- Contact the Committee

Mr. Chairman and Members of the Subcommittee:

I am Regina Foley, a Registered Nurse and Vice President for Patient Care Services and Chief Nurse Executive of Ocean Medical Center, a 237 bed hospital in Brick, Ocean County, New Jersey. Ocean Medical Center is a member hospital of Meridian Health, a health system consisting of three hospitals and a number of partner companies including long-term care and home care. As a Nurse executive, I have been directly involved with nursing workforce issues and the development of a wide range of short and long term nursing recruitment and retention strategies and programs.

My responsibilities at Ocean Medical Center include recruiting, maintaining, and developing a nursing work force that is appropriately prepared to deliver quality nursing care to our medically diverse patient population. In this testimony, I will discuss Meridian Health’s and specifically Ocean Medical Center’s commitment to nursing excellence through participation in the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program as well as other strategic initiatives that have enhanced the work environment for our nursing staff. I firmly believe that these initiatives have resulted in our lower than state average vacancy and turnover rates and have led to improved staff and patient outcomes. Currently, Ocean Medical Center’s nursing vacancy rate stands at one and one half per cent, far below New Jersey’s statewide average vacancy rate of 15 per cent.

The Magnet Recognition Program for Excellence in Nursing Services was developed by the ANCC in 1994 to recognize facilities that provide the very best in nursing care and uphold the tradition within nursing that supports professional nursing practice. The program is based on quality indicators and standards of nursing practice as defined in the American Nurses Association’s Scope and Standards for Nurse Administrators. Magnet status is important because it acknowledges hospitals that act as "magnets" for excellence by creating a work environment that recognizes, rewards, and promotes professional nursing.

Ocean Medical Center first applied and received Magnet recognition in 1998 and was the Magnet program’s 12th hospital to achieve this award. Just this past year, I am pleased to report we were re-designated as a Magnet hospital. All three hospitals in the Meridian Health family have achieved this recognition and we take particular pride in being the first health system in the country to be awarded this honor.
Our purpose in seeking this recognition originally was to highlight the quality of our nursing department and the importance of our nursing staff to our health care organization. Through the application process, we were able to reflect on our strengths as a nursing department. The in depth self study process provided us with focus and direction and helped to facilitate our growth in meeting and maintaining the highest standards of excellence. The site visit reinforced what we had learned and afforded us the opportunity to receive outside validation of the quality of the environment of practice at Ocean Medical Center. During our latest site visit, the appraisers cited three areas that were particularly noteworthy: nursing research, initiatives to care for the older adult, and nursing utilization of information technologies.

Receiving the Magnet Award, and being a part of a health system that values nursing and its contributions, has had a significant impact on our ability to recruit and retain nursing staff. Most nurses now recognize that the Magnet Award is the highest achievement that a nursing service can attain, and that it signifies nursing excellence and the highest quality of nursing care. Nurses identify a Magnet hospital as an organizational environment that is supportive of nursing practice. Attributes include a value system incorporating continuing education, research, collegiality, and collaborative practice. When asked why they chose to come to work at Ocean Medical Center, many of our new nurses tell us that they wanted to work in a Magnet designated facility for these very reasons.

All of our nurses participated in the preparation of the Magnet application and many interacted with the Magnet appraisers during the site visit. Going through the Magnet application process has promoted a greater sense of teamwork and camaraderie among them. In addition, the Magnet process has fostered in our nurses a sense of ownership because they understand that with this recognition comes responsibility as well as accountability to uphold these standards of excellence. I believe our turnover rates and vacancy rates have improved as the nurses have become more involved in decision-making and in improving their own practice environment.

New Care Model and Clinical Recognition Program.

Our participation in the Magnet Recognition program has led to a reassessment of our care delivery model to further enhance the work environment and promote staff retention. Across Meridian Health, the Nurse Executives with input from the nursing staff have developed a new model of care. To test the model of care, we have instituted a model “magnet” unit at each of our hospital campuses with increased staffing, a no float policy, enhanced technology (cell phones, lap top computers), and a dedicated nurse educator and physician champion. Nurses on these units are expected to achieve national certification in their area of specialty and to participate in the new CARE program (Clinical Advancement and Recognition of Excellence program). Nurse and patient outcomes are being monitored monthly to evaluate the impact of these enhancements. The CARE program, an outcomes based clinical recognition program, has been developed by staff to replace the process oriented clinical ladder. With this new clinical recognition program, nurses prepare portfolios that demonstrate achievement of increasing levels of clinical expertise. Through these initiatives, we hope to improve the nurses work environment, keep our nurses at the bedside, and better demonstrate nursing’s impact on quality patient outcomes.

Other Recruitment Activities:

In addition to our participation in the Magnet program, we have engaged in a number of recruitment and retention activities that have assisted in reducing our vacancy and turnover rates. I will briefly reference a few of the more successful programs:
• A active professional recruitment department who have developed a number of creative recruitment strategies including:
o The Boomerang Program: This program reinstates former employees with full benefits and seniority
o On and off site open houses, dinners and luncheons with guest speakers
o Salary Market adjustments
• Summer Student Nurse Externships with ability to stay on as per diem staff or participate in the OFFER program
• Scholarships: Meridian Health awards about $250,000 per year in nursing scholarships for students who are entering the profession and for nurses seeking to attain advanced degrees
• OFFER program: A program for employees enrolled in nursing programs to work Baylor hours on the weekend (two twelve hour shifts), received full time pay and benefits including tuition reimbursement in exchange for a two year work commitment.
• Revised Clinical Recognition Program with increased salary for advancement
• Salary increments for national certifications and Bachelors degrees

Other Retention Initiatives:

• At Ocean Medical Center we live the philosophy “Hire for Talent, train for skill.”
• We contract with Human Capital Management’s Talent Bank. The Talent Plus® screening tool is utilized to select quality employees.
• Peer interviewing is required for all applicants.
• Introductory interviews are completed within three months of hire to gage employee’s satisfaction with the organization.

In conclusion, at Ocean Medical Center we recognized the significance of the current and impending nursing shortage, our aging nursing workforce, and our aging patient populations and have taken steps to improve our recruitment and retention efforts. Effective recruitment and retention plans, however, must go beyond immediate necessity to fill vacant positions. The environment where nurses practice must be enhanced so that nursing is seen as an attractive profession that offers professional growth and satisfaction.
Participation in the Magnet Recognition program has helped us to enhance our efforts in improving the nursing work environment.

Thank you