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Design a clinical ladder program that works for staff and the organization

HCPro's Weekly Update on the ANCC Magnet Recognition Program®*, February 27, 2007

Presbyterian Hospital Dallas, an ANCC Magnet Recognition Program® (MRP) facility since 2006, used to limit the number of clinical ladder positions available to nurses. The reason was that the CEO was concerned that every staff nurse in the hospital would be earning the $4,160 bonus that is rewarded for reaching the top of the clinical ladder. But eight years ago, Rosa Belgard, MS, RN, MRP project director, manager of nursing and patient education at Presbyterian Hospital Dallas, says she assured the CEO that would not happen-and it didn't. Belgard says if a clinical ladder requires nurses to reach a certain level of experience or education for each level, then it can be fairly accurately projected how many staff nurses will attain each level. This allows allocation in the annual budgeting process to support the positions projected.   

"We also set minimum time you have to consistently perform in one level before you can move to the next level," Belgard says, adding that the requirements should be tough enough that reaching them is a stretch-even for the best nurses. "Our clinical ladder is one of our best avenues for reinforcing the Forces of Magnetism and having direct-care nurses involved in many projects and processes," she says.

Source: Rosa Belgard, MS, RN

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