What is this "magnetism" in practice settings that attracts and retains nurses? Is it a prize to be won? Is it an accolade to be awarded for recruitment and retention of nurses? Can any practice setting achieve this much sought-after recognition? How did this Magnet Hospital designation start?

The American Nurses Association and the American Academy of Nursing Task Force on Nursing Practice published the original Magnet Hospitals study in 1983. This was the time of a national nursing shortage and it was decided to capture what practice settings succeeded in attracting and retaining nurses as identified by a peer reference community of nurses.

A total of 165 institutions were nominated by fellows in the academy as potential Magnet hospitals, meeting the following criteria:

• Nurses consider the hospital a good place to practice nursing and a good place to work.

• The hospital has the ability to recruit and retain professional nurses, as evidenced by a relatively low turnover rate.

• The hospital is in a geographic area where it has competition for staff from other institutions and agencies.

• Academy fellows interviewed the directors of nursing and staff nurses, asking the following questions:

• What makes your hospital a good place for nurses to work?

• Can you describe particular programs in your situation that you are leading to professional/personal satisfaction?

• How is nursing viewed in your hospital and why?

•Can you describe nurse involvement in various programs and projects whose goals are quality of patient care?

• Can you identify activities and programs calculated to enhance, both directly and indirectly, recruitment and retention of professional nurses in your hospital?

• Could you tell us about nurse-physician relationships in your hospital?

• Please describe staff nurse-supervisor (various levels) relationships in your hospital.

• Are some areas in your hospital more successful than others in recruitment and retention? Why?

• What single piece of advice would you give to a director of nursing who wishes to do something about registered nurse vacancies and turnover rates in her hospital?

Of the 41 hospitals in the final report (1983), I had the privilege to be the nursing leader in two of the original study hospitals: Family Hospital in Milwaukee and Virginia Mason in Seattle. What is so important in today's search for magnetism is that not all settings need this designation in order to have positive, professional practice environments, and we did not set out to be designated as such.

Family Hospital took five years of turnaround strategies and Virginia Mason took at least three years before gaining Magnet status, but in each it took a strong nursing voice in planning and policy-making and gaining control of nursing practice with setting limits on what nurses would and would not do. The most significant factor is for the nurse leader to be a strong nurse advocate and to represent the needs of nursing in an articulate fashion with a caring philosophy that pervades the practice environment.

Nurses have to be empowered to direct their practice and create their practice environments in order to give quality patient care.

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