Clinical Ladder Dream or Deception?


To those who have a clinical ladder they've climbed where they work, are you happy with it? Does it have a demotion clause? Are they changing the terms to maintain the level each year to encourage nurses to drop down to RN II to cut the budget. That's what's been going on ever since we've had it. And if you climb the ladder and someone doesn't like you they will demote you for all sorts of reason of not maintaining the ever changing criteria to keep that onetime 4% raise! Each year they make the ladder harder for RN III-IV to maintain always with the option of going back down to RN II voluntarily with the cut in pay of course!


379 Posts

Specializes in critical care.

As a student, I'm not familiar with clinical ladders. What would be the advantage of voluntarily dropping down the ladder?


849 Posts

Specializes in Home Health.

We had the clinical ladder years ago. I think it was a crock!

Specializes in Emergency, Critical Care, Pre-Hospital,. Has 14 years experience.

Not my experience at all. Rather than demoting, we are encouraging promotion to Level IV with a 7.5% raise rather than the 5 % for other levels. Now we are striving for Magnet status and level IV includes BSN and national specialty certification. My hope is that this will continue.

Specializes in ED, ICU, MS/MT, PCU, CM, House Sup, Frontline mgr. Has 15 years experience.
each year they make the ladder harder for rn iii-iv to maintain always with the option of going back down to rn ii voluntarily with the cut in pay of course!

interesting post….. my facility has a similar ladder for the staff rns and after reading the requirements today (prior to this post) and i had the same thought….. your managers do not realize that the career ladder, if applied correclty, is to maintain high standards of care and retain good nurses. i think the powers-that-be are taking advantage of the ladder process and are using it to manipulate his/her budgets! this sounds awful and sadly completely believable. some people cannot manage to find his/her way out of a paper bag, let alone other human beings or a budget.

on the other hand, i also think that having some stringent requirements is a way for the facility to have iiis and ivs that actually put time in to learn, train, grow, lead, and mentor others.... otherwise, you have a bunch of rns that have years of work experience but are not very good nurses by the bedside. i worked in such a facility.... the experienced nurses with 10-20 years by the bedside had skills and thoughts regarding patient care that were very outdated and in some cases dangerous! they also gave the wrong impression that they always knew what to do. i am so glad i no longer work for that facility!

Specializes in Critical Care.

Well, I'm on tele step-down so new skills, knowledge and training are a constant. Training is mandatory and paid for and so nurses have up to date skills and recert for ACLS, BLS on a regular basis.

The changes to the ladder are system wide, it has nothing to do with our manager. It just seems that ever since it was initiated they just come up with more hoops to go thru just to maintain your RNIII, RN IV and the threat of demotion with pay cut was there from the beginning; so I never bought into it and just stayed a level II and I'm glad I did! Every year the nurses are stressed and running around trying to keep up with the latest demands just to keep that one time raise years ago.

It involves being on committees and doing research projects and a lot of unpaid time just to keep your one time raise. I just didn't feel it was worth all the hassle for a one-time raise with the constant threat of demotion. Only in nursing would they come up with a raise and then threaten to take it away in the next breath! I've known several people who were demoted against their wishes, just seemed like if your manager had it in for you, then you could kiss your raise goodbye. Only in nursing! It's so ridiculous and insulting how they have the nerve to treat us!

It turns out I was glad I stayed a RN II. Now I hear they are adding even more requirements for RN III, RN IV just to maintain so it seems obvious to me they are going out of the way to make it difficult for people to maintain and it seems they want to people to step down to save the hospital some money. Otherwise why make it such a hassle.

If it was a yearly raise then I could see that all the hoops might be worth it, but the way its set up now it just insn't! In fact, it's just an insulting joke on us nurses!


4 Posts

We have a clinical ladder application process where I work and so far it's a bear! I have submitted my application three times now - first rejection - not enough info, second rejection - not professional enough, third rejection - not within guidelines and not enough info. Problem? - no guidelines, no format, no guidance. We have had only one person ladder up to an RN III in the last year and she spent two years on her application. The applications are reviewed and passed by our "peers". I believe that I have enough to be a RN III - I'm a charge, nightshift supervisor, have TNCC, CCRN, and am an ECMO specialist. I also orient new employees, serve on a shared goverance council, the unit practice council, and am active on the unit. These hoops are getting smaller and higher up each time - I'm tired of it.