Critical Care Plus: Magnet Hospitals Increase Quality of Nursing Care

Respect, better conditions seen as important as money

With the health care penny being squeezed dry it’s not unexpected that nurses report they are unable to provide quality of care consistent with professional standards in today’s hospitals, says Julie Sochalski, RN, PhD, professor of nursing at the University of Pennsylvania School of Nursing.

Sochalski says hospital administrators can improve the quality of nursing care they need to incorporate the goals set by the magnet hospital movement.

Understanding why nurses who work in magnet hospitals are able to provide high-quality care is easy, Sochalski says. Magnet hospitals have made nursing a priority, including it as a primary goal in their mission statements.

"Nurses know when their contributions are recognized and valued," Sochalski says. "Respect is as important as money. Conditions in most hospitals today simply don’t allow nurses to deliver the professional standards of care."

The American Hospital Association says that hospitals around the country have 126,000 nursing vacancies, or 12% of capacity. Health industry experts predict that number could triple over the next decade as aging baby boomers require hospital care.

Sochalski observes that both patients and nurses fare better in magnet facilities. "The rate of needlestick injuries is lower, patient outcomes are better, and authority and autonomy to practice evolves to the individual nursing unit and to the nurses themselves, who are recognized as clinical experts capable of marshalling resources and organized care around making a positive difference to patients," Sochalski says. "When a hospital organizes around nurses being able to practice at the highest possible level, everyone benefits."

Sochalski points to the "failure-to-rescue" outcome measure developed by Jeffrey Silber, MD, physician and professor at the University of Pennsylvania, as supporting evidence of magnet hospital superiority. The outcome measures the death rate among hospital patients who experience severe complications, Sochalski explains. It’s not just who do bad things happen to but who dies from that, she adds.

Failure-to-rescue rates are predictably lower in magnet hospitals, which have more nursing staff to monitor and observe patients, and where nurses sit on staffing, quality assurance and policy-making committees, Sochalski says. They rise sharply in hospitals with less than optimal staff and in those that require mandatory overtime.

Patient care has rapidly deteriorated because RNs are performing more technical work while simple needs like bathing, oral hygiene and body transfers are not being met, says Stella Henry, RN, BSG, founder of Vista Health Services in Century City, Calif. Henry, herself a baby boomer, notes that when she was growing up nursing was a much more honored tradition than it is today. RNs today do more technical work that deprives them of time needed for hands-on care.

"We can successfully increase the number of nurses by financial reimbursement, education in high schools that spotlights the diverse, high-tech, hands-on career pattern in nursing and by increasing the number of professors available to teach nursing skills," Henry says.

Hospital nursing salaries have stayed relatively flat for a decade, according to the American Nurses Association, which recently produced public service announcements targeting high-school students. Henry describes this as a step in the right direction.

According to the New York Times, a recent survey by industry employment service Allied Physicians found that the national average nursing salary was $45,500. Nurses with graduate degrees, those with specialties like cardiac care and those who work in big-city hospitals, can make $60,000 and more, but entry-level salaries in many places remain low at $25,000-30,000.

Congress is expected to generate $136.7 million in new federal spending for scholarships, loan repayments and recruitment grants. (For more information contact Julie Sochalski at [215] 898-5673 or Stella Henry at [310] 390-9045.)