Some believe the Magnet journey is an intimidating endeavor filled with nearly impossible expectations and overwhelming demands. It is. Some have said it pushes resources to near exhaustion and personal relationships to their breaking point. It does. Some insist it generates an evolution from which they emerge profoundly changed. It has.



That's just for one hospital. Now imagine going through that process simultaneously for five separate facilities and you'll just begin to understand the magnitude of the accomplishment achieved by Palomar Pomerado Health (PPH) in North San Diego County when it received the first ever systemwide Magnet designation in California by the American Nurses Credentialing Center. This includes Palomar Medical Center in Escondido, Pomerado Hospital in Poway, skilled nursing facilities Villa Pomerado in Poway and Palomar Continuing Care Center in Escondido as well as Palomar Pomerado Home Health.

CRUNCHING THE NUMBERS: Meeting the statistical benchmarks of Magnet designation for five separate facilities required nurses, including Bonnie McKinney, RN (front) and Karen Manchester, RN, to pay strict attention to tailoring their submission for acute care, skilled nursing and home health. photo by Gina Addison Photography

If you understand the Law of Attraction, then you know people, events and objects attract similar counterparts. Beginning with the right leaders, right vision, right staff and right resources, the PPH Magnet movement became a center of gravity that grew exponentially, attracting the right experts, right planning and right opportunities. If there is no such thing as coincidence, then you might call this amazing achievement the synchronicity of success.

When Lorie Shoemaker, MSN, RN, NEA-BC, became chief nurse executive of PPH in 2004, she interviewed more than 350 nurses over 6 months to gauge their thoughts on the future direction of nursing practice, education and research. Their desires were perfectly in line with Magnet standards. But could it be achieved across the entire system ... at once?

"People we spoke to along this journey cautioned us against going for a systemwide approval because there are 14 Forces of Magnetism with 190 sources of evidence," Shoemaker explained. "That's for just one hospital. We were looking at a five-fold increase in that amount of work."

The nurses were insistent on taking that risk, leaving no facility behind. It's a kind of all-for-one cohesion that's almost a trademark for PPH.

"It was a group of our home health nurses who really insisted that every facility be included," recalled Brenda Fischer, PhD, MBA, RN, CPHQ, director of the Center for Nursing Excellence at PPH. "They wanted to aim really high and they wanted to do it together."

Making the Magnet commitment was one thing. Taking action was another. Through the creation of Championship Teams for each Force of Magnetism that included a nurse leader, advanced practice nurse and staff nurse, PPH tailored the Magnet process to its strengths and provided nurses with a sense of ownership that added momentum. The plan's success hinged on inspiring leadership.

"We have terrific leaders at each of our facilities who share the same vision," Shoemaker said. "We also invited staff nurses to participate at the earliest levels. This kind of collective participation allowed our leaders to continually refocus the staff and collaborate with them to redefine our goals and how our paths to get there would change."

Shoemaker insisted the success of the PPH Magnet journey was a direct result of the health system's nurse administrators, including Sharon Andrews, MS, RN, NEA-BC, Kim Colonnelli, MA, BSN, RN, NE-BC, Anne Wagner, MHA, BSN, RN, PHN, CDONA, NE-BC, Marilyn Bailey, MA, BS, RN, and Elissa Hamilton, MBA, BSN, RN, PHN, NE-BC.

Despite such great leadership, Shoemaker added, fear of such a huge goal resulted in a minor amount of dissention. Yet the process proved itself true.

"Eventually, every nurse comes to realize the Magnet journey is really a personal journey. It's all about them," Shoemaker stressed. "It's all about expanding the quality of care that nurses provide to their patients, not just on the institutional level, but on the most intimate level. When they come to that realization, that's when they come on board."

Even with the best laid plans and everyone on board, any Magnet candidate will say the toughest part of the journey is the documentation phase. Shoemaker, Fischer and three assistants worked 7 days a week, often 16 hours a day, for months to compile 17 volumes containing 3,751 pages.

"We knew the hard work all our nurses had put in to get that far, and if we didn't pull this off, they'd never be recognized for their efforts. That's what kept us going," Fisher recalled.

"It's at that point you really need to lead by example," Shoemaker shared. "Commitment is contagious, and I really felt if they thought I could do it, then they could do it, and together, we could make this happen."