Findings from 3 nurse-led research studies conducted in a large pediatric institution resulted in a call to action to support intensive and progressive care nurses experiencing moral and ethical challenges.


To evaluate the feasibility of and satisfaction with implementation of a Nurse Education and Support Team (NEST) coach role.


An interdisciplinary work group identified solutions for just-in-time support, including a new NEST coach role. This role was implemented in January 2017 to provide peer-to-peer support for nurses. The NEST coaches provide coverage 5 days per week in 4 intensive care units and 1 progressive care unit. Feasibility of the role was evaluated by assessing the number, type, length, and outcome of NEST coach consultations. Staff satisfaction was evaluated 6 months and 1.5 years after implementation.


A total of 6262 NEST coach consultations occurred across the units from January 2017 through November 2019. At both evaluation periods, more than 85% of respondents indicated that they were satisfied with their interactions with the NEST coach and nearly 80% indicated that they would seek consultation again.


Pediatric intensive and progressive care nurses experience many challenges in their practice environments. The innovative NEST coach role enabled access to just-in-time support and guidance through morally and ethically challenging situations. As evidenced by the number of consultations and the positive staff response, intensive and progressive care nurses have embraced and integrated the NEST coach role into their culture and practice.

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