AHNCC Nurse Coach Certification Program (FOR THE AHNCC WEBSITE ANNOUNCEMENT)
May 10, 2012; Draft 2
©AHNCC, Not to be reprinted without permission
AHNCC’S NURSE COACH CERTIFICATION PROGRAM
AHNCC ANNOUNCES A
CERTIFICATION PROGRAM FOR NURSE COACHES
FALL 2012.
Nurses from all specialties and areas of practice will be eligible to take the Nurse Coach
Certification Examination and earn the NC-BC credential. AHNCC Certified Holistic Nurses who
successfully pass the Nurse Coach Certification Examination qualify for the
Health and Wellness Nurse Coach credential, HWNC-BCi.
The Nurse Coach Role Defined
The Role of the Nurse Coach has been defined by Darlene Hess, Barbara Dossey, Mary Elaine Southard,
Susan Luck, Bonnie Schuab, and Linda Bark in Professional Nurse Coach Role: Defining Scope of
Practice and Competencies (2012), and endorsed by leading Nursing Organizations including the
American Holistic Nurses Association, American Nurses Association, American Academy of Nurses,
Sigma Theta Tau, Commission on Graduates of Foreign Nursing Schools, and the American Association
of Critical-Care Nurses. It is also under consideration by other leading Nursing organizations. According
to the authors Professional Nurse Coaching is “…a skilled, purposeful, results-oriented, and structured
relationship-centered interaction with clients provided by Registered Nurses for the purpose of
achievement of client goals.” (p. 9, 38) Clients of Professional Nurse Coaches are the experts of their
needs, and as such, set the agenda for the Coaching Process.
The Professional Nurse Coach “… may focus on health and wellness coaching, executive coaching,
faculty development coaching, managerial coaching, business coaching, or life coaching.” (p. 10) These
expanded roles require additional knowledge and skills, specific to the focus of the Nurse Coach’s
practice. AHNCC takes the position that knowledge, skills and attitudes related to health and healing are
inherent in Holistic Nursing (AHNA, 2007, Holistic Nursing, Scope and Standards of Practice, p. 6, 21).
Therefore, nurses Certified in Holistic Nursing have validated their competency in knowledge,
skills, and attitudes necessary to facilitate clients in their pursuit of health and wellness (AHNA,
2007, Holistic Nursing, Scope and Standards of Practice, p. 1-6, 26). Coupled with knowledge and skills
essential for the Nurse Coach and validated by AHNCC Nurse Coach Certification, Certified Holistic
Nurses can practice as Health and Wellness Nurse Coaches.
Nurse Coaching Described
Nurse Coaching occurs in a cyclic manner, with a dynamic unfolding of client and process. The aim of
Nurse Coaching is to facilitate “… clients to grow, develop, and/or change in such a way that
assists them to realize their potential” (Hess, D., Dossey, B., Southard, M., et al, p.3) Nurse Coaches,
aware that effective change evolves from within before it can be manifested and maintained externally,
use skills and knowledge that integrate body-mind-emotion-spirit. They achieve these ends by cocreating nurse-client relationships that facilitate their clients to identify their needs and related
goals; plan strategies necessary to meet these goals; and evaluate their progress.
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Nurse Coach Practice Settings
Nurse Coaches work with individuals and/or groups in all areas and specialties of nursing practice. They
“…are staff nurses, ambulatory care nurses, case managers, advanced practice nurses, nursing faculty,
nurse researchers, educators, administrators, or nurse entrepreneurs.” (Hess, D., Dossey, B., Southard,
M., p.10) Their involvement in the Nurse Coach role “…is dependent on coach specific education,
training, experience, position, and the population they serve.” (Hess, D., Dossey, B., Southard, M., p. 3,
10)
The Nurse Coach Domain
The body of knowledge of Nurse Coaching is specific to the competencies of the Nurse Coach, which are
embedded, in the basic precepts of Holistic Nursing. The knowledge and skills of the Nurse Coach are
organized around five (5) Core Values: 1) Nurse Coach Philosophy, Theories, and Ethics; 2) Nurse Coach
Process; 3) Nurse Coach Communication and Coaching Environment; 4) Nurse Coach Education,
Research, and Leadership; and 5) Nurse Coach Self‐Development (i.e. Self-‐Reflection, Self Assessment,
Self‐Evaluation, Self‐Care). (Hess, Dossey, Southard, et al, p.21)
Nurse Coaching is aligned with the ANA Nursing: Scope and Standards of Practice, Second Edition
(ANA, 2010a) and based within the precepts of Holistic Nursing. This means that the Nurse Coach role,
built upon basic nursing knowledge and skills, requires knowledge and a set of skills that are acquired by
additional education beyond that acquired as a professional nurse, and specific to the Nurse Coaching
Process.
