In 1983, the American Academy of Nursing conducted a survey of 163 hospitals to learn why some hospitals attracted and retained well-qualified nurses who were devoted to quality patient care.The 14 Forces are listed and described by the ANCC. The forces themselves include:
- Force 1 Quality of Nursing Leadership
- Force 2 Organizational Structure
- Force 3 Management Style
- Force 4 Personnel Policies and Programs
- Force 5 Professional Models of Care
- Force 6 Quality of Care
- Force 7 Quality Improvement
- Force 8 Consultation and Resources
- Force 9 Autonomy
- Force 10 Community and the Hospital
- Force 11 Nurses as Teachers
- Force 12 Image of Nursing
- Force 13 Interdisciplinary Relationships
- Force 14 Professional Development
Try it as an exercise. ...
Recruitment is ALL about magnetism.
If you are unsure, ask a magnet about the meaning of retention.
Demographics are already applying pressure upon these forces of magnetism. Not just when referred to explicitly in the USA within organizational media; but globally. Demographics is another magnet - it approaches with increasing force.
From here in the UK (and readers elsewhere) we have to exercise care when models are mentioned. While the theorists and philosopher's of nursing nail their definitions to the mast (h2cm?) there remains a models muddle, not just in the variety of models of care, but in the levels at which they operate. This is not a criticism, it's an observation - consider Force 5:
Force 5: Professional Models of CareIn the US in particular 'models of care' (moc) often refer to finance and accountability of costs (the market process), in the UK moc might refer to commissioning. In Force 5 the addition of 'Professional' (as the original author's no doubt recognized) is crucial. If you repeat the above exercise, plotting Force 5 on the Health Care Domains Model then you see how Force 5 works for nursing and remains to this day a great achievement as a yardstick for quality, assurance and retentive power.
There are models of care that give nurses the responsibility and authority for the provision of direct patient care. Nurses are accountable for their own practice as well as the coordination of care. The models of care (i.e., primary nursing, case management, family-centered, district, and holistic) provide for the continuity of care across the continuum. The models take into consideration patients’ unique needs and provide skilled nurses and adequate resources to accomplish desired outcomes.
In the almost 30 years since the research on the 14 Forces, I do wonder though if there is a need to imbue the following with magnetic properties:
- person-centred care;
- self-care;
- carers and public engagement;
- prevention;
- public (mental) health
- and informatics?
In the political and economical heat of an economic recession, however; magnets may reach their particular* Curie point. Then they cease to work.
The constant bangs and knocks of change, the incessant hammering of party politics and the 'market' on the door of "high quality nursing care" can also take its toll on magnetism.
Nursing needs to take care.
Related post on Healthcare IT News:
Top 10 trends for 2011 include IT, new care models
*OK it should be constant, but like our patients these magnets are not all the same - they have varying levels of vulnerability.
To follow some definitions from an olde book ...
