Magnet Recognition Program for Nurses - Research Paper Example

Registered nurses past and present are educated at different levels. Healthcare facilities are moving toward Magnet status to obtain certification of facility to present a high level of educated and knowledgeable care to the community serving. Administrative support is needed for the Associate degree nurse as they transition from staff nurse to nursing student. Recognition of experience and contributions of the ADN to the healthcare facility is a prerequisite for successful and satisfied nursing professionals as the facility moves into Magnet Status. Introduction Nursing is a profession that is in constant flux with changes in technology, educational requirements and professional excellence in nursing practice. With the advent of the Magnet Recognition Program® more healthcare facilities are seeking attainment of a higher level of professional nursing practice (ANCC, 2013). The rationale for healthcare facilities in seeking Magnet Status is driven by healthcare institutions wanting to serve the communities with the highest level of care possible in the use of innovative technology and excellence in care. Bargagliotti, West-Sands, Burchum & Selbe, (2002) note that in year 1960s, most nurses were trained at a diploma level, which was a two or three year hospital based nursing program where nursing students learned the basic skills to care for patients in the hospital. In the 1960’s, undergraduate programs were recognized as a path that nursing students should take to function at the professional level of nursing. This system was generally quicker and cost effective to utilize the diploma programs to produce a high functioning nurse to care for the large number of patients (Donley & Flaherty, 2008; Nelson, 2002). The diploma programs were the first to be extinguished from the education framework as the profession moved into the ADN and BSN programs of study (Donley & Flaherty, 2008 & Nelson, 2002). During times when nursing supply and demand did not meet the needs of society, Accreditation Commission for Education in Nursing, which operates under the auspices of the Committee for the Study of Nursing Education would make determinations to reduce the requirements of nursing program and change the accreditation standards to facilitate a larger volume of nursing students needed (Donley & Flaherty, 2008). There was a distinction between the two roles in the 1960’s but today the role of the RN is not as distinct; each level of education received the title of RN after successful passing of the state boards of nursing licensure test to become a practicing registered nurse (Pellico et al., 2009). Previous distinction of role included the definitions of the technical nurse and the professional nurse. The technical nurse was in the beginning educational preparation stage and attended a 2 year community college. The professional nurse was enrolled in a four year nursing program at a colleges or university; the distinction of roles is consistent with accreditation standards of thinking at the time (Donley & Flaherty, 2008). The goal was to expand the nursing programs and assist the technical nurse to transition into professional practice (Donley & Flaherty, 2008 & Nelson, 2002). These attempts notwithstanding, the needs of the educational curriculum were still not fulfilled for the RN at both levels after taking the state board licensure exam receives the same title, “RN”. There is a continued effort for nursing to elevate the profession at a higher educational level. healthcare facilities with Magnet® status help to push this process forward with the continued excellence in nursing practice outcomes. In 1965, the American Nurses Association’s First Position on Education in nursing was published to describe the need for educational reform in nursing (ANA, 1965). This argument continues today. The goal for a standardized nursing entry level of education has yet to be resolved. According to Smith (2009) the environment of nursing has evolved considerably and educational advances need to be changed. Historical Implications Nursing has been a definitive part of society since Florence Nightingale (U.S. Department of Health and Human Services Health Resources and Service Administration, 2010). Historical significance for change in education practices in nursing is wide spread as presented by the ANA Position Paper in 1965 and consistent position statements presented by the National League for Nursing and the National Council of State Boards of Nursing (Smith, 2009). The American Nurses Association has attempted throughout the past 40 years to change the entry level of nursing to the BSN prepared nurse. magnet® status is moving this process forward and with this rapidly changing environment in which the technical competencies will not suffice; knowledge and education is needed for the more complex technologies in healthcare today (Smith, 2009). Not long ago in the year 2010, The Joint Commission added its voice to the Robert Wood Johnson Foundation, which introduced the Future of Nursing Initiative to address the challenging issue of quality in the training of nurses who would be well educated