Healthcare has moved through three different questions over the past several decades—from diagnosing disease, to understanding lived experiences, to partnering with people in their care—one profession has quietly been leading this transformation all along. Long before "What matters to you?" became a global movement, Nurse Coaches were building their practice around that very question. It is the question this profession was built to answer.
Tiffany Grabinski MSN, RN, NC-BC
Tiffany is a registered nurse with nearly two decades of experience spanning labor and delivery, maternal-child home visiting, and healthcare leadership. She currently serves as Director of Maternal Child Health Programs at St. Luke’s Home Health and Hospice. She is a Board-Certified Nurse Coach, an Integrative Nurse Coach Academy Faculty Mentor, and an active leader in building the Pennsylvania I-NCA chapter.
Grounded in Nurse Coaching and a whole-person lens, Tiffany combines clinical depth with lived experience in her private Nurse Coaching practice, Tiffany Grabinski RN, where she helps women reconnect with themselves during major life transitions, from pregnancy and early motherhood to burnout, health changes, and beyond.
After nearly two decades as a nurse, I’ve noticed something remarkable: the most powerful question in healthcare is often the one that isn’t asked.
I spent the early years of my nursing career in labor and delivery. Later, I moved into maternal-child home visiting with Nurse-Family Partnership, sitting in living rooms with new mothers instead of hospital rooms. It may have been a different setting, but the same pattern kept appearing. Almost every woman I met had learned to answer one question well: what is wrong with you? Very few had ever been asked, “What matters to you?”
The gap between those two questions changes everything that happens next.
Three Questions, Three Eras
Healthcare questions have evolved over time. But over my career, I have seen three major shifts.
What is the matter with you?
This is the question most of us are most familiar with. It centers on the diagnosis. It is the first question most of us are asked by healthcare professionals when we show up for an appointment. There is no doubt it’s an important question. It helps a provider explore symptoms, identify a diagnosis, and treat it. It works well for some acute problems: a broken bone, strep throat, an infection that clears with the right antibiotic.
It works less well for more complex conditions: endometriosis, autoimmune disease, or cancer, where the diagnosis is only the beginning of a much longer story. It can also be ineffective with the areas of healthcare that require significant behavioral changes to manage: diabetes, chronic stress, anxiety, where treating the diagnosis alone rarely changes the day-to-day reality of living with it.
What happened to you?
Trauma-informed care approaches shifted the question toward understanding a person’s history. It recognizes that a person’s past, including hard experiences, shapes how they show up in a care setting today (SAMHSA, 2014). Why someone may freeze when asked about their symptoms, avoid eye contact, or struggle through a physical exam often has a reason behind it. This shift matters. But on its own, it can still leave a person defined by what happened to them rather than by where they want to go next.
What matters to you?
This is the newest question, and the one that is at the heart of every Nurse Coaching session. The concept was introduced in 2012 by physicians Michael Barry and Susan Edgman-Levitan in the New England Journal of Medicine (Barry & Edgman-Levitan, 2012), and it grew into the global “What Matters to You?” movement a few years later, spread by the Institute for Healthcare Improvement into hospitals, clinics, and community health programs around the world (Institute for Healthcare Improvement, 2022). It doesn’t ignore the diagnosis or someone’s past experiences. It simply refuses to let either one be the whole story. It puts the person back at the center of their own decisions, and asks what they want their health, their care, and their life to look like from here.
Three questions, all with real value, moving us steadily closer to individualized care for the person behind the chart.
Why Nurse Coaching Fully Embodies the Third Question
Plenty of healthcare settings can say the words “What matters to you?” Fewer are actually equipped to answer it. A fifteen-minute appointment does not leave room for someone to figure out what they want, let alone say it out loud. Nurse Coaching is structured for exactly that work.
A Nurse Coach brings a clinical foundation into the room, so they understand the diagnosis and the physiology behind it. They bring trauma-informed awareness, so they understand that a client’s history is shaping the conversation even when it may not be named out loud. Then they do what most of healthcare has no time for: they slow down. They ask reflective questions. They listen for what a client actually values, not just what they may have been told they should want.
This is where Nurse Coaching stands apart from general wellness coaching. Recognized by the American Nurses Association since 2010, Nurse Coaching operates under its own defined scope and standards of practice (American Nurses Association, 2021). It is not motivation without medical literacy, and it is not clinical instruction without genuine partnership. It is both, held together by a professional who has spent years learning to listen before they learned to advise.
Your Most Powerful Ally
An ally is not someone who takes over. An ally is someone who stands beside you, understands the landscape, and helps you move through it in a way that is actually yours.
That is what a Nurse Coach offers. They do not hand you a generic plan and call it personalized support. They help you get clear on what matters most to you, whether that is how you want to move through pregnancy or other life transitions, how you want to build health habits that fit your real life and support the health conditions you’re managing, or how you want to create more harmony in your life. Then they help you build a plan around that answer, informed by clinical knowledge but led by your own values, your own culture, and your own priorities.
A Nurse Coach also helps you carry that clarity into every other room you walk into. Once you have practiced naming what matters to you with someone who is fully listening, it gets easier to say it in your next appointment, in your next difficult conversation, in the next moment someone tries to make a decision about your life without asking you first.
That is self-efficacy. That is advocacy. It starts with one question finally being asked, and finally being answered.
Your Next Step
You are not asking for special treatment. You are asking to be seen, heard, and included in decisions about your body and your life. Nurse Coaching offers a structured, evidence-informed way to make that happen, with someone in your corner who is trained to ask the question that matters most.
If you have ever left an appointment feeling like the real conversation never got a chance to happen, you are not imagining it, and you are not without options. Ask yourself what matters to you, in your health, your care, and your life. Then go find an ally who will listen for the answer.
References
American Nurses Association. (2021). The art and science of nurse coaching: The provider’s guide to coaching scope and competencies (2nd ed.).
Barry, M. J., & Edgman-Levitan, S. (2012). Shared decision making: The pinnacle of patient-centered care. New England Journal of Medicine, 366(9), 780-781.
Institute for Healthcare Improvement. (2022). Why asking “What matters to you?” matters. https://www.ihi.org/library/blog/why-asking-what-matters-you-matters
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach.
Love this.