title: Nurse leaders' views on clinical ladders as a strategy in professional development.
abstract: OBJECTIVE
  To investigate nurse leaders' views on clinical ladders as a strategy in professional development of nursing.
  
  
  BACKGROUND
  Hospitals worldwide have implemented clinical ladders to boost professional development and improve quality of patient care. At ward level good leadership is vital in creating a learning environment and using nurses' new competence.
  
  
  METHODS
  The design was explorative and data were collected in focus groups with 19 nurse leaders at the ward level and 24 executive nurse leaders at hospitals with several years of experience with clinical ladders.
  
  
  RESULTS
  Most nurse leaders did not think strategically in promoting clinical ladders at the organizational level. Nurse leaders who considered clinical ladders a tool in developing nursing quality found motivational work challenging and rewarding. Not all nurse leaders managed to utilize clinical specialists' new competence.
  
  
  CONCLUSIONS
  Further investigation into nurse leaders' actions as strategic managers of development and use of nurses' competence is warranted. Implications for nursing management It is important that managers see the close connection between professional development of individuals and development of quality and high standard in the ward. A prerequisite is therefore to engage in the strategic planning of competence at all levels of decision in the organization.
authors.affiliation: Asker and Baerum Hospital, Rud, Norway. solveig.torstad@sabhf.no
authors.forename: Solveig
authors.initials: S
authors.lastname: Tørstad
authors.forename: Ida Torunn
authors.initials: IT
authors.lastname: Bjørk
mesh_terms: D001291:Attitude of Health Personnel; D002322:Career Mobility; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D007857:Leadership; D009042:Motivation; D009664:Norway; D009718:Nurse Administrators / Q000523:psychology*; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D017009:Professional Autonomy; D011361:Professional Competence; D036301:Qualitative Research; D011787:Quality of Health Care; D012944:Social Support; D013192:Staff Development / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013850:Thinking