and prepared to deal with quality and safety issues that currently face the health care sector (The Joint Commission, 2010). Literature Research There are several studies that support the need to educate the entry level nurse and for healthcare facilities to establish a high level of professional excellence of the professional nurse. The levels of nursing education play a significant role in this level of excellence and the basis for accreditation from the ANCC Magnet Recognition Program (American Nurses Credentialing Center, 2013). Nursing is the number one healthcare professional that staff healthcare facilities (Bargagliotti, West-Sands, Burchum & Selbe, 2002). Healthcare consumers are expecting a higher level of professional practice, the level of knowledge consumers have makes it necessary for nursing and healthcare workers to produce a higher level of nursing practices in the healthcare facility (Valentine, 2010). According to Smith (2009) the ANA continues to look at the past 100 years of healthcare and hopes to strengthen nursing with further education. The inconsistencies are that nursing leaders and educators continues to debate over establishing national standards in nursing education. The IOM report has discussed further contributions for the challenges in nursing education and the path needed for nursing to follow. Future of Nursing According to Smith (2009) the future of nursing is rapidly changing, the environment continues to evolve and nursing leaders and educators need to establish a national standard in nursing education. Accordingly Donley & Flaherty (2008) & Nelson, (2002) nursing and educational requirement’s need to maintain a high standard of professional nursing practice through growth and evolution. A difficulty in incorporation of the educational requirement throughout the country is that each state has specific requirements that do not necessarily coincide with any other state. These differences are that each state works by its own educations system, laws, regulations for licensure and work with distinctive healthcare related interest groups. According to Smith (2009), to standardize this process for nursing education and entry level into practice needs be for “each of the nursing boards and legislatures to recognize the value of a unified standard for entry into professional nursing.” (p. 1 paragraph 3). By the year 2020 Valentine (2010) notes the goal for the practicing nurse is that all nurses will have obtained a baccalaureate in nursing degree (BSN). Nurses working in the field at this time may be required by employers to return to school or experience a loss of present position (Benner, Sutphen, Leonard and Day, 2010). This is more evident as more and more healthcare facilities are becoming certified designated through the ANCC Magnet Recognition Program (American Nurses Credentialing Center, 2013). The important that the Institute of Medicine (IOM) has attached to the training of nursing lately makes it virtually out of place to discuss the future of nursing without referring to them. This is because the institute launched the IOM Report titled Future of Nursing. Upon its release, the American Nursing Association (ANA) commended the report as a useful working tool to transform nursing in the nearest future (ANA, 2010). As far as the future of nursing is concerned, some of the critical recommendations that the report makes is the need for nurses to practice to the full extent of stipulated education, training and licensure (ANA, 2010). The report also appreciates the effect of integrated health care as it recommends that instead of being partial partners, nurses should be full partners with physicians and other health professional as a principle for the redesigning of United State’s health care (ANA, 2010). This is an important recommendation for the future of nursing because isolating nursing from other forms of health care practice would create inefficiencies in the health care system because nurses cannot be in a position to take charge of all health needs of patients (Katri, 2009) To understand the verbiage of the nursing educational positions it is good to understand the definitions. List 1 below briefly defines nursing education. Definitions: 1. Associate Degree Nurse (ADN): 2 year community college education. 2. RN to BSN: This is a degree program designated for working nurses who have an ambition of meeting the growing educational job requirement. 