Where Does the Career Ladder Lead?

One nurse pulled an educator aside and discussed all of the other competing priorities. “Why can’t we just do our job and go home?” he retorted. While another nurse excitedly shared her recent experience with constructing and turning in her portfolio. The career ladder is an important tool for any facility to use as a source of recognition, retention and engagement. The theme that continues to emerge is that nurses are motivated by different factors. A career ladder should speak to the three different motivators. The three motivators are: recognition and acknowledgement by both leaders and cohorts, a financial token of appreciation, and a new wrinkle in the brain aka new knowledge.

Hospitals are beginning to place more emphasis on professional development. Professional development for nurses looks like several things which include: national certifications, advancing degrees, publishing in peer reviewed journals and even presenting on the local, state and national levels. This does not by any means reduce or discount the priceless work that is done at the bedside. But the days are gone when nurses came into their facility, clocked in, focused all efforts at the bedside then clocked out. Nowadays, there is mandatory participation on Nursing Shared Governance councils and quality committees. In order for nurses to truly own their quality of care and commitment to patient safety, they must first understand how their actions fit into the bigger picture and that is only done by holding one another to professional standards.

Career ladders take both the nurse, the leader and the organization somewhere. But where is that? Some may ask. Well, that is forward by way of scientific inquiry that leads to evidencebased practice at the bedside. Another way that facilities are experiencing progression is by way of education, mentorships, preceptorships, chart reviews by peers, peer review of the practice and other offerings for contact hours or resources that help with development of the nurse as a professional. At some hospitals there are affiliation agreements with intuitions of higher learning that have a consistent presence in an effort to make the application process smoother. A career ladder sets the nurses apart, it is telling which ones are clocking in to receive a paycheck and those who are on a career path in nursing. There are many components of the career ladder but usually there are opportunities for everyone to be successful.

The three motivators must be present to capture all of the professional nursing staff’s attention. You have some who would simply like to be acknowledged and celebrated for the stellar work that they do both on the unit and in the community. These are the nurses who are an active part of the professional nursing association, they are also on their unit-based councils and they are sharing their intellectual property in hopes of making things better in their work environment. The nurse who is motivated by acknowledgment by their leadership and cohorts are generally the nurses who have helped to mold other nurses and encouraged them to take ownership in the mission, vision and values of the organization. There is a quite a bit of heavy lifting that has to be done and this group of nurses are the agent to change. They should be thanked, and the career ladder helps to achieve this along with recognition on the badge or any other communications.

Next, there is the nurse who are like “show me the money”. It is true that most nurses use their nursing skills to secure the things in life that they want. That may be a trip, a new car, maybe a spa day or any other thing that is desired. So, it is important to tie the career ladder into either the evaluation for their merit increase or perhaps a bonus. Either way, it is imperative to remember this group of nurses’ bottom dollar, pun intended. They will quickly jump on board for the financial token of appreciation. How much is not the issue as much as the “what is in it for me?” One may think that the opportunities to improve as a professional or the unlimited professional development may be an incentive. But more information is being gathered about incentivizing others to help themselves. This is the same principle as offering free classes to patients but using lunch or give aways to get them there. The information gleaned is definitely a plus, but it is just not enough to get this group of nurses excited to put together a portfolio.

Lastly, but certainly not least are the group of nurses who seek out new opportunities, new innovations and a chance to improve themselves. There are just not enough hours in the day for this group who want to learn and grow continuously. This nurse can be a novice or an expert, this nurse could be a baby boomer or a millennial, there are lifelong learners sprinkled amongst the masses. Excitement is visible on their faces when a flyer about a new course offering or a chance to innovate is on the horizon. To this group, knowledge is something that cannot be taken away and they value the chance to learn a new skill or tool that they can add to their toolkit in nursing. This group of nurses do not always wait to hear about the next opportunity, they will create them, and they are very vocal about what is needed to help them achieve their professional goals.

Each nurse is in control of their own trajectory. The career ladder is a way to meet the needs of the profession and it is a great litmus test to see just what motivates the nurses in the organization. The advent of career ladders has caused some nurses who have not been to school in years to read peer reviewed articles and to continue to learn. With nursing being both and art and a skill, defining goals that further develop nurses as professionals is a huge win for all involved. Administration gets to see the nurses go from a lack of enthusiasm to proud and doting. The portfolio is not only useful for the current organization, rather it is a collection of programs, ideas and projects that the nurse can show case in new opportunities for advancement and in the speaker’s circuit.