The West region (Alaska, Arizona, California, Nevada, New Mexico, Oregon and Washington) boasts 34 Magnet facilities, according to the American Nurses Credentialing Center. Here, some of the regions leaders share how nursing practice has changed since achieving Magnet status and how they have embraced Transformational Leadership, one of the Five Forces of Magnetism.
Find the full list of Magnet facilities by state at http://nursecredentialing.org/.Debra Bennett, RN
Debra Bennett, RN, CCRN, Magnet recognition coordinator
Scripps Memorial Hospital, La Jolla, Calif.
Recognized in: 2005, 2010
At Scripps Memorial Hospital La Jolla, our nurses have embraced the opportunities, and the responsibilities that result from a structure of empowerment. In addition to our house-wide practice and quality councils, our staff RNs sit on unit-based practice councils; house-wide research, education and IS committees; as well as system-wide groups. As part of these teams, nurses are making decisions about how nursing is practiced in our organization.
Our Interdisciplinary Quality Council is an example of nurses stepping up to lead change in the organization. The council is comprised of representatives from each unit and department in the hospital, who are tasked with monitoring the quality of care and making suggestions for improvement. Since the inception of the IQC, our nurses have become more knowledgeable about performance improvement methodologies, and much more aware of our quality parameters and statistics.
Our nurses have recognized the importance of continually expanding their knowledge and developing their practice. Many of them take advantage of organizational support to become certified in their specialty area, to further their formal education, or to attend and/or present at national conferences. These activities not only benefit our nurses, but allow us to move new knowledge into practice for the benefit of our patients.”Peggy Reiley, RN
Peggy Reiley, RN, MSN, MS, PhD chief clinical officer and senior vice president
Scottsdale Healthcare Osborn Medical Center, Scottsdale, Ariz.
Recognized in: 2006
I am often asked how achieving Magnet recognition has changed the nursing care at Scottsdale Healthcare. It seems such a simple question but so much has changed there is no simple response. The nursing culture has changed dramatically and with the sheer number of nurses in our organization this change has influenced the entire organization.
The greatest change began with the focus on education. We are fortunate our organizations leaders collaborate to achieve goals, this being an important characteristic of a Magnet facility.
In just seven years, Scottsdale went from 23% to a whopping 54% of direct care nurses with a BSN of higher. The trend continues as many are now working toward Masters and Doctorates. Currently we have two Doctoral prepared nurse practitioners and 11 nursing leaders enrolled in a Doctorate of Nursing Practice program. The quest to advance knowledge is seen in other ways such as 74% of eligible nurses have certifications in their area of specialty.
So some may ask how this translates into nurses taking a more active role in leadership? Once learning occurs it offers a greater understanding of nursing theory, quality improvement, evidence based practice, research, and even business principles. The nurse has been challenged to think beyond the task and now is not satisfied with just going to work and collecting a pay check. They want to be a part of making improvements and have acquired the knowledge and skills to make those changes. It is evident the Magnet environment is alive as we see the increase number of nurses confident in testing their new knowledge by trying new roles such as joining the Nursing Research Council, Nurse Quality Council, Patient Care Council or become adjunct faculty at a university, present at national conferences, publish articles, and hold office in national professional organizations. To maintain the Magnet environment hospitals are required develop, encourage, facilitate each nurse in their professional growth.”Sylvia McKenzie, RN
Sylvia McKenzie, RN, MSN, CPHQ QI specialist and Magnet program director, patient care services
University of Washington Medical Center, Seattle
Recognized in: 1994, 1998, 2002, 2006
University of Washington Medical Center was the first hospital in the world to achieve Magnet Status in 1994. Since that time, structural empowerment has grown tremendously; in fact, all of our key quality initiatives have nursing leadership and are interdisciplinary in nature. Our shared leadership structure is thriving to the point where in many meetings, there is standing room only. Many of our staff in leadership roles, after being mentored by advanced-practice nurses, have elected to seek continuing or continued education leading to UWMC having very high BSN, MN and certification rates as compared to national benchmarks. One nurse describes her experience:
I recall precisely the day I expressed aloud for the first time to a UWMC Nursing Administrator my consideration of a PhD in Nursing Science – she said, I hoped this day would come – of course you should do it – what can I/we do to help? I completed my PhD last spring! It was an amazing experience.
Laurie Soine, PhD, ARNP, Nuclear Medicine
At University of Washington Medical Center, nurses at every level of practice are transformational leaders engaged in leadership strategies that are inclusive, respectful, innovative and creative while guiding change. We believe that every nurse should maximize their potential and work to the full scope of their licensure. We have integrated ARNPs into our medical and surgical intensive care unit teams, increased the number of patient advisory councils, and rolled out a new house-wide peer to peer RN mentoring program. Of particular note, our ARNPS are now full voting members of the medical staff. Throughout all of these and many other process improvements, input from direct care nurses has proven critical to improve the work environment and the quality of patient care in the most efficient and effective manner. Two nurse leaders describe their experiences:
Co-leading the Med-Surg Local Practice Council helps me to identify evidence-based improvements that support patients, their families, and nursing staff across our institution. We collaborate as a group to not only recognize the areas in need of development, but also to ask questions to continually make progress in areas in which we excel.
