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Welcome to the Magnet Page!

Can we improve on the Magnet Recognition Program?

Yes, we can. See our article "Magnet Status should be a floor, not a ceiling" published in 2015 in Advance for Nurses. And read below for more on what Magnet is, what Magnet is not, and what Magnet could be. Want more? Empower your nurses to go beyond Magnet to improve patient care and safety by bringing in our expert speaker!

What is Magnet status?

Magnet status is an award given by the American Nurses' Credentialing Center (ANCC), an affiliate of the American Nurses Association, to hospitals that satisfy a set of criteria designed to measure the strength and quality of their nursing. A Magnet hospital is stated to be one where nursing delivers excellent patient outcomes, where nurses have a high level of job satisfaction, and where there is a low staff nurse turnover rate and appropriate grievance resolution. Magnet status is also said to indicate nursing involvement in data collection and decision-making in patient care delivery. The idea is that Magnet nursing leaders value staff nurses, involve them in shaping research-based nursing practice, and encourage and reward them for advancing in nursing practice. Magnet hospitals are supposed to have open communication between nurses and other members of the health care team, and an appropriate personnel mix to attain the best patient outcomes and staff work environment. We encourage all nurses to learn more about the principles of Magnet certification, and to consider appropriate nursing certification programs for their hospitals.

 

What Magnet is not

We understand that some nurses are enthusiastic about the Magnet program and feel that it promotes the important practices outlined above. However, it is important to be aware that others, notably nursing unions, have been critical of the way the Magnet program has been implemented. Some critics, including the California Nurses Association and the Massachusetts Nurses Association, have argued that the Magnet program is primarily a hospital promotion tool that resembles The Joint Commission in its too-close relations with hospital management. Such critics have also asserted that there is little evidence that nurses at Magnet hospitals are really much better off than nurses elsewhere. Many nurses have written to us to say that once Magnet certification has been awarded at their hospitals, and the hospitals have begun trumpeting the new status, the Magnet coordinators and teams are fired or sidelined, and the progress made through the Magnet application process is dismantled. Magnet should not be a program that gives the impression of nursing excellence without actually achieving it.

What can you do if you have concerns about how Magnet is being implemented?

The first step should be to try to work with the appropriate people at the institution you feel is not living up to the Magnet principles. We understand that the hospital's Magnet leadership may not be receptive, or that you may fear negative consequences, but it should be considered first. Some people actually do believe in what they're doing.

If that does not work, contact the Magnet program directly. Unfortunately, the ANCC's Magnet webpages could be more receptive to those who wish to provide feedback or express concerns. The contact us page (as of 7/2019) appears to consist of a customer service email for the American Nurses Association. But after doing more research, we believe we have found contact information for the Magnet leadership. So if you have worked at a Magnet hospital that you believe has fallen short of Magnet principles, we urge you to report your experiences to these current leaders of the Magnet Recognition Program: Loressa Cole, RN, DNP, MBA, Vice President, Magnet Recognition Program and Pathway to Excellence;
Rebecca Graystone, RN, MS, MBA, Vice President, Magnet Recognition Program and Pathway to Excellence;
Maureen Lal, RN, MSN, Director, Magnet Recognition Program;
Christine Curto, RN, BSN, MS, Senior Manager, Magnet Appraisers and Program Support.

To the extent the Magnet program is not effectively promoting its important nurse empowerment goals, we would like to see it strengthened. In general, we hope that all nurses will work for strong, effective nursing credentialing programs to address the nursing crisis and improve patient care. Good luck!

 

Research comparing Magnet to non-Magnet hospitals. Mostly better, but not always.

Magnet hospitals make fiscal sense. J Healthc Manag. 2018 Nov-Dec;63(6):e131-e146. The Effect of the Magnet Recognition Signal on Hospital Financial Performance. Karim SA, et al.

Magnet hospitals have a 14% lower mortality risk and 12% lower failure to rescue rates. Matthew McHugh, Linda Aiken, et al. Also see the AMN Healthcare report.

