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Many nurses, both experienced and new graduates, put Magnet hospitals at the top of their lists of places they want to work. In some regions, after one hospital has received Magnet status, others have applied for the award or expressed interest in doing so. Magnet hospitals mention the award on their letterhead, in their advertising, even on lab coats and scrub tops.

In the last two years, inquiries about the Magnet program have increased sharply and applications have gone up nearly fivefold since 1999. But earning a Magnet award is no easy, overnight process, say appraisers, Magnet program coordinators and hospital administrators who have been through the process. In order to receive a Magnet award, they say, a hospital first must prove a deep commitment to nursing.

Hospital magnetism

The Magnet Recognition Program began during a nursing shortage in the early 1980s. The American Academy of Nursing appointed a task force to see why nurses weren’t working in hospitals. The task force found a number of hospitals that seemed to be nurse “magnets,” attracting and retaining well-qualified nurses when other organizations couldn’t.

The task force recommended that the academy identify a number of these hospitals and examine what made them successful, according to Ada Sue Hinshaw, Ph.D., RN, FAAN, and Margaret McClure, Ed.D., RN, FAAN, authors of Magnet Hospitals Revisited: Attraction and Retention of Professional Nurses.

The academy chose 41 Magnet hospitals from 165 nominated. Nominated hospitals had to demonstrate that nurses considered them a good place to work, that they had relatively low turnover rates and that they had competition for staff from other institutions and agencies.

Studies of these 41 hospitals showed certain common characteristics:

• Participatory management styles.
  
• Knowledgeable and strong leadership.
  
• Well-educated directors of nursing at the executive levels in the organization.
  
• Competitive salaries and benefits.
  
• Adequate levels of well-trained nurses.
  
• Educational and career development opportunities.
  
• Flexible scheduling.
  
• Professional practice.
  
• High quality of patient care.
  
• Autonomy for nurses.
  
• Good support staff.
  
• Nurse/physician collaborative practice committees.
  
• Interdisciplinary quality assurance and improvement committees.
  
• Ways of tracking patient outcomes influenced by nursing.

Using these studies, the American Nurses Credentialing Center developed a list of standards to recognize and reward hospitals that demonstrated their commitment to nursing. Health care organizations that prove they meet these standards, through extensive documentation and a site visit, are designated as nursing Magnets. Health care organizations must be redesignated every four years.

The process can take up to two years from the time of the initial application, said Mary Moon Allison, assistant director of the Magnet recognition and accreditation programs for the American Nurses Credentialing Center in Washington, D.C.

Health care organizations must show documents such as employee satisfaction surveys and quality improvement reports to demonstrate how they meet 80 core criteria and 14 “forces of Magnetism” (see below), based in part on the characteristics identified in the original Magnet study.

If they meet these criteria, appraisers visit the site and talk mostly with staff nurses to see how well the organization has put into practice what it has put on paper. Appraisers submit information and comments to a commission that decides whether to bestow Magnet status.

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