My hospital is going through the application process to become a Magnet hospital. Our manager told us not to complain when the Magnet people come to assess the facility. I need my job, but this hospital isn't a nurse-friendly place. Could the hospital legally fire me for being "insubordinate" (that is, honest), if it costs them the Magnet designation?-P.N., OHIO

Magnet evaluators are quite adept at recognizing phoniness, and they assess many factors to determine the quality of a hospital's environment. A hospital must establish a track record even to be considered for Magnet status and is reevaluated on an ongoing basis. These precautions serve to prevent hospitals from receiving this prestigious designation and then reverting to a culture that wouldn't merit the award.

Talk honestly with nursing leadership about your concerns. If your hospital isn't nurse-friendly, it will likely have trouble meeting the criteria. You don't want to intentionally interfere with the hospital's Magnet review process, but you shouldn't be forced to be dishonest either.

If you have peers who feel the same way you do, approaching management as a team may send an even stronger message and be safer for you as an individual. However, if you're the only one who feels this way, perhaps you should avoid working on the days the Magnet reviewers are on site, so that you aren't interviewed. If, as a lone dissenter, you caused the hospital to lose a Magnet designation, you might well be fired for insubordination.