Magnet hospitals provide better care for pressure ulcers, and had higher quality of care, innovations in practice and nursing excellence. But non-Magnet hospitals had better infection control and less post-operative sepsis. Non-Magnet hospitals had better staffing, with 30 RN hours per unit more per week. Colleen Goode, et al., 2011.

Magnet hospitals "have better work environments, a more highly educated nursing workforce, superior nurse-to-patient staffing ratios, and higher nurse satisfaction than non- Magnet hospitals." Linda Aiken, et al., 2011.

Magnet hospitals do not have any better working conditions than non-magnet hospitals. Alison Trinkoff and Meg Johantgen published in the Journal of Nursing Administration, 2010.

 

Let the Truth director's dynamic presentation take you beyond Magnet

Sandy SummersEmpower your nurses to fully embrace their role as patient advocates by bringing Sandy Summers, the Truth About Nursing's executive director, for a speaking engagement tailored to your needs. Bring nursing and patient care to the next level! Here are some specifics about the presentation:

Beyond Magnet: Can We Transform the Health Care Setting by Empowering Nursing?

Every day, nurses change the world, making the difference between life and death, progress and decline, hope and despair. And the Magnet Recognition Program aims to enhance the role nurses play in health care settings. But there is another level. In this inspiring multi-media presentation, Sandy Summers, RN, MSN, MPH, founder and executive director of the Truth About Nursing, encourages nurses to think about the value of what they do and how they can unlock their full potential. Even apart from formal criteria a health care institution may meet, many nurses see a social environment that does not understand their true role in care, in a world over which they seem to have little influence. Research shows that media products shape and reinforce inaccurate ideas about nursing, discouraging career seekers, demoralizing practicing nurses, and driving the under-funding of clinical practice. And despite some progress in the Magnet era, too few decision-makers seem to know that nurses are skilled professionals who save lives and improve outcomes. Sandy Summers will explore proven strategies to help nurses raise awareness of their true value across the board. We can empower nurses to improve safety for patients, reduce nurse turnover, and enhance public health. Sandy shows you how.

Widener University, 2019

Johns Hopkins University, 2016

Recommendations

From Brenda Kucirka, who brought Sandy to Widener:

"I highly recommend inviting Sandy Summers to share the work of The Truth About Nursing with your organization. Sandy brings a powerful message and a call to action for nurses to advocate for the profession. Sandy was the invited guest speaker for our Nightingale Ceremony. She reminded us of the history of nursing and the contributions nurses make to supporting public health and the wellbeing of our communities. Students left feeling empowered to step into their new role, inspired by the work of nurses and the significance of their choice to join the profession.

For nurses in the audience and faculty, she reminded us of why we chose nursing as a profession and the imperative we have to shape the profession as she shared the "Truth About Nursing". Feedback from students, guests and faculty was very positive. It was essential information for our new graduates as they transition to practice. Sandy is an excellent speaker who delivers a message that all nurses would benefit from hearing. Her call to action is the antidote to anyone who is feeling disillusioned about our profession or just needs a reminder of just how much power we have."

Brenda Kucirka PhD, RN, PMHCNS-BC, CNE
Assistant Professor Widener University School of Nursing

See more recommendations

Learn more about how to bring Sandy to speak at your hospital

 

Go above and beyond the Magnet Program to become a truly excellent hospital

In June 2006, the Truth About Nursing's founder and executive director, Sandy Summers, sat on an expert panel about the Magnet Program for The World Congress Leadership Summit for Chief Nursing Officers in Chicago, Illinois. In this presentation she encouraged the Magnet Program to incorporate the following ideas:

Safe Facilities

Green and organic environments

Improve hospital policies to protect and support nurses

Strengthen Nursing

Strengthen Nursing Managers

Staffing

Employee Benefits

Media

Strengthen credentialing process

Collaboration between the professions

Magnet hospitals should be nursing institutions

Magnet hospitals should exist to provide humane care to all patients

Ethics

Overall changes to the magnet program

Discussion

Safe Facilities

Magnet facilities should not be reservoirs for dangerous organisms such as MRSA. Each magnet facility should:

  1. Create health care environments using evidence-based designs to promote better patient outcomes and less stress on nurses. For guidance, seek help from The Nursing Institute for HealthCare Design.
  2. showerprovide uniforms for all staff who have contact with patients;
  3. wash these uniforms at temperatures sufficient to render them clean;
  4. provide adequate showering facilities for all staff so that all organisms are not brought out into the community and home to families;
  5. require that all staff change out of uniforms and shower before leaving the facility. See our analysis on this issue.

