The flame of achieving Magnet status is fueled once again, with over 150 hospitals having received this status and more than 270 in the queue. Described by some as a journey, others as an initiative, still others as a project, the achievement of Magnet status is receiving new attention and many more questions. Is Magnet status only for the "best"; should it be saved for the "elite" and be "difficult to achieve"? Or should it be a central foundation that is achieved by many who find the Forces of Magnetism so grounding, so essential, that Magnet becomes the central force in reorganizing nursing services?
The past 20 years offer a historical perspective and teach major lessons. The author McClure poses the above questions and suggests that Magnet hospitals demonstrate 2 traits that are not currently common in organizations: loyalty and stability. Once an organization achieves Magnet status, the sustainability becomes a byproduct of stability and requires stamina, vision, and hard work to keep the lofty designation. Several authors describe the momentum, and the challenges of recertification, as they discuss how years of Magnet status truly transform their organizations and become the strong foundation of nursing.
Collaboration as a principle affecting an entire state covers the power of diverse leadership. The power of suggestion and the beauty of example are seen in 4 other states that have 50% of the Magnet facilities in the country: New Jersey, Florida, Texas, and New York. Arizona is also working to achieve such status building a "magnet-like state" by using the diversity of local leadership in the nursing profession as an essential ingredient to collaboration.
Several practical and key viewpoints are offered. Through the eyes of the appraiser there are highlights shared from experience. The most challenging of the 14 Forces in one appraiser's eyes are shared governance/leadership, interdisciplinary care, clinical documentation that is truly integrated, reliability, acuity systems, and evidence-based nursing. Suggestions from best practices are shared with each challenge. Another practical article describes a strategy for certification and weaves this into each of the 14 Forces.
"How to Start" the journey is explored through the experiences of both community hospitals and academic medical centers. One inspiring example includes quotes from staff nurses who write about their motivation to achieve Magnet status, "Nursing has a voice in our Magnet hospital. The future of nursing is in good hands in Magnet hospitals today. Commitment to professional development is sincere, and I believe extends far beyond the walls of any manager's office." This same article, by Goode et al., addresses the structure decisions that are essential to sustaining Magnet status over years.
This issue concludes with a theoretical model and a peek into the future. Structure-Process-Outcomes as a model is applied to the historical advancement of the Magnet Award. Lessons and recommendations include encouragement to expand magnetism beyond nursing and its influence on an entire patient experience. The inherent conflict among disciplines is addressed. A suggestion is made to "modernize" the 14 Forces, and keep up to date with the interpretation of the Forces as they apply to today's patient care climate. There is also a call, from the authors Kramer and Schmalenberg, for clarity, for modernization, and for an expansion of the impact of Magnet to other disciplines.
Many authors have come together to share the spectrum of experience, including history, "start up," sustaining, appraising, visioning, and questioning. We thank the authors who have contributed to this issue and hope that wherever you are on your Magnet journey, you find inspiration, hope, and stamina from your reading of your colleagues' experience and wisdom.
Colleen Hallberg, MSN, RN
CEO, Banner Thunderbird Medical Center, Glendale, Ariz
Elaine Cohen EdD, RN, FAAN
Director of Case Management, Utilization Management, Quality and Outcomes, University of Colorado Hospital, Denver, Colo