With a well-publicized national nursing shortage continuing to vex the American health care system, nurses looking for a job have never had more options than they do today.
Novant Health has a key distinguishing factor that puts the health care system out there as a top prospect for nurses: It boasts four Magnet hospitals as among the nation’s best.
Only 2% of the nation’s hospitals have achieved that status, and only seven other North Carolina medical centers made the list.
Magnet programs are recognized for providing excellence and quality in nursing care and a working environment that stresses care, support and professional development for nurses. The research is clear: Magnet recognition have positive outcomes for patients, nurses and the workplace. Patients receiving care at Magnet-recognized hospitals have experienced lower mortality rates and greater satisfaction during their stay and are able to go home sooner.
Presbyterian has received the designation four times from the American Nurses Credentialing Center (ANCC), and Forsyth has achieved it five times. Visiting experts tour the hospitals to confirm they’re centers of outstanding patient care and innovation. Documenting that to satisfy a panel of outside appraisers is a time-consuming task. Renewal is not automatic.
"It's not something that's required of us to do, but it shows that you're invested in your nurses and interdisciplinary care teams that take care of your patients," said Leslie Robbins, co-manager of the magnet efforts at Novant Health.
Magnet hospitals must show support for nurses' professional development and their ideas for improving day-to-day practice. They're expected to exceed nationwide benchmarks for turnover rates, job vacancies and the percentage of nurses who are certified and/or holders of advanced nursing degrees. They must prove their nurses are making a difference outside the hospital — for example, by volunteering at health screenings. Patient satisfaction scores matter, too.
Making it all even more challenging, Magnet hospitals are expected to surpass their own previous performance.
"It's a high bar, but if we're doing the work, we will absolutely see the benefits in terms of nursing turnover, job satisfaction and patient outcomes," said DeShuna Dickens, magnet program co-manager.
Finding ways to attract and keep top nurses is a must.
The COVID pandemic led to an exodus of registered nurses nationwide, and nursing school enrollments have long been unable to keep pace with the need for qualified replacements. At the same time, aging Americans are battling lifestyle-related illnesses such as diabetes, heart disease and cancer. Federal authorities project a shortage of 63,720 full-time RNs and about 29,200 advanced practice RNs in the next five to seven years.
That's why the Magnet appraisers want evidence that hospitals are working hard to keep nurses in the fold by empowering them, fostering their growth and rewarding excellence.
"The goal is to showcase our best nursing initiatives and that is difficult when there are so many," said Robbins, who has coordinated the last four Magnet designations at Forsyth Medical Center.
Several programs are helping stem turnover and foster a climate of continued improvement among Novant Health's nursing corps, according to Daria Kring, vice president of the Novant Health Center for Professional Practice and Development.
Among them: a graduate RN residency program, which has helped more than 3,000 nurses transition from student to professional. Providing financial support for nurses to continue their educations and get professional nursing certification is another. A clinical ladder program rewards growth and development while fostering advanced nursing practice.
In their presentations to the Magnet teams, nurses also point to shared governance. It involves Novant Health nurses at all levels in decision-making, which promotes trust, according to Kring. Nurses feel comfortable speaking up, sharing ideas and investigating new processes that pay off for patients.
"We have less turnover than other hospitals without these resources," Robbins said.
"Nurses know they have a voice and the self-sufficiency and independence to determine what is right for their patients," Kring added. "These result in better outcomes."
Magnet review teams also have consistently been impressed with Novant Health's support for nurses to do original research.
Karen Cumbo is part of an interdisciplinary team at Forsyth Medical Center that includes nurses, obstetricians, midwives and others who care for women during labor and delivery. The possible need for anesthesia had long made eating during labor a safety concern. But Cumbo and her colleagues wondered if a light, nourishing snack might benefit women in the early stages.
With help from Novant Health nurse scientist Gloria Walters, a research study provided an answer that has led to changes in practice in many hospitals. Women who are deemed at low risk may now be offered a low-fat meal or snack during early labor at the hospital to boost energy and optimize the birthing experience.
The Magnet model
Hospitals must demonstrate excellence in five areas to gain Magnet Recognition.
1. Structural empowerment: Magnet hospitals have strong plans for improving patient outcomes and the health of their communities. Giving nurses the power to find the best ways to achieve these goals is key.
2. Transformational leadership: Leaders must have a clear vision and the systems to achieve it.
3. New knowledge, innovation and improvements: Magnet organizations are expected to contribute to new and better models of patient care.
4. Exemplary professional practice: Hospitals must provide outstanding patient care, innovate, document what works and share successes.
5. Empirical quality results: Hospitals must document how they've improved care.
