Shared decision making, influential nurses, lifelong professional development, and strong community partnerships are characteristics that exemplify structural empowerment—1 of the 5 components of ANCC’s Magnet® model.
In Magnet hospitals, structural empowerment brings to life an innovative environment where professional practice flourishes and the organization’s mission, vision, and values come to life. Staff members are developed, directed, and empowered to find the best way to accomplish goals and achieve desired outcomes. Flexibility is encouraged; one size does not fit all.
Structural empowerment is the component of the Magnet model that addresses how the workplace environment supports exemplary professional practice, new knowledge, and improved outcomes. The relationship between a positive workplace environment and improved organizational performance has been identified in literature, research, and examples of exemplary practices in Magnet-designated settings. This is the evidence behind structural empowerment’s ``Sources of Evidence’’ as delineated in the Magnet model.1 These characteristics were identified in the original study of Magnet hospitals reported by McClure et al2 in 1983.
Creating a workplace environment where nurses are involved and empowered requires transformational leaders who understand their management responsibilities. Magnet hospitals have demonstrated the ability to have nurses from all settings and roles involved in organizational decision. Shared decision making prevails in decentralized organizational structures that are flat. Self-governance thrives when direct care nurses are involved in establishing standards of practice and addressing issues of concern. The CNO serves on the highest level councils and committees, whereas nurses at all levels serve on committees and task forces that address excellence in patient care and a safe, efficient, and effective work environment. Direct care nurses are involved in the creation and development of personnel policies and programs that support professional nursing practice, work/life balance, and the delivery of quality care.
There are challenges to achieving and sustaining a culture of engagement and empowerment. Nurses need dedicated time, away from patient care responsibilities, to participate in decisions about practice changes. Efforts to control costs sometimes limit the amount of time nurses are paid to participate in meetings. The expansion and growth of healthcare systems increase the number of nurses required to be involved in standardizing policies and procedures. Transformational leaders in Magnet organization proactively address the issue of balancing costs and the importance of maintaining a culture of engagement. Leaders frequently review strategic plans, assessing to make certain valuable resources are being best used in the areas prioritized by nursing and the organization at large. Frequent and effective methods of communication are essential to communicate the current and future priorities of the organization.
Magnet organizations value and support the personal and professional growth and development of staff. They use multiple strategies to establish programs that promote formal education, professional certification, and career advancement. Magnet organizations demonstrate the ability to increase the number of bedside nurses and nurse managers holding baccalaureate degrees in nursing. Creative strategies have resulted in increases in the number of nurses with graduate degrees and certifications. Although findings are not conclusive, there is preliminary evidence of a positive correlation between nurses who are certified and the level of their practice.1
Solid partnerships with community organizations further strengthen nursing practice and improve patient outcomes. Magnet hospitals work to develop these relationships through their strategic plan, structure, systems, policies, and programs. Internally, their services are seen as essential by other members of the healthcare team, and they effectively impact system-wide processes. Externally, they extend their influence to associations and community groups to advance the nursing profession. Contributions and accomplishments are recognized in substantive ways, enhancing the image of nursing in the community.
The recognition of the contribution of nurses is built into the structure and process of organizational operations. Magnet hospitals exhibit creative methods of recognizing employees ranging from individual praise to facility-wide celebrations. Leaders in Magnet organizations value the importance of positive feedback. Research has shown that improved organizational performance is associated with a 5:1 ratio in giving positive feedback.1 There is value in recognition and celebration no matter how big or small.
The Forces of Magnetism represented within this Magnet model component are as follows:
* Organizational Structure (Force 2)
* Personnel Policies and Programs (Force 4)
* Community and the Healthcare Organization (Force 10)
* Image of Nursing (Force 12)
* Professional Development (Force 14)3
Magnet organizations value the input and expertise of nurses and all staff. Not only do they welcome feedback but they also create structures to implement ideas and put them into action to create an innovative environment where nurses can flourish. These structures will continue to evolve and be influenced by advances in technology and changes in financial methodologies, supporting the needs of nurses in positive work environments.
Next time: An in-depth look at the Magnet model component exemplary professional practice.
1. Drenkard K, Wolf G, Morgan S. Magnet the Next Generation—Nurses Making a Difference. Silver Spring, MD: American Nurses Credentialing Center; 2011.
2. McClure ML, Poulin M, Sovie M, Wandelt M. Magnet Hospitals: Attraction and Retention of Professional Nurses, Kansas City, MO: American Nurses Association; 1983.
3. American Nurses Credentialing Center. Magnet Recognition Program Application Manual. Silver Springs, MD: American Nurses Credentialing Center; 2008: 4.