How would you describe your dream hospital nursing job? Being able to work at a facility that has been nationally recognized as meeting the highest possible standards of nursing and patient-care excellence? An environment that not only values its nursing staff but goes out of its way to empower them and help them move upward in their careers? A place where nurses actually look forward to coming to work each day and love their jobs so much they wouldn’t think of working anywhere else?
Workplaces like these aren’t just the stuff of dreams—they really exist. They’re called magnet hospitals.
You’ve probably heard that magnet hospitals are excellent places for nurses to work because they provide a unique environment that fosters the advancement and development of their nursing staff. But did you know that they can also be exemplary places for minority nurses to grow their careers, because one of the key criteria for achieving magnet accreditation is meeting the industry’s “gold standard” for culturally diverse staffing and culturally competent patient care?
“One of the purposes of awarding magnet status is to recognize excellence in facilities that provide culturally sensitive care,” says Kammie Monarch, director of the American Nurses Credentialing Center (ANCC)’s Accreditation and Magnet Recognition Program. “[One way magnet hospitals do this] is by recruiting health care providers from diverse ethnic or cultural backgrounds who understand the [cultural needs of] patients the hospital cares for.”
“Magnet” hospitals are so called because they lead the industry in attracting and retaining the best in nursing talent. In other words, these facilities provide an environment of excellence that makes nurses want to work there—and stay there. Established in 1993, the Magnet Nursing Services Recognition Program for Excellence in Nursing Services has to date awarded magnet status to 41 acute care hospitals across the country and to one long-term care facility. (See “How to Find a Magnet Hospital.”)
Magnet status is the highest level of recognition the ANCC (which is affiliated with the American Nurses Association) can award to organized nursing services in health care facilities. In addition to showing a strong commitment to racial, ethnic and cultural diversity, magnet hospitals must meet criteria established by the ANA for excellence in patient care services, professional performance and support and development of nursing staff. To ensure that these high standards are maintained over time, hospitals must reapply for magnet accreditation every four years.
“Magnet hospitals are great places for minority nurses to work because the environment fosters inclusiveness as opposed to exclusiveness,” declares Alene Jackson, RN, MSN, CNAA, an African-American nurse who is director of medical/surgical services at St. Luke’s Episcopal Hospital in Houston, the first magnet facility in the Southwest. “A magnet hospital looks at opportunities for professional growth, collaboration among the disciplines and autonomy among the nursing staff. Everyone has an opportunity to participate and grow,” adds Jackson, who has been at St. Luke’s since her days as a student nurse 20 years ago.
Pulling for Diversity
Magnet facilities have a well-deserved reputation for hiring a racially and culturally diverse group of health care professionals, which match, in large degree, the demographics of the communities they serve. At St. Luke’s Episcopal, for example, the nursing staff is 49% Caucasian, 23% African-American, 22% Asian and 4% Hispanic. The patient population is similar, says Jackson, who boasts that the nursing staff speaks approximately 37 different languages between them.
Over the past few years, Fox Chase Cancer Center, a magnet facility in Philadelphia, has initiated long-term strategies to recruit minority nurses in order to better reflect its patient population, according to Anne Jadwin, RN, MSN, AOCN, assistant director of nursing. “We want to be sensitive to our staff population but also continue to mirror the diversity we see in our patients,” she notes.
To that end, Fox Chase has profiled some of its minority nurses—including men, who are considered a minority in this profession–in its latest recruitment and advertising campaign. John Butler, RN, an ICU staff nurse whose picture was featured on the back of city buses, hopes his likeness will encourage other members of underrepresented groups to seek employment there. “It’s just a good place to work, and if you’re a minority it’s that much better,” says Butler, who was recently recognized in the grocery store as a result of the ads.
This past summer, Fox Chase also began a recruitment effort aimed at Certified Nurse Assistants. “The CNA level provides a broader base for recruitment in terms of sheer numbers,” Jadwin explains. “We’re able to recruit more people into CNA positions and we target those who are interested in becoming RNs. We’ve seen a change in the ethnic diversity of our nurses because of all the CNAs taking advantage of this opportunity.” Most of the nearly 30 new CNAs who were hired were African American, she adds.
