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Study: Magnet hospitals don't offer better working conditions for nurses

August 13, 2010 | Richard Pizzi, Editorial Director

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BALTIMORE, MD – Magnet hospitals, which are recognized for better patient safety and outcomes, don't provide better working conditions for nurses than non-magnet hospitals, according to a new study by the University of Maryland School of Nursing.

The American Nurses Credentialing Center's Commission on Magnet Recognition recognizes about 350 healthcare organizations in the United States and four internationally. Hospitals with this distinction are viewed as "exemplar institutions of care," say study leaders Alison Trinkoff and Meg Johantgen, both professors with the UM School of Nursing, located in Baltimore.

"We've noticed that the magnet hospital emphasis has little to do with nurse working conditions – work schedules, such as hours, and job demands," said Trinkoff. "If I work in a magnet hospital, with greater autonomy and recognition for nursing, one might think there would be better working conditions as well."

The new study, published in the July/August issue of the Journal of Nursing Administration, found that's not necessarily the case, Trinkoff said.

"While the work and role of nursing may be improved because it is a magnet hospital, we found that consideration of nurses' work schedules is not really incorporated into the magnet hospitals,” she said. “But it is something that would fit in quite nicely – to create an optimal condition for nursing."

Magnet accreditation, said Johantgen, has evolved from its original intention to retain nurses and help prevent shortages in the profession to "an avenue to promote a hospital's appeal to both consumers and the nursing workforce."

She said other studies have identified benefits of magnet hospitals that do attract nurses, such as high autonomy, decentralized organizational structure, supportive management and self-governance.

"Magnet status is one way to show that nurses in that hospital are doing well and providing excellent care, but it is difficult to document," said Johantgen.

The researchers gathered data from nurses in two U.S. states. Trinkoff and Johantgen compared nurses working in magnet hospitals and those in non-magnet hospitals on many topics related to their working conditions because, they said, these studies are important to provide evidence-based information for policymakers and administrators.

In the study, nurses were asked to report the hours they actually worked, as opposed to those they were scheduled to work. The researchers measured psychological demands, physical demands, nurse practice environment and overall job satisfaction.

Nurses who worked in magnet and non-magnet hospitals did not differ in terms of demographic characteristics including age, sex, marital status, educational level and unit type. Whereas for race/ethnicity, the proportion of nurses of color working in magnet hospitals was significantly lower, 9 percent compared with 16 percent in non-magnet hospitals; overall there were very few differences in terms of their working conditions.
 

Richard Pizzi
Editorial Director for MedTech Media
Follow Richard on Twitter @HFNeditor
Related Topics:
  • Alison Trinkoff
  • Baltimore
  • Maryland
  • Meg Johantgen
  • United States
  • University of Maryland
  • University of Maryland School

Reader Comments (4)Login to Post a Comment

rnconcern says: magnet yah or nay
August 23, 2010 | 7:47PM GMT

I strongly disagree that Magnet status assures excellence in nursing care and/or working conditions. While Magnet status sounds nice I have not seen any real differences at my organization. During the credential process a few improvements with staffing were put into place, but soon after accreditation all went by the way-side. The pressure is on for certification which there is no compensation for. I have over 30 years of experience and a MSN, do I really have to continue to prove myself. Certification does not prove you are a good nurse. Healthcare organizations, educators, and nurses have forgotten the basics, patient safety. Healthcare is big business and those making the decisions are not at the bedside. At a previous hospital where I was employed I invited the CNO to come spend a day with me; she never came. I guess I am from the old school, I care what my patient looks like lying in bed. Patients deserved the "fluff and puff". I look around and I see foley bags on the floor, IV tubing uncapped ready to be connected, monitors alarming and no one paying attention. Someone once told me "I don't get paid by the patient, I get paid by the hour." I ask myself everyday " What has happened to the profession that I love?" I leave work physically drained and mentally exhausted. I have been told that my expectations are to high; well they should be and so should everyone else. Magnet status is to easy to gain. Unfortunately I don't believe Magnet status has the same inference as it once had.

Janell says: Magnet Hospitals DO make a difference in Working Conditions
August 19, 2010 | 2:26PM GMT

Working conditions are categorized by the AHRQ into 5 categories: workforce staffing, workflow design, personal/social factors, physical environment, and organizational factors. “Magnet hospitals, which are recognized for better patient safety and outcomes, don't provide better working conditions for nurses than non-magnet hospitals.” This statement appears to be inaccurate. According to the statement, you might be able to say, “Magnet hospitals, which are recognized for better patient safety and outcomes, don’t provide better working schedules for nurses than non-magnet hospitals.” Schedules must be maintained to provide 24/7 nursing care. Our staff are not required to work overtime, but MANY would like to. Nurses ability to self scheduling provides balance between work and family life. The fact that a Magnet hospital must demonstrate quality nursing leadership, empowerment for bedside nurses to manage their own professional practice, involvement of nurses at the point of care in scheduling and assignment processes, autonomy, and support for professional development, all of which would fall under one of the categories defined by the AHRQ, create better “working conditions” for nurses. As stated by the previous individual, “nursing is a demanding and stressful profession”, but working in a Magnet hospital diminishes much of the stress as nurses are supported in their work life and given the opportunity of providing quality care in a culture of excellence built upon the Magnet framework.

NURSE225 says: Magnet = more stress for nurses
August 18, 2010 | 9:56PM GMT

I worked for a magnet healthcare organization - and left for green pastures due to the frustration and stress. After achieving magnet we spent half of our time preparing for the next magnet survey and the other half preparing for the JCAHO survey - and whatever time we had left over we cared for patients! I was in a step-down unit - our ratio was 5 telemetry patients per nurse - that is on a good night. If we were short staffed - that ratio increased if we couldn't find another telemetry nurse and had to have a med-surg nurse on the floor. One night I had to monitor 10 patients due to a shortage - which meant taking care of my 5 patients and oversee the cardiac monitors of 5 other patients - I needed my own cardiac monitor! I laughed to myself as I thought - 'Wow! Magnet status - I wish the surveyors were here now - they would love to see this (tongue in cheek)!' Most nurses that I know don't look for a job because of magnet status because we realize that all Magnet is good for is a PR campaign for the organization - it doesn't improve patient care of nurses' working conditions. Don't even think about reporting your organization to Magnet or JCAHO - your organization will find out and you will be looking for another place to work!
Thank you for writing this article and adressing this issue - the reality of Magnet doesn't measure up to all of the fancy advertising!

Lolson says: Magnet status and working conditions
August 18, 2010 | 4:15PM GMT

I believe it's all in the way you define "working conditions". Nursing IS, by nature, a demanding and stressful profession. We have people's lives in our hands. While a magnet nurse may work same number of hours etc, that doesn't necessarily mean working conditions are not better. I CHOOSE to work overtime, it's not mandatory...in this economy I would be lost without it! Additionally, having a voice in shared governance, having the equipment we need when we need it, and working with other, credentialed and certified individuals I can trust to hold up their end, are, in my humble opinion, the best working conditions a nurse can have!

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