Sheila Hoelscher, RN, MN, ARNP, OCN
7SE/Heme/Onc, Gyn/Onc, Uro Assistant Nurse Manager
I am impressed by the concepts of leading by influence and not by power and enjoy identifying additional ways that nurses can become more involved on my unit. I plan to look for ways to identify informal leaders on my unit and give them opportunities to be involved.
Nancy Wiederhold, BSN, RN
6NE/General Medical, Family Medicine Assistant Nurse Manager
Julie McNulty, RN, MS, director, Center for Clinical Excellence
Alaska Native Medical Center, Anchorage, Alaska
Recognized in: 2003, 2009
During the Alaska Native Medical Centers Magnet journey, nurses gained recognition for the leadership roles that they were already embracing. Although bedside nurses are encouraged to step up and lead out of their comfort zone, this did not change after our Magnet designation, however it may have enhanced the leadership experiences. The Magnet process itself is a way for nurses to build confidence in these roles. We have front line staff leading process improvement/change initiatives, evidence-based practice teams, and shared governance initiatives. Our Clinical Ladder board is chaired by a front line nurse, and our shared governance activities are coordinated by an elected President of the Nursing Staff (PNS). Our current hourly rounding initiative is co-chaired by two front line nurses. Nurses are teaching in a formal and informal capacity.
Recently, we hosted a visit with Patricia A. Grady, RN, PhD, FAAN, director of the National Institute of Nursing Research. Her visit was coordinated by our PNS, and front line nurses gave presentations on their staff led projects. The confidence gained through Magnet recognition extends beyond these roles and into practice as well. For example, during a regulatory visit such as Joint Commission, Magnet nurses can exhibit confidence in their practice and ability to showcase it. When nurses are networking and interfacing with the community, Magnet gives them a positive framework from which to build and share. We are encouraged to mentor other organizations, and the staff to staff connections that are developed can be invaluable.
Approximately 18 months ago, we became a Studer organization. Nursing has led the way through consistent leader rounding on all employees, implementing ambitious behavior standards, and most recently through hourly rounding in the acute care areas. The results in improving patient outcomes, patient safety, and customer service tie directly back to the vision for the Alaska Native Tribal Health Consortium, which is for Alaska Natives to be the healthiest people in the world. These results would not be possible without the efforts of the entire health care team.”Salomeja Garolis, RN
Salomeja Garolis, RN, director of professional practice
Providence Portland Medical Center, Portland, Ore.
Recognized in: 2005, 2010
Nurses have changed from quietly practicing to recognizing the care they provide is excellent. They are key coordinators of what patients and families experience in the hospital and transitions to the community. With this mindset, nurses have taken leadership roles, they own their practice, and create their work environment.
Extending beyond their units, nurses have utilized shared governance to influence product use, equipment needs, as well as defining healthy work environment. In the past, managers or staff outside of nursing would lead improvement teams. Now it is staff that lead teams focused on their patients by implementing evidence based practice, and taking accountability for nurse sensitive quality indicators such as patient falls and hospital acquired pressure ulcers.
Transformational Leadership is demonstrated throughout nursing. From the chief nurse to direct care staff, each nurse knows the vision for a connected patient experience. Elements of connected care mean Providence Portland Medical Center nurses know their patients, care for their patients, and ease their way. Nurse-led teams focus on purposeful rounding and in-room shift handovers, and staff-driven teams influence nurses to change practice, as well as design the right approach to facilitate the change. Providence Portland nurses are among the first in the Pacific Northwest to participate in an international collaborative designed to give nurses more time to be with their patients, the model known as Releasing Time To Care has been highly successful in Great Britain and is driven by nurses at the bedside. Overall, Magnet has propelled our staff to proudly share their connection and care of patients and demonstrate excellence in nursing outcomes.Andrea Segura Smith, RN
Andrea Segura Smith, RN, MSN, NEA-BC, interim associate VP nursing/CNO
John Muir Medical Center, Walnut Creek, Calif.
Recognized in: 2008
John Muir nurses have embraced opportunities for leadership from the beginning of our Magnet journey. As more direct care nurses have opportunities to lead and participate on unit service councils, performance improvement activities and special projects they have developed their formal leadership skills. They also experience the organization from a different perspective-learning how change happens, how change affects many stakeholders and what are successful strategies to manage change. Staff have moved into management positions as a result of leadership opportunities.
Our goals as nursing leaders is to create an environment of trust, transparency and collaboration with our nurses and the interdisciplinary team members. We work with our shared governance structure to engage nurses and staff in shared decision-making about their practice and work environment. We support collaborative forums for nurses and physicians to address patient care delivery issues and professional relationships.