Hear from registered nurse health coach Judith Beaulieu as she talks about her career.  You can find her at www.femtique.org, or follow her on her Twitter feed in the side bar of this interview.  

What do you do for a living?

I’m an RN(Registered Nurse) Health Coach.

How would you describe what you do?

The most important thing that encompasses a Nurse Health Coach Profession is to advocate the most important health and wellness goal pertinent to the client.

To clarify: An example of how this works: A Patient Navigator would negotiate a hospital bill and work as a liason on managed care issues such as insurance coverage.

An RN Health Coach works with the patient to help them achieve an optimal level of perceived health and maintain wellness in light of such diagnoses as diabetes, Cardio-Vascular Disease, Heart Attack, Cancer, High Risk Pregnancy, etc. If they were hospitalized and a diagnosis was made the doctor is made aware of healthcoaching services that would help his/her patient get help with the life-style changes required to achieve an optimal level of perceived health and maintained wellness.

A client may contact the Health Coach directly to engage services such as life-style changes pertaining to a new baby in the household, loss of a job, planning a move…. All 8 realms of life are addressed in Health Coaching. These are: Physical, Psychological, Social, Economic, Spiritual, Academic, Professional/Vocational and Environmental. You can call it a holistic approach to Health an Wellness Care. Wellness is not simply the absence of illness or dysfunctionality. It is the optimal level of perceived performance and resultant functionality encompassing all of life. People want answers as to how an illness or dysfunction will affect life. They need empowerment to attain achievable goals. An RN Health Coach is able to partner with the client to put together a strategic plan and include referrals that will provide ways to move at their own pace in accomplishing goals. Once a plan is established, the RN Health Coach assists to find solutions with any roadblocks that occur. Attached are definitions on how wellness is defined in each realm.

What does your work entail?

Empowering someone with information, and helping them to recognize the most important lifestyle change that leads to an optimal level of perceived health and maintained wellness.

EXAMPLE (1) A recently diagnosed diabetic (an obese teenager) is being discharge from the hospital. The doctor and patient need to have a reliable resource for follow-up care. A referral to see an RN Health Coach. The coaching provides a thorough education about the disease process, life-style changes, medication regimens, diet and exercise and working with the patient to overcome roadblocks. The patient and family member overseeing their care will be provided time to discuss their concerns with impact upon social aspects of their teenage life, psychological/emotional aspects of the diagnosis, how this affects the economic realm of life and resources to help with this aspect, identifying and applying a spiritual component to life-style changes, discussing academic and professional goals and environmental impact encompassing the diagnosis of “diabetes”.

EXMPLE (2) A young woman has delivered a still-born at 7 months gestation. She is having trouble coping and has been unable to return to work. Her employer engages an RN Health Coach to help her through the grieving process. Sessions are set up at the workplace within a room that provides the necessary privacy. As a result the employee is able to remain at work while applying strategies set forth for coping while at work. While the RN Health Coach is working with the employee, the employee’s manager sets up an in-service on what is to be expected during the grieving process for the rest of the department. The presentation is provided by an RN Health Coach credentialed as a grievance counselor specific to the loss of a baby/child.

What’s a typical work week like?

This is variable. Sometimes I work with the Healthcare Provider who refers clients to FEMTIQUE. The HCP identifies a diagnosis that requires a Health Coach intervention to help that person become educated about the medical diagnosis and know the lifestyle changes that are necessary for them to survive as well as attain an optimal level of wellness.

How did you get started?

Two and one half years ago I was laid off. After 22 years of clinical nursing experience and then 19 year of corporate life within the Pharmaceutical Industry, I decided to start my own patient advocacy business.

What do you like about what you do?

Helping women to identify their potential to advance their lives into an optimal level of health and wellness.

What do you dislike?

The ignorance of government and the managed care industry (insurance companies) to recognize the private sector of Health Coaching administered by Registered Nurses.

How do you make money/or how are you compensated?

Anywhere from $75/hour to $100/hour for coaching.

This service is only 5 years old and has just been getting the publicity it deserves. I began my company as a non-profit in order to get compensated for our RN Health Coaching Services through grants and donations in order to establish wellness programs within the community of those clients we service who cannot afford the full amount. Some insurance companies are starting to pay for RN Health Coaching Services and this will probably become the norm as the new Healthcare Reform Bill goes into affect in 2013. Another avenue that has been paying for these services is the corporate “human resources” departments. They have been most supportive of the use of RN Health Coaches to help develop wellness programs for their employees.

