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ABSTRACT
In June 1990, Santa Rosa Children's Hospital instituted a multitrack career ladder program for registered nurses, in response to the issues of retention of expert nursing staff and development of professional nursing practice. The program incorporates clinical, education, and management tracks, providing vertical and lateral mobility to the registered nurse. Performance evaluation criteria complement the promotional process, and the registered nurse has a menu of requirements to fulfill each year upon promotion to or maintenance of career ladder level. Through incorporation of a graduated salary system, the program has been a retention bonus for registered nurses at Santa Rosa Children's Hospital. In addition, the career ladder program has been very successful in promoting professional nursing practice within the hospital.
Retention of expert nurses is a critical issue in today's health care setting. The continued development of professional staff is a challenge for managers and educators in hospitals. In response to these needs, the career ladder committee at Santa Rosa Children's Hospital developed a multitrack career ladder program to address the issues of retention of expert staff, and development of professional nursing practice.
COMMITTEE SELECTION AND PROGRAM DEVELOPMENT
The committee chair was selected by the associate administrator for patient care services, and was charged with selecting a committee that was representative of the various patient care areas. Those selected represented a cross-section of the different levels of nursing at Santa Rosa Children's Hospital. The committee met once a month for a period of four months. After an initial discussion of the group's thoughts and concerns, a literature search was done and current articles were shared with the committee for education and feedback (Alt & Huston, 1986; Davis, 1987; McKay, 1986; Sanford, 1987; Taylor & Salome, 1984; Vestal, 1984). Benner's From Novice to Expert (1984) was seen as a compatible framework on which to base the career ladder program. The issues then to be addressed were identified as:
* performance appraisals,
* peer review,
* application design and process,
* menu selection,
* education and management tracks, and
* financial compensation.
By consensus, a career ladder program was designed and presented to nursing administration. With rrdnor revisions, the program was presented to nursing administrators of the four-hospital Santa Rosa Health Care Corporation. A small corporate...