Theory of Integrative Nurse Coaching

Authors – Barbara M. Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC; Susan Luck, MA, BS, RN, HNC, CCN, HWNC-BC; and Bonney Gulino Schaub, MS, RN, PMHCNS, NC-BC

Year First Published – 2015
Theory of Integrative Nurse Coaching.
© International Nurse Coach Association.,
Major Concepts
  • Healing
  • The metaparadigm in nursing (nurse, person, health, environment [society])
  • Patterns of knowing in nursing (personal, empirics, aesthetics, ethics, not knowing, sociopolitical)
  • Five specific Nurse Coach components:
    1. Nurse Coach Self-Development (self-reflection, self-assessment, self-evaluation, self-care;
    2. Integral Perspectives and Change;
    3. Integrative Lifestyle Health and Wellbeing;
    4. Awareness and Choice; and
    5. Listening with HEART© (Healing, Energy, Awareness, Resiliency, Transformation)

Middle-range theory


The Theory of Integrative Nurse Coaching (TINC) is a middle-range theory that honors clients as whole beings. All clients have their unique histories, stories, cultures, perspectives and the inherent wisdom to discover individual healing. Healing is a lifelong journey seeking harmony and balance in one’s own life and in family, community, and global relations.

The TINC includes three major concepts and five specific nurse coach components. The three major concepts are: 1) Healing, 2) Metaparadigm in Nursing (nurse, person, health, environment [society]) (See Note 1), and, 3) Patterns of Knowing in Nursing (personal, empirics, aesthetics, ethics, not knowing, sociopolitical) (See Note 2). The five specific nurse coach components are: 1) Nurse Coach Self-Development; 2) Integral Perspectives and Change; 3) Integrative Lifestyle Health and Wellbeing (ILHWB); 4) Awareness and Choice; and, 5) Listening with HEART©. All five TINC components are fully integrated and have equal value. (Download PDF TINC Five Components Overview).

The TINC assists Nurse Coaches in creating a unique relationship of trust and mutual respect with the client. This holistic and co-creative approach places the client at the center as a starting point while recognizing that one’s own internal and external environments will influence health and wellbeing (See Note 3). This reflective process is deepened by asking the client curious questions in the moment with no need to ‘fix’ any thing. (Download PDF Listening with Heart Reflective Questions).

Through this self-discovery process the Nurse Coach co-creates with the client a plan of care where her/his goals are identified as opportunities to enhance life journey and steps towards desired change, transformation, and human flourishing. The client will choose the specific integrative interventions to use. (Download PDF Integrative Nurse Coaching Interventions Most Frequently Used).

The TINC guides the nurse coaching endeavors that are broad enough to be useful in complex situations and leads to implications for practice, education, instrument development, theory testing through research, and healthcare policy.

The TINC has a designated tool, the Integrative Health and Wellness Assessment (IHWA) (IHWA short form-5 pages; IHWA long form-12 pages) that supports health and wellbeing and research in the field of nurse coaching.  
Download PDF short form
Download PDF long form


  1. In the Metaparadigm in Nursing appears Environment [Society]. Society in placed in brackets to denote the vastness of humanity’s capacities for expanded states of consciousness to facilitate healthy people living on a healthy planet—local to global. The environment is the context within which all living systems participate and interact, including the physical body and its physical habitat along with the cultural, psychological, social, and historical influences; it also includes both the external physical space and the person’s internal physical, mental, emotional, social, and spiritual experiences.
  2. The TINC uses the word and concept not knowing rather than the term unknowing. Not knowing includes the Nurse Coach and the client and each of their capacities to engage in healing presence and open spontaneously to the moment with no preconceived fixed ideas, answers, or goals. It engages authenticity, mindfulness, openness, receptivity, surprise, mystery, and discovery with self and others in the subjective space and the intersubjective space. This allows for new solutions, possibilities, and insights to emerge. It acknowledges the patterns that may not yet be known or understood that may manifest related to various situations or relationships over time.
  3. The TINC spells wellbeing as one word to denote a holistic and whole sense of life’s experience, purpose, and values. Wellbeing spelled as one word is also use by the WHO in their definition of health as ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity’; it refers to a positive rather than neutral state, framing health as a positive aspiration.

