Clinical Ladder at a small hospital

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Hello everyone! I have recently transitioned from a large, level 1 trauma hospital to a small 120 bed community hospital. I was actively involved in and very happy with the clinical ladder program at my past job. I am curious if anyone currently works for a small hospital that has a successful program or if this is something only to be expected at a larger facility. Thanks for any feedback!

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Specializes in CCRN, House Sup, CCT, Unit Director, ICU.

What do you mean by clinical ladder?

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Specializes in critical care/tele/emergency.

I work in a 100 bed community hospital and we have recently started the clinical ladder program here. I'm not certain what you mean by successful, so far in the year and a half after implementation, we've had only a dozen reach the 3rd level and none the top level. I think we've seen a larger amount of nurses enroll this coming year.

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Specializes in being a Credible Source.
a small 120 bed community hospital
This made me smile... We have 10 m/s beds... Now, we're *small*

Sorry for the OT response but it's the middle of the night, I'm tired, and a bit punchy having worked 62 hours over the last 4 days.

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Specializes in Hospital Education Coordinator.

we have 130 beds. Our clinical ladder program is a farce and is more a retention bonus plan than anything.

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What do you mean by clinical ladder?

A process that grants increased pay based on program participation. It involves several categories: experience, education, research, volunteer, and such. By completing tasks like national certifications, additional education, participation in task forces and hospital committees, precepting... you reach certain levels which correlate with an advanced pay grade or bonus.

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I work in a 100 bed community hospital and we have recently started the clinical ladder program here. I'm not certain what you mean by successful, so far in the year and a half after implementation, we've had only a dozen reach the 3rd level and none the top level. I think we've seen a larger amount of nurses enroll this coming year.

Not exactly sure what I was basing "successful" on myself. ;) I suppose just how you answered. Employee response and participation to the program.

At my last hospital we had a large participation level hospital-wide and on my unit, I really felt the c.l. nurses made a huge contribution and many positive changes through task forces, education, program development, etc. It really was a big part of creating unity and working together on many projects gave us a sense of accomplishment and increased job satisfaction. With around 70% unit participation (in a 30 bed ICU), most of our nurses were BSN or working towards it, as well as nationally certified. Our manager was extremely helpful and supportive. We were also happy with the compensation at 4, 8, 12, and 16% of base pay!

I am hoping to develop an interest at my current job (which does not offer a c.l. program), but curious how the response would be with a smaller employee base. Also, we received a lot of our credit by precepting the many students and new nurses, working on hospital based community volunteer products, and joining the numerous committees available at the large hospital.

Curious this is feasible in a smaller environment, where less opportunities are available for participation.

Thank you for responding!!!

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Ugh. Most everyone at my hospital hates the ladder.

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Specializes in Critical Care.

The clincial ladder where I work is just an excuse to micromanage and twist the nurses like pretzels, constantly changing the rules, upping the ante, always with the demotion option voluntarily or not with pay cut. The clinical ladder is the hospitals answer to wall street and dedicated employees who are willing to live and breathe for the hospital above all else, especially their own family and personal time! For this you get a one time raise that is a pittance coupled with a constant threat of demotion. Count me out!

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Specializes in PACU.

I work in a small hospital. We are all expected to serve on committees and such (at least in my department, but it seems to be the same throughout the hospital). Specialty certification results in extra pay, as does precepting (for hours that you actually precept). I don't like the sound of a rigid clinical ladder program.

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Specializes in Emergency & Trauma/Adult ICU.

I'm a big fan of the clinical ladder concept, because it maintains the organizational culture that staff nurses will participate in quality initiatives, departmental and facility-wide projects and continuing education. It sets up the mindset that this will be the rule, not the exception.

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Thank you for all the replies!!!

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