Nurses Ponder the Significance of the Nation's Most Coveted Nursing Award

Sitting among fellow newcomers on her first day of orientation, 莱奥妮·法灵顿困惑地听着一位资深护士解释她的新雇主, The Johns Hopkins Hospital, was a Magnet nursing institution. "I had never heard of Magnet before," recalls Farrington, who’d worked as a nurse in her native Ireland, and later in Canada, for the past 12 years. “但我知道这是一件很棒的事情，因为每个人似乎都非常自豪."

Stories like Farrington’s aren’t uncommon. Despite a nationally growing emphasis on achieving and maintaining Magnet status, 仍然有许多护士——不管是因为年龄还是受教育程度——不熟悉这个词的含义. "I know the hospital’s changed over time, but I don’t know how," says new labor and delivery nurse Michelle Frances, who, two years into her first nursing job, is still learning the significance of Magnet status. "I think the older, 更有经验的护士应该谈谈我们成为磁石之前的情况. What’s changed? What’s different? 有时候，如果你知道你真正欣赏的是什么，你就会更加欣赏它."

For Farrington, Magnet remained a mystery until last year, 她的护士经理要求她代表她所在的单位参加由77名护士组成的“磁铁大使委员会”, one per unit, 负责教育他们的同事如何保持医院的吸引力. 法灵顿说:“当我对它了解得更多时，我发现这是一件非常特别的事情。. "I was honored that people would think I should be a part of that."

Awarded by the American Nurses Credentialing Center, 磁铁称号于1990年首次进入医疗保健领域，作为一种认可提供优质护理服务的医院的手段. Since then, only 258 of the nation’s 7,569 hospitals have received the honor, and only one in Maryland—The Johns Hopkins Hospital, which applied for and received the designation in 2003. This year, the Hospital’s Magnet status is up for review.

"Nursing has always had a strong presence at Hopkins," says Magnet ambassador Martha Conlon, an NC-III in the Wilmer Eye Care Pavilion. “获得磁石称号确实证明了这里的护理服务是超越的."

在霍普金斯大学刚刚开始职业生涯的护士，在欣赏磁铁医院工作的价值时，参考点较短. Veteran nurses, however, have firsthand knowledge.

Twenty or 30 years ago, "there wasn’t as much interaction between nurses," says Martha Conlon, a 28-year nurse and NC-III in the Wilmer Eye Care Pavilion. "Today, nurses really take much more responsibility for themselves. We develop our own standards and policies, 与其他部门有更多的互动，更多地关注我们的教育."

过去和现在护理之间最明显的区别存在于护理环境中. Back then, Conlon says, nurses sometimes had more than a dozen patients in their care and, as a result, their duties were much different.  护士往往更以任务为导向，专注于帮助推荐十大正规网赌平台洗澡和更换绷带等基本工作. Because no one returned home with their sutures still in, patients stayed in the hospital longer, and there was little coordination between inpatient and outpatient practices.  虽然这样的互动让护士与推荐十大正规网赌平台建立了牢固的关系, 他们还阻止护士承担学术和领导导向的角色，而这些角色在霍普金斯大学是如此珍贵.

"I’ve definitely seen the other side of the fence, and it’s very different," explains Farrington, 她在爱尔兰的护理经历为护士在非磁铁机构中的角色提供了一个生动的例子. "I think if you start out at Hopkins, it’s probably easy to believe that nursing is the same everywhere," she says. "But it’s not, it’s truly not."

In Ireland, where Magnet rankings don’t exist, she says, nurses have less authority and autonomy over their practices. Their opinions carry little weight with physicians, research opportunities are scarce, salaries are lower and nurses are often viewed as non-influential, matronly figures—hardly the integral role they play at Hopkins.

“在国内，你可能会待上几年，却永远得不到你在霍普金斯大学所拥有的机会," Farrington says. "For me, it’s very exciting to constantly be told, you can do all of these things."

法灵顿记得，她在爱尔兰的那些年的情况与非磁铁国家的护士类似.S. hospitals. Conlon, for example, 她描述了一位不在霍普金斯工作的同事的工作:“她是一名护士经理, and she has to do everything. She’s auditing charts, doing evaluations, managing the finances. 一个人不可能完成所有的工作，同时还能保持她的推荐十大正规网赌平台实践."

