Enhancing Professional Practice at Lancaster General
In the midst of rapid technological and scientific advances, nurses are challenged with providing customer-focused quality healthcare. Lancaster General Hospital is committed to recognizing and supporting registered nurses in their efforts to increase skills and knowledge to meet this challenge.
The Clinical Ladder defines the professional expectations of the registered nurse at Lancaster General Hospital. In addition, it provides a pathway for the RN to develop and expand clinical expertise and advanced nursing practices while remaining at the bedside.
The Clinical Ladder is a behavior driven system with four levels of practice. It is based on Patricia Benner’s model of nursing practice that includes 7 domains of practice and 5 levels of competency.
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RN I Entry Level |
RN II Competent |
RN III Proficient |
RN IV Expert |
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Level Expectation |
Reflects the experience of a recently licensed nurse. |
Reflects the minimum level of competency and experience required for employment. |
Reflects clinical expertise and leadership abilities in area of practice. |
Reflects advanced clinical expertise and leadership across Lancaster General and the community. |
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Requirements |
Must be met by 90-day review. |
Must be met by first annual review. |
- Voluntary
- Financial Incentive
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- Voluntary
- Financial Incentive
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Entry Requirements |
- 2 peer evaluations
- 1 preceptor evaluation
- Skills checklist
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- Level declaration
- 3 peer evaluations
- Project summary worksheet
- Supporting data
- Skills checklist
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- Level declaration
- 3 peer evaluations
- Resume
- Project summary worksheet
- Supporting data
- Exemplar optional for renewal
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- Level declaration
- 3 peer evaluations
- Resume
- Project summary worksheet
- Supporting data
- Exemplar optional for renewal
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Maintenance |
May only be maintained for 90-day introductory period. |
Mandatory for continued employment of all Lancaster General Hospital RNs. |
Must meet RN III performance standards yearly to maintain level status at time of annual review. |
Must meet RN IV performance standards yearly to maintain level status at time of annual review. |