Dr. Anita All, RN, PHD and MSN Program Director at AUM is also a Magnet appraiser who travels around the country evaluating hospitals aspiring for the magnet status. She has graciously agreed to join our blog and answer questions and take your comments regarding the magnet status process. Below is her impressive bio so you will become more familiar with her and her credentials in this subject.Hi everyone just a note to tell you a little about myself. I have been a nurse for a long time and have had over 20 years of clinical experience mostly acute care. I finished an ADN [Indiana University at Indianapolis] degree about the time that ANA started discussing the BSN as entry into practice.
Many years later I completed a ladder program and got my BSN [University of Wyoming]; I was working as a head nurse in a family practice residency program and did some part-time teaching with BSN nursing students from University of Wyoming. I discovered I loved teaching but knew I would need increased education so went in to a MS program that focused on nursing education. I within a semester went into a PhD program. My PhD is outside of nursing and is in Human Services Rehabilitation. It has allowed me to maintain a focus on chronic illness. My dissertation work actually began in my MS program with my research proposal that looked at Anxiety and Fears in Health Care workers in connection with people with HIV/AIDS. There was little in the literature at that time.
My advisor encouraged me to submit the literature review part for publication and glory be it was accepted! My publishing career was started. I took my first teaching position after my PhD at the Medical College of Georgia, left there to take a graduate only teaching position at the University of Oklahoma Health Sciences Center. I was there for 10 years progressing from a tenure track Associate Professor to a Tenured Professor during that time frame. I have been blessed with many wonderful students and many of them have become friends and valued colleagues since their graduation. Karen Martin is one of those past students.
Almost a year ago I was approached about my current position and really did not think I was interested in a move. I also saw it as an opportunity and came to interview and decided this position would give me a chance to make a difference in graduate nursing education by being on the ground floor of a new program. So here I moved last September.
Because of my “other life” moving for me is not simple. In my “other life” I am married to a wonderful man who retired just about the time I finished my PhD and he takes care of the home piece. I love, own and competitively show American Quarter Horses. We moved 8 horses [2 of which were pregnant] into boarding here last September and rented a furnished apartment in Montgomery until November when we found a home in Tallassee on acreage that fit our needs. Twenty-three acres with a great home, pond, and salt water pool but no barn or fencing. Needless to say that is what my husband has been doing the past year! We had two beautiful colts [boys] born in the spring out of championship bloodlines. I also have a 9 year old palomino that I have raised and won the Palomino World Amateur Western Pleasure and several National Snaffle Bit Association World Championships. I have two full brothers to this horse and of course a couple of others.
I was given the opportunity in the Fall of 2005 to apply for the first group of nurses from academia to apply to be a MAGNET appraiser. I was selected and attended training in February of 2006. In the past all appraisers had been clinically focused individuals. The addition of nurses from academia was a positive addition to balance the appraisal teams. After the initial face to face training, I was assigned an application. I was called a MAGNET fellow. To progress to being a genuine MAGNET appraiser I needed to score a written document and then follow that same document/application to a site visit. Luckily my first assignment went to a site visit and after the visit I was “promoted”. I have done a total of 9 appraisals with 2 not making it to site visit. I just finished a visit and have my final documentation to write up this weekend. I am looking forward to participating from my perspective of the MAGNET Journey.
9 comments:
Dr. All,
Thank you for agreeing to comment and answering questions regarding the magnet journey. As you will note in some of the posting the application fee and other added fees are extremely expensive and not understood by many. What is the incentive for the hospitals to take on the task and expense of becoming magnet recognized when the economy is so unstable and health care is having to tighten its belt when it comes to expenses? It appears the money could be used in a more beneficial way for the facility, staff, patients, and care provided.
Welcome to the site, Dr. All! I look forward to hearing your perspective on the Magnet process. Has it changed now that you see it from the appraiser side? What piece of the magnet journey do you feel is most important for the hospital to achieve?
Hi everyone! Being a Magnet appraiser is an awesome job!
The Magnet journey is expensive even before you make application. The incentive has to do with an environment that values nursing and therefore they have input into almost all projects [e.g. remodeling the ER and putting plugs at waist level. The ratio of nurse to patient is often lower in a Magnet hopsital and patient care is impacted.
The most important part of the journey is the engagement of nurses in being a part of the leadership even for the bedside nurse.
I guess the one thing I can say about what I have learned is that even with the amount paid the credential cannot be brought. The use of evidence-based practice is of upmost importance in a Magnet hospital
Dr All,
Welcome to this site! We all appreciate your time and expertise.
With regard to evidence-based practice, what is the most valued method that hospitals attaining or aspiring to Magnet status utilize? How are evidence based practices best disseminated? What argument do you feel best sells the need for internet access at least on the unit for quick research of applicable bedside nursing evidence based practice?
Dr. Faulk had this comment and question posted in another area.
Would you please address it for us?
In looking at the first two forces of magnetism Debbie, I am struck by the first one related to leadership. There is evidence that shows that it may take a novice nurse 5 years to reach a level where he or she feels comfortable taking on a leadership role. How wonder how that impacts that "force?" Ideas anyone?
Dr. All,
Do hospitals that are Magnet status get a greater reimburse percentage than hospitals that are not?
What interesting comments and questions.
I feel that the most important part of the journey for hospitals to achieve is the shared leadership and recognition of nurses as not just the people who work but don't think. The next piece is the use of evidence in providing quality patient care and not we have done it this way and it has worked most the time.
Perhaps the most valued method is a model/theoretical framework that is used to educate and disseminate. ACE STAR is one. Also the one Magnet hospitals begin with can be outgrown and they need to move to a more comprehensive EBP model.
Can anyone really move into a leadership role without experience and professional development really move into that role in any time frame?
There is not a difference in reimbursement as such, but think of the savings when you look at fiscal outcome such as length of stay. Just taking 1/2 day of an ICU stay can save the organization lots of money.
Dr. All,
I have been reading some hospital and nursing sites where their facility was not granted the magnet status. In your experience what are the top three reasons that a facility would be denied magnet status? Does the facility have a time frame that they can reapply if they meet up to standards for status and is there an additional cost to the organization?
Debbie:)
Hi everyone, I have been gone quite a bit in the last two weeks. The first week of March I was at the National Association of Clinical Nurse Specialist National Conference and then this past week at a workshop for CCNE accreditation of the MSN program. I leave on Thursday March 19 for a 2 day training Magnet workshop on the new Magnet Manual.
One thing that I think is important to think about is the impact that the Magnet Journey has outside of nursing in facilities applying for Magnet. The most probable cause of this is transformational leadership. There is definitely a change in values, beliefs, and behaviors when there is a well-defined vision. All professionals have the obligation to contribute to patient care, the facility, and the profession in terms of new knowledge, innovation, and improvements. This leads to interprofessional practice that benefits the patient and the professionals.
Remember outcomes follow structure and process. The creation of a professional practice environment is contagious and other departments will follow with such things as sabbatical programs, tuition reimbursement, and values.
Debbie, asked why organizations might not obtain Magnet. The first and probably only reason is the lack of enculturation of the ideals. If a system applies too early it might only be leadership who understands and embraces or even just the CNE/CEO. The culture of excellence in all forces must involve direct-care nurses and they must embrace shared governance. This is sometimes very hard since they can easily get caught up in just surviving the shift day ect. There is a good article in the March 2009 issue of American Nurse today on the impact of Magnet on other departments
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