BATESVILLE—White River Medical Center may soon become among the first Arkansas hospitals to achieve Magnet® status, a prestigious recognition granted by the American Nurses Credentialing Center (ANCC) to less than 10 percent of hospitals in the United States.

 

Even though other hospitals in Arkansas are on the same journey toward Magnet designation, WRMC is unique because of its locale in the North Central Arkansas city of 10,000, some 90 miles north of Little Rock. In 2009, the 34-year-old hospital received the prestigious Governor’s Award for Performance Improvement, Arkansas’ highest quality award.

 

“When we began our Magnet journey, we were encouraged to see how many of the Magnet components were already a part of our corporate culture,” said Michelle Bishop, RN, Magnet coordinator for WRMC. “Being a Magnet organization is not about the title, it’s about being an organization that values excellence and provides patient care using evidence-based best practices that improve the health of our community one patient at a time. Magnet designation represents our mission to provide high quality patient care and our vision as the organization where patients choose to receive care, employees desire to work, physicians choose to practice, and family and visitors feel welcome.”

 

Among the steps toward Magnet designation is incorporating nursing shared governance into the hospital system, which even Robert Hess, PhD, an expert in the practice, defined as akin to “pinning Jell-O to a wall.”

 

Beyond the description—an innovative organizational model that gives staff nurses control over their practice and may extend their influence into administrative areas previously controlled only by managers—it’s difficult to ascertain. Shared governance is shared decision-making based on the principles of partnership, equity, accountability, and ownership in patient care. It empowers all members of the healthcare team to have a voice in patient care. But the reason for its emergence is clear: the nursing shortage has revitalized the shared governance structure, which has been around since the early 1980s. The Magnet Recognition Program was the result of a national study of nursing shortages in the 1970s and ‘80s by the American Academy of Nursing Task Force on Nursing Practice in Hospitals. The study identified areas where hospital leaders could focus efforts to improve the quality of nursing practice, and the ANCC awarded the first Magnet organization in 1994.

 

“White River Health System is not experiencing a nursing shortage,” said Bishop. More than 425 nurses serve the 199-bed regional referral center and the flagship facility of White River Health System (WRHS). “However, we’re very aware of the trends that indicate a growing number of patients requiring care. Our organization is working with educational institutions to support nursing programs and supporting students through scholarship programs to ensure the availability of qualified registered nurses.”

 

When WRHS added Stone County Medical Center in Mountain View to its portfolio in 1999, its service location expanded to nine counties—Fulton, Independence, Izard, Jackson, Sharp, Stone, and parts of Cleburne, Lawrence and Van Buren. The commitment to pursue the Magnet designation journey began last year.

 

Healthcare organizations on the journey to Magnet recognition use a model known as the Forces of Magnetism to evaluate and improve nursing practice in seven key areas: transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation, improvement and empirical outcomes. This model provides organizations with the tools to prepare for a Magnet review by ANCC examiners, including a self-evaluation essential to achieving the highest levels of nursing professionalism and high quality patient care. Multidisciplinary committees, councils and teams made up of nurse leaders, staff nurses and ancillary staff work together to implement best practices, identify improvement and document progress in each key area, explained Bishop.

 

Professional nursing practice includes the development of a culture for nurses that demonstrates the organization’s core values, Bishop pointed out, and by identifying a nursing theory, nurse leaders are able to share theses core values with staff nurses and students to provide a clear picture of the expectations for the delivery of quality patient care and exceptional service.

 

The WRMC Shared Leadership and Practice/Research Councils led the process of selecting a nurse theorist whose values are most closely aligned with the culture of WRMC. Of five possible choices presented by the council, nurse leaders selected The Theory of Caring by Kristen Swanson, RN, PhD, whose theory defines the dimensions of caring as “knowing, being with, doing for, enabling, and maintaining belief.”She defines caring as a “nurturing way of relating to a valued other.” Swanson is part of an eclectic group that includes nurse advocates Florence Nightingale and Patricia Benner, RN, PhD, which WRMC nursing leadership had identified as authors that define the organization’s nursing philosophy.

 

“Nursing philosophy is communicated through nursing newsletters, educational training programs, and one-on-one mentoring that enable nurses to incorporate nursing theory into the way care is delivered at the bedside,” explained Bishop. “The development of nursing philosophy is the foundation of our delivery-of-care model—one component of the journey to Magnet recognition. Each element of the Magnet program reinforces WRMC’s strategic objective to achieve our mission to promote healthier communities and provide quality efficient healthcare.”