Florence Nightingales energy, vision and activism live on in many of todays nurses, some of whom have become legends in the profession. Nurse.com profiles several exemplary nurses from a variety of backgrounds who reflect the scope of Nightingales influence, including their thoughts on the link between Nightingale and current practice.
Margaret L. McClure, RN, EdD, FAAN, is professor and retired chief nursing officer, New York University Medical Center
McClure had been a nursing student in a diploma school inside a hospital for about a year when the hospital hired someone to supervise the nursing staff and nursing school.
I became aware of how much the situation for the patient and for the nurses improved dramatically after this new person took charge, she says. I realized the person at the top has a terrific impact on everything you could and couldnt do and how you should treat people. I made the decision to go into nursing administration then and there.
McClure quickly rose through the ranks: Army corpsmen nurse supervisor, night supervisor in a hospital ED and then nurse manager, while earning bachelors and masters degrees during and between jobs. In each, she found a common thread.
Nurse turnover was always a problem that I became dedicated to solving, she says. When I interviewed nurses, I tried to figure out what would make people enjoy the institution. We started cutting down the turnover rate, but couldnt figure out why.
She decided to try with her doctoral dissertation, choosing as her topic The Reason for Hospital Staff Nurse Resignations.
Ten years later, as a member of the American Nurses Association, she was asked to chair a four-person task force to examine the nationwide nurse shortage. One of the task force members had just completed a study of nurse resignations at Texas hospitals, and she was interested in the fact that some hospitals werent having trouble with turnover. So we decided we would study why nurses stay in their jobs, McClure says.
The members of the group thought they would receive plenty of funding. They got none. Undaunted, they proceeded to ask fellows of the ANA to identify successful hospitals in their regions, then sent chief nursing officers a lengthy questionnaire asking for data that included turnover rates. They completed a pilot study and interviewed nurses at hospitals with low turnover still with no funding.
The upshot was a book, Magnet Hospitals: Attraction and Retention of Professional Nurses, published in 1983 by ANA. The task force chose the appellation magnet because of its use by Magnet schools to denote excellence.
Today, the Magnet designation by the American Nurses Credentialing Center recognizes quality patient care, nursing excellence and innovations in professional nursing practice.
McClure says nursing has made great strides since the inception of the Magnet program.
No institution becomes a Magnet and stays there without constant tending, she says. Maybe one of the most important issues is that a Magnet hospital is not just a nursing hospital. It attracts and retains good people throughout the organization.
At the same time, nursing is the core business of the hospital, she says.
Like Nightingale, McClure keeps busy with projects aimed at strengthening nursing.
Magnet was my project in the 70s and 80s, she says. Now its nursing education and increasing the number of baccalaureate-prepared nurses. Were replicating an Oregon program that encourages nursing students to enroll right away as students who intend to earn bachelors degrees.
The complexity of care has increased so much and will only continue to increase, McClure says. We just have to understand that nursing is a lifelong learning process.
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