Nurses deserve to work in healthy environments that support their well-being, and a new approach piloted at the largest healthcare system in the Carolinas is demonstrating impressive results in creating an environment where nurses thrive.

After three years, the Well-Being Coaching Initiative implemented by Atrium Health resulted in an average 30 percent reduction in turnover, saving an estimated $3 million in one year.

Further, participants surveyed 12 months after the first year in the program reported a 42 percent reduction in burnout, a 36 percent reduction in stress, an 18 percent increase in engagement, as well as a 41 percent increase in self-leadership and 28 percent increase in self-compassion!

So, how did they accomplish these exciting results?

Atrium’s leadership recognized the profound impact COVID-19 had on its workforce. It was one of the earliest systems to publish data on factors influencing well-being of its healthcare workers during the pandemic, releasing results in July 2021.

In November, then-CNO Maureen Swick partnered with Diane Sieg, who spent 23 years in emergency nursing before transitioning to training and coaching nurses on well-being, to create a formal nurse wellbeing program focused on coaching.

“We heard from our nursing teams that resilience – particularly in that 2021, 2022 period – was just a buzzword for management. It made leaders feel better,” said Robert Rose, Market Chief Nurse Executive at Atrium. “We took that to heart.”

Sieg also intentionally doesn’t use the terms resilience or ‘self-care’ to describe the coaching program, instead focusing on ‘self-leadership.’ Her definition for self-leadership is the relationship you have with yourself, how you feel about, treat, and talk to yourself. It is critical, she says, because it determines the decisions you make every day to help you feel good about yourself and what you do.

"We don’t tell nurses what to do,” Sieg said. “It’s training them to coach themselves – and not only themselves, but others as well.”

The program works by training and coaching a small group of ‘champions’ or coaches over 8 weeks, where they learn the skills to develop self-leadership for themselves and to develop and train others.

”After graduation, these 10 coaches go on to train champions and coaches within the organization,” Sieg explained. “In the first year, there are a hundred people impacted. Then the next year, the new coaches start training more coaches and champions. At the end of four years, it’s almost 6,000 people impacted.”

Sieg requires organizational and individual commitment and that is one reason why Atrium Health has been so successful. “This program really focuses on changing culture, versus just the one and done,” she said. “We go deep, and we go long.”

Rose agreed that commitment is essential. “You’ve got to continue to keep it a focus,” he said. “You’ve got to continue to resource it appropriately. Sustainability helps to keep the principles of the coaching program intact.”

Coaching is a skill of its own, Sieg says, and it’s not necessarily one nurses traditionally learn.

“Nurses mentor and precept and problem solve and create, but coaching is different,” she said. “Instead of giving advice or more information, coaching is about slowing down, listening, and asking open-ended questions so the coachee can determine their own best next action steps.”

Participants develop these skills through an 8-week intensive course, which includes pre-program assessments, individual coaching, group coaching, accountability partners, text and email communications and more. At the end of the process, there’s a graduation and each graduate shares their story.

“It’s very emotionally charged,” said Miranda Scoggins, a Clinical Outcomes Leader and nurse at Carolinas Medical Center. “For a lot of people, it’s the first time they have had 8 weeks to focus on themselves. We learned how to make ourselves a priority.”

“That sort of blew me away,” said Rose. “They got very vulnerable in that room. It came from the coaching experience they had.”

For Sieg, the graduation aspect grows in importance as coaches graduate their own champions.

“They get to see what I get to see – this transformation of growth and learning when the light bulb goes on,” she said.”

Sieg and the Atrium team are eager to publish their results, with a paper expected in The Journal of Nursing Administration in January of 2025.

And the work continues at Atrium, Scoggins said. “I love the program so much that I and one of the other coaches operationalized it so it could be implemented across our facilities.”

Learn more about the Well-Being Coaching Initiative.