Nurses' Perceptions of Clinical Ladder System

Purpose: The purpose of this study was to identify the nurses' perceptions of clinical ladder system among different units (operation room, intensive care unit, emergency room) and to explore the effects of empowerment and unit-level professionalism on the nurses' perceptions of clinical ladder system. 

Methods: The sample was 155 nurses conveniently selected from a tertiary care hospital in Seoul, South Korea in 2012. Data were collected using the perception of clinical ladder system scale developed by Park and Lee. Hierarchical linear modeling were performed using HLM 7 software.

Results: Nurses' perception of clinical ladder system significantly differed according to the unit that nurses are belonged (F=6.698, p=0.034). Although gender status (t=1.159, p=0.248) and level of education (t=-0.411, p=0.682) did not significantly predict changes in perceptions of clinical ladder system, total month of working (t=2.834, p=0.005) and empowerment (t=7.282, p<.001) significantly predict changes in perceptions of clinical ladder system. In terms of cross level interaction, there is significant cross level two way interaction between unit-level professionalism and empowerment (t=3.745, p<.001). That means, professionalism significantly predict changes in the relationship between nurses empowerment and perceptions of clinical ladder system .

Conclusion: This study identifies that the perceptions of clinical ladder system are different among working units, and working experience and empowerment, unit level professionalism are significant predictors for nurses’ perceptions of clinical ladder system. Based on these results, nursing department and medical institution can develop programs that would increase empowerment and professionalism in order to raise the perceptions of clinical ladder system among nurses. Furthermore, by providing education program to newly graduated nurses rather than long working experience nurses, nursing managers can expect the effective increase of perceptions of clinical ladder system. in turn, will contribute to effective human resource management.