The primacy of magnet designation as a contextual variable indicating a quality work environment was affirmed. A larger percentage of magnet hospitals meet the magnet profile now than in 2003. Item analysis of the EOMII subscales provides guidance on how to improve the unit work environment. Suggestions are made for additional study and research.

Staff nurses in 14 magnet hospitals identified 8 attributes associated with the original concept of magnetism as essential to their ability to give quality care. The 8 Essentials of Magnetism (EOM) tool was generated from participant observation and interviews with 289 magnet hospital staff nurses. The psychometric properties of the EOM tool were established in a study involving 3602 staff nurses in 16 magnet and 10 nonmagnet hospitals. The authors discuss the EOM tool and its use in diagnosing elements needed in the environment to produce what staff nurses say is essential for productivity of quality patient care.

Do Nurse Residency Programs (NRPs) reflect the professional socialization process? Residency facilitators in 34 Magnet hospitals completed Residency Program Questionnaires constructed to reflect the goals, themes, components, and strategies of the professional socialization process described in the literature. NRPs in 4 hospitals exemplified the complete two-stage (role transition and role/community integration) process. In 14 hospitals, NRPs were of sufficient length and contained components that reflected the professional socialization process. In 16 hospitals, NRPs exemplified the "becoming" role transition stage. What components are most effective in the professional socialization of new graduate nurses? A total of 907 new and experienced nurses, nurse managers, and educators working on clinical units with confirmed healthy work environments in 20 Magnet hospitals with additional "excellence designations" were interviewed. Components identified as most instrumental were precepted experience, reflective seminars, skill acquisition, reflective practice sessions, evidence-based management projects, and clinical coaching-mentoring sessions. Suggestions for improvement of NRPs are offered.

Throughout the 1990s, a great deal was written about the importance of "good" nurse-physician relationships, about how high-quality nurse-physician relationships were 1 of the 3 cornerstones of excellent (magnetic) work environments, about how the quality of nursephysician relationships is more of a concern to nurses than to physicians, and about how physicians consistently rate the quality of these relationships higher than do nurses. [18][19][20][21] In all of these writings, what constitutes good or high-quality relationships between physicians and nurses is seldom defined, and when an attempt is made to assess goodness, nurse-physician relationships are measured as though all interactions between nurses and physicians on

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