3. Magnet Recognition Program® “recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice. Consumers rely on Magnet designation as the ultimate credential for high quality nursing. Developed by the American Nurses Credentialing Center (ANCC), Magnet is the leading source of successful nursing practices and strategies worldwide.” http://www.nursecredentialing.org/Magnet.aspx Core Issues and Barriers for the Associate Degree Nurse Issues To adequately serve the already practicing associate degree RN, healthcare facilities need to evaluate the nursing staff already employed and determine experience and skills that may benefit nurses in the delivery of their duties. This is mainly for the nurse that is at a point in their career opines that returning to school is challenging due to age, close to retirement age or health issues. Healthcare facilities need to have a level of understanding of the challenges that full-time RN’s have when returning to school to further education to maintain employment status. These already practicing nurses with their vast experience at the bedside may find returning to school life altering and challenging, due to old age and the need for them to readjust their social lives, most of which includes family responsibilities. Nursing Shortages Nursing shortages has been a significant issue in nursing. According to Valentine (2010) there is a rich supply of new nurses and an abundance of nurses, therefore, the healthcare markets are hiring nurses with a higher educational degree such as a BSN. On the other hand the American Association of Colleges of Nursing project that there remains a nursing shortage and will continue to rise as the baby boomer age and leave the healthcare market (AACN, 2013). Nursing is a competitive business today and the Magnet certification assumes to elevate the status of the professional nurse, reputation and standards of the nursing profession and, by association, raises educational expectations for the workforce. Practicing in an acute care setting that is in a process of becoming a credentialed Magnet Hospital through American Nurses Credentialing Center (ANCC, 2013) poses many challenges for the graduating nurse for the ADN. Expert Nurses Another issue that is evident in this situation is that nurses that have years of experience may feel threatened to return to school. This may form resentments toward the administration and staff. According to Benner’s (2004) Novice to Expert skill acquisition model, a nurse becomes an expert in the profession role with increased experience, education and practice. Full time. A nurse returning to school while working at a full time position is extremely difficult and is dependent on external and internal life issues. It is important to expand the program that currently ensures that ADN nurses receive credit for MS, Pysch, OB, Peds and other qualifications to include more working nurses based on their years of experience to transition into a BSN program and test out of areas of expertise based on Benner’s stages of expertise. Part-time employment Returning to school is a costly endeavor. There are student loans, scholarships and grants that students can apply for to assist in the cost of tuition and books. This is limited though for those nurses that exceeds the financial limits needed to apply for these programs. School takes much time and effort and working part-time may have a negative effect to the student’s financial stability. Years of Experience This subject has been discussed previously and is a significant issue for nurses returning to school. Years of experience should be taken into account for nurses already working in a facility moving to Magnet status. Nurses with extensive experience possess knowledge of knowing and learning on the job. In a recent study, the American Association of Colleges of Nursing (2012) noted that the majority of nurses hold an ADN are women and are between 40 – 50 years of age. The association continues to assert that the associate degree nurse education is 11.7 % higher than the nursing students graduating from a BSN program. Each year there is a small rise in students that graduate from an ADN program, from 2004-2008 there was a rise of 2.5 % and the BSN prepared student increased 2.7%. Both programs are consistent in yearly increases of graduating students. At the same time nursing programs struggle with increasing enrollment of candidates that will be successful in the nursing program. Clinical Certification Today nursing and other healthcare related field secure certifications beyond their degrees. As a certified nurse this is consistent with an competent status in your specialty. This alone has a significant role for the nurse at a Magnet facility (Lacey, Cox & Lorfing (2007). Supportive role for Magnet Status According to Ulrich, Buerhaus, and Donelan (2007) “Magnet status is associated with many positive outcomes for nurses, patients, and organizations” p. 213. Magnet characteristics are significant in the outcomes on both the patients and nurse. Fourteen characteristics have been identified and play a key role in a professional nursing environment. Registered nurses find that the Magnet status is essential to continued job satisfaction and positive patient outcomes. Positive Outlook for the Profession of Nursing. According to Ulrich, Buerhaus, and Donelan (2007) the essential characteristics found in Magnet status have shown “positive nurse-physician relationship, autonomy, a culture in which concern for the patient is paramount, clinically competent coworker, control over nursing practice, adequate staffing, support for education and nurse manager support” p. 213. Overcoming Limitations Staffing Shortages One area of concern is the nursing shortage and how it affects the goals of the magnet status and need to facilitate nursing at a higher educational level. According to Ulrich, Buerhaus, and Donelan (2007) staffing shortages whether at a Magnet