Despite the clear evidence of the advantages, only about 8% of U.S. hospitals achieve Magnet designation, with just 475 Magnet-designated hospitals currently in the nation today, and 34 of those are in California.
So why do hospitals hesitate to embark on the Magnet journey? For starters, it is a “lengthy and costly process,” writes Debra Anscombe Wood, RN, in her Nurse.com article, “Pursuing Magnet designation: pros and cons.” She notes that “some hospital administrators wonder if it is worth the time and effort,” despite a preponderance of data that indicates vast improvements in the work environment, which correlate with lower mortality rates and better patient outcomes.
Other organizations believe that some of the requirements of the Magnet® Recognition Program will constrain hiring for nurse workforce staffing and credentialing practices and dictate their nurse-to-patient ratio. “Dispelling Magnet Myths,” published in the Journal of Nursing Administration, refutes these claims, with the Magnet Program Office of the American Nurses Credentialing Center (ANCC) setting the record straight so organizations can weigh their decision based on facts.
Deconstructing Magnet myths
Myth #1 - Magnet requires organizations to hire only BSNs
This is not so — according to AANC, “there is no requirement for organizations to exclusively hire nurses with baccalaureate degrees.” Rather, Magnet asks organizations for an “action plan” to help RNs progress to a BSN or higher degree, which is considered a prerequisite to assume leadership roles.
Why the focus to cultivate more nurse leaders? According to the Institute of Medicine (now the National Academy of Medicine) in their report “The Future of Nursing: Leading Change, Advancing Health,” it’s about being better prepared to meet industry challenges created by healthcare reform and growing complexities of the U.S. healthcare system. “Nurses have valuable insights and unique abilities to contribute as partners with other healthcare professionals in improving the quality and safety of care as envisioned in the Affordable Care Act.”
The report recommended that the number of BSN-prepared nurses increase to 80% by 2020, and, while that has yet to be achieved, Magnet hospitals typically have a higher proportion of BSN nurses, with 59% BSN compared to 34% BSN at other hospitals, according to the AACN.
Myth #2 - Magnet dictates a prescribed staffing model/nurse ratio
This is false information, although there are several staffing models in place at Magnet-recognized facilities. What Magnet does require is that organizations show how they are supporting their nurses to achieve board certification, asking that they establish a baseline based on resources in place and setting a goal to increase the percentage.
Why does board certification matter? According the AANC, “Achieving board certification demonstrates to patients, employers, and the public that a nurse’s knowledge reflects national standards and a deep commitment to patient safety.” In short, it is all about “raising the bar” for nursing excellence. To ensure equity, ANCC limits inclusion to board certifications accredited by the Accreditation Board for Specialty Nursing Certification, the National Commission Certifying Agencies, and other recognized accreditors.
Myth #3 - Magnet has a prescribed staffing model/nurse ratio
Perhaps the most controversial myth and also an untrue one — Magnet does not dictate the nursing care delivery used by an organization. However, several staffing models are in place at Magnet-recognized hospitals, which encourage participation and lead to positive outcomes.
Is there a preferred staffing ratio for nurses to patients? It depends. According to an article in the Journal of Family Medicine and Primary Care, “the optimum level of nurse-to-patient ratio for a particular unit depends on several factors, such as intensity of patients’ needs, the number of admissions, discharges, and transfers during a shift, level of experience of the nursing staff, layout of the unit, and availability of resources, such as ancillary staff and technology.”
The American Nurses Association supports a legislative model in which nurse-led staffing committees create unit-level staffing plans based on a patient population’s acuity and needs, matched with the staff’s skills and experience. As of March 2022, 16 U.S. states have also taken action to address staffing in hospitals either through laws or regulations.
Cultivating a culture of change
Ultimately, hospitals and health systems that embrace change, which is a key cornerstone of Magnet, are proving to be better positioned to respond to the plethora of challenges impacting today’s healthcare industry. If COVID-19 has taught us anything valuable, it is that the highly fluid nature of healthcare demands flexibility, especially from nurses, to ensure patients get the care they need.
The American Nurse Journal article, “Magnet® and COVID-19 response,” notes that a successful response to change aligns with Magnet model components that support a program’s framework for high-quality care and job satisfaction, including:
- Transformational Leadership to communicate with and advocate for teams
- Structural Empowerment to develop partnerships at all levels
- Exemplary Professional Practice that focuses on safety and multiple data points
- New Knowledge, Innovation, and Improvement to integrate evidence-based practice and nursing research into care
- Empirical Quality Outcomes resulting from strong structures and processes.
A range of resources are available to learn more about how your organization might benefit from a Magnet Journey. Visit the American Nurses Credentialing Center (ANCC) to learn more.
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