National Nurses United

"All the new grads are BSN, some even MSN. We don't have any ADN [new hires] anymore," she said. "When they start out as BSN, in my experience, they often leave the bedside." Abogado said that the trend is for nurses with bachelor's and advanced degrees to move into management positions or quickly return to school for an even higher degree, such as nurse practitioner. "I've been a bedside nurse for 25 years this year. Those who've been at the bedside long enough know it doesn't matter if you have a Ph.D," Abogado continued. "You don't really accumulate knowledge until the day you start working as a bedside nurse. You can put a Ph.D nurse and an experienced ADN nurse in that room, and if I'm the patient, I want the ADN nurse." Given that BSN nurses are so prized in the Magnet system, it's no surprise that a simple Google search for "What is Magnet status?" turns up results full of glowing praise from nursing schools eager to convince prospective students that earning a BSN makes them more likely to get a job in a Magnet facility. That way, just like Magnet Coordinators on the job market, nursing schools can cash in on the ANCC's program. In the process, nurses whose life circumstances and bank accounts don't allow them to pursue four-year programs or advanced, accelerated degrees remain disempowered and disad- vantaged in the labor market. Spinney in Texas said she's also seen high turnover with BSN new hires. Like the posters celebrating Magnet status, it's another irony of the Magnet program: while it's ostensibly about nursing reten- tion, it incentivizes hospitals to hire nurses who may be more interested in what comes after the bedside. "All the BSN new hires already have a career path and are not spending much time bedside. They're checking that box for experi- ence and moving on," she said. "Some of the best nurses do not have BSNs. They are the ADNs." * * * * * T o be sure, the nursing profession is experiencing a retention and staffing crisis. The aims of respecting and prioritizing registered nursing care are worthy ones. But NNU nurses we spoke to made clear that unions are the way to actually accomplish the goals Magnet claims to strive for. While Magnet talks a big game about empowering nurses, there's no teeth to back it up the way there is when RNs exercise their union rights. When Maine Med first began its Magnet campaign around 2000, the nurses had just waged an unsuccessful unionizing drive. To Strum, the timing was anything but coincidental. When Maine Med finally attained Magnet status in 2006, she remembers, "We might've got a free coffee or something, but I don't think we even got a pizza party, to tell you the truth. Probably, we didn't get our breaks that day, like any other day." Nothing changed until more than 20 years later, when the Maine Med nurses finally won their union and their first contract, gen- uinely creating major improvements at the facility. At LAMC, Abogado said she can see the stark difference between authentic nurse-controlled bodies and for-show Magnet groups when she compares her union's Professional Practice Committee (PPC) with management's Unit-Based Committees (UBCs). "In the UBC, [management's] still in charge. They tell you to fill out this form, do this, do that," she said. "But with the PPC, we have a voice. It's more like 50-50. We don't have to listen to you, and nurses can bring up our own issues. And those issues are relevant because we're the ones at the bedside." For Spinney in Texas, even though they're still fighting for a first contract, the union campaign has already produced major wins that never would've been possible through Magnet. Nurses have success- fully pushed back on a policy mandating employees could only pick up prescriptions at company pharmacies, and they've fought to ensure nurses are only called upon to precept other nurses when they have a proper amount of experience to do so, as being forced to precept was driving nurses away from the facility. Given what she's seen, Spinney had words of wisdom for nurses at facilities seeking Magnet designation, saying, "Spend your time organizing. Spend your time doing anything else besides working on that." Strum from Maine Med was similarly vocal in advocating for unions before Magnet. "If you're not sitting at the table with management making deci- sions, then it will be unilaterally made by management, and nurses' opinion and nursing is just going to be dragged along," Strum told National Nurse. "Magnet does not give you a say in it. It doesn't put you at the table. You cannot negotiate a contract with Magnet. You can't strike. You can't do anything." "Unions are the only way," she said. Lucy Diavolo is a communications specialist with National Nurses United. A P R I L | M AY | J U N E 2 0 2 3 W W W . N A T I O N A L N U R S E S U N I T E D . O R G N A T I O N A L N U R S E 19 Tinny Abogado, RN

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