Dean Angela Amar, Ph.D., RN, FAAN, is a professor, active researcher, and administrator for the UNLV School of Nursing. This nursing leader is a national expert on mental health nursing, sexual and dating violence, diversity in nursing leadership, and forensic nursing. Her research on dating violence, sexual assault, and mental health responses to traumatic experiences has earned funding from the Robert Wood Johnson Foundation, the National Institute of Child Health and Human Development, and the National Institute of Nursing Research.
Dean Amar is an important nursing leader, and we’re pleased to profile her as we celebrate Black History Month with the Black Nursing Leaders Series 2023.
The entire month of February, we’ll highlight healthcare leaders who are prominent figures in their organizations and making transformational impacts in nursing.
Meet Dean Amar, Dean and Professor at the UNLV School of Nursing
Please talk about your career path and how you ascended to your role at the UNLV School of Nursing.
My Dad was very sick and hospitalized a lot when I was in high school. I admired the nurses who took care of him. I’d always liked science and wanted a career where I’d connect with people. Nursing was the perfect choice for me.
What inspired you to become a nurse?
My Dad was very sick and hospitalized a lot when I was in high school. I really admired the nurses who took care of him. I’d always liked science and wanted a career where I’d connect with people. Nursing was the perfect choice for me.
What are the most important attributes for today’s nursing leaders and why?
Nursing and healthcare are in a period of great transition. The nursing leader of today has to be able to respond to the multiple issues confronting the field. Leaders need to make employees feel valued, heard, and respected. Nursing leaders must respond to challenges with flexibility and the ability to change course as needed. Finally, they must be able to communicate a vision, work with others to plot a course, and inspire others.
What does it mean to you to be a nursing leader, and how are you making a difference?
As a leader, I use my voice to help others. My various professional roles have expanded my reach, so I sit at many tables, often as the only nurse or Black woman. In these forums, I speak out on issues and bring the voices of those I represent. Also, I mentor a lot of nurses across the country. I use my experiences to help others and learn from my mentees.
What is the most significant challenge facing nursing today?
In the aftermath of the pandemic, nursing is in trouble. Our nurses are feeling burnout and fatigue. They’re not feeling valued and heard. We are headed for a shortage. Academic nursing is seeing retirements in leadership and senior faculty which makes for gaps in increasing enrollment. Further, COVID-19 exposed health inequities and racial injustice in our society and healthcare.
As a nursing leader, how are you working to overcome this challenge?
As Dean of the UNLV School of Nursing, one of the most diverse universities in the country, we work to prepare students as expert clinicians, scholars, and leaders who are prepared to address the challenges facing the profession. Our school of nursing also works with local nursing leaders to address the problems facing our region. I also work through my leadership in national organizations to make meaningful changes for the nation.
What nursing leader inspires you the most and why?
Just one! That’s hard. In my career, I’ve benefited from multiple mentors. I learn so much and am inspired by so many nursing leaders. Dr. Carolyn Mosely has been my mentor since I was an undergraduate student. She pushes me and many others to be our best. She has led in multiple capacities in universities, nursing and professional organizations, and communities.
What inspirational message would you like to share with the next generation of nurses?
Keep doing the work you’re doing to change the system. We see you. You bring a new and fresh perspective and approach that is so needed in our healthcare system. Change is hard. It gets messy, but the end is worth it. So keep working and keep fighting for change. And keep bringing new insights and perspectives. The profession needs you.
Fayetteville State University’s (FSU) School of Nursing launched a statewide initiative to train more Sexual Assault Nurse Examiners (SANEs).
FSU is the first HBCU in the country to host a SANE training program at its nursing school, thanks to a $1.5 million appropriation from the state of North Carolina. Right now, there are fewer than 100 SANEs certified across the state of North Carolina, even though they are the best people to care for sexual assault victims and to collect forensic evidence.
“The state of North Carolina recognizes the need not only for a higher number of these specially trained nurses across the state but also a more diverse pool of these professionals to help make survivors feel more comfortable during an already traumatic time,” says Dr. Sheila Cannon, associate dean of FSU’s School of Nursing. “Fayetteville State University is in a unique position to fulfill those needs.”
FSU’s SANE program aims to train 20 specially qualified nurses per semester, including the summer, to reach 60 per year.