Each Magnet facility should be a safe place for patients and nurses. They should be:

  1. Latex-free facilities
  2. Mercury-free facilities
  3. Free of toxic cleaning chemicals that lead to illness.

Guidelines for creating safe facilities can be found on Sustainable Hospitals and Health care without harm

Green and organic environments

Magnet hospitals should be green facilities, that recycle, compost, separate out electronic waste and serve only cholesterol-free organic food in their food facilities.

See Health Care Without Harm; and

Greening the NICU: An Expert Interview With Kathi Randall, RNC, MSN, CNS, NNP-BC on Medscape.


Improve hospital policies to protect and support nurses

  1. Each institution should have "no lift policies" and appropriate lifting equipment. (See Franken bill on no lifting.)
  2. Magnet hospitals should have needleless IV systems and safe needles.
  3. There should be zero tolerance for abuse practices and procedures.
  4. Critical incident stress debriefing sessions should be offered to all employees who suffer physical or sexual assault of any kind.
  5. Hospital attorneys should pursue with police and the district attorney, the cases of employees who have been assaulted, physically or sexually, while at the hospital.
  6. Adequately address nurse fatigue.
  7. When considering patient assignments, patients being admitted or discharged should count as 2 patients to account for the higher mortality associated with bed turnover.

Strengthen nursing

  1. All care should be delivered by Registered Nurses (RNs) such as is the case at Hahnemann Hospital in Philadelphia.
  2. The nursing model should be a primary care nursing model, not a team model.
  3. Magnet hospitals should have at least one-year nursing residencies for all new nursing graduates. (Studies (1, 2) show that nurses who went through residencies had about a 90% retention rate. Without residencies, a third to more than half of nurses leave the profession.) See our discussion of nursing residencies.
  4. Each unit of each hospital should have at least one clinical nurse specialist on duty 24 hours per day, seven days per week.
  5. Magnet hospitals should not recruit nurses from nations with shortages more dire than their own. When hospitals increase staffing by taking nurses from countries that desperately need them, it violates nurses' ethical obligations to the needs of our patients around the globe.
  6. Each nursing manager should be a clinical nurse specialist in a relevant field for his unit.
  7. Each nursing manager should have a full-time administrative assistant to help with paperwork and budgetary duties to allow managers the time to focus on nursing excellence, instead of clerical duties.
  8. Nursing managers should practice clinical nursing on his/her unit at least 16 hours per week.
  9. Over 50% of staff nurses on each unit should be certified in their fields.
  10. Each facility should have at least three centers for nursing professional improvement; one each to strengthen nursing research, nursing clinical practice and nursing education within the hospital.
  11. Efforts should be made to provide zero distractions to nurses as they perform critical tasks such as medication administration. (see article.)
  12. Build nurse-designed models of care

Strengthen nursing managers

  1. The chief nursing officer should have at least a master's degree in nursing.
  2. Nursing managers should have significant and ongoing management training.
  3. Nursing managers who do not receive positive evaluations by more than 80% of nurses who work under them should be replaced.
  4. New nursing manager hires should be interviewed by the staff nurses they will supervise.

Staffing

  1. Charge nurses should be allowed to set the staffing levels on their floors determined by what nurses feel they can safely handle; and filled staffing should be filled by an appropriate mix of nurses based experience and expertise.
  2. Basic minimum nurse-to-patient ratios should be set no higher than those set by the current California legislation, whether or not the institution is located in California.
  3. Nurse-to-patient ratios should be posted very visibly for visitors to see on every unit and updated every shift.