PDF TINC Five Components Overview
PDF Listening with Heart Reflective Questions
PDF Integrative Nurse Coaching Interventions Most Frequently Used
Download PDF short form
Download PDF long form

Moore, A. K., Avino, K., & McElligott, D. (2021). Analysis of the Theory of Integrative Nurse Coaching. Journal of Holistic Nursing: Official Journal of the American Holistic Nurses’ Association, 8980101211006599. Download PDF (available by permission)

Primary Source

Dossey, B., Luck, S., & Schaub, B. (2015). Nurse coaching. Integrative approaches for health and wellbeing. North Miami, FL: International Nurse Coach Association.

Website: International Nurse Coach Association

Application sources

Southard, M. E., Dossey, B. M., Schaub, B. G. & Bark, L. (2020/September). The Art and Science of Nurse Coaching: The Provider’s Guide to Coaching Scope and Competencies (2nd ed). Silver Spring, MD:

McElligott, E., Eckardt, S., Dossey, B. M., Luck, S., & Eckardt, P. (2018). Instrument development of integrative health and wellness assessment. Journal of Holistic Nursing, 36(4): 374-384. DOI: 10.1177/0898010117747752

American Holistic Nurses Credentialing Corporation (AHNCC) (n.d.). AHNCC Nurse Coach Certification. (

About the Authors

Barbara M. Dossey (1943 – )
Barbara Dossey

Barbara Dossey, PhD, RN, AHN-BC, FAAN, HWNC-BC, is internationally recognized as a pioneer in the holistic nursing and nurse coaching movements. She is a Florence Nightingale scholar, nurse theorist, and national and international speaker and teacher on the role of integrative nurse coaching in the emerging integrative health care paradigm. She is Co-Director, International Nurse Coach Association (INCA), Core Faculty and Co-Director, Integrative Nurse Coach Academy, North Miami, Florida; International Co-Director and Board Member, Nightingale Initiative for Global Health (NIGH), Santa Fe, New Mexico and Gatineau, Quebec, Canada; and Director, Holistic Nursing Consultants, Santa Fe, New Mexico. For more information, see, and

Susan Luck (1948 – )
Susan Luck

Susan Luck, MA, BS, RN, HNC, CCN, HWNC-BC, is the Co-Director, International Nurse Coach Association, Co-Director and Core Faculty, Integrative Nurse Coach Academy, and Director, EarthRose Institute. Susan has been teaching and developing coaching programs, online and on site, nationally and internationally, and currently through the Integrative Nurse Coach Academy. She is Board Certified in Health and Wellness Coaching, Holistic Nursing, and Clinical Nutrition. Susan has authored numerous articles and chapters on Nutrition and Environmental Health for Holistic Nursing, Integrative Nursing, and Nurse Leadership textbooks. She has co-authored Nurse Coaching and Self-Assessment chapters in Holistic Nursing: A Handbook for Practice, 7th edition (2016) and is co-author of the award winning book Nurse Coaching: Integrative Approaches for Health and Wellbeing (2015) and The Art and Science of Nurse Coaching (2013), that led the way to establishing the standards for practice in the emerging Nurse Coach role. As a concerned global citizen, Susan is the founder and education director of the EarthRose Institute, a not-for-profit organization dedicated to environmental health education and advocacy.

Bonney Gulino Schaub (1945 – )
Bonney Gulino Schaub

Bonney Gulino Schaub, MS, RN, PMHCNS, NC-BC is a Psychiatric/Mental Health Clinical Nurse Specialist who has taught the clinical applications of meditation, imagery and transpersonal psychology in undergraduate (Molloy College, Rockville Centre, NY) and graduate (The College of New Rochelle) nursing programs. She is director of the Huntington Meditation and Imagery Center and the Psychosynthesis Psychology Group. She is guest faculty of the Italian Society for Psychosynthesis Therapy (Florence) and Texas Wesleyan University (Fort Worth). She is a co-author of the award winning book Nurse Coaching: Integrative Approaches for Health and Wellbeing (2015) and The Art and Science of Nurse Coaching (1st ed. 2013; 2nd ed 2020), that led the way to establishing the standards for practice in the emerging Nurse Coach role. She is also the author of five books, numerous professional articles, and the developer of the Vulnerability Model that has now been integrated into Nurse Coaching. Her training course for the Vulnerability Model was granted European Union approval for the education of psychologists and psychiatrists. She is one of the original teachers and creators of the theory of Integrative Nurse Coaching. She is the innovator of the Transpersonal Nurse Coaching model that is endorsed by the American Holistic Nurses Association. For more information see: