In the June 2nd issue of WAVE, Dr. Geiseke wrote a thought-provoking blog titled “Are you a facilitator of agency?” Human agency is the capacity of people to have the power and resources to fulfill their potential. It reminded me of a train-the-trainer certificate I received in PHI Coaching Supervision ® ten years ago.¹ Coaching supervision is an untraditional method of supervision that emphasizes active listening, self-awareness, self-management, paraphrasing, delivering feedback, and other forms of verbal and non-verbal communication. It was specifically developed with long-term care managers and supervisors in mind. In 2021, AHCA/NCAL partnered with PHI to offer a new online training of this program for all assisted living, skilled nursing, and ID/DD staff with supervisory responsibilities.²

Fortunately, this approach to supervision in both acute and long-term care settings has been researched and reported in nursing literature. Two citations are provided to you in case you are interested in learning more about this approach to supervision.^3,4 It has been my long-standing belief that this approach to supervision has the potential to be effective in performing clinical supervision. By this I mean that best practices and sustained implementation of clinical guidelines may be effectively embedded in routine practices of SNF staff, in addition to the more traditional supervision focused on attendance and employee evaluations. 

As promising as this approach is, there are systemic barriers that must be overcome for coaching supervision to be widely implemented. The greatest barrier is that some corporations may favor a more traditional and punitive approach to supervision. Another barrier may exist within the nursing service itself. The performance of coaching supervision is a skill that requires the commitment and competence of directors of nursing. This type of supervision takes time. While it is widely recognized that there is a limited presence of registered nurses (RNs) in nursing homes, it is not commonly recognized that supervision is a type of indirect care. This is care performed on behalf of residents but away from them. Time provided for indirect care is even more limited than that provided for direct care.⁴ 

If professional RN time is insufficiently present, advancing the professional agency of the director of nursing and clinical staff will remain a serious challenge to achieve. I suggest that we do not necessarily need RNs around the clock to implement coaching supervision. But we do need talented and competent directors of nursing who have educated and qualified RN directors of staff development to make this approach to human resource management and development of nursing home staff agency a reality. 

1. https://www.phinational.org>service>phi-coaching-approach/
2. https://www.ahcancal.org
3. Richardson C, Wicking K, Biedermann N, & Langtree T. (2023). Coaching in nursing: an Integrative literature review. Nursing Open, 10, 6635-6649. https://doi.org/10.1002/nop2.1925
4. Dellefield ME, Madrigal C. (2022). Nursing leadership-transforming the work environment in Nursing homes. Nursing Clinics of North America, June; 57(2): 299-314. Doi:10.1016/j.cnur.2022.02.008