护士们思考国家最令人垂涎的护理奖的意义

第一天的培训，她坐在新同学中间, Leonie Farrington listened in confusion while a veteran nurse explained that her new employer, The Johns Hopkins Hospital, was a Magnet nursing institution. “我以前从来没听说过磁铁," recalls Farrington, 在她的祖国爱尔兰当过护士, and later in Canada, for the past 12 years. "But I knew it was something wonderful, because everyone seemed to be incredibly proud."

像法灵顿这样的故事并不少见. 尽管全国越来越强调实现和保持磁铁地位, there are still many nurses— whether because of age or education—who remain unfamiliar with what the term means. “我知道医院随着时间的推移发生了变化, but I don’t know how,新上任的分娩护士米歇尔·弗朗西斯说, who, 她的第一份护理工作已经两年了, 还在学习磁铁地位的意义吗. "I think the older, more experienced nurses should talk about what things were like before we became Magnet. What’s changed? What’s different? Sometimes if you know what exactly it is you appreciate, you appreciate it that much more."

For Farrington, 直到去年，磁铁仍然是个谜, when her nurse manager asked that she represent her unit on the Magnet Ambassador Committee— a team of 77 nurses, one per unit, charged with educating their coworkers about maintaining the Hospital’s Magnet status. "Once I learned more about it, I saw that it was a really special thing," Farrington says. “人们认为我应该参与其中，我感到很荣幸."

由美国护士资格认证中心颁发, Magnet designation first entered the health care scene in 1990 as a means of recognizing hospitals that offer excellent nursing care. Since then, only 258 of the nation’s 7,569家医院获此殊荣, 马里兰州只有一家——约翰霍普金斯医院, 2003年，哪个国家申请并获得指定. 今年，医院的磁石地位有待审查.

“护理在霍普金斯大学一直占有重要地位,Magnet大使玛莎·康伦(Martha Conlon)说, 威尔默眼科护理馆的NC-III. "Receiving Magnet designation really proves that the nursing care here is above and beyond."

Nurses whose careers are just beginning at Hopkins have a shorter point of reference when it comes to appreciating the value of working at a Magnet hospital. 然而，经验丰富的护士有第一手的知识.

Twenty or 30 years ago, “护士之间没有太多的互动," says Martha Conlon, 一位28岁的护士和威尔默眼科护理馆的NC-III. “如今，护士确实为自己承担了更多的责任. 我们制定自己的标准和政策, have more interaction with other departments and focus more on furthering our education."

The starkest difference between past and present-day nursing exists in the care environment. Back then, Conlon says, 护士有时要照顾十几个推荐十大正规网赌平台, as a result, their duties were much different.  Nurses were often more task-oriented and focused on basics like assisting patients with bathing and changing bandages. 因为没有人回家时还缝着缝合线, 推荐十大正规网赌平台在医院待的时间更长, 而且住院和门诊之间几乎没有协调.  And while such interactions allowed nurses to build strong relationships with patients, they also prevented nurses from taking on the academic and leadership-oriented roles that are so prized at Hopkins.

“我肯定看到了栅栏的另一面, and it’s very different," explains Farrington, whose nursing experience in Ireland offers a vivid example of a nurse’s role in a non-Magnet institution. “我认为，如果你从霍普金斯大学开始, 人们可能很容易相信，各地的护理都是一样的," she says. "But it’s not, it’s truly not."

In Ireland, where Magnet rankings don’t exist, she says, 护士在实践中拥有较少的权威和自主权. 他们的意见对医生来说无足轻重, research opportunities are scarce, 工资较低，护士通常被视为没有影响力, 她们在霍普金斯大学扮演着不可或缺的角色.

"Back home you could go for years and never have the opportunities you have at Hopkins," Farrington says. “对我来说，经常被告知你可以做所有这些事情是非常令人兴奋的."

The situations that Farrington remembers from her years in Ireland are similar for nurses in non-Magnet U.S. hospitals. Conlon, for example, describes the job of a colleague she knows who doesn’t work at Hopkins: "She’s a nurse manager, and she has to do everything. 她审核图表，做评估，管理财务. One person can’t possibly do all that work and still maintain her patient practice."

