In 1981, Dr Maggie McClure was appointed chair of the American Academy of Nursing (AAN) Taskforce on Nursing Practice in Hospitals. As the lead author of the landmark study, "Magnet^(R) Hospitals: Attraction and Retention of Professional Nurses,"1 Dr McClure set the stage for transforming nursing practice but, most importantly, identified evidence to support the retention of nurses. Her early research focused on "examining characteristics of systems impeding and/or facilitating professional nursing practice in hospitals."1 The results provided the foundation for the Magnet Recognition Program^(R), which began in 1990. Dr McClure (Maggie) credits her team and the participants for sharing their commitment to nursing and patient care.

Dr Brooks: What led to the AAN appointing a special task force to study the nursing shortage?

Dr McClure: In her 1980, AAN presidential address, Dr Linda Aiken prioritized the nursing shortage in hospitals. This led to the AAN Governing Council appointing a special nursing practice taskforce in 1981. Four AAN fellows from nursing service and nursing education developed a study to examine issues related to the shortage. This study reflected the importance of the nursing shortage and resulted in a report that nursing professionals used in practice, education, and research to improve hospital nursing.

Dr Brooks: Could you share a few highlights from conducting the study?

Dr McClure: We felt honored to be appointed to this taskforce. The AAN had limited resources available to conduct the study, but we were determined not to let anything stop us. Knowing that the work was important helped us recruit and engage AAN fellows and other nurse leaders in the process. We partnered with volunteers to identify the hospitals to sample, coordinate site visits, and conduct data collection. After data collection was complete, we worked analyzed the results and authored the report. I used my airline reward miles (accumulated during my presidency of the American Society of Nursing Service Administrators) so that the other 3 members of the taskforce could fly into New York, stay at my house, and get the work done. We analyzed the data during long weekends and were appreciative and grateful for each other's competence, expertise, and generosity of spirit.

Dr Brooks: What made the team successful?

Dr McClure: First, we shared the same vision and commitment to finding out why nurses stay. Listening to nurse leaders and bedside nurses, using a structured methodology, helped us understand the depth and breadth of the issues involved in hospital nursing shortages. Second, we respected each other's skills and expertise and used our time wisely as nurse researchers to answer the question "Why do hospital nurses stay?" rather than "Why do they leave?" We designed an innovative methodology, applied it consistently, and identified common themes in the 41 hospitals that became the "Magnet hospitals." While the publication of the study findings ended the formal work of the AAN taskforce, our team continued to feel connected long afterward.

Dr Brooks: Did the nursing community react to the 1983 study?

Dr McClure: Not much! We presented the findings at the 1983 AAN annual meeting and were disappointed by the lack of response. While most fellows in 1983 were in nursing education and research, the team thought that the findings from the study were helpful to all roles and settings and could be integrated into education, practice, and research to address various aspects of the nursing shortage.

The reaction to the study by the 41 hospitals recognized as Magnet was different. The study raised awareness of how these organizations successfully developed positive practice environments, achieved retention of nurses, valued and provided professional development, and prioritized communication. Most hospitals named "Magnet" used this recognition to celebrate their existing programs in marketing materials and develop initiatives that added value to building and sustaining cultures of excellence.

Dr Brooks: What career lessons did you learn from the study?

Dr McClure: Three basic lessons stood out. First, listening to bedside nurses should be a high priority. Using their feedback and ideas to improve is critical to building and sustaining a culture of mutual respect and engagement. Second, the nurse leader should mentor and coach nurses to involve them in decision-making. Third, developing interprofessional relationships adds value to patient care and fosters a positive work environment. Nurse leaders can role model and work to promote collaboration. Nurse leaders play a crucial role structuring environments where nurses, physicians, and other professionals can effectively collaborate.

Dr Brooks: Did any outcomes surprise you?

Dr McClure: We thought the 1983 study was important, but no one imagined what the study would launch. The Magnet program reflects the leadership, creativity, and persistence of so many nurses in creating and continuously improving the structures, processes, and outcomes that impact healthcare.

The 2nd surprise is the widespread recognition of Magnet designation and outcomes by professional organizations and entities outside of nursing. Dr Aiken's research and publications were instrumental in raising awareness and establishing credibility based on results. Who would have thought that recognizing outcomes by the Centers for Medicare & Medicaid Systems, US News & World Report ratings, and the public's knowledge of what the designation represents would occur? Hospitals and health systems use Magnet designation to reassure the public that they offer the best nursing care.

Another surprise has been the pride and exuberance of nurses in achieving Magnet designation. Anybody who attends a Magnet conference recognizes the effect of meaningful recognition and the joy one feels in the environment. Attendees reflect how the Magnet program is the anchor for building and sustaining positive work environments, giving voice to nurses, and producing outstanding patient outcomes. To listen to the incredible accomplishments of nurses, those selected as Magnet nurses of the year, and the special recognition given to an organization receiving the coveted Magnet designation is amazing and humbling.

Dr Brooks: What message would you like to send to Magnet nurses?

Dr McClure: I am proud of their work, commitment to excellence, advocacy, passion for continuous learning, and willingness to do whatever is needed to make patient care a priority. I am grateful for their amazing leadership and work during the pandemic and resilience during times of unprecedented challenges. Because they role model excellence, nurses apply what the Magnet journey is all about not perfection but overcoming obstacles. They know that excellent nursing care attracts and retains nurses and physicians who want to practice in an environment where their patients are well cared for, feel safe, and appreciate genuine interprofessional practice.

Dr Brooks: Looking back, any regrets?

Dr McClure: My only regret is that my partners, Drs Muriel Poulin, Margaret Sovie, and Mabel Wandelt, did not live to see these outcomes. They would be proud.

Dr Brooks: What is the future of Magnet.

Dr McClure: The future is bright! I am confident that the Magnet program and Magnet nurses will continue to shape and transform healthcare. We will see expanded research and innovative interprofessional practice models, with Magnet nurses serving on boards and holding elected offices. Patients and families benefit from knowing "why nurses stayed" in 1983 and continue to stay in 2022 and beyond.

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