Nurse Coach Certification Eligibility Criteria
Table 1. provides Eligibility Criteria required for nurses who seek AHNCC Nurse Coach Certification,
effective April 1, 2013. Alternative criteria, effective September 1, 2012-March 31, 2013 are shown in
Table 2. A full explanation for the criteria shown in Table 2 is provided immediately following Table 1,
just before Table 2.
Table 1. Eligibility Criteria for the AHNCC Nurse Coach Certification Examination
DATES
EFFECT
IVE1
LICENSE
EDUCATIONAL
BACKGROUND
PRACTICE
AS A NURSE
CONTINUING
EDUCATION2
PRACTICE AS A COACH
April 1,
2013
Unrestricte
d and
current
United
States RN
license
A minimum of a
Baccalaureate
Degree in Nursing
from an academic
accredited
institution
Active practice
as a RN for a
minimum of 2
years fulltime
or a minimum
of 4,000 hours
1) 60 CNEs, accrued
over the past 3
years, that include
content consistent
with the Nurse
Coach Core Values3
1) 60 hours experience that
has been mentored, and/or
supervised by a Certified
Nurse Coach5.
1
2) Validation letter from a
Candidates who apply for the Professional Nurse Coach examination April 1, 2013, and thereafter will be required to meet
the requirements indicted in this set of criteria. September 1, 2012-March 31, 2013 applicants will be accepted who meet
criteria shown below.
2 AHNCC stipulates CNE units as required. Academic credits that address content specific to the Nurse Coach Core Values
will be accepted from accredited institutions with the same ratio as required by ANCC CNEs (60 minutes contact time of
teaching-learning is equal to 1 CNE).
3 Professional Nurse Coach: Scope and Competencies (Hess, Dossey, Southard, et al, 2012).
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AHNCC Nurse Coach Certification Program (FOR THE AHNCC WEBSITE ANNOUNCEMENT)
May 10, 2012; Draft 2
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the past five (5) 2) A minimum of 10 qualified Nurse Coach.
years.
hours of personal
coaching experience
is recommended as a
way of obtaining
learning experiences
related to Core
Value 5: Nurse
Coach SelfDevelopment4
AHNCC recognizes that several professional nurses have been actively and competently practicing the
Nurse Coach role, but do not meet our educational and/or practice criteria as stipulated in our criteria
effective April 1, 2013 (shown immediately above). AHNCC also recognizes that many of these nurses
have the knowledge and skills necessary to practice Professional Nurse Coaching as described in our
Handbook. Therefore, Effective September 1, 2012 through March 31, 2013, applications will be
accepted from nurses who are able to meet criteria shown below immediately. Nurses who meet these
criteria and have their Application postmarked by March 31, 2013, will be able to sit for the AHNCC
Professional Nurse Coach Examination through December 31, 2013.
Table 2. Alternative Eligibility Criteria for the AHNCC Nurse Coach Certification Examination
DATES
EFFEC
TIVE6
LICENSE
EDUCATIONAL
BACKGROUND
PRACTICE
AS A NURSE
CONTINUING
EDUCATION7
PRACTICE AS A NURSE
COACH
Sept 1,
2012 to
March
31,
20138
Unrestricted
and current
US RN
license.
A minimum of
ADN or NonNursing
Baccalaureate
degree from an
accredited
institution.
Active practice
as a RN for a
minimum of 2
years fulltime
or a minimum
of 4,000 hours
the past five
(5) years9.
1) 60 CNEs,
acquired over the
past 5 years, that
include content
consistent with the
Nurse Coach Core
Values10 ,11
2) A minimum of
10 hours of personal
coaching experience
is recommended as a
way of obtaining
1) 60 hours experience that
has been mentored, and/or
supervised by a Certified
Coach13.
or
1) Year active practice as a
Nurse Coach that can be
verified by a Certified
Coach.
5
A Certified Nurse Coach is an AHNCC Certified Nurse who is certified by a nationally recognized organization.
Personal Coaching will also help candidates complete the Self-Reflective component on the Nurse Coach Application.
6 Nurses who meet these criteria and have their Application postmarked by March 31, 2013, will be able to sit for the AHNCC
Professional Nurse Coach Examination for up to one year from the date of their Application acceptance, but no later than
December 31, 2013.
