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ADVANCE Perspective: Nurses

Magnet Hospitals Must Do More on Scheduling Issues

Published August 17, 2010 7:25 AM by Valerie Newitt

A hole in the forces of Magnetism? (Gulp.) Is it possible?

Yes and yes, answers a study by the University of Maryland School of Nursing, Baltimore. Led by Alison Trinkoff, ScD, RN, FAAN, and Meg Johantgen PhD, RN, research revealed that Magnet hospitals do not necessarily provide better working conditions for nurses than non-Magnet hospitals.

While the American Nurses Credentialing Center's (ANCC) Commission on Magnet Recognition does indeed touch upon "personnel policies and programs" in its original Force No. 4 (now incorporated into the newer model component of "structural empowerment"), there appears to have been a failure to translate that objective into meaningful scheduling improvements.

Magnet vs. Non-Magnet

The researchers analyzed secondary data from 837 nurses working in 171 hospitals (14 Magnet, 157 non-Magnet) in the states of Illinois and North Carolina.

 "When survey respondents were asked how many hours they worked, whether they had to come back to work with less than 10 hours off, how often they have to work 13 hours or more, whether they work on a scheduled day off, there were no differences between nurses in Magnet and non-Magnet facilities," explained Trinkoff. "The work hours and schedules of the Magnet and non-Magnet nurses really didn't differ."

It's an area of great anecdotal concern among nurses, Trinkoff told ADVANCE.

"Many hospitals have gone to 12-hours shifts and for many RNs that's just too draining. I'm concerned that some of the older best and brightest nurses, those with the most experience, have left because of the scheduling demands when they still have so much to contribute. Many nurses do not get time to eat a meal, sit down and relax, take a break."

Not Enough Sleep

Trinkoff also pointed to research by a university colleague, Jean Geiger-Brown, PhD, RN, who looked at sleep patterns of nurses working successive 12-hour shifts. It revealed they sleep, on average, just 5.5 hours a night between shifts.

"When a nurse can't sleep adequately, doesn't get good rest, doesn't feel well, she is not at her best. Those are all tied to hours and scheduling" reminded Trinkoff. "And a rested workforce is better prepared and better performing."

Magnet hospitals may have overlooked their responsibility in improving scheduling, but now that the research is out, there's more of an imperative to get the job done.

Time to Get Going

Trinkoff admitted she had expected to see better schedules within Magnet facilities. But she didn't.

"But what I do see is an opportunity. Now we have a pathway for real improvement within the nursing profession. If some of the Magnet hospitals take leadership and give this issue more of a ‘showcase,' others will follow suit."

Other researchers on the study, which was published in the July/August issue of The Journal of Nursing Administration, were: Carla Storr, ScD, Kihye Han, MS, RN, Yulan Liang, PhD, and Susan Hopkinson, MS, RN, all of the University of Maryland, and Ayse P. Gurses, PhD, of Johns Hopkins University.

Oh, and another annoying "hole" that just happened to showed up in the data: The proportion of nurses of color in this sample working in Magnet hospitals was significantly lower (8.6 percent) than among nurses working in non-Magnet hospitals. But that's a research topic for another day.

Valerie Neff Newitt is senior associated editor at ADVANCE.

3 comments

Greg from Florida, the only thing in this article stated was the fact that the nurses of color is low. Sounds like your the one with a chip on your shoulder. You accomplishing BSN is wonderful but everyone goes through their struggles to get there. So next time you open your mouth try showing some empathy or did your school not teach you that.

Tasheaka, Nurse - Student February 2, 2011 9:10 AM
Paola KS

As a 'victim' of affirmative action I am offended by your comments in this article that eluded to nurses of color

were not being hired by magnet hospitals. Yes, I am a caucasian male in 'our' profession. Because of Affirmative Action I was

denied funds and entrance to medical school because the color of my skin and gender. So I decided if I couldn't beat them I would join them. 3 part time jobs and 7yrs, I obtained my BSN. That was 25yrs ago. Now you are 'race-baiting' and attempting to illicit emotions from a by-gone era of failed social policies.

Just as busing showed that you can not sit a child of color next to a child of non-color and expect by osmosis that the child of color will absorb all the knowledge of the non-colored child you can not expect a hospital to hire an individual of color with a magic wand and make them a nurse without that person of color

coming to the front door with a piece of paper in their hand saying they have met the requierments of being a Nurse! I

would be very scared if as a patient/consumer  I knew that the nurse was hired on the basis of her skin color and not the knowledge and experience needed for that role.

You and the other so-called nursing leaders need to get back to the bedside of your local community hospitals and experience

what the real problems that face the direct care giver and leave the social engineering to those  'with a chip on their shoulder'.

PS: I thought 'white' was a color.

Greg, ICU - RN August 27, 2010 9:47 AM
Orlando FL

Self scheduling is good for nurses if they work only 2 successive flexible days or every other day. But there are some nurses who want to work 3 or 4 days in a row so that they can go and work in other hospitals after hence defeating its advantage of promoting rest. There are a lot of staff also who does not want to work Mondays and Fridays due to reasons of  plenty of admissions and discharges or traffic and you will end up with no one to work if it gets followed.Some nurses also make their schedule that when they call in sick in between, they can have a mini vacation. And even when you have followed the schedule that they have made, they still request for a change of schedule.

Florencia, Med- Surg - RN August 26, 2010 3:12 PM
Bronx NY

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