A nurse health coach works with patients to help them achieve their health goals. When working with clients, they might:
- Use motivational interviewing skills to help patients identify personal health goals
- Apply behavior-change strategies to help patients adopt new habits
- Provide expert health information so patients can make actionable and realistic health goals
- Communicate with other providers about a plan of care
- Share resources and referrals for additional support
In many ways, this job is similar to case management in that nurse health coaches work individually with people to ensure they have the tools, resources, and information to improve their health and wellness.
However, nurse health coaching is more patient-driven compared to traditional case management. Additionally, most nurse coaches are trained to provide holistic support that might employ a range of resources from both conventional and alternative medicine.
What does a nurse health coach do?
While anyone can call themself a life coach or a health coach, nurse coaches are highly trained and specialized healthcare providers.
Nurse coaches use motivational interviewing and scientifically-based behavior change strategies to help patients improve their health.
Coaching might include conventional treatments, like medication teaching and condition-specific education. A nurse coach might also recommend referrals to specialists, like addiction counselors or child therapists. Coaching could also include referrals to other modalities like yoga or acupuncture.
Some nurse coaches specialize in issues like heart health or diabetes, while others emphasize mental health issues. A typical session might involve goal setting, discussions about habits, and even a little talk therapy.
Regardless of the specialty, nurse health coaching is characterized by patient-driven sessions where patients identify their own priorities and objectives.
“The job is part nursing, part coaching, part patient advocate,” according to Beth Olmstead, BSN, RN, CCM, NASM-CNC, NBC-HWC, a nurse health coach who works remotely for a major insurer in Warsaw, North Carolina. “The patients do all the work, but I can guide them and make recommendations.”
How is nurse health coaching different?
While nurse health coaching is similar in many ways to case management, there are important differences.
Case management usually follows patients with chronic healthcare issues or specific diagnostic codes. In these instances, the case manager helps the patient prepare for a procedure or access resources to deal with a chronic health issue according to pre-defined algorithms provided by the employer.
On the other hand, nurse health coaching is patient-directed. The nurse coach helps the patient identify and reach their own health goals.
“The highest priority on the provider’s list may not be the patient’s priority,” says Beth.
“For example, the provider can counsel the patient about quitting smoking at every visit. But if the patient doesn’t want to quit smoking, I’m not going to push that,” Beth continues. “Instead, I work with the patient to find other strategies to control their blood pressure, cholesterol, or whatever the concern might be. We meet the patient where they’re at.”
Nurse health coaching is also different from traditional therapy or mental health counseling, according to Kacie Salas, BSN, RN, NC-BC, a nurse in California who also maintains a side business as a nurse health coach. Kacie specializes in supporting other front-line nurses struggling with trauma, burnout, depression, and other mental health challenges.
“The coaching aspect is different from therapy because it’s more goal-oriented,” Kacie explains. “If someone is really struggling, we refer out to a licensed mental health provider. I can’t prescribe. But health coaching is very personalized. I use a holistic and integrative approach to help patients with whatever they are struggling with.”
A day in the life of a nurse health coach
A nurse health coach who works for a provider or insurance company might start their day by logging into a proprietary system or electronic health record. Then, they review their call list of patients who need outreach.
Patients might be flagged for outreach if they have a chronic condition and their latest visit shows vital signs outside the recommended ranges. Or they could be otherwise healthy patients who qualify for outreach based on their insurance plan.
Sessions can last anywhere from 5 minutes up to half an hour. After a session, the nurse coach typically writes a visit summary that is included in the electronic health record or shared with the provider. Then, the nurse coach might respond to emails or patient inquiries.
Independent nurse health coaches might meet with clients who respond to their ads or request a session from their website. Session length is dictated by the nurse coach but is usually about an hour. Their day might also involve writing up plans of care or providing resources or referrals to patients based on their individual goals.
Independent nurse coaches must also invoice clients, market and reach out to potential clients, stay on top of their bookkeeping and self-employment taxes, and manage their LinkedIn and website.
Who hires nurse health coaches?
Nurse health coaches can work independently or as part of a larger organization.
Traditional employers that provide benefits might include:
- Insurance companies
- Provider groups or clinics
- Hospitals or larger healthcare organizations
- Mental health clinics or providers
- Home health or hospice
- Employee wellness groups for large organizations
Other nurse coaches prefer to run their own businesses where they have complete control over things like:
- What type of clients they serve (like children, or adults with chronic health issues, or other healthcare workers, for example)
- How many clients they serve and how many hours they work per week
- How they run their sessions and what tools they use to help patients
- Session length
- Conditions or issues they serve
Background and experience for nurse health coaching
It’s helpful to have clinical experience before becoming a nurse health coach. This allows the nurse coach to recognize and support different health conditions with greater expertise.
Clinical experience also provides the opportunity to learn more about patient education and common barriers to behavior change that patients might encounter in a traditional clinical setting.