4
7
Continuing education units must be offered by a nationally recognized body such as ANCC, ICF, and IACET
must approve CE courses.
8
Applications postmarked after March 31, 2013 will be required to meet criteria indicated as Effective, April 1, 2013. No
exceptions apply.
9
Two years practice ensures that nurses are well prepared to practice within the context of ANA’s Nursing: Scope and
Standards of Practice, 2nd Edition (2010), Code of Ethics for Nurses with Interpretive Statements (ANA, 2008), the Position
Statement on Holistic Nursing Ethics [AHNA, 2007]).
10 Professional Nurse Coach: Scope and Competencies (Hess, Dossey, Southard, et al, 2012).
11 While CNE’s are preferred, AHNCC recognizes that nurses often attend educational programs that offer CEs rather than
CNEs. If these are submitted as evidence of eligibility, it is essential that candidates describe how these educational units
prepare them for the Nurse Coach role.
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learning experiences 2) Letter of practice
related to Core
competency validated by a
Value 5: Nurse
Certified Coach.
Coach SelfDevelopment12
Certification Credential
Nurses who have successfully completed the AHNCC Nurse Coach Certification Program may use the
designated credential NC-BC. Nurses who have successfully completed the AHNCC Nurse Coach
Certification Program, and are Certified in Holistic Nursing may use the designated credential, HWNCBC. These credentials verify that the individual has met all eligibility and testing requirements and is
currently certified as a Professional Nurse Coach or a Professional Health and Wellness Nurse Coach
respectively.
The nurse must maintain certification in Holistic Nursing and Nurse Coaching to be able to use the
HWNC-BC credential. HWNC-BC Nurses who fail to maintain their certification as a Holistic Nurse, but
continue to maintain an active Nurse Coach certification can use the NC-BC credential and describe their
practice as a Certified Nurse Coach, but cannot describe their certified practice as a Certified Health and
Wellness Nurse Coach.
NC-BC and/or HWNC-BC cannot be used when the nurse has:
1. Not completed or maintained the respective AHNCC certification requirements;
2. Failed to follow required steps for recertification;
3. Requested inactive status as a NC-BC or HWNC-BD; or,
4. Had certification withdrawn by AHNCC.
NURSE COACH CERTIFICATION FEES
Nurse Coach (NC-BC)
$425.00
NC with active Membership in an
Endorsing Organization14
$375.00
NC with active AHNCC Holistic
Nurse Certification (i.e. HWNCBC)
$350.00
Fees are effective September 1, 2012
13
A Certified Coach is a nurse coach who has been certified by a nationally recognized organization. A list of nationally
recognized organizations can be found in the AHNCC Documents Library by clicking www.ahncc.org/documents
12 Personal Coaching will also help candidates complete the Self-Reflective component on the Nurse Coach Application.
See Hess, Dossey, Southard, Luck, Schuab, and Bark, Professional Nurse Coach Role: Defining Scope
of Practice and Competencies (2012) for listing of Endorsing Organizations.
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AHNCC Nurse Coach Certification Program (FOR THE AHNCC WEBSITE ANNOUNCEMENT)
May 10, 2012; Draft 2
©AHNCC, Not to be reprinted without permission
INFORMATION ABOUT THE NURSE COACH EXAMINATION
Exam Development
AHNCC and the Professional Testing Corporation collaborated to develop a reliable and valid
Certification Examination for the Professional Nurse Coach based on the current practice of Nurse
Coaching. A multiple four-step process guided the development of the Certification Examination:
1. A systematic review of the literature was undertaken in 2009-2010 to assess the inclusion of
references to or about the nurse coach (Hess, D. & Dossey, and B. M. 2012. Nurse coaching: A review of the
literature.) Given that the literature provided evidence of the emergence of the role of the nurse coach,
a study was undertaken to assess the need for a Professional Nurse Coach Certification Program
(October 2010- October, 2011).
The results indicated a strong interest in the Professional Nurse Coach Role. AHNCC established a
liaison with a group of Nurse Coaches involved in drafting a document to define the scope of the
Nurse Coach. A liaison was established between this group of Nurse Coach leaders and AHNCC with
the agreement between the two that AHNCC would further explore the need/interest in a Nurse
Coach Certification and the “work” group would continue to work on drafting a document defining
the Role of the Nurse Coach. This group of nurse leaders authored the first edition of the Professional
Nurse Coach Role: Defining Scope of Practice and Competencies (Hess, Dossey, Southard, Luck,
Schuab, & Bark, 2012) (in press)
2. The literature was revisited to identify the practice activities and practice behaviors of the Nurse
Coach. A listing was created and categorized according to the ANA Standards of Professional
Nursing (ANA, 2010). This was followed by the review of an expert panel of currently practicing
Nurse Coaches to review the listing and evaluate each item to determine if: a) it was a Nurse Coach
Competency, b) if yes, if it reflected the standard under which it was categorized, c) its clarity, d)
redundancy, and e) other comments. They were also asked to do a secondary review of the listing, to
consider it as a total set of competencies, and to determine if competencies were missing. If one was
missing, the reviewers were asked to write the competency and identify the related Standard of Care.
