Will Magnet Save Nursing?

The American Nurses Credentialing Center (ANCC) was established in 1991 as a separately incorporated entity of the American Nurses Association. It is the only national system for accreditation and approval of continuing education in nursing.The Magnet Recognition Program for Excellence in Nursing is based and administered by the ANCC. The program was based on research completed by nurse researchers in the early 1980s who identified the attributes of organizations that were able to recruit and retain professional nurses.The Magnet program identifies excellence in the provision of nursing services, an environment that fosters and rewards quality nursing, recognizes the management philosophy and practice of nursing services and the adherence to standards for improving the quality of patient care.

The Magnet designation means that the hospital has created an environment that supports nursing practice and focuses on professional autonomy, decision making at the bedside, nursing involvement in determining the nursing work environment, professional education, career development and nursing leadership. This can only be accomplished with the support and participation of all the departments and employees in the hospital that place patient care first and foremost in the mission of their daily work.

As of June 2008 there are 289 Magnet organizations in 45 states as well as New Zealand and Australia. Do you think Magnet designation actually effects the nursing shortage? When looking for a job does Magnet status matter to you?

(ANA, 2008)

Addressing the shortage here at home (TEXAS)

Like many states, Texas is facing the nursing shortage and trying to battle it head on. Green, Wick, et al., (2004) noted that in Texas unfilled nurse positions ranged from 10% to as high as 18% in some specialty areas. They also contribute the nursing shortage in Texas to an aging nursing workforce with an average age of 46 years, aging nursing faculty with an average age of 51 years, increased age and number of Texas citizens needing care and a vast variety of job options for women.

So what are we doing?
During the 2007 session of the Texas Legislature several bills were presented that addressed the nursing shortage. They are presented here.
• SB 138-Relating to promoting the retention and graduation of students enrolled in professional nursing programs (Texas Legislature Online, 2007).
• SB 139-Relating to the Texas Higher Education Coordinating Board and the Board of Nurse Examiners to study the current nursing curriculum and recommend improvements in order to ensure that Texas nursing programs teach the highest quality nursing curriculum (Texas Legislature Online, 2007).
• SB 289-Relating to the use of professional nursing shortage reduction program grants to encourage clinical nursing instruction by part-time faculty at public or private institutions of higher education (Texas Legislature Online, 2007).
• SB 992/HB 1894-Relating to the use of money from the permanent fund for health-related programs to provide grants to nursing education programs (Texas Legislature Online, 2007).
• HB 1775-Relating to the allowance of Stephen F. Austin State University to issue tuition revenue for the expansion of the school of nursing (Texas Legislature Online, 2007).
• HB 3443-Relating to the creation of the Texas Hospital-Based Nursing Education Partnership Grant Program (Texas Legislature Online, 2007).

The key elements to reducing the nursing shortage are increasing funding and programs that support nursing education, nursing faculty and the nursing workforce.

Specific Action Steps
• Form partnerships among institutions for nursing education, hospitals as nurse employers, governmental agencies providing funding and regulations, and the private sector as monetary donors and researchers. Resourceful and effective strategies can be created to attract additional nurses to the profession.
• Recognize nursing schools that are successful in retaining and graduating students. Bring the current graduation rate in Texas nursing programs from 56% to 85% (Nelson, 2006). This rate will have to quickly improve to keep up with the demands for nursing care in the state of Texas.
• Enhance funding for educational programs—renovations to school facilities, faculty salaries, and student loans/scholarships.
• Legislation to improve nurse satisfaction, to provide healthy work environments, and to improve patient safety and patient satisfaction.
• Focus on improving in three important areas: create a culture of retention, bolster the nursing educational infrastructure, and establish financial incentives for investing in nursing (Green, Wick, et al., 2004)

Addressing the shortage

In many of the comments to the previous post, several people touched on the desire to have "quality" nurses not "quantity" nurses. An alarming issue regarding the nursing shortage is that of enrollment in nursing schools, particularly entry-level baccalaureate nursing programs. According to the AACN (2008), a 7.4% increase in the number of graduates from entry-level baccalaureate nursing programs was seen from 2006 to 2007; but to meet the future need, a 90% increase in graduates is required. AACN’s (2008) preliminary 2007 data showed that 30,709 qualified applicants were declined admission to an entry-level baccalaureate nursing program. Barriers noted to accepting all qualified students were limited faculty, clinical placement sites and classroom space to satisfy the demand. What are other barriers you see and what are your ideas to address this issue? If we are already behind in the "quantity" of nurses needed, how would you suggest to improve the "quality" of those graduating?

A look at the issue

Reports regarding the shortage of nurses in the workforce have brought a serious matter to the forefront in the United States. This issue has drawn noticeable media attention as well as public attention because the critical shortage affects the entire population. Registered nurses (RNs) are the largest group of healthcare providers (United States General Accounting Office, 2001). In a report from the American Association of Colleges of Nursing (AACN) (2008), the Health Resources and Services Administration (HRSA) predicts that by the year 2020 in order to meet the national need, one million new RNs will be needed in the United States healthcare system. A shortage of registered nurses in the workforce will mean less quality care provided, less access to care, and even greater demand for services. The AACN (2007) addresses numerous factors contributing to the nursing shortage: nursing schools not enrolling enough students to meet projected demands for nurses over the next ten years, limited faculty to teach in nursing programs preventing increased enrollment, fewer nurses entering the profession causing the average age of registered nurses to rise, the aging population needing more care, nurses leaving the profession due to job burnout or dissatisfaction, and high nurse turnover and vacancy rate.

Has the nursing shortage affected your unit or hospital in a way that has compromised patient care? How have you seen this issue addressed? Please share your thoughts.