Heraclitus, a Greek philosopher, is credited to say, "Change is the only constant in life." This statement has been the cornerstone of the American Nurses Credentialing Center(R) (ANCC) Magnet Recognition Program(R) journey. Since 1994, the program name and logo have changed twice, the original 14 Forces of Magnetism were incorporated into a more contemporary model depicting the domains of excellence, the review has iterated from predominately qualitative to a quantitative format enhancing rigor and interrater reliability, and the submission manual has been updated at least 4 times, allowing for improved translation and focus. There have also been important, if not seismic, "requirement" changes-higher education for nurse leaders and empirical outcomes focus, and in 2019 nurse satisfaction performance is nonnegotiable. The Magnet Program has ignited nurses to get certified, to go back to school, become nurse researchers, and contribute to the science of nursing. The Magnet evolution and the subsequent favorable impact on patient outcomes have been important, intentional, bold, and transformational and have unquestionably changed the way the healthcare industry values nursing. Unexpectedly and refreshingly, Magnet has also changed me.
In 2001, I was a family nurse practitioner in a hospital-owned practice. I was asked to take a 9-month leave from my practice to write my hospital's Magnet document. My goal was to help put the Magnet obelisk in the trophy case. Nine months turned into 31/2 years (built >40 new programs), and in 2004, John C. Lincoln-North Mountain was designated Magnet, and everything about my professional life plan had changed. For the 1st time in my career, I had worked with a chief nursing officer (CNO), Sue Hollabaugh, MSN, RN, who epitomized Magnet principles. Sadly, the CNO prior to Sue was the dark side-did not know and did not seem invested in frontline issues. Watching Sue's remarkable leadership, I understood that CNOs should and could be the light that promotes excellence. When I came to the amazing realization that this was not about an obelisk in the case but a culture that touches all who enter our hospital doors, I made the 180-degree decision to move down the CNO track. Who knew? I wanted to be a Magnet leader. But that was just the beginning of my Magnet inoculation. The Magnet Program was going to become a more central part of my professional life.
In 2002, I had called the Magnet office so many times to ask clarifying questions about the Magnet manual that Stephen Snell (1 of 2 program office administrators) asked me to apply to be an appraiser. My 17 years as an appraiser has been a postdoctoral experience in excellence. I have become a more thoughtful, courageous, and complete leader as a result of my learnings. I have acquired an organic understanding of how Magnet organizations, with more than 60 organizational reviews of all sizes, locations, and complexities, predictably drive excellence and produce sustained outcomes. I know these organizations are not perfect, but they are perfectly suited to understand their challenges and relentless in addressing them.
The challenges facing nursing across the United States and globally are similar-staffing, financial constraints, hardwiring top decile metric performance, healthy work environment, and generational differences, among others. I have seen the power of Magnet nurse leaders, interdisciplinary teams, and direct care nurses simplify the most complex problems to solutions that are effective and efficient. I have witnessed shared governance councils demand patient-centered and evidence-based practice change-not because it was easy but because it was right. I have felt the impact of authentic and transparent leadership on creating a culture of believing that excellence is possible and expected, every time for every patient. I know that if you ask a nurse a question, you will get the truth followed by a well-articulated explanation of the future plan. Magnet nurses put their patients 1st, never forgetting compassion and caring.
Fortunately, Magnet is not just about compassion and caring. Magnet is recognized as the "gold standard" recognizing hospital health for US hospitals and beyond. The program has transformed from a small research study sponsored by the American Academy of Nursing to an international designation that has correlated nursing practice to the healthcare trifecta-improved patient, staff, and organizational outcomes. Many financial institutions have factored in Magnet as a performance safety net and provided advantages to hospital's bond ratings. This business case distinction is important to support for Magnet growth and sustainability. Appraisers and the Magnet Program Office (MPO) understand the responsibility of upholding this Magnet reputation. I am proud to be associated with a program that is recognized beyond the healthcare industry.
Lastly, working with my esteemed appraiser colleagues and MPO staff has broadened my vision. Appraisers come from across the United States and are expert in their fields of either service or academe. They are prominent nurse leaders who are completely dedicated to the Magnet concept. With each appraiser team experience, I have learned valuable leadership lessons. Equally impressive is the MPO personnel. The MPO staff are dedicated, intelligent, and forward thinking in ensuring that Magnet is understood and operationalized on both the appraiser and organizational sides. The team is the true north for Magnet principles. They are ground zero for understanding when it is time to consider programmatic change.
The MPO also has worked with the Magnet Commission to clarify what is working and what needs to be modified. Ultimately, the Magnet Commissioners have had the courage to implement disruptive but essential change. This change has not always translated to tranquility but has been instrumental in advancing national and international nursing professional standards. As a Magnet CNO and appraiser, I am grateful for the guidance, if not a significant shove, to ensure that nurses are central to healthcare excellence. Nurses have been positioned at the most influential decision-making tables as a result of the Magnet movement.
Being a part of this Magnet journey has been the most professionally rewarding and transformative experience of my career. As a Magnet appraiser, I have seen some of the best in the healthcare world turn crisis into opportunity. As a Magnet CNO, I have been privileged to work with my teams to establish a culture that promotes an environment that benefits all-so very inspiring that it becomes contagious. There is no magic to Magnet designation, but rather commitment, teamwork, and execution. In the center of it all is agility[horizontal ellipsis] a willingness to change. Hats off to all the early Magnet pioneers who discovered key ingredients to highlight that nurses are the secret sauce to excellence. Applause for the ANCC's willingness to launch an innovative program to showcase nursing's contribution. Kudos to those early Magnet hospitals who promoted Magnet recognition and created a phenomenon that has exceeded expectations. This is a journey of change that has elevated the future of nursing and unleashed the possibilities of our profession to be a leader in healthcare reform. Today is a great time to be a nurse, and particularly a Magnet nurse.