Programs: Nursing Career Ladder

The Staff Nurse III/IV, HH/H III, and NP III programs have been developed to offer recognition and career advancement opportunities for those nurses who have excelled in clinical practice, leadership and professionalism.

The roles are designed to enable the clinically expert nurse to find continuing recognition and rewards in the provision of direct care in his/her area of clinical specialty.

The nurse functions in the clinical setting as an exemplary care giver to patients, a model of proficiency for co-workers, and a colleague to physicians. From years of nursing experience and a continued expansion of clinical knowledge, the Clinical Expert (SN III & IV HH/H III, and NP III) is a skilled practitioner who demonstrates leadership by:

1. Identifying, communicating and fulfilling patient needs;
2. Coordinating and utilizing facility and community
3. resources to meet patient needs;
4. Promoting a multi-disciplinary approach to patient care;
5. Assuming a teaching-coaching role with other nurses and health team members, and;
6. Maintaining a flexible approach to resource constraints.

Application & Renewal Application Timeline

• Applications are accepted every four (4) months – deadlines are March 1, July 1, and November 1 of each year.Renewals are made every three (3) years. It is each RN/NP’s responsibility to ensure they meet all renewal requirements and they submit their renewal application on time.

Minimum Qualifications

Here is a general overview of the requirements for advancement on the Nursing Career Ladder. Please see the current application or renewal packets for the most accurate and up-to-date information.

Staff Nurse III/Home Health/Hospice Nurse III

1. Current license to practice as a Registered Nurse in California.
2. Five (5) years of clinical experience as a Registered Nurse.
3. Work in the area of clinical specialty with the Employer for the last two years.
4. Work in the area of clinical specialty with the Employer for an average of 24 hrs/week over the last year.
5. Signed performance evaluation based on the applicable performance standards for each year at the midpoint or above on average Electronic and hand signatures are accepted; however, AACC requires hand signatures of RN managers on the evaluation.
6. Performance evaluation must be at mid-point or above on average.
   • Performance evaluations are found on the MyHR website > KP & Me > Performance Management. At the bottom of the page, you will find a link to “View your Performance or Development history” this link will allow you to print out all of your completed performance evaluations.
   • All pages of the performance evaluation must be submitted
7. Fifteen (15) CEUs in her/his area of clinical specialty in the past year.

Home Health/Hospice III only

1. A current license to practice as a Registered Nurse in California.
2. Five (5) years of applicable RN experience within the last five years.
3. Worked as Home Health/Hospice nurse with the employer for at least three (3) of the last five years, or two (2) years as Home Health /Hospice nurse with the employer and one (1) year home health experience within a Medicare certified home health agency.
4. Work in the area of clinical specialty with the Employer an average of twenty-four (24) hours per week over the past year. See calculation below.
5. A Public Health Nurse (PHN) certification,or serve as a HH/H case manager.
6. Current signed performance evaluation at the midpoint or above on average.
   • Fifteen (15) CEUs in her/his area of clinical specialty in the past year.

Minimum qualifications for NP III shall include:

1. Current RN licensure and nurse practitioner certification to practice in California.
2. Four (4) years experience as a nurse practitioner.
3. Work in the clinical area for the Employer for the last two (2) years.
4. Ongoing work in clinical area for a minimum of 24 hours/week over the last year. A NP who is in a NP QL role (20 hour/week position) meets this qualification.
5. Current performance evaluation by applicant’s RN manager (or DONP or RN AMGA) within the last twelve (12 months), at the midpoint or above for (a) clinical competence, (b) interpersonal relationships and (c) professional characteristics. Applicants may request the sample form in the appendix be used for their evaluation.Clarification: The applicant’s evaluation needs to document a midpoint evaluation overall for each of the three requirements — clinical competence, interpersonal relationship, and professional characteristics. The FSC will apply its judgment to determine “midpoint overall” if needed. Evaluations on other areas are not part of the clinical ladder process.Note to applicants: All FSC members will review the evaluation submitted with this packet. FSC members will be expected to maintain the confidentiality of this document.
6. Thirty (30) CEUs/CMEs which are applicable to clinical area over the past two (2) years or that meet national certification requirements. Masters/Post-Masters/Doctoral Degree courses (copy of transcript or certificate) shall apply if applicable to clinical area and are recognized by the BRN.Clarification: If the applicant has a current national certification and a current license at the time of application, they meet the CEU requirement regardless of timeframe for CEUs.If in question, the applicability of the CEU to the clinical area may be established in two ways: (1) the applicant may choose to provide an optional written description of how the CEU applies in their application and (2) the applicant may clarify applicability in the interview.