In addition to offering a team-building program to foster a partnership between its CNAs and RNs, Fox Chase offers a three-day clinical skills training program for newly hired CNAs, as well as a college tuition reimbursement program for those looking to advance to RN careers. “We want to mentor and encourage the people who are the shining stars to continue in their professional development,” Jadwin emphasizes.
A CNA for 16 years, Lisa Landingham, RN, BSN, now a staff nurse at magnet facility The Miriam Hospital in Providence, R.I., knows that relations between the different levels of nurses aren’t always smooth. “I had worked at another hospital where there was a lot of prejudice within line staff and between nurses in different positions. The RNs didn’t want to associate with the CNAs,” she recalls.
In contrast, she found a completely different environment at The Miriam Hospital, where she has been a nurse for nearly two years. “That type of competition doesn’t exist here. Everyone helps each other reach their goals and the staff is receptive to all people, no matter what their cultural background or position,” says Landingham, an African American of Cape Verdean descent.
Attracting Tomorrow’s Nurses
Many magnet facilities are pointing their drawing power not just toward the current minority nurse talent pool but toward the next generation as well. One particularly popular strategy is to team up with one or more local high schools—many of which have predominantly minority student populations–to introduce teenagers to the world of health care careers.
At The Miriam Hospital, for example, high school juniors and seniors can shadow an RN for a couple of hours four days a week, says Elaine Joyal, RN, MS, the facility’s Magnet Project coordinator.
Beginning this fall, Fox Chase Cancer Center will serve as a co-op for seniors from a local vocational high school with a CNA program. The students will work part-time at the hospital under the direction of a unit manager and school supervisor, says Jadwin. The two organizations are currently working out the details of the program, which resulted from one of the center’s RNs lecturing about the nursing profession at the high school’s career day.
St. Luke’s Episcopal, too, has established a nursing career awareness program with a Houston-area high school. As Jackson notes, “We now recognize that we have to start recruiting nurses when they’re in middle and high school. One of the best ways to get them interested in a nursing career is to let them see positive role models.”
Some magnet facilities extend similar opportunities to minority college students. The 10-week Nursing Summer III program at Mayo-Rochester Hospitals in Minnesota provides approximately 150 students from across the country—many of whom are people of color–with the chance to participate in direct and indirect patient care. The students enhance their nursing skills while working under the direction of RNs, says Kathryn M. Niesen, RN, MSN, clinical director of nursing. The program has resulted in the hiring of many minority nursing staff, she reports.
Aurora Health Care, a five-hospital system in the Milwaukee area, partners with several local high schools and colleges. As part of the Youth Apprenticeship Program, one Aurora facility trains students for entry-level positions, such as nurse assistant or health unit coordinator. Aurora hospitals also participate in INROADS, an internship and scholarship program that focuses on preparing talented minority college students for corporate and community leadership.
“Wisconsin is one of five states that focus on health care [within the INROADS program],” comments Linda Cottreau, director of patient care services at Aurora’s Sinai Samaritan Medical Center. Six of the 13 interns currently working at the hospital are in nursing.
In addition, Aurora Health Care is working with another local college to start a new CNA-to-RN program that will include identifying high-potential candidates and assisting with financial aid.
“This program will help bring in more minority nurses who either don’t have the funds to go to school or can’t take time off from work to go,” says Vickie Hinds, RN, a patient care manager at St. Luke’s Medical Center in Milwaukee, another Aurora facility. An African-American nurse who is currently working toward her master’s in health care administration, Hinds knows first-hand how helpful tuition reimbursement and a flexible schedule can be—as an Aurora employee, she receives both.
When a powerful magnetic force attracts a piece of metal, it just doesn’t want to let go. The same is true for magnet hospitals: Not content to merely attract dedicated nurses, they go the extra mile to retain the multicultural talent they’ve hired, by providing mentoring, preceptorships, recognition awards, career advancement programs and other kinds of support.
For instance, St. Luke’s Episcopal Hospital has an OR residency program linked to a local nursing school that has a high percentage of minority students. “One advantage of this OR preceptorship for us [as an employer] is that we get to see a person’s ability, interest and aptitude for OR nursing,” says Jackson. “We hire many of the graduate nurses who have done clinical rotations here.”
