We are excited to have you a part of our “state of the art” Professional Nurse Clinical Ladder “PACE” Program! The clinical ladder is a tool developed specifically at CHOC to assist in reaching our vision for nursing.

The clinical ladder is a structured system to provide our nurses with career advancement while remaining in the clinical setting and providing direct patient care. Our program is used to distinguish advancement in care, recognize professional development and differentiate levels of nursing expertise and contributions.

CLINICAL LADDER LOGIN IS ONLY THROUGH CHOC SINGLE SIGN ON (SSO) PAGE

Clinical Nurse I Minimum Eligibility Criteria

RN Resident, RN Fellow <2 years experience.

Clinical Nurse II Minimum Eligibility Criteria

At 2 years experience all Clin I nurses required to advance Clin II (must complete RNR and RN Fellows classes, as assigned)
Personal score of 3 and above on performance evaluation

Clinical Nurse III Minimum Eligibility Criteria

Greater than 3 year of practice
BSN (or >25 years experience at CHOC)
National Certification
Personal score of 3 and above on performance evaluation

Clinical Nurse IV Minimum Eligibility Criteria

Greater than 5 year of practice
BSN or MSN (or >25 years experience at CHOC)
National Certification
Personal score of 3 and above on performance evaluation

PACE Program

Clinical Nurse I

Under the guidance of a preceptor/mentor, the nurse collects objective data according to guidelines and rules obtained from nursing education and in orientation. The nurse describes a clinical situation from the viewpoint of what they need to do rather than relating the context of the situation to how the patient responds. The nurse is gaining experience in clinical and technical skills, building a knowledge base and is comfortable in a task-oriented environment. The nurse practices from a theoretical knowledge base while recognizing and providing for routine patient needs and is guided by policies, procedures, and standards. The practice of the nurse at this level may vary widely as one transitions from new graduate to an independent nurse.

CN I Minimum Eligibility Criteria

RN Resident, RN Fellow <2 years experience.

Clinical Nurse II

Minimum two (2) years experience to advance from Clin I. Must complete RNR and RN Fellows classes as assigned.
The nurse integrates theoretical knowledge with clinical experience in the care of patients and families. The nurse sees one’s actions in terms of long-range goals or plans. Care is delivered using a deliberate systematic approach and practice is guided by knowledge of patterns of patient responses in recurrent situations. The nurse demonstrates mastery of most technical skills and begins to look at clinical situations from the patient’s and family’s viewpoints. The practice of the nurse at this level may vary widely.

CN II Minimum Eligibility Criteria

At 2 years experience all Clin I nurses required to advance Clin II (must complete RNR and RN Fellows classes, as assigned)
Personal score of 3 and above on performance evaluation

Clinical Nurse III

The proficient nurse (minimum 3-5 years of experience) who has an in-depth knowledge of nursing practice; the nurse perceives each situation as a whole and comprehends the significant aspects of situation based on one’s experience. The nurse demonstrates the ability to recognize situational changes that require unplanned or unanticipated interventions. The nurse responds to most situations with confidence, speed, and flexibility. Progression is from a task orientation to a holistic view of patient care. The nurse develops effective relationships with other caregivers and provides leadership to the health care team in formulating integrated approaches to care. Able to effectively mentor and precept newer nurses. Focus is primarily unit based. The nurse interprets patients’ and family’s experiences from a wider perspective and can envision other possibilities.

CN III Minimum Eligibility Criteria

Greater than 3 year of practice
BSN (or >25 years experience at CHOC)
National Certification
Personal score of 3 and above on performance evaluation

Clinical Nurse IV

Nurses are expert practitioners (minimum 5-7 years of experience) whose intuition and skill arise from comprehensive knowledge thoroughly grounded in experience. One’s practice is characterized by a flexible, innovative, and confident self-directed approach to patient and family care. This nurse identifies situations, formulates solutions, initiates change, and monitors outcomes. Expert nurses operate from a deep understanding of the total situation. They are able to articulate their practice comfortably and proficiently. They are involved in activities on the organizational level and understand how their unit aligns with the strategic goals of the organization. The nurse keeps one’s personal values in perspective and therefore is better able to encourage and support patient and family choices. Expert nurses collaborate with the interdisciplinary team to challenge and coordinate resources in order to maximize advocacy for patient and family care
and in achieving the most effective outcomes. The nurse serves as a role-model and readily shares knowledge.

CN IV Minimum Eligibility Criteria

Greater than 5 year of practice
BSN or MSN (or >25 years experience at CHOC)
National Certification
Personal score of 3 and above on performance evaluation