Magnet Hospitals: Are they the answer for our profession?

Attracting and retaining nursing staff is a key issue for Australian hospitals. JOANNE JOYCE, who is researching the concept of organisational "magnetism" in Australian hospitals, explains:

What's in a name? The Oxford Dictionary defines a magnet as a thing or person that attracts, and magnetic as having the properties of a magnet.

The term Magnet Hospitals was coined in the United States from research that sought to understand why certain hospitals were able to attract and retain staff while others couldn't.

Those hospitals that were successfully attracting and retaining staff (often at the expense of other institutions) were called magnets - for obvious reasons.

The recruitment and retention of professional nursing staff is a global issue. Nursing shortages are being experienced worldwide due to a combination of factors including an ageing workforce, fewer individuals entering the profession and the inability of health systems to retain nursing staff.

Nursing shortages create a vicious cycle as staff become over-worked and dis-satisfied, and patient care can suffer accordingly.

Australia is certainly not immune from this problem and it is clearly a priority for health systems here, as elsewhere, to identify possible solutions to the issues of recruitment and retention if the current shortages are to be resolved. The Magnet Hospital concept which has been developed in the US over the past 20 years provides such a solution.

The US research shows that the secret to the Magnet Hospitals' success is straightforward. It is based around strong leadership, inclusive management style, autonomy for nurses, positive nurse-physician relationships, good resources, quality career development and further training, and good prospects for promotion.

Hospitals that exhibit these features are able to attract well-qualified and committed nursing staff despite shortages across the industry and are regarded as good places to work.

Two major studies have demonstrated that Magnet Hospitals also consistently produce better outcomes for staff and patients as demonstrated in job satisfaction and quality patient care.

During the 1990s the Magnet Hospitals research was used as the basis for a credentialing system for hospitals that acknowledges excellence in nursing. Developed by the American Nursing Credentialing Centre, a division of the American Nursing Association, it has awarded Magnet status to just over 100 of the more than 6000 hospitals in the US.

It is a valuable assessment tool for hospitals that can be developed in the Australian context, as we also grapple with the nursing shortages and the difficulties hospitals and other health service providers face in attracting and retaining good nursing staff.

Brisbane's Princess Alexandria Hospital is the first hospital in Australia to undertake the credentialing process to achieve Magnet Hospital status, with accreditation confirmed earlier this year.

Hopefully the Princess Alexandria experience will demonstrate to Australian hospitals and nurses that Magnet Hospital characteristics can play a major role in achieving excellent patient outcomes and the retention of nursing staff.

In Australia the nursing shortage is perhaps the biggest challenge our profession faces, yet up until now our hospitals have been slow to embrace the Magnet concept.

Magnet is the only program for attracting and retaining nurses that has a body of evidence to support it - 20 years of rigorous research that shows powerful outcomes. Research also provides clear evidence that they also deliver higher quality care and a significantly lower patient mortality rate.

It is hard to imagine any Australian nurse not positively desiring the Magnet attributes in his/her workplace, and many Australian hospitals and nurses will be watching the process at Princess Alexandria with great interest.

Having said that, it has been identified that importing an American concept to Australia has some limitations, and we are rightly asking how we can develop the Magnet concept in Australia.

Indeed, providing an Australian context for measuring Magnet features in our hospitals was one of the key motivating factors for my development of the Nurses Working Index-Revised (Australian) Tool.

Joanne Joyce is Director of Clinical Education at the University of Wollongong's Department of Nursing.




Joanne Joyce

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