Tipton Health, the nation’s leading nursing consultancy, is highlighting the contributions that nurses make each day to advancing the profession of nursing and improving care. We are proud to focus this issue on the lifetime of support for nursing excellence from Eisenhower Health’s Dixon Bennett.
Dixon Bennett has been the Magnet Program Director at Eisenhower Medical Center in California for over a decade. He comes from a family of healthcare professionals and has a varied background, including three master’s degrees— in psychiatric nursing, nursing administration, and nursing education.
Tipton Health had the honor and privilege of interviewing Bennett, during which he shared his unique perspective on the evolution of nursing practice over the past several decades and how that evolution has been impacted by changing healthcare systems, academic preparation, and two global pandemics. He said his role as Magnet Program Director (MPD) has been the “most rewarding position because I’ve been able to use all the skills I’ve been taught and learned over the years.”
Building Bridges: Integrating New Nurses into a Culture of Excellence
ANCC Magnet® designation promotes and supports a culture of nursing excellence, recognizing organizations that prioritize evidence-based practice and patient-centered care. It supports professional development where nurses are empowered, and leadership is strong.
Bennett’s commitment to developing a Magnet culture begins with helping nurses discover that they significantly impact patient outcomes and organizational values. In other words, there is more to nursing than coming to work for 8 to 10 hours. One of the benefits he’s experienced as an MPD is watching nurses recognize the collective impact their practice has on patients and throughout the organization.
As nursing staff recognize their impact, it helps develop camaraderie and promotes nursing development that drives excellence in care and culture. Bennett believes this engages bedside nurses in what he calls the 3 A’s: authority, autonomy, and accountability. These factors significantly influence the individual and collective care of the nursing unit staff.
Integrating new and experienced nurses into a Magnet-recognized healthcare organization requires strategic planning and implementation. Bennett discussed the preceptorship and mentorship programs at Eisenhower that help nurses to integrate into a nurse-led environment.
These are some of the steps that help build interprofessional bridges within a Magnet culture. This process is driven by nurses’ voices and included in shared governance and decision-making, leading to more autonomous practice and shared leadership.
The Role of Evidence-Based Practice in Nursing
Bennett related the shift in evidence-based practice and the concept of excellence in nursing through the eyes of someone who has lived through two global pandemics. Advancing technology during the AIDS crisis changed the practice of nursing, developing practice models that allowed nurses to engage without being harmed or infected.
“Wearing masks, wearing gloves, and isolating came to the forefront during AIDS. We always put patients with tuberculosis in negative air pressure rooms and gowned, masked, and gloved. But other than those individuals, I don’t remember too much isolation,” he explained about care in the early 1980s.
“The AIDS epidemic spurred change in research and nursing practice. In the late 1980’s, the Centers for Disease Control (CDC) recommended “universal precautions”, which included using protective clothing and gloves when there was a risk of exposure to blood and body fluids”. Bennett says, “This was a significant shift in hospital practices as it became clear that infection control was crucial to prevent the spread of diseases like HIV”.
One of the positive nursing care changes that developed during COVID was continuous glucose monitoring (CGM) devices to help manage blood sugar for COVID patients experiencing hyperglycemia secondary to steroid therapy. Post-COVID, CGM devices and insulin pumps significantly enhance the care of diabetic patients by providing more precise control of blood sugar levels and reducing the risk of complications. This has extended to patients wearing their insulin pumps during surgery to manage blood sugar levels better.
Another change that occurred over the years was in the measurement and metrics of nursing excellence. In the past, nurses used chart audits to ensure that signatures were present and that orders were written correctly. Today, nursing excellence benchmarks measure patient outcomes.
“Especially in a Magnet hospital, that’s our focus. We look at patient engagement surveys at the unit level, to monitor nursing performance and ensure we are meeting standards and performing above the national benchmarks,” Bennett explained.
Nursing care within a Magnet organization is compared to information gathered in a national database. The data gathering begins with care on the unit level, which contributes to the overall outcomes of the nursing unit.
This means that nurses are collectively responsible for the unit metrics, whether they contribute to individual care or not. Bennett shared that in the past, nursing leaders received benchmark reports and then distilled the information to the bedside nurses, identifying the required changes to improve care.
However, in a Magnet-designated organization, the reports are posted, and the concerns are addressed by the unit-based nursing council. This is a significant change in the nursing leadership model. It shifts control from nursing managers to bedside nurses, giving the unit nurse the ability to improve collective responsibilities.
“If you’re using evidence as your basis of practice, then you achieve nursing excellence because you are extending care in the way that it should be. Therefore, you have fewer comorbidities, fewer fallouts, and you achieve baseline or above baseline for your indicators,” Bennett elaborated.
Institutional Memory: The Invisible Backbone of Magnet Organizations
It may take longer to implement change as organizations transition to practice leadership, involving bedside nurses in decision-making. It can also be challenging for managers to change their leadership style.
Bennett sees this as one of the first hurdles an organization must overcome before beginning a Magnet designation journey. He advises that interested nurses and healthcare organizations engage with hospitals that have Magnet recognition. Representatives from Magnet healthcare systems can speak with leaders about how the designation is important to patient outcomes and improving nurse retention.
These cross-hospital meetings are a functional way of communicating institutional memory from one healthcare organization to another, while sharing many benefits and hurdles that must be addressed for successful appraisal.
Bennett concluded by talking about Magnet enculturation, or the process of integrating the principles and practices associated with Magnet into your organization’s culture and daily operation. He describes the process as planting a seed, watering it, and allowing it to grow over time, fostering a sustainable and high-performing environment where nursing excellence is valued.
“Magnet appraisers always tell us they can feel it (enculturation) when they walk in the door. It’s hard to describe, but it’s about creating a sustainable, thriving environment where nursing excellence is a core value. This extends to the supporting relationships we have with patients/families and ourselves,” Bennett concluded.