Keep your nurses from choosing another ED

In addition to fielding questions from prospective emergency department (ED) nurses about schedules and benefits, you soon may be asked "Is your facility recognized by the Magnet Nursing Recognition Program?"

"Many ED nurses are now asking if we have this," says Katherine Scipione, RN, MS, director of emergency services at Robert Wood Johnson University Hospital in New Brunswick, NJ, which is a magnet hospital.

The Magnet Recognition Program is administered by the Washington, DC-based American Nurses Credentialing Center, and it identifies facilities that have met specific criteria demonstrating excellence in nursing care, and growth and development of nursing staff. More than 60 hospitals are recognized as magnet facilities. (For more information, see "Sources/Resource" section at end of article.)

Magnet status can definitely make or break the decision for a nurse to choose your ED, explains Sandy Fox, RN, ED nurse manager at Avera McKennan Hospital in Sioux Falls, SD, which became a magnet hospital in June 2001.

"A new nurse hired from outside of the facility commented on the positive environment that we maintain, and how it made the decision an easy one when comparing us to a competing hospital," she says. Fox predicts that this trend will continue, fueled in part by the ongoing nursing shortage. "It will be even more important in the future if the money incentives go away, such as sign-on bonuses," she says. "Emergency nurses will pay more attention to what the facility has to offer regarding professional development, and the amount of voice nurses have."

Here is what magnet hospital EDs are reporting:

• The department and hospital have lower turnover rates.

Victoria Ritter, RN, MBA, manager of the ED at University of California at Davis, reports that her ED has a turnover rate of only 5%, which she attributes to the magnet program. According to a report from the American Organization of Nurse Executives, the national average turnover rate for acute-care hospitals was 21.3% in 2000.1 All the other EDs in her area are using traveler nurses, Ritter reports. "Several are almost exclusively staffed with travelers," she says.

• Nurses are asking for magnet status.

ED managers are using magnet status as a powerful selling point for their departments. "This is something nurses are very aware of, as evidenced by the interviews I’ve had since we became a magnet hospital," Ritter says.

Several new recruits have stated that they were looking for a magnet hospital for their next career move, she says. "These individuals are typically from out of state and are willing to relocate to work here," she says.

An important trend is that many nursing students are aware of the program’s benefits, Fox says. "They state that their instructors have told them to look for magnet hospitals because of the opportunities for professional development and educational opportunities," she says.

• Professional growth is a major concern for nurses.

Fox’s ED supports the professional growth of nurses in two key ways: scheduling around educational commitments, and financially through employee benefits and college scholarships. This focus on professional growth is probably the single most important criteria of the magnet program in the eyes of ED nurses, she says.

"Many of our nurses are associate degree or diploma nurses and are working on a four-year degree in nursing or a related field," she says. Many want to become midlevel practitioners and are specifically looking for a facility that offers educational benefits, Fox points out. "We have recently had six ED nurses complete their nursing degrees, and one now works here as a nurse practitioner PRN," she says.

For nurses who don’t want to complete a degree, the ED offers a program in which nurses can complete projects to earn reimbursement for health club memberships, uniforms, and educational conferences.

• Nurses increasingly want to be involved.

At Scipione’s facility, multidisciplinary committees involving ED staff are an important component of the magnet criteria. Similarly, Fox says that her ED’s "shared governance" philosophy for nursing is a major selling point for prospective nurses. "It gives nurses a major role in the direction of nursing for the ED," she says.

There is a committee with representatives from every position in the ED, including Fox, two ED nurses, one flight nurse, one dispatcher/unit secretary, and one patient care technician. They meet bimonthly to work on issues such as patient flow, review policies, and plan education.

The group has written policies on floating nurses to other units, identified ways to reward nurses for seniority, created a resource nurse role, and developed ways to help nurses advance professionally. Nursing grand rounds have started, with nurses presenting on a variety of topics, many involving case studies, Fox reports. An ED nurse on the facility’s shared governance committee travels to job fairs to discuss the self-governing philosophy, she says.


1. American Organization of Nurse Executives. Acute Care Hospital Survey of RN Vacancy and Turnover Rates in 2000. Washington, DC; 2002.


For more information on magnet status and recruitment, contact:

• Sandy Fox, RN, Nurse Manager, Emergency Department, Avera McKennan Hospital, 800 E. 21st St., P.O. Box 5045, Sioux Falls, SD 57117-5045. Telephone: (605) 322-2077. Fax: (605) 322-2030. E-mail:

• Victoria Ritter, RN, MBA, Manager, Emergency Department, University of California — Davis Health System, 2515 Stockton Blvd., Sacramento, CA 95817. Telephone: (916) 734-2363. E-mail:

• Katherine Scipione, RN, MS, Director, Emergency Services, Robert Wood Johnson University Hospital, One Robert Wood Johnson Place, New Brunswick, NJ 08901. Telephone: (732) 828-3000, ext. 8790. Fax: (732) 418-8299. E-mail:

For more information on the Magnet Recognition Program, go to Click on "Magnet." Or, contact the American Nurses Credentialing Center, 600 Maryland Ave. S.W., Suite 100 West, Washington, DC 20024-2571. Telephone: (202) 651-7262. E-mail: