Does the Clinical Ladder violate Labor Laws?

[Valerius]

Does anybody have any expert information regarding Clinical Ladders in violation of labor laws? Or examples of cases (related to clinical ladders) challenged in the court of law for violating labor laws?

I have read and studied a lot to understand the Synergy Model of Nursing theory and it's application in the nursing profession. Now, I want to go a step further; Is it the best and fair way for an institution to recognize and compensate for the performance of the nurse, or to encourage the nurse to pursue a higher degree of education?

As an example, my institution is not able to, nor can it show that a clinical ll or a clinical lll have different expectations when working side by side within a 12 hour shift. Nor do they have different job descriptions. However, the clinical lll nurse is being financially compensated (8% more) for doing exactly the same job as everybody else. I know that the 'Equal pay Act was passed into law to deal with salary inequalities between men and women, but it has been used in court arguments similar to this, and the Equal pay Act doesn't even require 2 employees to have exactly the same job descriptions to be compensated equally, the language in the law says 'similar job descriptions'.

I know that clinical lll and lV nurses are required to participate in committees, etc, etc, etc.....but, they are paid for that extra time they put into these "extra curricular activities", and in a 12 hour shift, when two nurses report to work, one is being paid more when both are expected to provide the same care. Clinical lll or lV nurses are never expected to be the first ones to take extra patients when short staffed, or to take the most challenging assignments, or to do CVVHD, or to precept a new employee. The charge nurse making the shift assignment is more inclined to give the 600 lb patient to the young male nurse because can lift more than the 62 year old female nurse; however, he can not claim or demand extra payment because they have the same job descriptions and both are expected to perform the same tasks.

There is also such a thing encoded in labor laws as discrimination based on education....there is a famous McDonald's case where an employee with a college degree was being paid more than a high school kid when both had exactly the same job descriptions of flipping burgers side by side. The court ruled in favor of the high school kid. The state is the organ that grants nursing licenses, not making distinctions between the diploma, associate, or baccalaureate degrees.....then, the hospital creates these artificial classes of nurses that don't exist.

What are your thoughts on this? I'm particularly interested in hearing about the legality part of the all argument.

[lamazeteacher]

When I saw that this subject mentioned a new concept in nursing practise, I looked it up and read the overview written by an official of the organization that dictates changes in nursing theory. Then I read some of the comments, and realized that this theory translates into being all about money (or at least it boils down to that). So, as usually happens, everyone wants more!

Having been a nurse for over 50 years, I have seen many changes within nursing, that happen without/despite others' perception of a change. However, I think everyone would notice this change if nurses started driving high end vehicles, and lived in luxurious, high cost homes, as doctors did, when their charges increased dramatically about 40 years ago. When we look at changes in any profession these days, the remuneration of the profession seems to be the bottom line. However in ours, itd the product - patient well being - that matters most. That's our product, like manufacturers' products reflect the thought and caring qnd standards that make them superior to others.

The overview I read, put emphasis in the care provided by nurses, and the patient situation for whom the care is given. Obviously, the more education (investment) one has in their career, the more financial gain they expect. Otherwise colleges and universities would see a severe drop in enrollment. It seems that having greater continuing education units than is required, was seen by one poster as another means of achieving higher salaries. That is really not the purpose of doing that. It is expected of any professional, that being current in his/her field of work, is very necessary (hence the need for 30 units to get the license to practise renewed.

Other posters mentioned their perception and possible favoritism of some nurses' capabilities (not expertise, experience or preparation) that in their opinion makes one eligible for higher compensation. Nothing has changed about that personal evaluation, except the general conception that more education can be an asset tht results in more money/gain/promotion, in our work. There are wonderful, very consciencious LPNs, NAs, etc. out there, for sure. However it's the application of greater knowledge that makes recognition of achievement. In all the workplaces where I've been, the only reward for superior capability seems to be in the wallet. That's important, of course, however I've also worked as a volunteer (both during my years of employment and after retirement.

When the money factor is removed, recognition by means of specific attributes is enough recognition, as well as advancement in the roles we play in organizations. I wish that would be incorporated into other areas where skill and ethics is needed. Not that a statue or pin could ever replace remuneration, but recognition of merit is necessary, too.

[IRONMANRN]

I can honestly say that I'm a full time, non-benefited RN with 16 years experience, making the same rate as a two year experienced nurse. It does open my eyes to the "PUSH" of management to have employees put in extra time and effort to make extra money. I guess, you get oout what you put in after all.

Does anybody have any expert information regarding Clinical Ladders in violation of labor laws? Or examples of cases (related to clinical ladders) challenged in the court of law for violating labor laws?

