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Discussion

Clinical ladders

How does your hospital recognize nurses. Most places I have start new nurses at RN I, advance nurses to RN IIs automatically then you must perform some leadership or committee roles to earn the RN III and IV. How does your institution do it? Do any institutions require a bachelors degee to advance past RN II?

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My organization has a more vague clinical ladder. I honestly wouldn't even call it one, but one of the hospitals received magnet status with this ladder. There are the staff RNs, then Clinical Nurse II who are basically the permanent charge nurses/assistant manager types. In addition to being charge for their shift, the Clin II has administrative duties as well and must participate on various communities and fill in for their managers as needed for meetings or when the manager is out. The next step up is the nurse specialist (or clinical nurse specialist). This person serves as an expert resource for the unit and these nurses must have a BSN and obtain their CNS within three years, or already be a CNS. Beyond these roles are the nurse manager, director, and CNO. The thing with this ladder is that nurses must be hired into these positions (or promoted into them) and other nurses can only reach these positions if one becomes vacant, regardless if they have the experience and ability to perform the duties.

new grads hired in as RN 1, and there are multiple pay steps. expected to do nursing inservices

to get RN 2 requires BSN, also multiple pay steps. expected to do nursing inservices, lead projects, charge nurse

RN 3 requires MSN - not many of these folks, very experienced (20 yrs+), nursing Gods

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Where do u work sunny Calif? U can just say the state and what part or the hospital name if your comfortable. That seems a very strict ladder. Are the roles for RN 4s different than the RN 2 or 3?

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