现在她已经习惯在磁石医院工作了, 法灵顿无法想象去别的地方. “我来到这里，发现了一个完全不同的护理环境，”她说. “我想我再也回不去了."

The reasons are all Magnetic.

There are 14 "Forces of Magnetism,“一个机构必须满足的条件才能被考虑获得这一荣誉. Among them are strong leadership, supportive management, promoting nurses as educators and providing opportunities for professional development—all a prevalent part of Hopkins nursing culture. 上面有很多医院赞助的课程, 还有学费报销计划, Hopkins nurses receive numerous opportunities to extend their education and receive promotions. 他们还参与研究并在重要委员会任职. 最重要的是，他们的意见对护理团队的其他成员很重要.

"If you’ve never worked anywhere else, you might think, Isn’t every place like this?儿科护理主任丽莎·菲弗说，“答案是否定的。. No, no, no, no. 全国只有250家这样的医院."

The ANCC doesn’t just hand out Magnet designations to institutions based on reputation alone, nor is the title bestowed without considerable effort made by the institution in question. Hospitals must take the initiative upon themselves, and the process can take a full year or longer. 此外，获得一次磁铁身份并不是终身保证. Some institutions have found themselves stripped of their Magnet title upon re-evaluation, which is required every four years.

当ANCC在1990年首次宣布新的认证系统时, 霍普金斯大学护理部门的领导对此并不在意. 菲弗说:“我们决定不需要那种级别的指定。. “我们觉得我们已经达到了标准，没有什么需要证明的."

Over time, though, a question kept arising among job applicants and competing hospitals: Why wasn’t Hopkins a Magnet nursing organization? Nursing students and veterans alike were beginning to look at Magnet designation as a must-have for their employers, and a growing—albeit still small— number of hospitals across the country were seeking and receiving the title. 所以在2003年，菲弗说，霍普金斯大学决定做同样的事情.

"The opportunity to validate that we did indeed meet Magnet nursing standards was a wonderful journey," Phifer recalls. “我们看了每一个标准，然后说，是的，我们这样做. 我们可以举出具体的例子." Unlike some institutions that need two or three attempts before they make the cut, 霍普金斯大学在第一次尝试时就获得了磁铁的地位. 菲弗说，现在的任务是保住它.

While administrators assemble the thousands of pages of paperwork needed for the re-designation application, Magnet ambassadors are holding monthly meetings with co-workers to build enthusiasm and talk about how to prepare their units for the inevitable site visit—when a Magnet investigator comes to the Hospital to conduct an inspection. 菲弗毫不怀疑他们的努力会再次得到回报.

菲弗说:“我们的护士很闪耀，他们就是很闪耀。. "Part of the beauty of our receiving Magnet status the first time was that we didn’t have to do or change anything to achieve it. 这是我们的一部分——霍普金斯护理等于磁铁护理."

Magnetic Practices

Magnet designation first emerged in 1990 as a way to recognize hospitals that successfully attracted and retained high-quality nurses, 即使是在护理短缺时期. 在霍普金斯大学，快速阅读护理部门2006年的R.N. 满意度调查显示了医院达标的原因.

叫做国家护理质量指标数据库, the survey polls more than 76,以确定他们的整体工作满意度, 监测他们多年来的进展, 并评估各个机构与竞争对手的比较. 由于预计护士短缺, it’s an important question, 特别是对于任何希望改善其招聘的医院. Fortunately, Hopkins made a good showing— receiving high scores that fared above the national averages in most categories.

At Hopkins—where 1,612 nurses and 71 units participated—nurses registered a higher level of satisfaction with their professional development opportunities, co-worker interactions, 决策能力和医生关系. 霍普金斯大学的护士对同事的团队合作也表现出更高的满意度, 2005 - 2006年工作满意度与领导能力.

“这是我们最重要的评估工具之一,护理副总裁卡伦·哈勒说. "It’s so gratifying to see that we didn’t have any low scores, and in many areas we saw improvement."