The information provided from their review was used to revise the competency listing. The revised
set was sent to a new panel of expert Nurse Coaches. They were asked to follow the same system.
Their comments and recommendations were again used to refine and tighten the listing of
competencies. Finally, the 2012 document drafted by Hess, Dossey, Southard, et al was reviewed to
ensure that the competencies compiled by the above process were reflected in this seminal document;
both omissions and commissions were considered. Minor changes were made to a few of the
competencies; a third Panel of Experts reviewed the changes.
3. The competencies were submitted to the Professional Testing Corporation (PTC) May 12, 2012 to
be used as bases for a Role-Delineation Study (RDS). A survey will be developed and pilot tested.
The survey and data collection methods will be revised according to the findings in the pilot test. The
RDS will be undertaken this summer-fall of 2012. A Blue Print will be derived for the examination
based on the findings of the RDS.
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Input Needed from Practicing Nurse Coaches
AHNCC needs the help of those who are currently practicing as a Nurse Coach in two ways. First, we
need your help as an item writer for the Nurse Coach Certification examination. The competencies
identified through a rigorous process, starting with a literature review led to a specification of
competencies. These were reviewed by two expert-panels with revisions following each review. The
final set of competencies provided the basis for a Role-Delineation Study (currently underway), and
will be used as a guideline for item-preparation. They are included in Appendix B of our Nurse
Coach Item-Writer’s Handbook. If you are willing to help us, please click here to download the
Handbook.
We will also need a substantial number of Nurse Coaches, from various settings, and from different
geographical areas, to respond to our Role Delineation Study that will be undertaken this summer. If
you are willing and interested in participating, please contact us by sending your name, address, and
information through our website (www.ahncc.org, Recertification page) or by contacting us at
ahncc@flash.net. As soon as the study is ready, we will send you the link and instructions.
i
AHNCC POSITION STATEMENT
Holistic Nursing
Holistic Nurses organized in 1982 around key concepts relevant to the current international
healthcare reform that were recently legalized in the United States by the Affordable Care Act
(HR3590, Section 4001, March 23, 2010). Our Scope of Practice and Standards (AHNA, 2007)
identifies and defines these concepts as:
•The person as an entity (or being) with“… unity, totality, and connectedness of everyone and
everything.” (p. 6)
• Health is defined as a “…balance, integration, harmony, right relationship, and the
betterment of well-being…” (p. 6) and, “An individually defined state or process in which the
individual (nurse, client, group, or community) experiences a sense of well-being, harmony,
and unity such that subjective experiences about health, health beliefs, and values are honored;
a process of becoming and expanding consciousness.” (p. 68)
•Holistic Nursing Practice is “…a science…and an art…” (p. 7) Holistic Nurses use “…critical
thinking, reflection, evidence, research, theory…intuition, creativity, presence, and selfknowing…” (p.7) to guide their practice. They also use“…warmth, compassion, caring
authenticity, respect, trust, and relationship as instruments of healing….” (p.7)
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•“Holistic Nurses have a particular obligation to create a therapeutic environment that
values holism, caring, social support, and integration of conventional and CAM approaches to
healing…A particular perspective of holistic nursing is the nurse as the ‘healing environment’
and an instrument of healing” (p. 15), core requirements for facilitating an individual’s
unfolding, and discovery of “…self in healing.” (p. 15) The environment is “…both the
external physical space and the person’s internal physical, mental, emotional, social, and
spiritual experience.” (p. 67)
Underlying the Holistic Nurse’s practice are “…values and ethics of holism, caring, moral
insight, dignity, integrity, competence, responsibility, accountability, and legality….” (p.7)
The Holistic Nurse’s role as a facilitator of health and healing is further described with this
statement: “People as active partners in the healing process are empowered when they take
some control of their own lives, health, and well-being, including personal choices and
relationships” (p. 6)
This document indicates that healing is “... natural and a part of life, learning, and movement toward
change and development.” (p. 6) It states that healing “…involves those physical, mental, social, and
spiritual processes of recovery, repair, renewal, and transformation that increase wholeness and
often…order and coherence. …Healing can lead to more complex levels of personal understanding and
meaning, and may be synchronous but not synonymous with curing.” (68-69). Wellness is defined as
an “Integrated, congruent functioning aimed toward reaching one’s highest potential.” (p. 71)
Nursing as a Profession
These concepts are not new to nursing; they have existed since Florence Nightingale’s time. Yet,
nursing at large has struggled with the tension between two models of practice that consist of a
foreground and a background (Parse, R., 1987; Erickson, H., 2010). In the first model, the primary
focus of caring is on the individual’s disease and/or condition, the human aspects of the individual
are secondary; they are often viewed as related, but not essential in understanding what is needed
to provide person-centered care. On the other hand, the holistic model places the human aspects of
the individual in the foreground, they are considered as primary to the caring process. The
individual’s perceptions of how their disease or conditions affect their health and well-being are
essential in understanding the individual’s life experiences. All nurses understand that their
practice is based on a caring process, and is person-centered, but the two models emphasize
different practice activities.