I have read and studied a lot to understand the Synergy Model of Nursing theory and it's application in the nursing profession. Now, I want to go a step further; Is it the best and fair way for an institution to recognize and compensate for the performance of the nurse, or to encourage the nurse to pursue a higher degree of education?

As an example, my institution is not able to, nor can it show that a clinical ll or a clinical lll have different expectations when working side by side within a 12 hour shift. Nor do they have different job descriptions. However, the clinical lll nurse is being financially compensated (8% more) for doing exactly the same job as everybody else. I know that the 'Equal pay Act was passed into law to deal with salary inequalities between men and women, but it has been used in court arguments similar to this, and the Equal pay Act doesn't even require 2 employees to have exactly the same job descriptions to be compensated equally, the language in the law says 'similar job descriptions'.

I know that clinical lll and lV nurses are required to participate in committees, etc, etc, etc.....but, they are paid for that extra time they put into these "extra curricular activities", and in a 12 hour shift, when two nurses report to work, one is being paid more when both are expected to provide the same care. Clinical lll or lV nurses are never expected to be the first ones to take extra patients when short staffed, or to take the most challenging assignments, or to do CVVHD, or to precept a new employee. The charge nurse making the shift assignment is more inclined to give the 600 lb patient to the young male nurse because can lift more than the 62 year old female nurse; however, he can not claim or demand extra payment because they have the same job descriptions and both are expected to perform the same tasks.

There is also such a thing encoded in labor laws as discrimination based on education....there is a famous McDonald's case where an employee with a college degree was being paid more than a high school kid when both had exactly the same job descriptions of flipping burgers side by side. The court ruled in favor of the high school kid. The state is the organ that grants nursing licenses, not making distinctions between the diploma, associate, or baccalaureate degrees.....then, the hospital creates these artificial classes of nurses that don't exist.

What are your thoughts on this? I'm particularly interested in hearing about the legality part of the all argument.

[Nccity2002, MSN, RN]

Does anybody have any expert information regarding Clinical Ladders in violation of labor laws? Or examples of cases (related to clinical ladders) challenged in the court of law for violating labor laws?

I have read and studied a lot to understand the Synergy Model of Nursing theory and it's application in the nursing profession. Now, I want to go a step further; Is it the best and fair way for an institution to recognize and compensate for the performance of the nurse, or to encourage the nurse to pursue a higher degree of education?

As an example, my institution is not able to, nor can it show that a clinical ll or a clinical lll have different expectations when working side by side within a 12 hour shift. Nor do they have different job descriptions. However, the clinical lll nurse is being financially compensated (8% more) for doing exactly the same job as everybody else. I know that the 'Equal pay Act was passed into law to deal with salary inequalities between men and women, but it has been used in court arguments similar to this, and the Equal pay Act doesn't even require 2 employees to have exactly the same job descriptions to be compensated equally, the language in the law says 'similar job descriptions'.

I know that clinical lll and lV nurses are required to participate in committees, etc, etc, etc.....but, they are paid for that extra time they put into these "extra curricular activities", and in a 12 hour shift, when two nurses report to work, one is being paid more when both are expected to provide the same care. Clinical lll or lV nurses are never expected to be the first ones to take extra patients when short staffed, or to take the most challenging assignments, or to do CVVHD, or to precept a new employee. The charge nurse making the shift assignment is more inclined to give the 600 lb patient to the young male nurse because can lift more than the 62 year old female nurse; however, he can not claim or demand extra payment because they have the same job descriptions and both are expected to perform the same tasks.

There is also such a thing encoded in labor laws as discrimination based on education....there is a famous McDonald's case where an employee with a college degree was being paid more than a high school kid when both had exactly the same job descriptions of flipping burgers side by side. The court ruled in favor of the high school kid. The state is the organ that grants nursing licenses, not making distinctions between the diploma, associate, or baccalaureate degrees.....then, the hospital creates these artificial classes of nurses that don't exist.

What are your thoughts on this? I'm particularly interested in hearing about the legality part of the all argument.

Uhhh..., now, that is an interesting correlation between labor laws and clinical ladder programs. I think it all come down to education. If someone is willing to go throught the time comsuming process of going up the ladder, well... they do deserve to be compensated for it (more education= more money...it is a basic concept). Every facility is different, but besides the bedside care responsibilities, there is a bigger picture that you may not be aware of in regard to the role and responsibilities of those up in the ladder. For instance, most facilities around my neck of the wood, do require Clin III to work on projects, in order to maintain their status.

Sorry, I do not think your labor law violation theory (in relation to the clinical ladder nurses) has any merit.

