MOTIVATING AND DEVELOPING STAFF 235
Horizontal promotion rewards the excellent clinical nurse without promoting the nurse to management. A clinical ladder, based on Benner’s (2000) novice-to-expert concepts, includes:
1. Clinical apprentice—new nurse or nurse new to the area
2. Clinical colleague—a full partner in care
3. Clinical mentee—demonstrates preceptor ability
4. Clinical leader—demonstrates leadership in practice
5. Clinical expert—combines teaching and research with practice
The strength of the system is that superb, clinical nurses can remain at the bedside, clinical excellence can be rewarded, and nurses can move back and forth among the levels based on their personal and professional goals and needs.
Another example of clinical advancement program was used at a Magnet-certified insti- tution, Cincinnati Children’s Hospital Medical Center (Allen, Fiorini, & Dickey, 2010). The program’s goal was to improve the quality of patient care, provide career opportunities for par- ticipating nurses, and to enhance job satisfaction and nurse retention. Evaluation of the program illustrated that goals were met. An additional finding revealed that the program had a substantial positive fiscal impact on the organization as well.