How much money do health coaches make?

An RN Health Coach makes $75 to $125/hr.

Health and Wellness Coaching is the new healthcare reform. It is kicking in as the biggest cost effective resolution to medical care. Refer to Healthy People 2020 which is a government sponsored initiative working to expand upon Healthcare Reform.

Some Health Coaches make $200 and up an hour – and this is out-of-pocket expense from clients who are willing to pay it. The industry standard is to be able to make this affordable for all people. NIH endorses the use of RNs and MDs for Health and Wellness Coaching. Compared to medical expenses Health Coaching is less expensive and has a higher acceptance among consumers. A business plan requires the following: What is an achievable amount of money you would like to make within your practice? How many clients will be needed in order to make this amount? Remember, starting your business from scratch will take 3 to 4 years. Marketing your services is the next step to get the volume of clients that you need. Business’s are your best customers. They are able to afford Health Coaching vs. Medical Costs for their employees.

I began my business on a full-time schedule which involved coaching 6-7 clients a day based upon one-hour sessions. I started FEMTIQUE Associates Incorporated to accommodate nurses who want to contract through an already established entity. FEMTIQUE is non-profit organization working to establish most full-time positions for RN Health Coaches, however, an RN Health Coach can contract as a second means of income on a part-time basis and coach 6-7 clients a week or less. It is up to the RN. Certified RN Health Coaches start at $75/hour. If the nurse has a Master’s Degree within an applied science, the fee starts at $125/hr. or higher according to experience and speciality e.g. Nurse Practitioner, Physician’s Assistant, or similar.

Fee for service is the standard and the best way to make a living within this industry. Salaries are paid for through working for a private practice physician, managed care company or hospital. The salary is usually based upon an hourly fee of $20-$25/hr.($40,000/yr ish)

How much money do you make starting out as a health coach?

Starting at $50/hour up to $150/hour.

What education, schooling, or skills are needed to become an RN Health Coach?

At least 5 years experience as an RN, plus a certification in Health Coaching.

What is most challenging about what you do?

Since this is a new profession, my physician colleagues are still reluctant to employ nurses to help them get their patients to achieve the goals prescribed. This might be all about ego, however, part of this is that insurance does not always pay for this “third party service”.

What is most rewarding?

Feedback from clients who identify what has worked as a result of the health coaching.

What advice would you offer someone considering this career?

Don’t think that every situation will be a success.

Patient Advocacy work in Health Coaching is not easy. You need people skills and an on-going education that includes the psycho-social sciences. Always collaborate with the healthcare team taking care of the client. You are there to help the client get to goal with their situation and to stay on track with maintaining wellness. Helping people should not be about taking sides. Sometimes emotions are out of control, especially when someone is sick and not getting better or something is standing in the way of getting the proper intervention. The best approach I have is to be “solutions” oriented and not “problem oriented”. Words of wisdom come from Martin Luther King, Jr. “The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.”

The other thing about starting an advocacy business is to be persistent and hang in there. Net work with colleagues who are in the same profession. This vocation is very new to everyone. No one really knows what it is all about yet. The evolution of the Health and Wellness industry has always been a successful venture. Look at the trends that have taken place within the exercise industry alone not to mention the vitamin suppliment industry! Health and Wellness services have taken hold and are continuing to grow within areas of life outside of the medical profession. Those of us who venture into it will be very successful. Again, just hang in there.

How much time off do you get/take?

Health Coaching provides flexible hours.

I take off whenever I need it. I was able to take off these past 2 weeks and enjoy time away with my husband in Puerto Rico. Most of the time I coach through webcasts and I can coach from wherever I am in the world. This allows me to work while on vacation if I so chose or go on speaking engagements and fit in a client coaching session as well.

What is a common misconception people have about what you do?

That they do not know about health Coaching and what it encompasses.

What are your goals/dreams for the future?

That every doctor’s patient be assigned an RN Health Coach.

What else would you like people to know about your job/career?

RN Health Coaches are the most credentialed in the industry. They abide by a very strict regulatory system unlike a non-medical professional calling themselves a Health Coach. RN Health Coaches work with the patient’s Healthcare Provider(s) to ensure continuity of care and an optimal level of understanding between the two disciplines of medicine. The RN Health Coach helps to devlope a care plan that is within the client’s best interest and designed from the client’s perspective based upon their life structure.