A core responsibility of the nurse manager is staff development and coaching. Unfortunately, managers anecdotally report spending the majority of their coaching time with low performers when they could be accomplishing more if they nurture and grow the middle and high performers. Evidence-based research by the Studer Group has shown that in most organizations, 34% of staff members are high performers, 58% are middle, and 8% are low. Ideally, nurse managers could shift the majority of time spent on the fewest people (low performers) to make better use of their coaching time.1 Development and accountability conversations can be difficult, emotionally charged, and time-consuming. Nurse managers aren't routinely taught an effective, simple process to guide these important but complicated conversations. This case study asserts that through the use of an efficient communication process during conversations with low performers, nurse managers can become more effective leaders.Although accountability conversation techniques are uncommon, every RN is well versed in The 5 Rights of Medication Administration.2 This medication safety concept is central in the nursing curriculum from a nursing student's first class to the last, and consists of right patient, right medication, right dose, right route, and right time. This same concept is repeated through nursing orientation and reinforced as nurses mature in their practice. Through consistent repetition over time and broad recognition that all five elements must be present to prevent medication errors, this conceptual structure is core to nursing. By applying The 5 Rights in a new context—staff development conversations—nurse managers can more effectively and efficiently coach low-performing nurses up or out.