“This program emphasizes two of Fayetteville State University’s core missions, to prepare our students for success in their careers and to serve our community,” says FSU Chancellor Darrell T. Allison. “As much as we wish they weren’t needed, there is a shortage of these specially trained nurses in our state and community. Thanks to the exceptional training our current nursing students receive at our university, the state trusted us with the responsibility of filling that need. I have no doubt our faculty, and content experts are up to the task.”
Beyond SANE training, a SANE nurse certification requires a candidate to have at least two years of nursing experience, complete dozens of hours of training and clinical work, and pass a written exam by the International Association of Forensic Nurses.
“Many nurses in the state have had some training either in a classroom or through the hospital, but they don’t have the full credential,” says Cannon. “A SANE nurse needs to know more than just how to collect DNA evidence. They are also trained to know where to look for injuries, how to ask delicate questions, and how to interact with survivors as they process what happened to them.”
FSU’s nursing school aims to grow and sustain the program to address a void in specialized nursing care, particularly in underserved and underrepresented communities.
For the last two years, hospitals have been reliant on travel nurses, with the demand for travel nurses skyrocketing. However, turnover has recently begun to increase, and hospitals and health systems are facing a turning point in addressing the staffing shortage crisis.
Minority Nurse chatted with Beth Brooks, Ph.D., RN, FACHE, and Clinical Advisor to Vivian Health, about how travel nursing is changing the nursing workforce and what hospitals can do to reconfigure the work environment to optimize the existing workforce.
Beth A. Brooks, Ph.D., RN, FACHE, and Clinical Advisor to Vivian Health
How is travel nursing changing the nursing workforce?
There have been travel nurses in the 30 years I’ve been a nurse. Of course, there have always been nurses who have chosen a full-time travel career path because they either wanted to travel the country or wanted the challenge of building robust clinical skills in a particular specialty. But for the most part, these travel nurses primarily filled temporary vacancies during past nursing shortages or labor strikes.
There are currently 4.4 million RNs in the U.S. nursing workforce. Between 2020 and 2021, the Bureau of Labor Statistics reported a 55% increase in travel nursing (from 43,160 to 66,790 RNs), representing 2.34% of the RN profession. Because travel nurses were all over the country working for different health systems during COVID, they are in a unique position to speak to how prepared (or unprepared) employers are to support nurses in their careers and mental health. As travel RNs consider permanent work, they are looking for employers to prioritize their mental health and well-being and provide flexibility, autonomy, career progression opportunities, and higher compensation to feel supported and respected.
Hospitals and health systems face a turning point in addressing the staffing shortage crisis. So what can we do to bring nurses back to nursing?
The industry has been facing many challenges. Recent research reveals that 600,000 Boomer RNs are expected to retire by 2030. The latest American Nurses Foundation (ANF) Workplace Pulse survey revealed that nearly half (49%) of direct patient care nurses intend to leave their position, 19% intend on leaving in the next six months.
That said, there’s some good news: 18-29-year olds remain interested in nursing careers. The National Nurse Work Environment study by the American Association of Critical-Care Nurses indicated that 75% would recommend nursing as a career, and interest in nursing school remains high. Rebuilding the workforce with these nurses is crucial, but the need to reconfigure the nursing workforce is equally important. This means adjusting how hospitals address staff churn and changing the care delivery model to ensure nurses are working at the top of their licenses. In addition, increasing the focus on mental health and well-being support, improving compensation, and reducing the complexity gap as more veteran nurses leave the profession and are replaced by newer, less experienced RNs.
Another interesting trend we’re watching is the new careers available to nurses. ANF’s Workplace survey indicates that 18% of RNs intend to find a nursing position outside the hospital setting, showing a growing interest in career pathing among nurses to build their career so it’s tailored to their specific lifestyle and interests.
During the pandemic, travel nurses tripled their pay by moving from job to job. But many see the short-lived boom as a temporary fix for a long-term decline in the nursing profession. So, do you think the travel nurse gold rush is over?
Travel nursing is not for everyone. It is its specialty, like pediatrics, critical care, peri-operative, medical/surgical nursing, or nursing leadership. Every nurse chooses a specialty area to focus on at some point in their career. Travel nurses feel that a higher salary compensates them for ever-changing patient assignments and adapting quickly to new organizations, making travel nursing their specialty. Some generational cohorts, such as millennials, are also drawn to travel nursing, but typically for a finite period.
