James A. Haley Veterans Hospital achieves magnet status

Editor's Note: Elaine Patterson, AAACN member and member of the AAACN VA SIG, has written this article about the Tampa VA's recent recognition of magnet status. Elaine is the Assistant Nurse Manager. Primary Care Clinics, at the Tampa VA.

James A. Haley Veterans Hospital (Tampa VA) is the recipient of the 2001 Magnet Nursing Award. The Magnet Recognition Program for Excellence in Nursing Service was developed by the American Nurses Credentialing Center (ANCC) in 1994 to recognize facilities that provide the best in nursing care.

The program provides a vehicle to disseminate successful practices and strategies among hospital nursing systems and is based on quality indicators and standards of nursing practice as defined by the American Nurses Association Scope and Standards for Nurse Administrators (1996). Jones-- Schink (2000) notes some of the key characteristics of magnet as:

* Professional autonomy over practice

* Nursing control over its practice environment

* Effective communication among nurses, physicians, and administrators

Quality Care

Under the leadership of Sandra K. Janzen, MS, RN, CNAA, Associate Chief of Staff/Nursing, Tampa VA incorporated all these elements in its practice setting to achieve the prestigious Magnet Award. Ms. Janzen creates a work environment that is visionary for patient care and nursing practice by promoting staff motivation, achievement, growth, networking, excellence and teamwork in the daily operation of the facility.

Motivation - The challenge to retain valuable employees and encourage top performance is satisfied by providing incentive programs and compensation plans tailored to the needs of each employee.

At Tampa VA, nurses who carry out the work of the mission are rewarded by the leader who recognized that "One Size Fits All" plans do not suit today's multi-generational workforce, but that incentives play an important role in motivating, rewarding, and energizing employees.

Nursing personnel are entrusted with decision-making regarding patient care and unit operations. For example, when restructuring of the nursing service was necessary to improve operational cost and patient care outcomes, the evening and night tour supervisors' positions were eliminated and staff nurses were empowered to make autonomous decisions regarding staffing and patient care issues.

Programs such as the Gold Star that recognize excellence in customer service and the Recruitment and Retention Program, which is a peer-to-peer recognition program, were established to reward staff nurses and other nursing personnel for their contributions to patient care and the mission of the organization.

Periodic step increases or monetary awards are given based on performance appraisals. Opportunities for promotion and flexibility for lateral transfers are practiced. These management strategies support employee motivation, facilitate the needs of the staff, both individually and collectively, and contribute to employee satisfaction and willingness to perform.

Achievement - Professional development of the nurses is encouraged. Collaboration between Tampa VA and area nursing schools has resulted in many nurses receiving their advanced practice and BSN degrees. To facilitate easy access to education, an on-site BSN and MSN program was established in the facility. At least four nurses successfully completed the nurse practitioner distance-learning program, which is fully supported by the Associate Chief Nurse. In the year 2000 alone, $90,000 was spent on academic advancement and more than $50,000 on outside continuing education for assuring ongoing competency and upward career mobility opportunities for nursing staff (Hixon, 2000). Advanced Practice Nurses in the facility share their expertise by mentoring other nurses in undergraduate programs. This staff education and training is transcended into patient care delivery resulting in highly competent nursing practice and quality health care to the veterans.

Growth - The Tampa VA nursing leader embraces productivity as the key to keeping the organization viable. This concept is evident by nursing involvement in clinical program changes that affect the overall care of patients. Restructuring the nursing department to facilitate expansion is an innovation to support the mission of moving from a hospital to a health care system. Outpatient care at Tampa VA (the busiest in the nation) is improved by developing a community-based outpatient clinic and telephone liaison care to bring health care closer to the veterans. Registered nurses are the key coordinators and facilitators in the operation of these community-based clinics.

Networking - The Tampa VA nursing department uses organizational stewardship to build links between individuals and groups in the organization through networking and participation on action teams. Mentorship programs between multiple local universities and the VA use the knowledge of the experienced staff nurse to enlighten and enable the student nurses on the many facets of nursing and, at the same time, open an avenue for potential recruitment of young nurses for the VA. Opportunities are provided for staff nurses and managers to engage in VISN-Wide (Veterans Integrated Service Network) and national work groups, task forces, and councils to maximize professional contributions and career development.