Retaining quality, engaged nurses is a fundamental goal of every nurse leader and manager in today’s work environment. In the last year alone, the nursing turnover rate grew by an average of 8.4% nationwide, resulting in the loss of talented and knowledgeable staff and hundreds of thousands of dollars per nurse. Dedicated nurses want to provide the most competent care possible and receive recognition for their efforts.


What is the Clinical Ladder?


The clinical career ladder is one of the most meaningful ways to provide this recognition of a nurse’s commitment to quality outcomes and the safety of our patients. It is a tool used by healthcare systems to encourage nurses to progress in their careers. Nursing clinical ladders reward dedicated nurses who meet defined criteria, including skills, education, competencies, and professional expertise. The program looks at a nurse’s education level, certifications, and years of experience. Then, the nurse must complete tasks, such as learning activities and evidence-based practice projects, providing proof of clinical leadership.


Significantly, the clinical ladder motivates nurses to continue developing skills beyond the classroom. It also promotes excellent patient care, encourages expert nurses to remain at the bedside, fosters self-growth and career advancement, and supports recognition and retention. To retain and advance the career of staff nurses, improving the implementation and visibility of the clinical career ladder is essential. Using the clinical ladder program from StaffGarden allows nurse managers and staff to monitor progress, provide real-time feedback, and support nurses’ growth.


The clinical ladder program has five levels of career development:


  • Novice—new nurses who perform limited tasks
  • Advanced Beginner—nurses with acceptable performance, starting to link prior experiences to meaningful actions
  • Competent—nurses with two to three years of experience, who can plan their actions through analytical thinking, have greater efficiency, and are more organized
  • Proficient—nurses who make informed decisions, learn from their experiences, and can see whole situations, not just parts 
  • Expert—experienced nurses with an intuitive understanding of clinical situations, flexibility, and high proficiency; they don’t rely on rules to connect situations with actions


Nursing morale is closely tied to the clinical ladder program because it


  • Encourages empowerment,
  • Promotes nurse productivity to the fullest capability of licensure,
  • Uses evidence-based practice at the bedside,
  • Improves patient satisfaction, 
  • And produces new ideas for the unit they work on.


The nursing clinical ladder program is a way to incentivize and recognize career advancement and continued nursing development while nurses continue providing direct patient care in their units. Nurse managers and supervisors that encourage and provide time for this activity will notice positive effects, including increased nurse engagement, job satisfaction, and decreased turnover rates. 


Education and Advancement Opportunities


The clinical ladder process is a resource for nursing managers to steer their staff toward career advancement and education. Clinical ladders encourage a measure of competence and commitment for the nursing professional. Nursing clinical ladders provide staff nurses with recognition and financial rewards while promoting responsibility, accountability, and commitment to patient safety and quality.


In addition, the clinical nursing ladder encourages nurses with more expertise to support the nurses with fewer skills. Nurses participating in clinical ladder programs are more likely to make informed decisions about patient care, safety, and quality measures than nurses not engaged in career ladders. Managers will notice that nurses involved in effective clinical ladder programs have a higher level of job satisfaction and awareness of patients’ recovery, nursing tasks, and education.


Types of Clinical Ladder Programs


The clinical ladder program gives engaged nurses a way to improve quality and safety measures in their departments and a voice in changing processes and nursing care. Nurse managers and staff nurses are more likely to engage in a clinical ladder process that provides clarity, transparency, and ease of use. Yet, some clinical ladders can be cumbersome paper and binder programs that are not easily accessible and require hours without feedback, decreasing a nurse’s willingness to participate.


Grow from StaffGarden takes the pain out of the traditional clinical ladder programs. Grow is an online program that can be accessed from your phone, laptop, or desktop, allowing both staff and managers easy access. This program helps nurse managers and mentors give real-time guidance to nurses who embark on the clinical ladder process. An online program that allows ease of access and ongoing feedback is more likely to be successful for the institution and the individual nurse. 


Cons of Traditional Clinical Ladder Programs


  • No real-time insight into the progress
  • Paper and binders decrease access 
  • The application review process is cumbersome
  • Decreased accessibility by future nurses

What Grow Gives You


  • Transparency and accessibility to staff and managers
  • Cloud-based, mobile-friendly application
  • Real-time oversight and feedback
  • Easy review of applications
  • Access to historical projects 
  • Trends of nursing interest 


Grow Your Nursing Morale and Engagement


In today’s market, nursing retention and staff turnover are real issues nursing managers and administrators must address daily. The StaffGarden program Grow assists them in retaining engaged, happy nurses by taking the clinical ladder to a new level. This program allows nurses to apply online and helps managers and administrators review reports and engage with applicants. Grow conveniently promotes staff nurses’ clinical excellence without adding another meeting to managers’ days.


Improve the morale and engagement of your nursing staff by scheduling a demonstration today. 




Climbing the clinical ladder—one Rung at a time : Nursing management. (2013, May). LWW.

Gamble, M. (2022, October). The cost of nurse turnover in 23 numbers. Becker’s Hospital Review – Healthcare News.

The effects of a clinical ladder program on professional development and job satisfaction of acute care nurses. (2019, July). International Open Access Journals | HSPI.

The impacts of career ladder system for nurses in hospital | Enfermería Clínica. (2019).




Rebecca Flynn, MSN, RN, AMB-BC, NE-BC is a writer that specializes in nursing management, health, and wellness. She has 20 years of experience as a Licensed Vocational Nurse and 8 years as a Registered Nurse working in primary care and nursing management. Her years of working as a patient advocate and leader provide her with the knowledge to write with an understanding of the needs of patients and nursing staff.