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Navigating the clinical practicum; making a case for Magnet®

Murray, Kathleen MSN, RN, CNA

doi: 10.1097/01.NUMA.0000403282.50120.10
Department: Leadership Q&A

Vice President of Patient Care Services, Baptist Medical Center Downtown, Jacksonville, Fla.

Q I'm currently attending graduate school for a degree in nursing administration. I want to do my clinical practicum with my facility's CNO, but my professor won't let me. Is this fair?

Don't perceive this opportunity as a negative. Clinical rotations should include experiences in a variety of settings that will help you develop skills as you prepare for your future as a nurse leader. Realize that your professor is looking to provide you with a clinical practicum that will expand your perspective by enriching your clinical experience to develop new knowledge and skills. Your professor wants you to gain a greater understanding about how healthcare services are provided outside of your organization.

Most clinical practicums are planned in a variety of acute care and nonhospital settings to help the student gain preparation in the management of resources, staff, and the future of healthcare delivery. It's important that preparation in these areas addresses the diversity of traditional and emerging roles in an evolving healthcare delivery system. Your practicum should be focused on elements of a nursing care system; the responsibilities of the nurse administrator in research, education, and clinical practice; and human resource management.



With healthcare reform on the horizon, it would be beneficial to observe how another CNO is planning for the future of the intense fiscal and outcomes accountability of the nurse administrator. Embrace this practicum as an opportunity to apply administration principles under the guidance of a qualified preceptor outside of your organization.

Q I'm a nurse manager of a large ICU. I've had two staff nurses ask me why our organization hasn't applied for Magnet® recognition. I approached our CNO, but she doesn't see the value in it. How should I proceed?

You're clearly a manager who's passionate about the Magnet journey. When you approached your CNO about why your organization hasn't pursued Magnet recognition, was it in the appropriate setting and how prepared were you? I would recommend that you do an extensive search for the benefits and barriers for hospitals pursuing Magnet recognition.

After you've done your homework, request a meeting with the CNO to understand the reasoning behind why the organization hasn't pursued Magnet recognition. I would recommend that you ask the following questions during your meeting with the CNO:

  • What are the key influencing factors regarding the decision to not pursue Magnet recognition for our facility at this time?
  • Have we completed a Magnet gap analysis and, if so, what were the outcomes?
  • I know the research infrastructure has been identified as one of the biggest challenges for any organization. Have you considered this weakness and what role can I play in leading our organization in implementing the infrastructure to fulfill the new knowledge model components?
  • What do you need from your leadership team to support you in possibly pursuing Magnet recognition?
  • If we aren't ready for the Magnet journey, would pursuing "Pathways to Excellence" be an option? (Be ready to discuss the benefits of how implementing the Pathway to Excellence standards can improve nursing care, satisfaction, and retention.1)

After your meeting with the CNO, you may find that it isn't necessarily the reluctance of the CNO, but that a gap analysis has been completed and the outcomes of the analysis identified a lack of resources to pursue Magnet recognition at this time. Your role as a leader will be to support the CNO and forge ahead as a champion of implementing the Magnet infrastructure that could potentially lead to a successful achievement of Pathways to Excellence or Magnet recognition.

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1. American Nurses Credentialing Center. Pathways to Excellence Program Manual. Silver Springs, MD: American Nurses Credentialing Center; 2009.
© 2011 by Lippincott Williams & Wilkins, Inc.