizational and patient outcomes. In addition, this article showed what a difference one trusted and open leader can make. The nurse managers felt coaching was punitive, and because the COO/CNO shared her personal and open experiences, the entire organization’s culture and care changed. That’s the power of a leader!