Nurses attracted to travel nursing for the first time did so because early in the pandemic, they wanted to assist in regional COVID “hot spots.” Certainly, the salaries were a big draw. Still, these new travel nurses enjoyed control over their schedules, more autonomy, and flexibility, but whether these factors outweigh what they gave up – being part of a team, knowing the system, and professional development opportunities – remains to be seen.
We don’t know how many RNs will return to permanent roles or choose travel nursing as their specialty.
What has been the impact of travel nurses treating COVID patients for two traumatic years?
The pandemic has impacted every nurse – research studies of stress, fatigue, anxiety, moral distress, burnout, and some post-traumatic stress disorder reveal these findings. And let’s not forget that most of the 100,000 RNs who left the workforce during the pandemic were 49 years old or younger – not retirement age, as many assumed. What has been interesting is looking at the years of experience of travel nurses data: RNs who decided to travel for the first time during the pandemic report slightly higher stress, fatigue, and burnout levels than experienced travel RNs.
Do travel nurses feel like they answered the call and raced to help COVID patients, and now they’re being cut? Are the cuts attributed to federal and state funding drying up or something else?
During the early phases of the pandemic, permanent staff nurses were less tolerant of the initial drastic nurse staffing cuts when elective procedures were canceled. Then, during COVID surges, it was all hands on deck. This was hugely unsatisfying and may have fueled the interest in travel nursing (in addition to high salaries).
Nurses understand that when patient census decreases, there is less need for RNs, so their unit assignment or work schedule may change. This is true of permanent RN and travel RN staff. A lower patient census for RNs on travel contracts has led to a flurry of travel contract re-negotiations with hospitals. Negotiations to either end a contract early happened because patient census has decreased, or, where travel RN agencies benefited from federal and state funding by drastically increasing their billing rates, hospitals have been re-negotiating contract rates.
What can hospitals do to reconfigure the work environment to optimize the existing nursing workforce?
There are two areas to highlight: The first one is toxic cultures. Bullying, incivility, and violence perpetrated by patients and families towards nurses and hospital staff occurred at alarming rates. In acute care settings, 65% of RNs reported bullying or incivility, and 40% of RNs experienced violence. Nurses must have safer and more secure workplaces to provide the best care.
The second is to use more sophisticated math for nurse staffing and scheduling. Some savvy hospitals now view nurse staffing and scheduling as a logistics problem. Using a logistics management approach enables hospitals to use the science of operations research and more powerful math like linear programming. Predictive modeling is used to deploy the right number of staff with the right skills, at the right location, at the right time, with the appropriate patient assignment, and factor in the lowest cost with the best patient outcomes. This complex problem requires big data and sophisticated math, which is different from how nurse staffing and scheduling is typically done today. Nursing staff budgets are based on the “flaw of averages,” using rudimentary math to base nurse staffing on the census at midnight (Average Daily Census) and Nursing Care Hours per Patient Day (HPPD). This inevitably leads to some shifts being overstaffed (a nurse is sent home or floated to another unit) and some understaffed (not enough nurses during the day when the patient census is higher than at midnight). It is very dissatisfying for nurses.
Nurses are looking for scheduling flexibility and control. Health systems should consider creating different scheduling options like 8- or 10-hour shifts. Since nurses are familiar with gig economy-type jobs or travel nurse positions, they should also consider implementing these or similar options, which will be particularly attractive within large, geographically dispersed health systems.
Please discuss Vivian Health’s State of the Healthcare Workforce Survey findings. For example, why are nurses willing to trade the higher pay of travel nursing for a stable job with a strong employer?
Travel nurses learned to enjoy the sense of control and greater flexibility they had over their schedule while traveling during the pandemic. As a result, some want to continue traveling to see the country or build a robust clinical skill set. In addition, the pandemic created numerous work-at-home options. Those nurses with a partner who can “work from home” may choose to remain a travel nurse to continue enjoying greater control and autonomy regarding where and when they work.
It is becoming clear that while some first-time travel nurses want to return to permanent positions, they are demanding healthier work environments, flexible schedules, a sense of control, better staffing, more autonomy, and more significant compensation. Vivian Health’s recent survey asked travel nurses about their future career plans. Fifty-five percent were seeking a permanent position with a median salary of $65 per hour and being part of a team.
Why are nurses willing to trade the higher pay of travel nursing for a stable job with a strong employer?
