Clinical Ladder Discovery Committee

[Blueskies]

I'm a new grad, working in my first RN position. I have been asked to sit in a committee to discuss formation of a "Clinical Ladder" which will serve as the framework for a system of bonuses in our hospital. While experienced in business, I was not familiar with Clinical Ladders. Discussions about them seem to bring out very emotional reactions. Could I ask you all to pitch in your "two cents" and give me your impressions, feelings, etc. so I can draw on your collective wisdom? What is your experience with them? Potential problems/pitfalls to avoid? Opinions of strengths and weaknesses?

Thanks much!

Brian

[traumaRUs, MSN, APRN]

Hi Brian and congrats on your new job! As you have already found out, clinical ladders can be a positive or negative depending on your outlook. I worked in a large (710 bed) hospital for 10 years and we had clinical ladders which could add up to $8,000 to your paycheck throughout the year. Yes, it involved further formal and informal education, it also involved committee time, precepting time, etc. However, I felt that it was worth it. It also brought me a sense of professionalism because it measured and rewarded my efforts.

I already know that you will get those naysayers who only want to do the minimum. That is fine. Then they don't progress up the ladder. If they are happy with that, so be it. There are also folks who have more family responsibilities, other jobs, etc for whom the additional work of clinical ladders just don't add up. Here is one example of a California's hospital's clinical ladder program:

http://nursingpathways.kp.org/ncal/careers/ladders/index.html

Here is how a hospital system in Colorado does it:

http://www.uchsc.edu/ahec/cando/nursing/diffpractice97.htm

Hopefully these links will help. Good luck. When our hospital developed clinical ladders they sought out the unofficial leaders in nursing (more senior, well liked staff nurses) and won them over first and then they spread the word. That helped much.