How to Create a Nursing Career Ladder for Your Team

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Written by Katherine Zheng, PhD, BSN Content Writer, IntelyCare
A newly hired nurse meets a fellow nurse and doctor, and shakes hands with a doctor.

Nurses are constantly finding new ways to advance their careers in this diverse field, often seeking jobs that will support their long-term growth. With this in mind, it’s worthwhile for facility leaders to create a nursing career ladder that will help attract, develop, and retain the best workforce possible.

Establishing a career ladder allows your bedside nurses to continually advance their skills, bringing many benefits to your workflow, culture, and quality of care. We’ve created a starter-kit detailing what a nurse career ladder (or “clinical career ladder”) program is, why it’s important, and how to create one for your team.

What Is a Nursing Career Ladder?

In clinical settings, a career ladder is a type of professional development program that incentivizes nurses to continue growing their clinical skills and knowledge. More specifically, these programs provide structured, upward mobility for nurses who want to stay at the bedside, fostering a sense of commitment and fulfillment.

Since there is no industry-wide standard for establishing a program, career ladders will look differently from unit to unit. However, strong programs will typically aim to encourage three main pillars of growth:

  • Personal development
  • Educational advancement
  • Leadership opportunities

How Do Facilities Benefit From Creating a Nursing Career Ladder?

Creating a career ladder is a great way to invest in the long-term success of your workforce. By motivating nurses to develop their professional skill set, you’re also benefiting the patients they serve, which can boost your facility’s performance as a whole.

For facilities, creating a career ladder can lead to a number of positive outcomes, including:

  • Increased nurse retention — Studies have shown that the fulfillment from climbing a career ladder helps nurses feel significantly more satisfied in their jobs. This leads to higher retention of staff, saving facilities on costs associated with turnover. As the registered nurse career path can expand well beyond the bedside, this also incentives more nurses to continue working clinically.
  • Higher quality of care — Engaging in professional development will maximize a nurse’s ability to deliver the best care for patients. Additionally, these programs encourage participation in clinical research and quality improvement projects, which can also go back into improving overall care delivery.

3 Steps for Building a Clinical Career Ladder Program

1. Establish Levels of The Ladder

The first step to creating a career ladder is establishing the levels of the ladder. Nurses should have a clear sense of what climbing the ladder means in order to reach tangible goals.

A career ladder program will generally have a tiered ranking system that nurses can progress through as they meet certain objectives. As a simplified example, a program may provide “bronze,” “silver,” and “gold” levels that nurses in the program can work towards.

2. Create a System For Climbing The Ladder

Once you’ve defined the levels of your ladder, the next step is organizing a system to advance up the ladder. Generally, nurses are evaluated based on their clinical performance and commitment to growth.

Clinical performance can be evaluated by observing a nurse’s clinical abilities and skills on the floor. Since nursing leaders provide annual performance reviews of their staff, they may also use similar metrics to determine whether they’re ready to advance up the ladder.

Commitment to growth is commonly evaluated through a point-based system, where a predetermined number of points is awarded each time a nurse participates in an activity that facilitates their development. For instance, helping out with a quality improvement project may be worth 20 points, and attending a skills training seminar may be worth 10 points.

Using the examples we established earlier, we can take a look at how a nurse would climb up the ladder through these evaluation methods:

  • Bronze — Demonstrates basic clinical skills and has 30 total points
  • Silver — Demonstrates meaningful clinical decision making and has 60 total points
  • Gold — Demonstrates strong initiative, intuitive clinical decision making, and has 90 total points

Not all programs have to be point-based, and there are other ways you can ensure that nurses are meeting development objectives. For instance, you may simply want to create a set list of activities a nurse must participate in to reach each level. The way you structure your program will likely depend on what development activities your facility offers.

This is also a great opportunity for team building and engagement through the use of gamification. This is where game-like elements are added to professional development activities — an approach that fits well with a laddered process and which has been shown to increase overall engagement. Here are just a few basic gaming elements that you can fold into your professional development process:

  • Progress/status tracking
  • Leaderboards
  • Milestone badges and rewards

3. Incentivize Participation

Beyond establishing a program, it’s important to incentivize your nurses to participate. Nursing career ladder programs are typically voluntary, allowing any nurses who are interested in career advancement to apply.

  • Raise program awareness — Nurses need to be aware of a program and its benefits in order to participate. Facilities can raise awareness by promoting the program in the job application, during onboarding, and in any newsletters or communications that reach their staff on a regular basis.
  • Make the application accessible — Some nurses have reported being turned off by a nursing ladder program because the application was too vague or burdensome. Creating a clear application that inquires about a nurse’s goals and credentials can often be enough to determine their fit. It’s also important to make the program as inclusive as possible and avoid eligibility criteria that only senior nurses would meet.
  • Provide practical rewards beyond titles — It’s crucial to ensure that nurses are being rewarded beyond their title advancements. Participating in a nursing clinical ladder program takes time and dedication, so offering additional incentives such as a pay increase at each level is an important motivator for participation.

Seeking More Ways to Support Staff Development?

Now that you’ve learned the fundamentals of creating a nursing career ladder, you may be wondering what other resources you can provide to foster professional development. IntelyCare’s free newsletter provides dozens of practical tips and guides that can help you grow the best workforce possible.