status or non-magnet status do not differ. The highest nursing degree for those nursing working in a Magnet Status and non-magnet status healthcare facility are not significantly different. Registered nurses are educated at the level of the Associate Degree in Nursing and at the Baccalaureate Degree in nursing level. Both levels of nursing take the same licensure exam to become a Registered Nurse (RN), working at the same level of patient care within an acute care setting. The trend toward an entry level degree is however not consistent with the degree of rise in number of Magnet Hospitals throughout the United States as there are currently 391 institutions with Magnet status out of over 5000 hospitals (Drenkard, 2013). Financial Limitation from Healthcare Facility Financial and economic challenges for nursing to facilitate moving into a higher educational level without financial backing or support of the governing institution continues to face the nurse. Nurses are predominantly women and many are single caring for children alone on one income. The cost of tuition, raising a family and other external factors present another barrier to a nurse that is required to return to school to maintain job stability and attain a higher degree is and can bring about a financial burden for these persons. This limitation can be overcome with financial management, use of financial aid and supportive network at the healthcare facility working. Additional monetary stipends would be helpful to the staff member to fulfill the requirements of the healthcare facility for BSN prepared nursing staff. Administrative Support To adequately serve the already practicing RN, healthcare facilities need to evaluate the nursing staff already employed and determine experience and skills that may benefit the nurse in other areas of the facility. Healthcare facilities need to have a level of understanding of the challenges that full-time RN’s have when returning to school to further education to maintain employment status. These already practicing nurses with their vast experience at the bedside may find returning to school life altering and limiting. Resources necessary to further education should not be one sided on the part of the RN, it should be a collaborative effort on the part of the healthcare facility and the RN. The expectations of the administration for nurses to return to school and further education in which most nurses do willing, it is a benefit that administration support those in any way they can to help the nurse transition Promotions Leadership roles are evident that with higher education the nursing role can and is elevated with more increase in responsibilities and pay (Smith, 2009). Clinical ladders for educational advancement are specific for each facility (U.S. Department of Health and Human Services Health Resources and Service Administration, 2010). Clinical ladders are not as evident today, but it is not for the process but the names of the process being completed. In the area working today, the Head Nurse is now the nursing manager, the charge nurse is now the Clinical Nurse II. These are just a few examples of how the clinical ladder has evolved and progress and technology continue to change. Positive Reflection and Outcomes With the entry level of nurses elevated by facilities going to Magnet status the effect on the healthcare system is seen in a positive reflective manner. The role of a BSN in a Magnet Accredited healthcare facility opens many doors for advancement. Leadership roles expand advances in other departments open up, knowledge is power and the BSN education will open doors for alternative roles to the nurse at the bedside (Drenkard, 2013). Associate degree nurses reflect positively on the Magnet status and that with this status the nurse has the ability to reach a higher goal and outcome in the professional role. The expansion and lifelong learning is paramount to the role of a practicing nurse. Nursing is continuously striving to stay abreast of new trends in technology and advances in nursing care. This alone is a positive reflection to the practicing ADN Program Support Initially program support was seen in a negative light. The ADN nurse found it difficult to acclimate to the change in role and the possibility to loss of position if continued education was not obtained. As the months progressed it was evident to all communicated with that nurses were looking forward to continuing and returning to school to get there BSN. This opened other avenues for the nurse to practice and become educated. Many of the nursing staff found that they would like to go forward and become nurse practitioners. Lifelong learning is an added benefit to nurseing education. Nurses are consistently learning new skills or adding to old knowledge with new technology; it is only fitting that education at a higher level to meet the Model of the Magnet Status five areas of excellence is a benefit to nursing practice. Embrace the staff To adequately serve the already practicing RN, healthcare facilities need to look at these nursing professionals as individuals and in doing this really see these individuals from their perceptions of the world they