Last year, Mayo-Rochester Hospitals piloted a nine-month Nursing Diversity Mentoring Program, which will be implemented this April. According to Debra M. Berland, RN, MSN, nursing administrative specialist, the program’s objectives are to support and retain new staff from underrepresented populations and provide an opportunity to enhance their leadership potential. Mentees receive training in such career development essentials as effective communications and building networking relationships within the context of the organizational culture.
Estella DeDosantos, RN, and Rochando Pelmore, RN, were two of the 14 nurses who participated in the pilot program. Both of their mentors had worked at Mayo-Rochester for several years, serving as excellent resources to help the two newly hired nurses of color navigate their way.
“Mayo is a huge organization,” Pelmore explains. “My mentor helped me find out about the things I want to get involved with and helped me make the necessary connections. She’s still a mentor for me now. I go to her if I have questions or need a second opinion.”
Magnet-style mentoring takes other forms as well, such as providing additional training. When Michele Mobley, RN, began working at Fox Chase Cancer Center in 1999, she had yet to develop her confidence and skills as a staff surgical nurse. “Instead of just tossing me out, they hired someone to help and support me until I got my skills up to par,” says Mobley, for whom nursing is a second career.
The African-American nurse believes she would not have received such supportive, individualized training at a non-magnet facility. “My first job at another hospital was awful. There was no quality of care and no relationship among the co-workers. If you made a mistake, even if it wasn’t life-threatening, they would write an incident report,” she recalls. “But since I’ve been here, I’ve learned so much as a nurse. Now I have confidence and can go from floor to floor.”
When Mobley told her clinical manager that she wanted to get involved in hospital policy-making, the manager started naming committees she could join. Mobley chose to serve on the research utilization committee.
After 11 years in obstetrics, Lola Denise Jefferson, RNC, BSN, a nursing supervisor at St. Luke’s Episcopal Hospital, decided she wanted to switch to ICU. “They not only let me get out of ob/gyn, they also sent me to all the necessary classes and gave me a preceptor who helped me obtain skills for the ICU,” she says proudly. “When I wanted to be a supervisor, I got another three months of training. They did that for me and I appreciate it.” When she had worked at another hospital, she couldn’t even transfer to labor and delivery from high-risk antepartum, which are in the same specialty.
Jefferson also appreciates how St. Luke’s Episcopal recognizes and encourages minority nurses to seek advancement. Each month, three of the hospital’s approximately 5,000 employees receive the Award for Excellence. “Sometimes the awardees are all minorities and that’s because we are being judged by the content of our character and not by the color of our skin,” says Jefferson, who won the award in June 2000.
The facility also has several minority nurse managers and supervisors who have served in those leadership positions for several years, she continues. “Minorities are allowed to achieve and advance here and I haven’t seen that at other facilities.”
“This is My Home for Life”
For many minority nurses, continuing their professional education and earning advanced degrees are key factors in advancing their careers—and here, too, magnet hospitals are ready, willing and able to provide valuable support.
“Aurora Health Care places a very strong emphasis on continuing education,” says Dennice Bonds Montgomery, RN, MS, a patient care manager at Milwaukee’s St. Luke’s Medical Center. “Eighty percent of the inpatient managers here have a master’s degree, or are currently pursuing one, because of the support from Aurora.” That group includes Montgomery herself, who received her master’s in medical administration in 1995. She was also given a flexible work schedule to accommodate her studies, which required her to commute to Madison.
“Aurora also has the Student Nurse Financial Assistance Program, which is very attractive to minority students, who tend to have a significant amount of educational loans,” continues Montgomery, who is African American. The program writes off a significant amount of these loans in return for a two- to three-year commitment of service in an inpatient area at an Aurora facility.
Rahat Sayed, RN, BSN, OCN, a staff nurse for nine years at Fox Chase Cancer Center, earned her bachelor’s degree while working at the magnet hospital and is now attending a master’s-level nurse practitioner program, which she hopes to complete in two years. “I’m able to do that now because I get tuition benefits and I’m encouraged here,” says Sayed, who hopes to stay on as a nurse practitioner at Fox Chase.
Training in culturally competent patient care and workplace diversity are also a staple at many magnet facilities. Last year, The Miriam Hospital held six such programs, focusing on cultural sensitivity and nondiscrimination, for its entire nursing staff, reports Joyal, who plans to coordinate monthly sessions in 2002.
