Thursday 8 June 2017

Since the American Nurses Credentialing Center (ANCC) unveiled its Magnet Recognition Program in 1993, the designation “Magnet Hospital” has become a coveted honor that attracts nurses and patients to the few healthcare organizations that earn this “gold standard” credential.

Understanding Magnet Hospitals

But for nurses who work at these hospitals – or wish to work there – is the designation really meaningful?

Or is the designation more of a status symbol than a marker of higher job satisfaction, better working environments, and superior patient outcomes?

Although Magnet Hospital definitions vary, in general, an ANCC Magnet Hospital must demonstrate the following:

◐ Higher percentage of satisfied registered nurses
◐ Lower RN turnover and vacancies
◐ Greater nurse autonomy
◐ improved patient satisfaction

In practice, say some critics, Magnet Hospitals don’t necessarily offer better working conditions for nurses, and some accreditation criteria are difficult to actually document.

So where does the truth lie?

Should you put Magnet Hospitals at the top of your list of potential employers? And what does it take to land at one?

How Do Hospitals Get Magnet Status?

Magnet accreditation is a resource-intensive process that takes an average of 4.25 years to complete at an average cost of $2,125,000.1

Because of the serious investment needed to demonstrate nursing excellence and high-quality patient care, only 8.8 percent of U.S. hospitals (425 total) had this performance-driven credential in 2015.2

Though the list of criteria for receiving Magnet status is lengthy, here are a few key requirements:

Data Collection. The hospital must collect relevant data related to nursing, which must then be compared with that of other hospitals for benchmarking purposes. This data must also be used to identify problems areas and the means for improvement.
Feedback Process. The institution must develop a way for nurses to confidentially express concerns about the hospital’s practices in a way that encourages them to do so.
BSN Degrees. Nurse leaders, with a rank between manager and chief nursing officer (CNO), must have at least a bachelor’s degrees in nursing.
Management. Nurse Managers must be registered nurses. They have around-the-clock accountability for the RNs at the hospital, handle performance reviews, recruiting, and other managerial duties related to the nursing department.
Chief Nursing Officers. The CNO must be a participant in the hospital’s governing body, as well as the body responsible for strategic planning. The CNO must have at least a master’s degree. If the degree is not in nursing, the officer must have either a bachelor’s degree or a doctorate in nursing.
Nurse Empowerment. All nurses should have a say in patient care and be involved in data collection, a collaborative approach that empowers nurses.

What Magnet Means for Nurses, Patients, and Hospitals

Over the past two decades, a number of studies have shown that most Magnet Hospitals do live up to the prestigious reputation associated with the designation.

A Gallup survey found that Magnet Hospital nurses were more engaged with their work, which correlates with better outcomes. 3

In addition, the study estimated that the average Magnet facility experiences 7.1% fewer safety-related incidents. These organizations also have significantly fewer RN workplace injuries and lower rates of blood and body fluid exposure.

The Gallup survey found that nurses in Magnet Hospitals have higher job satisfaction rates, including more desire to remain in their positions. (The study estimated that Magnet Hospitals have 1.7% less turnover than the industry average.)

Other studies discovered that nurse safety is significantly better at Magnet facilities, including fewer cases of musculoskeletal injuries and needle-stick incidents, and that patients with hip fractures were less likely to develop pressure ulcers or to fall.

And the benefits of Magnet status extend beyond patients and nurses to the hospitals themselves.

A study funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative found that the revenue increases achieved by obtaining Magnet status more than offset the costs of achieving it. “Net patient revenue increased on average by 3.89 percent compared to non-Magnet Hospitals, while costs increased only by 2.46 percent.” 4

Such revenue increases are due, in part, to the publicity that comes with the credential.

Magnet Hospitals are often ranked among the nation’s best – e.g., in U.S. News & World Report’s annual list of “America’s Best Hospitals” and Fortune’s “100 Best Companies to Work For.”

“Having Magnet status heightened our visibility in the community and state for being a leader for health care,” said Cabiria Lizarraga, RN, manager of telemetry at Sharp Grossmont Hospital in San Diego. “When people see we are a Magnet facility, they know the employer is committed to nursing excellence.”5

The Major Criticisms

But Magnet Hospitals are not without their critics.

A study by the University of Maryland School of Nursing found that Magnet status had little to do with nurse working conditions, including work schedules, hours and job demands.6

“My hospital spent tons of money getting magnet status, and then just a couple of months after we got it … they said, ‘We’re sorry, but we are millions of dollars in the hole right now, so you will have to work at 103% productivity and a person short now and then,’” one nurse complained in a forum at

The University of Maryland study also noted that, while nurses working in Magnet and non-Magnet Hospitals didn’t differ in most demographic characteristics, Magnet Hospitals employed far fewer nurses of color – just 9% compared with 16% in non-Magnet Hospitals.

And some critics say there’s no evidence that nurses at Magnet Hospitals are more empowered than their non-Magnet counterparts.

Getting a Job at a Magnet Hospital

Before submitting applications to Magnet Hospitals, you should know that they tend to be very selective in their hiring. Put bluntly: most give preference to RNs with BSN degrees.

So the first and most obvious step to getting your foot in the door is earning a BSN.

You should also show that you’re serious about professional development. Magnet hospitals are looking to advance the nursing profession, so they want nurses who strive for excellence in their field.

If you have any special awards or have taken leadership roles (like sitting on committees or suggesting new procedures), make sure that’s clear on your resume or in your interview.

It’s also smart to develop contacts at Magnet Hospitals by networking with HR personnel in the hospitals you’ve targeted, as well as the current nurses and managers. 


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