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When bad things happen to good organizations: a focused approach to recovery using the essentials of magnetism.

Sustaining Magnet status requires commitment and determination to achieve a higher standard of nursing practice. The Miriam Hospital (TMH) has achieved Magnet status twice and is scheduled for a third designation in 2006. Throughout the 8 years of designation, TMH has experienced many of the same workforce and financial challenges experienced by hospitals all over the country. Senior leadership strives to identify standards that serve as a framework for continuous improvement and creativity, and in doing so, has weathered the frequently labile and tumultuous environment and has emerged with a strong and desirable culture. Nursing leadership at TMH has not only used the Magnet standards as a means to improve but also the Magnet research and literature were critiqued and applied to the development of programs and initiatives that have become part of the culture of the organization. The essentials of magnetism, identified by Kramer and Schmalenberg, have served to provide a framework for change and sustainability.