Clinical Health Coach ProfileStacey Cayler
Stacey Cayler, is a Clinic Care Coordinator and Diabetes Program Coordinator. Stacey has been an RN for over 22 years and received her Diploma of Nursing from Mercy School of Health Sciences and her Bachelors of Arts in Sociology from Simpson College in Indianola, Iowa. She is a certified diabetes educator and is board certified in Gerontological Nursing. Stacey leads the diabetes education program as well as the NRACO (National Rural Accountable Care Organization) in care coordination at Iowa Specialty Hospital.
| Julie: | What is your role in your hospital? |
| Stacey: | We have a rural health clinic within our hospital. My role is diabetes educator and program coordinator. I also have the role of outpatient clinical care coordinator in Clarion, IA. |
| Julie: | What is one thing that really excites you about Clinical Health Coaching? |
| Stacey: | It was really good timing for me as our facility had embarked on being part of the NRACO (National Rural Accountable Care Organization). The whole focus of how we treat patients by looking at value vs. volume has really changed our habits of how we are approaching our patients. We looked at our high risk patients and are changing our focus of what may be a priority for me, may not be a priority for them. After being a diabetes educator for 18 years, I have always had a checklist of what needs to be covered during a visit vs. taking a different approach and figuring out what is important to the patient. |
| Julie: | You really had to change your approach? |
| Stacey: | Absolutely. It was a real change for me. And then to be that coach, if you will, for our providers as well and our patients because changing the providers habits of how they have always taken care of their patients has changed as well, and will continue to change. |
| Julie: | Are the physicians referring patients to you? |
| Stacey: | Well, we are getting there. We have worked really hard on our morning huddles. The nurses of the physicians are really looking at their daily schedules and focusing and viewing their schedules differently. They are looking at how they will approach certain patients on that particular day. |
| Julie: | How have your patients related to the changes you’re making? |
| Stacey: | They don’t recognize that it’s different, but I do see a difference in compliance. |
| Julie: | How often do you see your patients? |
| Stacey: | Everyone is individual. I may have 5-6 that are on my radar that I may do a call each week to see how things are going. I have gone to do home visits. Gaining the trust is important and some patients may not qualify or may not want public nursing in their home. Going out and doing some of those home visits have been a real eye opener of what may be going on with those patients. |
| Julie: | Can you share a success story? |
| Stacey: | I had a patient that had come into his primary care provider for a visit because his A1C had gone from 6.5 to 10.0 and nothing had really changed. The Provider as well as wife had noticed some cognitive decline, but he was really kind of in denial to that. It took us a few office visits to talk to him and identify what his needs were. He started to open up and was very welcoming for me to come to his home. When patients are here in the clinic, we don’t always get the full picture. When they say 80-85% of patient care is self-care, it’s so true. We were able to straighten out his meds and set up his planner. |
| Julie: | What skills do you use to get to that point? |
| Stacey: | I really made him feel like his decisions were his choice and really “up to him”. He was “driving the bus”. It doesn’t really matter what I think or what the physician thinks, but what the patient is willing to do. Asking the question like, “What is important to you”? Finding out where each individual stands is important. Asking vs. telling and asking open ended questions. |
| Julie: | How did the Clinical Health Coach training help you find success with your patients? |
| Stacey: | The Clinical Health Coach® Fusion training really helped me guide the patients in their goal setting and helping to figure out what is most important to them. It might be most important to me to have them check their blood sugars three times a day, but for them it may be simply that they remember to take their meds five out of the seven days. |
| Julie: | What challenges have you faced? |
| Stacey: | As care providers, we have all had to really change our mindset and habits. Sometimes, this is difficult. |
| Julie: | What advice would you have for someone just starting out with health coaching. |
| Stacey: | I would say that you aren’t going to be a professional at it right away. You really have to practice and incorporate the skills into your everyday life. I’m not an expert and I have to practice, but it definitely compliments what I have been doing. |
| Julie: | What skill do you find yourself using most? |
| Stacey: | Well, what was hardest for me was listening. During the Clinical Health Coach training, when we partnered up to practice, I would have to tell myself to be quiet and not jump on a patient with advice. It seems so simple, but it is really hard. You learn so much when you actually listen. We are trained as an educators to provide information and fix things. It is still something I need to work on. |