Class 1 Unit 3 Comment 2

Guidance and Coaching Role Differences
The role of teaching and coaching as a registered nurse has similarities and differences with the role of guidance and coaching as an advanced practice nurse. The main similarity between the two roles is patient education. Patient education is done by registered nurses and advanced practice nurses to inform patients about medical procedures, treatment choices, and their medical conditions (Hamric, Hanson, Tracy, & O’Grady, 2014, p. 185). Hameric et al. (2014) explains that patient education is often included in guidance and coaching (p. 185).
Although there are similarities between these two roles, I feel there are more differences than similarities. As a registered nurse when I am teaching and coaching patients I tend to do more teaching and coaching about disease management rather than disease prevention. For example, in the long-term cares setting I may be teaching a patient with congestive heart failure how to lower sodium intake and about the importance of wearing their compression stocking and taking their diuretics to manage their disease. This process follows more closely with the sickness model rather than the wellness model. It would be much more beneficial to teach the patient prior to the congestive heart failure about blood pressure management, low sodium intake, weight loss, and exercise to prevent the congestive heart failure. This would follow more closely with the wellness model. Hamric et al. (2014) describes the advanced practice nurses’ role of guidance and coaching has a holistic approach centered around disease prevention and early interventions (p. 184, 193). I believe this is a very important difference between the role of the registered nurse teaching and coaching and the advanced practice nurse guidance and coaching.
I feel that the most important difference between these two roles is the use of motivational interviewing. As stated in Hamric et al. (2014) motivational interviewing is a technique used by advanced practice nurses to motivate and empower their patients to improve their own health (p. 186). This is achieved by using active listening and open-ended questioning to better understand the patient’s motivation and use this information to empower the patient to make better health care decisions (Hamric et al, 2014, p. 199-200). As a registered nurse this is not a concept I was familiar with and had not previously learned about in my undergraduate degree. This is a very different way to guide and coach patients. I am so used to correcting patient’s misinformation and teaching them about the “right” way to do something. This is a very interesting concept to me which I look forward to exploring.
Hamric, A. B., Hanson, C. M., Tracy, M. F., & O’Grady, E. (2014). Advanced practice nursing:
an integrative approach (5th ed.). St. Louis, MO: Elsevier/Saunders.

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