However, there is no particular specialty or background that is best. Nurses from all specialties can bring valuable skills and expertise to the table.
A BSN can also be useful. Most important, however, is a desire to connect deeply with patients and form long-term collaborative relationships.
“Anyone who is burned out at the bedside is a good fit for this career,” Kacie explains. “We get wrapped up in the idea that the bedside is the only way to use your nursing degree or serve patients. It’s not true.”
Certification options for nurse health coaches
The American Holistic Nurses Credentialing Corporation (AHNCC) offers two certification options:
- The Nurse Coach – Board Certified (NC-BC) certification
- The Health and Wellness Nurse Coach – Board Certified (HWNC-BC) certification.
There are also certification options for nurses with and without a Bachelor of Science in Nursing as well as advanced practice nurses.
Another option is the National Board Certified Health & Wellness Coach (HBC-HWC) credential offered by the National Board for Health & Wellness Coaching (NBHWC).
The National Society of Health Coaching also offers a training and certification program. The training program starts at $875.
Nurses who are curious about certification options can find more information at the International Nurse Coach Association (INCA).
It’s important to know that certification may not be required for all positions.
Kacie explains, “There’s no regulation on nurse coaching. You can call yourself a coach today without any certification except lived experience. That’s very prevalent in social media.”
It’s also important to understand how the certification and training will serve you before investing time and money in the training, some of which can be lengthy and expensive.
“We all like the alphabet soup behind our name, and we all get very attached to our certifications,” Beth cautions. “While there are certainly some jobs that reward you for those certifications, I think prior to spending the time and money on those programs, you need to look at what job opportunities are out there and whether they match your goals.”
How to become a nurse health coach
While anyone can call themself a nurse health coach, training programs can provide specific instruction on motivational interviewing, goal-setting, behavior change, and business development.
There is a list of approved training programs on the NBHWC website. Note that some programs are Masters-level programs that require full-time enrollment at a university. Others require just a few months (or weeks) of coursework with prices that typically start around $2,000.
Some employers also provide nurse coach training directly. Additionally, there are courses to help independent nurse coaches learn how to manage the business side of things, like this one from the International Nurse Coach Academy, which also offers a basic nurse coach training package for $4,999. Some nurse coaches also offer their own training programs, like this one that starts at $4,999.
How much do nurse health coaches earn?
Finding a position that provides fair compensation for nurse health coaches can be tricky. While traditional employers often provide other perks, like healthcare and retirement plans, the hourly pay can be low.
For this reason, many nurse health coaches look into private practice. And as of July 2022, nurse health coaching is eligible for insurance coverage under an approved CPT code. This increased coverage makes it more accessible to patients. Additionally, private sessions can be paid for with HSA and FSA funds.
According to Salary.com, the average salary for a nurse health coach is $65,158 per year. Most nurse health coaches report earning between 44 – 75k per year.
However, a search for “RN health coach” on glassdoor.com turned up multiple opportunities in the 95 – 105k range, suggesting there are positions available with better pay that reflects the training and experience nurses bring to this position.
Challenges of working as a nurse health coach
Nurse health coaching is a relatively new and emerging field, and there are some challenges to working in this area.
Nurse coaches who choose to run their own businesses have to deal with the demands of entrepreneurship, like how to:
- Manage self-employment taxes
- Obtain a business license
- Market and find clients
- Invoice clients and get paid
- Maintain a website and LinkedIn presence
These are very learn-able skills, but they can feel overwhelming to some new nurse coaches, especially in the beginning.
Nurse health coaches who prefer traditional employment can face other challenges.
First, it can be difficult to find a job that provides fair compensation for the education, experience, and training that goes into being both a nurse and a certified health coach.
Second, not all providers – including MDs and advanced practice nurses (APNs) – understand the value of nurse health coaches.
Nurse health coach job satisfaction
Despite the frustrations that might be involved with running your own business or getting paid well for your work, many nurse coaches report that they love their jobs.
Kacie says, “Being a nurse coach really saved me from burnout. It allowed me to find joy in nursing again.”
“I love being a part of the patient’s story,” Beth says. “I feel better about myself as a person doing health coaching as opposed to other jobs like prior authorization or case management, which requires nurses to follow mandated protocols based on the diagnostic code. A traditional program isn’t going to make individual concessions for individual circumstances.”
Many nurse coaches also say that the skills they learn as a health coach makes them a better nurse at the bedside.
“I use my nurse coach skills in my day job as well. I’m sort of the emotional support nurse,” Kacie laughs.
Are you interested in working as a nurse health coach?
Nurse health coaching provides a rewarding and meaningful way to help patients improve their health and reach their goals. It’s a great fit for nurses who might be dealing with burnout but who still want to connect deeply with patients through long-term, collaborative relationships.
Not sure if nurse coaching is right for you? If you love the idea of running your own business, then legal nurse consulting or freelance health or medical writing could be a better fit.
Check out the Nurse Fern job board for more opportunities in remote nursing!