Similarly, Mayo-Rochester Hospitals offers ongoing workshops on topics like “Diversity Respect and Skill Building,” “Preventing Bias and Promoting Respect” and “Valuing Diversity in Our Communities.” According to Niesen, “Sometimes we have multidisciplinary teams participate in the programs together.”
Finally, many magnet hospitals provide support to minority nurse professional associations, including sponsoring scholarships and programs. When Jefferson founded the Fort Bend County Black Nurses Association, her Caucasian chief executive officer gave her money to sponsor a chapter event. In addition, the CEO has advised Jefferson on diversity issues on several occasions, he belongs to an organization for minority executives and he has a zero tolerance policy for racial and ethnic discrimination in the workplace.
“When you see things like that, you know that [minority nurses] will be represented and are appreciated,” says Jefferson. “I’ve previously worked at two other major hospitals, and St. Luke’s is my home for life unless God says differently.”
Getting into the Magnetic Field: How to Find a Magnet Hospital
If the empowering environment magnet hospitals provide sounds like the career opportunity of your dreams, it’s time to stop dreaming and start looking–for a magnet “home” of your own. You probably won’t have to look very far to find one: Currently, 42 health care facilities in 19 states throughout the nation hold the magnet designation, conferred by the American Nurses Credentialing Center (ANCC). “We’re hoping that this year we’ll have at least one magnet facility in every state in the U.S.,” says Kammie Monarch, director of the Accreditation and Magnet Recognition Program.
Here’s a complete list of magnet facilities as of February 2002. The most up-to-date list, including contact information, can be found online at www.nursingworld.org (click on “American Nurses Credentialing Center”).
Aristocrat Berea Skilled Nursing and Rehabilitation Facility (Berea, Ohio)
Aurora Health Care* (West Allis, Wis.)
Avera McKennan Hospital & University Health Center (Sioux Falls, S.D.)
Baptist Hospital of Miami (Miami, Fla.)
Bayfront-St. Anthony’s Health Care (St. Petersburg, Fla.)
Catawba Memorial Hospital (Hickory, N.C.)
Cedars-Sinai Medical Center (Los Angeles, Calif.)
Children’s Memorial Medical Center (Chicago, Ill.)
Fox Chase Cancer Center (Philadelphia, Pa.)
Hackensack University Medical Center (Hackensack, N.J.)
High Point Regional Health System (High Point, N.C.)
Inova Fairfax Hospital (Falls Church, Va.)
James A. Haley Veterans’ Hospital (Tampa, Fla.)
Jersey Shore Medical Center (Neptune, N.J.)
Jewish Hospital (Louisville, Ky.)
Long Island Jewish Medical Center* (New Hyde Park, N.Y.)
Mayo-Rochester Hospitals (Rochester, Minn.)
Medical Center of Ocean County (Point Pleasant, N.J.)
Middlesex Hospital (Middletown, Conn.)
The Miriam Hospital (Providence, R.I.)
Morristown Memorial Hospital (Morristown, N.J.)
Mount Sinai Medical Center (Miami Beach, Fla.)
North Carolina Baptist Hospital of Wake Forest University Baptist Medical Center (Winston-Salem, N.C.)
North Shore University Hospital (Manhasset, N.Y.)
Poudre Valley Health System – Poudre Valley Hospital (Fort Collins, Colo.)
Providence Vincent Medical Center (Portland, Ore.)
Riverview Medical Center (Red Bank, N.J.)
Robert Wood Johnson University Hospital (New Brunswick, N.J.)
St. Francis Medical Center (Trenton, N.J.)
Saint Joseph’s Hospital of Atlanta (Atlanta, Ga.)
Saint Joseph’s Hospital & Medical Center (Paterson, N.J.)
St. Luke’s Episcopal Hospital (Houston, Texas)
St. Luke’s Regional Medical Center (Boise, Idaho)
St. Peter’s University Hospital (New Brunswick, N.J.)
University of California, Davis, Medical Center (Sacramento, Calif.)
University of Kentucky Hospital (Lexington, Ky.)
University of Washington Medical Center (Seattle, Wash.)
West Boca Medical Center (Boca Raton, Fla.)
*Facility includes multiple hospitals