Travel nurses learned to enjoy the sense of control and greater flexibility they had over their schedule while traveling during the pandemic. As a result, some want to continue traveling to see the country or build a robust clinical skill set. In addition, the pandemic created numerous work-at-home options, so those nurses with a partner who can “work from home” may choose to remain a travel nurse to continue enjoying greater control and autonomy as to where and when they work.
It is becoming clear that while some first-time travel nurses want to return to permanent positions, they demand healthier work environments, flexible schedules, a sense of control, better staffing, more autonomy, and greater compensation. Vivian Health’s recent survey asked travel nurses about their future career plans. Fifty-five percent were seeking a permanent position with a median salary of $65 per hour to be part of a team.
What about global nursing? What is the value of an American nursing degree internationally? What role do travel nurses play abroad?
First, there is a global nursing shortage. While we usually see nurses from abroad coming to the U.S. to work, many U.S. RNs travel abroad to work. There are a few interesting differences: First, travel contracts are for 1-2 years, not 13 weeks. Second, RNs traveling overseas need a U.S. Passport, an active, unencumbered RN license from a U.S. state, vaccines, and perhaps a work visa. Third, a language proficiency exam and board certification in a nursing specialty may be required. Finally, RNs who want to travel overseas must check each country’s regulations since they differ.
And yes, the value of an American BSN degree is significant. Unlike the U.S., where the minimum requirement for nursing is an AS degree, the BSN degree is the minimum requirement to be licensed in European countries.
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Healthcare is a dynamic field with countless opportunities for advancement and growth, with nurses poised at the forefront as hospitals attempt to meet the pressures to treat, educate and manage our aging U.S. population
Economists predict the demand for registered nurses to grow 9% through the remaining decade with 200,000 openings. If you are a nurse, seeking a hospital with Magnet designation allows you to work for the top 10% of the nation’s most respected and leading healthcare institutions with ANCC recognition.
Working for a preeminent Magnet hospital focused on benchmarks for their patients and staff, superior nursing, ongoing innovation, and leadership excellence should be at the top of any nurse’s wish list. The five facilities listed excel in patient care, research, and education, and they are selective employers that will give your resume and your career a boost.
Explore our showcase of Magnet hospitals to find an institution that meets your needs.
Here are the top five Magnet Hospitals you might consider for your next career opportunity.
1. Johns Hopkins Hospital for Education and Research
If teaching and biomedical research top your list for potential employers, look no further than Johns Hopkins Hospital in Baltimore, Maryland. This Magnet-accredited hospital — one of the top 100 oldest hospitals in the United States — is a world-renowned leader in patient care. Hopkins has ten top-ranked specialties and is number one in rheumatology. With continuous innovation, research, unparalleled medical advancements, and unsurpassed patient care, Hopkins deserves your attention as a potential employer.
2. The Baylor Scoot & White Medical Center – Temple for Trauma Care
The Baylor Scott & White Medical Center – Temple Trauma Center in Temple, Texas, the only designated Level I Trauma Center between Dallas and Austin, ranks among the best for overall trauma care, dating back to the fall of 2019. The hospital received its first Magnet designation on February 4, 2021. According to the American College of Surgeons, this medical campus ranks among North America’s top 10% of Level 1 trauma centers.
3. Children’s Hospital of Philadelphia for Pediatric Care
The Children’s Hospital of Philadelphia (CHOP) has ranked among the best children’s hospitals in the United States for the last two decades. The main campus is renowned for delivering safe, high-quality, and family-centered care serving pediatric patients with complex conditions worldwide. This Magnet hospital is the nation’s first hospital devoted to the care of children. Since 1855, CHOP has fostered countless medical innovations to improve pediatric healthcare worldwide.
4. Cleveland Clinic for Cardiac Care
Cleveland Clinic ranks as one of the world’s best healthcare delivery systems. The main campus has been recognized as a Magnet® organization since 2003. And for three decades, Cleveland Clinic has ranked as the top hospital for cardiology, and heart surgery in the U.S. Cleveland Clinic is a top destination with a pedigree of high-quality patient outcomes, maximum safety, and continuous innovation.
5. Mt. Sinai Hospital for Foreign Travel
If you love to travel, leverage your mobility to explore Mt. Sinai Hospital, Canada’s renowned acute care academic health science center affiliated with the University of Toronto. Mount Sinai Hospital, part of Sinai Health, is Canada’s first and only hospital to receive Magnet recognition for nursing excellence and patient care, with a worldwide reputation for excellence in genetic research.