[6spdftwtm]

At our facility, the big push for Magnet status has been well underway for a couple years. The dear people in HR even made a position for our "Magnet status consultant". At any rate, I feel certain that this has something to do with what our hospital calls CAP (clinical achievement program). It's just another name for the same thing. What's really astounding is that for each advance in your CAP level, your pay rate increases by $1/hr. CAP I and II are such a piece of cake. It's more along the lines of sitting down and forming a very elegant, fancy resume with some staff education and community service. You also recieve a $0.50 to $1 /hr raise for any certifications (CEN, CCRN, CRRN, etc.)

With that said, the difference in pay between ADN and BSN is a massive $0.30/hr. YEAH!! Totally the hottness! LOL. Then again, greater education isn't only for financial gain - it should be more for personal satisfaction.

I don't know exactly how HR correlates experience with pay rates, though. I would imagine that it's somewhere around $0.50 / yr of experience. Maybe not that much.

Having been a RN for 6.5 yrs, I definitely would like to make more money. However, it would REALLY irritate me to think that I had been working as a bedside RN since dirt was invented and making the same wages as someone who was fresh out of school. I absolutely support higher pay rate for greater experience. However, I think patient outcome needs to somehow be factored into that pay rate determination. I have worked with some absolutely BRILLIANT nurses who were very, very new and who were very, very ancient. I have also worked with some of the most rigid, stubborn "seasoned" nurses who rarely had any communication between the right and left braincell and the same of many newer nurses.

Late,

Trav

[kindaquazie]

The issue is this: Any individual ADN may be better than any or every BSN new graduate nurse, however, scientific studies are based on aggregates. In the aggregate, hospitals with more BSN nurses generally (to a statistically significant level) have better patient outcomes for nurse sensitive quality indicators. Therefore, hospitals will provide incentives to nurses for achieving a BSN and frequently provide opportunities for RN to BSN education.

[MSNRN2013]

TNTRN: I understand what you are saying about the experienced ADN and agree that most are invaluable assets. However, I do believe that nurses with advanced degrees see things differently related to the whole system of healthcare. That thinking comes with the research that is required in school and is not incorporated into ADN programs due to time constraints. Clinical Ladders have a place in healthcare, they provide incentive to continue learning beyond what is required by state licensing boards. If you look closely you will see the difference in staff members who actively participate in the facility and those who do not.

I do not know if this will make a difference in how you view the clinical ladder but it may broaden the thinking that goes into a clinical ladder. If you cannot see a difference in the care delivered, I would recommend observing how the patient and family is educated, what the charting looks like, etc... that is often where you can see the greatest difference.

[vera4130]

At my hospital, our nurses who are RN IIIs ARE expected to take harder patients and precept. There is a very specific list of qualifications to be an RN I, II, III, IV, and V - you have to resubmit every year. It isn't discriminatory as far as I know, if you qualify you get the title and the bonus. Our RN IIIs have to be involved in committees, and there are a lot of great seasoned nurses who do not participate in the leveling system. That's fine, they don't have to. But some of us would like to be rewarded for taking the extra time and effort to complete CEs beyond what is required, getting certified, or obtaining or BSN or MSN. Unless your RN levels are awarded by choice and not by qualifications, I do not see how it could be a violation of labor laws. We actually try to staff our RN IIIs evenly across shifts, because they ARE a valuable resource.

[nightengalegoddess]

It is clearly my experience that nurses of higher levels are resources for the unit they provide service in. They mentor (although inherent personality determines how well)....they can easily care for the more critical patients; and I do believe...their experience is worth more money. And I am stuck at level 2 because of lack of motivation to do all the extracurricular stuff. I am happy with my wage. I earn it honestly....as I feel the level 3/4 does.

When first starting in ICU I had a terrible preceptor who was all image and no teaching ability. She is still worth level 3 because she has the smarts and action to do what is needed when a level 2 is new and doesn't know what the heck is going on yet. She can reflexively take over. That is why she should be paid more.

Taking care of a stable pair competently....even excellently.....is nothing close to taking care of a highly unstable patient with a chance to survive. That is why they should be paid more.

Of course there are the level highers who just want to mentor all the time and are crappy at it so they can have an easier shift. But hey.....good with the bad. When push comes to shove they can still be the brains to move the situation even if the brawn is lacking.

This is truly my opinion; and I live in a non-union state and am planning on moving into union advocacy within the next few years in another state.

People need to be paid for their experience. It is fair.

If assignments are lax and unfair, that is the particular institutions' fault and yes.....they ought to be struck for that. Careful research needs to be performed on these to decipher which are abusing this concept.