Employee Benefits

  1. Nurses should receive full tuition reimbursement for education that will enable them to stay in nursing or public health.
  2. Hospitals should pay for at least 15 hours of continuing education hours for each nurse per year.
  3. From the day they begin work, all employees, including part-time employees, should be provided with health insurance for themselves and their families.
  4. All employees, including part-time employees, should be provided with retirement benefits.

Media

  1. At least half of the public relations officials at Magnet hospitals should be charged with solely promoting nursing.
  2. When a hospital loses its magnet status, the Magnet Credentialing Center should send press releases to at least the two largest newspapers in the area, the four major television networks and local news radio stations regarding the removal of magnet status and the specific reasons why the status was removed.

Strengthen credentialing process

  1. The Magnet Credentialing Center evaluators should come to evaluate hospitals at a surprise time.
  2. The Magnet Credentialing Center should choose hospital staff members they wish to interview--not allow interviewees to be hand-picked by hospital managers.
  3. The Magnet Credentialing Center should separately contact, through home mailing addresses, all nurses who works at the institution to inform them of policies by which they can report infractions by hospitals.
  4. The Magnet Credentialing Center now has an anonymous tip line to report hospital misbehavior, which is recent since we last reviewed the ANCC informationi. We applaud this action.

Collaboration between the professions

  1. The professions should have recurrent training in how to function as a team.
  2. Physicians should be expected to seek nursing input on patient rounds and morbidity and mortality rounds.
  3. Physicians and medical students should follow nurses at work for at least 12 hours per year so that they can understand the value of nursing and how to collaboratively work with nurses.
  4. Magnet hospitals should have an incivility and bullying hotline to address all acts of reported incivility by a committee that is comprised of at least half staff nurses.

Magnet hospitals should be nursing institutions

  1. At least 51% of the board of trustees should be nurses.
  2. The CEO of the hospital should be a nurse.

Magnet hospitals should seek to provide the best care possible based on the latest research

  1. Magnet hospitals should be non-profit institutions. Corporate profits have no ethical place in the delivery of health care. Studies show that non-profit nursing homes provide better care than for-profit nursing homes.
  2. Uninsured patients should pay no more for any service, procedure or item than the lowest amount accepted by the hospital from any private or government insurance program.
  3. Absolutely no dumping of patients should occur.
  4. Patients should not be woken to have labs drawn. If physicians want lab results with their rounds, they should come to the hospital at noon or later, so lab draws do not interrupt sleep and patient health.

Magnet hospitals should exist to provide humane care to all patients

  1. Music in should be provided in rooms of all patients. A growing body of research shows that music reduces pain, blood pressure, depression, physical signs of stress and cortisol levels. See this interesting research in many different studies by nurses from Japan, South Korea and Sweden. Music affects the blood pressure of pregnant women more intensely.
  2. Noise should be reduced as much as possible. See the nursing research.
  3. Hospitals should institute The Pause after someone dies to take a moment to reflect on the person's life, and efforts of the health workers to save them. See more about it on the website of Jonathan Bartels, who is a nurse, and the innovator of the practice.

Ethics

  1. Magnet hospitals and each person who works in them including physicians, should adhere to the principles of accepting no gift from any pharmaceutical company or medical supply company, and be a member of No Free Lunch.
  2. Being that hospitals are nursing institutions, the ethics committee should be comprised of at least half nurses.
  3. Magnet hospitals should follow the Code of Ethics for Nurses.

Overall changes to the magnet program

The Magnet program should be a government program to which all hospitals must adhere.

Discussion

Above is the list of changes and improvements to the Magnet program that our executive director presented to the World Congress of Nurses in June 2006. We would like to hear what all nurses (and patients) think of Magnet hospitals and our suggestions for improvement, especially those who are at magnet facilities.

Please let us know your experiences with Magnet hospitals at info@truthaboutnursing.org. Thank you!

The list for suggested improvements to the Magnet program expressed herein are those of Sandy Summers, RN, MSN, MPH, the Truth About Nursing's founder and executive director. They do not necessarily reflect those of the Board Members or Advisory Panel of The Truth About Nursing.

Last updated July 4, 2019

(Formerly titled "What is Magnet status and how's that whole thing going?")

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