Dr Lal: How did you get started on your Magnet(R) journey?
Dr Ives Erickson: I was in graduate school at Boston University (BU), and my program chair was Dr Muriel Poulin. Dr Poulin was, of course, one of authors of the original AAN Magnet study.1 The study was released while I was at BU. To those of us in the beginning, the standards became an important component of who we are. Many of us went on to lead Magnet organizations.
Dr Lal: Dr Poulin's study introduced the 14 Forces of Magnetism. What intrigued you about these forces?
Dr Ives Erickson: Dr Poulin was passionate about helping us understand that, as nurse executives, we played an important role in creating a professional practice environment, an environment that supported that excellence. Above all, our work was to ensure the integrity of the nurse-patient relationship. The 14 forces got us thinking about how to elevate not only the profession of nursing but also our own organizations. At MGH, the forces served as a road map for my nursing team and me to develop a strategic plan and, within that plan, create a professional practice model that focused on shared decision making, bedside autonomy, nurse satisfaction, evidence-based practice, etc.
Dr Lal: How does Magnet bring value? What do you say to people who question the cost of pursuing the credential?
Dr Ives Erickson: I encourage people to think of the value of Magnet in these terms:
* Nursing-sensitive indicators. We know that every pressure injury, every hospital-associated infection, and every patient fall not only leads to human suffering but also costs us money.
* Reputation. A positive reputation draws patients, both new and returning.
* Aspects of the environment that attract and retain nurses. Nurse turnover has a negative impact: on team morale, on institutional wisdom, and on the bottom line. It costs money not only to recruit new team members but also to onboard them.
Dr Lal: With all the changes in healthcare, is Magnet still relevant?
Dr Ives Erickson: Although the original Magnet study was done in the 1980s,1 its relevance to today's very challenging environment is stronger than ever. Right now, nursing turnover and the flight from the nursing profession is a crisis that is getting worse. Increasingly, organizations must think about the components of a Magnet organization that not only attract and retain nurses but also create excellence in patient care delivery.
What's happening in healthcare today has many people frightened. Patients are afraid they will not be able to get the care they need when they need it. Whether that means waiting for an appointment with their doctor, or waiting in a hospital emergency department, or waiting for an inpatient bed. This uncertainty has a big impact on the human spirit. Not only for patients, but also for those delivering care. Negative stories are not doing us good. Magnet organizations have positive stories to tell. As Commission Chair throughout the COVID-19 pandemic, I read hundreds of stories from organizations about how they were meeting the challenges by finding ways to continue to excel. We all know that COVID had an enormous negative impact immediately, but I could see, through applications and appraiser site visits and calls, that nurses and those they work with were reinventing themselves. One big change: administrators were delegating to teams to make decisions faster, at the clinical level, where they would impact patients immediately. That's the hallmark of Magnet organizations: structural empowerment of clinical nurses. The outcomes associated with these empowered nurses are worth their weight in gold.
Dr Lal: Your thoughts on your role-how does the COM ensure Magnet's continued significance?
Dr Ives Erickson: Being a commissioner was a privilege, as well as a significant responsibility, one I did not take lightly. It's an honor to be connected with Magnet organizations around the world. I get a firsthand look at their hard work and their innovations and creativity, across the entire interprofessional team. Being a commissioner also takes hours of work. We read the submitted documents and appraiser reports. We prepare our own reports. There's a lot of informal conversations that happen. We talk about standards, answer questions, and spend time developing the new manuals. We seek out experts in the field to inform our decision making. We want to make sure we are in touch, grasping changes in the environment, keeping up with evidence-based practice, and understanding issues that nurses are struggling with. We've introduced new initiatives, such as the new Magnet with Distinction(R). We have the privilege to share the exemplars of the Magnet Prize, Magnet Nurse of the Year. We've updated the Magnet manuals to ensure we are staying relevant to what's happening in healthcare today.
Dr Lal: How does the COM reflect diversity in healthcare?
Dr Ives Erickson: There is wonderful diversity on the COM and among commissioners. It's a forward-thinking commission, and the representatives reflect diversity of thought and diversity of experience. This allows the commission to better understand what is happening across the world and bring that knowledge to the table to influence conversations. It's important to reiterate, with the global challenges facing nursing and healthcare, Magnet is more relevant and timelier than ever. Sometimes, the language we use changes, but the concepts do not.
Magnet puts an important focus on excellence in nursing, healthcare, and teamwork. It focuses the organizational lens on patient outcomes. Just because we are currently challenged, we must not lose our focus. Magnet provides that focus.
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