Hi CaronRN58. I've participated in discussions about clinical ladders on this bb.
My experience with the clinical ladder system has been somewhat disappointing in that it was more political then objective. I felt the basis for it was a good idea, however. When ladders are being discussed, it is imperative that there be input from bedside nurses.
are flattening their layers of management. Bedside nurses and frontline managers and supervisors are being increasingly expected to take on more of the responsibility in addressing administrative and patient care issues. Higher levels of management are justified at our expense.
Some of the questions I have about clinical ladders is:
1. If patient care is tiered, for instance, as nurse I, II, and III, then at what level would APNs (advanced practice nurses)fall or should there be a fourth level for APNs?
2. If a nurse wanted to go into management, what educational background would be required assuming that bedside nursing practice is considered a rung below management?
3. Should bedside nurses be required to increasingly give concern and attention to unit business as they move up the direct care ladder?
4. Should there be a dual clinical ladder program in which bedside nursing and management are viewed equally?
I think a clinical ladder program can be helpful to address some of the turf problems that exist between nurses with different educational backgrounds, skills, and experiences. It can only work if done, as I pointed out earlier, skillfully and in an objective way.
[This message has been edited by Mijourney (edited April 01, 2001).]