Magnet hospitals don't provide better working conditions for nurses than non-magnet hospitals: Study

Magnet hospitals, while widely recognized for better patient safety and outcomes, don't provide better working conditions for nurses than non-magnet hospitals, according to a new study by the University of Maryland School of Nursing.

The American Nurses Credentialing Center's Commission on Magnet (hospital) Recognition recognizes about 350 healthcare organizations in the United States and four internationally. Hospitals with this distinction are looked to as "exemplar institutions of care", say study leaders Alison Trinkoff, ScD, RN, FAAN, professor, and Meg Johantgen, PhD, RN, associate professor with the School, located in Baltimore.

"We've noticed that the magnet hospital emphasis has little to do with nurse working conditions—work schedules, such as hours, and job demands," said Trinkoff. "If I work in a magnet hospital, with greater autonomy and recognition for nursing, one might think there would be better working conditions as well." The new study found that it's not necessarily the case.

Trinkoff continues, "While the work and role of nursing may be improved because it is a magnet hospital, we found that consideration of nurses' work schedules is not really incorporated into the magnet hospitals. But it is something that would fit in quite nicely—to create an optimal condition for nursing." The study is published in the July/Aug. issue of the Journal of Nursing Administration.

Magnet accreditation, said Johantgen, has evolved from its original intention to retain nurses and help prevent shortages in the profession, to "an avenue to promote a hospital's appeal to both consumers and the nursing workforce." She said other studies have identified beneficial attributes
of magnet hospitals that do attract nurses, such as high autonomy, decentralized organizational structure, supportive management, and self-governance.

"Magnet status is one way to show that nurses in that hospital are doing well and providing excellent care, but it is difficult to document ," said Johantgen.

The researchers gathered data from nurses in two U.S. states. Trinkoff and Johantgen compared nurses working in magnet hospitals and those in non-magnet hospitals on many topics related to their working conditions because, they said, these studies are important to provide evidence-based information for policymakers and administrators.

Although nursing shortages have diminished in certain areas because of economic downturns, employers, nursing organizations, and labor representatives should focus attention on the important issue of working conditions and designate efforts toward developing long-term solutions that will increase the appeal of nursing positions and improve nurse well-being and performance, explained the researchers.

In the study, nurses were asked to report the hours they actually worked, as opposed to those they were scheduled to work. The researchers measured psychological demands, physical demands, nurse practice environment, and overall job satisfaction.

Nurses who worked in magnet and non-magnet hospitals did not differ in terms of demographic characteristics including age, sex, marital status, educational level, and unit type. Whereas for race/ethnicity, the proportion of nurses of color working in magnet hospitals was significantly lower, nine percent compared with 16 percent in non-magnet hospitals, overall there were very few differences in terms of their working conditions.