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Magnet Nursing Services Recognition Program

Cedars-Sinai Medical Center

Hackensack University Medical Center

UC Davis Medical Center

By Todd Stein
May 11, 2000

When actor Judd Hirsch sang the praises of nurses on a New York radio station late last year, it had an astounding effect on the profession.

"We got calls from nurses all over New York saying, ‘My God, it was so inspiring,’ " said Toni Fiore, MSN, RN, chief nursing officer at Hackensack (N.J.) University Medical Center. "It showed that people really do care about nursing."

Hirsch, who was paid for his services, announced Hackensack’s receipt of "magnet hospital" status from the American Nurses Credentialing Center (ANCC), an honor that so far only 17 hospitals and one long-term care facility can claim. The award certifies that a hospital meets 14 standards of nursing care, which the credentialing center credits with fostering a pro-nurse workplace. The standards seem to make it easier for a hospital to attract and retain nurses.

The Washington-based, nonprofit arm of the American Nurses Association evaluates nurses’ status, freedom to make emergency care interventions without fear of punishment, collaborative efforts to improve patient care with physicians and administrators, and the ratio of nurses to patients.

"Magnet recognition is the one award that exists in the nursing profession that recognizes that an institution provides outstanding quality care and service, and is the best place to work for nurses," said Linda Burnes Bolton, DrPH, RN, FAAN, chief nursing officer at Cedars-Sinai Medical Center in Los Angeles, which in January became only the second California hospital to earn magnet status. "It’s a great feeling."

Cedars-Sinai Medical Center staff with the magnet hospital  award, Linda Burnes Bolton, DrPH, is second from left. Photo courtesy of Cedars-Sinai Medical Center

It also is a great promotional tool. Magnet hospitals tend to flaunt their status to draw patients, win grants, beat their competition, and recruit nurses. Hackensack Medical Center splashed its certification on roadside billboards, and Cedars-Sinai handed out free phone cards to its 1,200 nurses at the magnet award ceremony, telling them to "call their friends and tell them you work at a magnet hospital," Burnes Bolton said.

In an era of chronic nurse shortages and rampant job burnout, it is understandable why hospitals would go to such lengths to advertise their virtues to nurses. But is the magnet award more than a gimmick?

Definitely, said Linda H. Aiken, PhD, RN, FAAN, director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania in Philadelphia, and a recognized nurse-practice researcher. "Magnet status is the most positive idea around in this era of re-engineering nursing," she said.

Aiken was the lead author of a recent study that found nurses at the credentialing center’s 17 magnet hospitals had higher levels of job satisfaction and lower burnout rates, and gave the quality of care provided at their hospitals higher ratings than did nurses at other top hospitals in the country.

The study, published in the March issue of the American Journal of Nursing, compared nurses’ written evaluations of their jobs at ANCC-designated hospitals to those from nurses in 41 hospitals studied in 1980-83 by the American Academy of Nursing—what the academy then called "magnet" hospitals for their high quality of care and their ability to attract and retain nurses.

Aiken and her colleagues are nearing completion of a much broader study of 700 hospitals in the United States, Canada, England and Germany that will research whether hospitals with magnet-like qualities actually produce better care. "Our preliminary research to date suggests that the answer to that question is ‘yes,’ " Aiken said. "Nursing is the single most important factor in a hospital’s ability to save the life of a patient who develops a serious complication."

Aiken estimated that as many as 20 percent of American hospitals could qualify for magnet status under the credentialing center’s guidelines. That only 17 have done so reflects more on the center’s internal process than on the quality of U.S. hospitals. The center offered magnet certification only as a pilot program in 1995, and opened the process to all hospitals just two years ago.

Many hospitals are still not aware of the award. But word is spreading fast. The ANCCreports that 63 hospitals have paid the $500 magnet application fee and are in the early stages of certification.

UC Davis Medical Center

"Many hospitals haven’t bothered with the magnet program because they’re looking for quick solutions to the nursing shortage, such as sign-on bonuses and bringing in travel and registry nurses," said Carol Robinson, MPA, RN, associate director of patient care services at the only other magnet-designated hospital in California, the University of California, Davis, Medical Center in Sacramento. "They don’t really think about the core reasons that people don’t want to come or don’t stay."

While the UC Davis center had promoted magnet-like nursing values and programs for years, Robinson said the credentialing center’s lengthy certification process encouraged the staff to listen more carefully to floor nurses when making care decisions.

"It has really heightened our sense that nurses should be making those decisions from the bedside," she said. "Now, every time we make a decision from the perspective of clinical care, we ask:‘What is it that the staff nurses would want us to do?’

"And for our staff, it’s a recognition that what they do is of the highest quality, which is a message I think they should hear as often as possible."