practice and live. The goal is to assist the healthcare facilities to understand the challenges full-time RN’s have when returning to school to further education for employment requirements. These already practicing nurses with their vast experience at the bedside may find returning to school life altering and limiting. Resources necessary to further education should not be one sided on the part of the RN, it should be a collaborative effort on the part of the healthcare facility and the RN. All nurses at every level should be encouraged to go back to school and continue the path of lifelong learning in the profession of nursing. Lacey, Cox & Lorfing (2007) anticipated that the entry level for nursing will be the BSN which consists of entry level by the year 2020. This process continues and will continue until all can agree to the level and expectations of the professional entry level of the nurse. References American Association of Colleges of Nursing, “Clinical Nurse Leader,” Remarks Delivered by AACN President Kathleen Ann Long at the Business Meeting, October 27, 2012. American Nurses Association (2010). ANA applauds IOM’s release of ‘future of nursing’ report. News Release. American Nurses Credentialing Center (ANCC), retrieved on July 18, 2013 http://www.nursecredentialing.org/Magnet/ProgramOverview/New-Magnet-Model Bargagliotti, L. A., West-Sands, L, Burchum, J., & Selbe, J. (2002). A dual degree model for associate and baccalaureate nursing education. Nursing Education Perspectives, 23(5), 234 237. Benner, P., Sutphen, M., Leonard, V., Day, L., (2010). Educating Nurses: A Call for Radical Transformation, The Carnegie Foundation for the Advancement of Teaching. Blaney, D. R. (1986). An historical review of positions in baccalaureate education in nursing as basic preparation for professional nursing practice 1960-1984. Journal of Nursing Education, 25(5), 182-185. Donley. R.; Flaherty, M.J. (2002). Revisiting the American Nurses Association’s First Position on Education for Nurses". Online Journal of Issues in Nursing. 7(2), Retrieved from http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/RevisingPostiononEducation.aspx Drenkard, K., (2013). Change is good. Introducing the 2014 magnet application manual. The Journal of Nursing Administration, 43(10), 489-490. Khatri, N., et al, (2009). From a Blame Culture to a Just Culture in Health Care. Health Care Management Review, October/December, Vol. 34. 23-24 Lacey, S.R., Cox, K.S., & Lorfing, K.C. (2007). Nursing support, workload, and intent to stay in magnet, magnet-aspiring, and non-magnet hospitals. The Journal of Nursing Administration 37(4), 199-205. Nelson, M.A. (2002). Education for professional nursing practice: Looking backward into the future. Online Journal of Issues in Nursing, 7(3), retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume72002/No2May2002/EducationforProfessionalNursingPra ctice.ht ml Pellico, LH, et al., (2009). “Moving On, Up or Out: Changing Work Needs of New RNs at Different Stages of Their Beginning Nursing Practice,” Robert Wood Johnson Foundation. Smith, T.G. (2009). A policy perspective on the entry into practice issue. Online Journal of Issues in Nursing, 15(1). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol152010/No1Jan2010/Articles-Previous-Topic/Policy-and-Entry-into-Practice.html The Joint Commission (2010) In Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine (2010). Retrieved from http://www.jointcommission.org/assets/1/18/RWJ_Future_of_Nursing.pdf U.S. Department of Health and Human Services Health Resources and Service Administration (2010). The registered nurse population. Initial findings from the 2008 national sample survey of registered nurses. Retrieved from http://www.hhs.gov/ Ulrich, B.T., Buerhaus, P.I., Donelan, K., Norman, L., & Dittus, R., (2007). Magnet status and registered nurse views of the work environment and nursing as a career. The Journal of Nursing Administration 37(5), 212-220. Valentine, N.M. (2010). Viewpoint: What today’s bumper crop of new nurses means for nursing education, healthcare employers, and consumers. American Nurse Today, 5(10). Retrieved from http://www.americannursetoday.com/article.aspx?id=7130&fid=6852 CRITERIA POINTS 1. Authors’ guidelines: Meets the authors’ guidelines, each step (except actual submission). 2 2. Manuscript Content: Well referenced, well explained, consistent use of terms, presents new ideas or ideas in a new way, contributes to the body of knowledge. 4 3. Manuscript Organization: Content flows logically, meets an objective, interesting to read, addresses target audience, paragraph and section introduction and transition is clear. 3/4 This paper should approximate the length proposed in your original outline, double spaced, and 12 point font. This does not include title page or references. Please use headings and subheadings in your paper. Include as many references as you’ve found to support your manuscript and found useful to include. Pay attention to weighting of categories/sections with more points require more depth of content. Up to 2 points may be deducted for errors in grammar, style, format, or not blinding the manuscript. Total Points 9/10 Read More