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Nursing Clinical Ladder

The Nursing Clinical Ladder program was developed at CRMC to create an environment that promotes high-quality patient care. It also provides an incentive for RN’s in direct patient care-roles to increase and broaden their current experience. CRMC also wanted to attract and retain highly skilled RN patient care givers. The clinical ladder provides a vision for nursing.

The mission statement for the clinical ladder states: The Clinical Ladder Program at CRMC will provide a method for nurses to participate in a program to increase professionalism, improve patient care, increase patient and staff satisfaction and promote recruitment and retention.

The clinical ladder truly is "by nurses for nurses". It is currently open to any RN who provides direct patient care as their primary responsibility. They must have been an RN for at least 2 years, one year of which must have been here at CRMC. It is open to any RN who is employed at CRMC for greater than 400 hours per year. The nurse must have received all "2’s" on the most recent evaluation and no written disciplinary action within the past 12 months.

Entry level is Level I. It is expected that new nurses to 24 months after graduation would fall into this category. RN’s at this level are expected to independently plan and implement routine nursing care in predictable situations using accepted standards. They would begin to assume leadership responsibilities. Needs minimal supervision.

Nurses in Level II plan and implement nursing care, individualizing care as needed, without supervision. They are able to manage routine and emergency care. They assume basic leadership responsibilities.

In Level III, the nurse manages complex patient care situations using broad knowledge base to assess unique patient needs and determine appropriate interventions.

At Level IV, the nurse assesses effectiveness of unit or department patient care systems and initiates interdisciplinary action to improve systems. They manage unusually complex patient situations well.

Applications are accepted in January and July. The applicant then has one year to complete a portfolio of activities with points awarded for each activity. The activities are based on a wide-range of areas. These areas include: Unit based Professional activities, Publication and Research, Community based, and Education & Certification. It is expected that the applicant will have points from each of these areas. Review of the portfolio by a panel of peers determines the points for each activity.

To reach Level II, the nurse must score between 75 and 100 points. Level III needs 101 to 150 points. Level IV requires 151 to 225 points. The Board of Directors has approved a monetary reward for each level. Nurses reaching Level II, III or IV will receive recognition at the Leadership Meeting following the review process. Current plans also include a reception to honor these nurses.