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Hospitals identify their biggest Magnet challenges

Nurse Leader Weekly, April 21, 2005

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Applying for Magnet status requires patience, persistence, and time management. Hospitals must allocate resources, corral organization-wide support, and implement cultural changes. Meanwhile, they navigate an unfamiliar application process, often for the first time. Throughout their Magnet journeys, hospitals inevitably face unanticipated challenges. Some seasoned veterans reflect on their biggest hurdles. 
     
Tackling the obstacles
Achieving senior leadership's support of the Magnet initiative proved challenging for Hartford Hospital because at first leaders thought the endeavor was to pursue an award or recognition, which the hospital does not do, according to Laura Caramanica, RN, PhD, vice president of nursing at Hartford Hospital in Hartford, CT.  

 After Caramanica explained the benefits of Magnet and gained the support of nursing leadership, Hartford Hospital worked diligently to communicate the importance of the award to almost 5,500 managers, employees, medical staff, and board members. Hospital officials distributed explanations of the Magnet standards as evidence of what constitutes an environment that attracts and retains highly-qualified staff and physicians, says Caramanica. 

Other challenges Hartford Hospital encountered included determining the right time to communicate the hospital's future plans and reasons for pursuing the status, preparing the application, and undergoing the site visit.
     
Dealing with the time crunch
Many hospitals felt the pressure of tight timelines. "We had a six-month deadline," says Katherine Riley, BSN, RN, director of integrated clinical services and Magnet coordinator at Southwestern Vermont Medical Center in Bennington, VT. "Pulling all of this documentation together in six months was very difficult. Luckily for us we felt we met all the standards so we did not need to change processes or structures." 

Anne Jadwin, RN, MSN, AOCN, CNA, director of nursing at Fox Chase Cancer Center in Philadelphia agrees. "Keeping strict adherence to the timeline was a huge challenge," she recalls. Trying to incorporate the writing time into an already packed daily schedule of other job responsibilities was also tricky, she says.

Writing the application
Translating the language of the 14 Forces of Magnetism into tangible sources of evidence stymied some coordinators. "The biggest challenge in applying for the recognition was to demonstrate compliance with the standards and criterion for nursing research and evidence-based practice," says Cole Edmonson, MS, RN, CHE, CNAA,BC, associate administrator, patient care services at Medical City Dallas Hospital and Medical City Children's. "These concepts were not very evident in the service environment and needed to be more clearly demonstrated." 

Gathering all the information needed to write the application requires knowledge of hospital processes and structures. "We had many creative and innovative things happening around the hospital," says Patricia Collins, RN, MSN, AOCN, Magnet coordinator at South Miami Hospital. "The challenge was to bring all these together and determine where they should go in the application. The writers attended retreats held by nursing leadership at which the application standards were reviewed and then brainstorming occurred about how we met each of them." 

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