Design: Non-experimental, descriptive/correlational, model testing

Sample: 177 Registered Nurses from an academic medical center in the United States. Participants and non-participants in the program were recruited

Variables: Clinical ladder effectiveness, job satisfaction, organizational commitment, and turnover intention.

Methods: Data collection through a mail survey approach. Data analyses included MANOVA with univariate post-hoc tests, structural equation modeling, with verification of structural equation modeling results through path analysis using ordinary least squares.

Findings: Participants rated only the fringe benefits subscale of the job satisfaction measure significantly higher than non-participants. Significant group differences were present based on program participation for all subscales of the clinical ladder effectiveness measure except the guide to evaluate performance subscale, with participants scoring higher than non-participants. In model testing, clinical ladder effectiveness was a significant predictor of job satisfaction, but not a significant predictor of organizational commitment or turnover intention.

Conclusions: Clinical ladder programs were perceived as effective by participants and this effectiveness was a significant predictor of job satisfaction. Given the evidence of job satisfaction as a significant predictor of intent to remain employed with an organization, the claim that clinical ladder programs improve nurse retention receives some empirical support in these cross-sectional data.

Implications: Clinical ladder programs represent a viable, effective addition to a multifaceted program of nurse recruitment and retention strategies. However, clinical ladder programs should not be perceived as a “cure-all” for nurse recruitment and retention, but rather as an additional option directed toward providing a means of professional recognition for nurses.

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Back to 15th International Nursing Research Congress
Sigma Theta Tau International
July 22-24, 2004