Magnet recognition is widely considered the crowning honor in nursing practice, but its costly and time-consuming conditions typically limit Magnet hopefuls to hospitals with ample funds.
For its excellence in nursing, Duke Raleigh Hospital earned Magnet designation from the American Nurses Credentialing Center last month, capping a rigorous three-year application and evaluation process.
All told, the expense for Magnet designation can range from $15,000 to more than $50,000, depending on the facility's size, Duke Raleigh Chief Nursing Officer Rosemary Brown said.
Approximately 5 percent of all health care organizations in the United States have achieved ANCC Magnet designation, said Doug Vinsel, Duke Raleigh Hospital chief executive officer, noting that hospitals must have "real substance and direction" to receive such recognition.
But the Magnet recognition is expensive: A hospital of Duke Raleigh's size would spend more than $15,000 for just an appraisal, according to the ANCC Magnet application Web site. The documentation review fee is $2,500 for each Magnet Appraiser leader, and the visit to the site costs $1,850 per appraiser per day.
In addition to the required fees, an enormous dedication of time and energy is required, Brown said. But even in today's economic condition, the payoff greatly outweighs any costs, she added.
"Everyone, from the CEO to the staff, believes that there is a return on investment," Brown said. She noted that a large investment in the recognition is worthwhile, because a Magnet hospital's appeal to top nurses would attract more patients and encourage further growth and development for the hospital.
Evidence of the recognition's value is perhaps that Moses Cone Health System in Greensboro, N.C., has chosen to undergo its third redesignation after seeing increases in recruitment and retention of its nurses since it was first deemed a Magnet hospital, she said.
Research has shown that Magnet-designated health care organizations outperform their competitors in nurse recruitment and retention. Since 2004, U.S. News & World Report has incorporated hospitals' Nurse Magnet designation into the total score for inpatient care quality for its annual "America's Best Hospitals" rankings.
In the 2008 Honor Roll rankings published last July, seven of the top 10 institutions, including Duke, were Magnet hospitals.
Duke Raleigh Hospital, however, has not had problems recruiting or retaining nurses in the past, Brown said. This is likely because of the rapidly growing population of Wake County, where the facility is located, allowing the hospital to expand about 4 percent annually, she added.
But the hospital could still benefit from more recruitment, Brown said.
Impressive expansions and new developments are in the works, Vinsel said, noting that these projects will require a significantly larger cadre of nurses.
The nursing department currently staffs about 550 nurses, 450 of whom are full-time equivalents. A total of 1,200 employees work at the hospital.
Although some nursing unions nationwide have criticized the recognition process for primarily serving as a means of hospital promotion, Vinsel pointed to the program's rigorous application and evaluation process as evidence that the honor is not easily attained.
This summer, a new operating room will be constructed at the hospital, he said. The emergency department will expand, the cancer center will be renovated and a step-down unit will be created. The hospital also plans to upgrade its cardiovascular services, he added.
Although these large-scale developments were on the drawing board before the hospital achieved its Magnet status, Vinsel said the recognition will help recruit the task force of staff members that will be needed to serve the hospital.
"Few jobs have more demand than supply right now, as nursing does, so nurses can be pretty selective about where they go to work," he said.
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