Now that she’s accustomed to working in a Magnet hospital, Farrington can’t imagine going anywhere else. "I came here and found a totally different nursing environment," she says. "I don’t think I could ever go back."

The reasons are all Magnetic.

There are 14 "Forces of Magnetism," requirements that an institution must meet to be considered for the honor. Among them are strong leadership, supportive management, 促进护士成为教育者，并提供专业发展的机会——这些都是霍普金斯护理文化的重要组成部分. With an extensive list of hospital-sponsored classes, as well as a tuition reimbursement program, 霍普金斯大学的护士有很多机会扩展他们的教育并获得晋升. They also take part in research and serve on important committees. And, most importantly, their opinions matter to the rest of the care team.

“如果你从来没有在其他地方工作过，你可能会想，不是每个地方都这样吗??" says Lisa Phifer, Pediatrics’ director of nursing, "And the answer is no. No, no, no, no. There are only about 250 hospitals in the country like this."

ANCC不会仅仅根据声誉就给机构颁发“磁铁”称号, 该机构也并非没有付出相当大的努力就获得了这一头衔. 医院必须主动采取行动，这个过程可能需要整整一年或更长时间. Furthermore, earning Magnet status once is no life-time guarantee. 一些机构在重新评估后发现自己被剥夺了磁铁的称号, which is required every four years.

When the ANCC first announced the new credentialing system in 1990, Hopkins’ nursing department leadership thought little of it. "We decided we didn’t need that level of designation," says Phifer. "We felt like we already met the criteria and didn’t have anything to prove."

Over time, though, 求职者和竞争医院之间不断出现一个问题:为什么霍普金斯大学不是一家有吸引力的护理机构? 护理专业的学生和退伍军人都开始把磁铁认证视为雇主的必备条件, 全国各地越来越多的医院——尽管数量仍然很少——正在寻求并获得这一称号. So in 2003, Phifer says, Hopkins decided to do the same.

“有机会验证我们确实达到了Magnet的护理标准，这是一次美妙的旅程," Phifer recalls. "We looked at every single standard and said, Yes, we do that. And we could give specific examples.“不像一些机构需要两次或三次尝试才能达标, Hopkins was granted Magnet status on its first try. Now, Phifer says, the task is to keep it.

而管理人员则在整理重新指定申请所需的数千页文件, “磁铁大使”每月与同事举行会议，以建立热情，并讨论如何为不可避免的现场访问做好准备——当“磁铁”调查员来医院进行检查时. Phifer has no doubt that their hard work will once again pay off.

"Our staff nurses shine, they just shine," Phifer says. “我们第一次获得磁铁地位的部分好处在于，我们不需要做任何事情或改变任何事情来实现它. It’s part of who we are—Hopkins nursing equals Magnet nursing."

Magnetic Practices

磁铁称号最早出现于1990年，是对成功吸引并留住高素质护士的医院的一种表彰方式, even during periods of nursing shortages. At Hopkins, a quick read of the Department of Nursing’s 2006 R.N. satisfaction survey shows why the Hospital measures up.

Called the National Data-base of Nursing Quality Indicators, the survey polls more than 76,000 nurses across the country to deter-mine their overall job satisfaction, monitor their progress through the years, and evaluate how individual institutions compare to their competitors. With the predicted shortfall in nurses, it’s an important question, particularly for any hospital hoping to improve its recruitment. Fortunately, 霍普金斯大学的表现很好，在大多数项目上都获得了高于全国平均水平的高分.

At Hopkins—where 1,612名护士和71个单位的护士对职业发展机会的满意度较高, co-worker interactions, decision-making abilities and physician relationships. Hopkins’ nurses also showed in-creased satisfaction with co-worker teamwork, job satisfaction and leadership be-tween 2005 and 2006.

"This is one of the most important assessment tools we have," says Nursing Vice President Karen Haller. “很高兴看到我们没有任何低分，而且在很多方面都有所进步."