Today, healthcare is more complex than ever. Opportunities for nurses are abundant. Whether you choose a Magnet hospital offering ideal working conditions, increased job satisfaction, leadership opportunities not found elsewhere, or a top hospital of your choice, do research before committing.
We’ll be at the 2022 ANCC National Magnet Conference® October 13-15 at the Philadelphia Convention Center in Philadelphia, PA. Stop by booth 2018. We look forward to seeing you there!
Hospital administrators across the nation advocate the merits of Magnet designation. The American Nurses Credentialing Center (ANCC), an affiliate of the American Nurses Association, awards Magnet status to hospitals that satisfy designated criteria that measure the strength and quality of the institution’s nursing care.
What Are Magnet Hospitals?
Magnet-designated hospitals are regarded as the pinnacle of nursing practice, leadership, and innovation. A Magnet designation stands on five pillars: transformational leadership, structural empowerment, professional practice, innovation, and empirical outcomes.
More than ever, hospitals seek to attract the best nurses, physicians, and ancillary medical staff. Magnet hospitals appear to fare better with these recruiting metrics, but do the benefits outweigh the costs? The return on investment requires measurable patient care metrics, a superior nursing environment involved in hospital decision-making, and higher net patient revenue than non-Magnet hospitals. With consumers looking to hospitals for quality, hospitals seek to raise the bar with a Magnet designation as a roadmap for excellence.
Finding a Hospital with Magnet Status
With nurses becoming more valuable amid the growing shortage, nurses can leverage their demand by exploring open nursing jobs and finding a Magnet hospital that meets their needs. How do you apply to a Magnet hospital? As with any hospital, search the institution’s website and locate the nursing employment link. Use our Magnet Showcase to review Magnet-designated hospitals to research your next employment opportunity.
Safety Across the Board
Hospitals are constantly striving to improve patient safety. However, a safer work environment extends beyond patient safety through lower nurse-to-patient ratios. A Magnet appointment is an investment into a safer physical work environment for the nurses. Reduced physical injuries and decreased blood and body fluid exposure rates translate into healthier nurses and reduced costs.
When nurses have an elevated level of job satisfaction, patient outcomes improve. Low staff nurse turnover, a path to grievance resolution, decentralized decision-making, participation in data collection, and involvement in patient care delivery encourage and reward nurses through advancement in nursing practice. A Magnet designation validates the hospital’s mission.
The COVID-19 pandemic left the nursing landscape littered with shortages and premature departures. Nurses seek engagement and empowerment; competition is fierce for high-quality, professional nurses. As health care grows, patients are becoming more complex. Shift work is demanding, with long pressure-filled hours. If you include the mental, physical, and emotional factors that fuel attrition in nursing, obtaining a Magnet designation can lead an institution toward an increase in the quality of the work environment.
Within health care, quality improvement is a sustained culture of practice improvement. The professional development of nurses is a tenet of Magnet: having employers support nursing autonomy and empowerment can lead to cooperation in leadership and vision. To succeed in health care, interdisciplinary communication and a collaborative mission of nursing practice can result in better partnerships with hospital leadership.
Obtaining Magnet status can be expensive for smaller institutions. It takes over four years to complete the process, with an average of over two million dollars invested by the hospital. Proponents will argue that Magnet designation will offset the associated cost with higher net patient revenue and improved outcomes. A Magnet-designated hospital receives an adjusted net increase in inpatient income of $104.22–$127.05 per discharge. This translates into an added $1,229,770–$1,263,926 in income per year. Hospitals achieve payback from Magnet Status in two to three years using this data.
Critics argue little evidence exists that Magnet hospitals’ nurses are better off compared to their non-award-bearing competition. More than an impression of nursing excellence is needed to justify the added time and cost for what some professionals consider a marketing gimmick. For nurses weighing the claimed benefits of a supportive work environment, autonomy, less risk of burnout, opportunities for education and research, and the real-world practice environment of a Magnet hospital is imperative. So, nurses, do your research.
We’ll be at the 2022 ANCC National Magnet Conference® October 13-15 at the Philadelphia Convention Center in Philadelphia, PA. Stop by booth 2018. We look forward to seeing you there!