The practice activities of the first group tend to focus on assessing, understanding, and care focused
on parts of the person. Outcomes are often measured in respect to alleviation or management of
symptoms related to the disease or condition. Strategies used to effect health rarely include the
nurse as an instrument of healing. Health is defined accordingly; a person who has their disease or
condition managed, controlled, or cured is considered a healthy person (Smith, 1981).
On the other hand, practice activities of the Holistic Nurse focus on the relationship between nurse
and client; there is an emphasis on understanding of the person’s perceptions of health and
wellness, what they need to grow and heal; their strengths (not their weaknesses or what needs to
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be fixed); their ability to help themselves; and how their disease and/or conditions relate. There is
also an inclusion of the nurse’s need to know and understand self as an instrument of healing.
Health is defined as indicated above; it involves all aspects of the human, including disease and
conditions.
These two paradigms of nursing exist today. They influence how nurses think, how they assess
situations, where they focus their care, and the competencies they emphasize in their practice
(Erickson, 2010, pp. 1-69). Yet, nothing is all one way or another. In reality, most nurses subscribe
to some of the philosophy of Holistic Nursing, even though they don’t call themselves holistic
nurses, and don’t carry the philosophy, standards, and competencies throughout their practice.
Instead, they practice on those aspects of the Holistic Nursing philosophy that blends with their
own belief system.
For example, as nurses, we know that “…a succinct statement of the ethical obligations and duties
of every individual who enters the nursing profession (is) nonnegotiable… “ (ANA, 2001, p.5). This
code confirms that we are ethically bound to “…practice with compassion and respect for the
inherent dignity, worth, and uniqueness of every individual” and that “…the nurses primary
commitment is to the patient, whether an individual, family, group, or community” (ANA, 2001, p.
4). These are core obligations of all nurses. In addition, many nurses have a eudemonistic view of
health—one that focuses on quality of life and wellness (Smith, 1981; Erickson, 2010, pp. 44, 55);
one that defines healing as a bringing together the parts in such a way as to enhance wellness. Many
also view themselves as instruments of healing, use presence and intentionality, focus on the
strengths of their clients, and aim to empower—not fix—them. While members of this later group
may not define themselves as holistic nurses, they are practicing within basic precepts of Holistic
Nursing.
The AHNCC Nurse Coach Certification Program
The Professional Nurse Coach Role, conceptualized by Hess, Dossey, Southard, et al, 2012 was
aligned with the Standards and Ethics of Nursing as defined by ANA (2010) and developed within
foundational precepts of the Holistic Nursing philosophy and paradigm.
The American Holistic Nurses’ Credentialing Corporation (AHNCC) holds that:
1. Many nurses have the attitudes and beliefs essential for the Nurse Coach practice.
Furthermore, nurses who hold these values run across the profession of Nursing, practice
in all settings and with all populations. AHNCC believes that these nurses, with the
appropriate additional educational experiences and practice, can fulfill the role of the
Professional Nurse Coach as defined by said document.
2. AHNCC is the official credentialing body for practice based on the precepts of Holistic
Nursing; therefore AHNCC is the appropriate Credentialing body to develop a national
certification program for the Professional Nurse Coach.
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3. Nurses Certified in Holistic Nursing and certified in the Professional Nurse Coach role are
qualified to practice as a Health and Wellness Nurse Coach and should be credentialed
accordingly.
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