Clinical Career Ladder

The Clinical Career Ladder (CCL) was initiated at UVA Health System in 1988 and is based on Benner’s From Novice to Expert. [1]  The PNSO CCL behaviors integrate the ANA 2015 Nursing: Scope and Standards of Practice, Third Edition  and the ANA Code of Ethics for Nurses with Interpretive Statements (ANA, 2015), and the UVA Nursing Professional Practice Model.


The Ladder was developed to promote individual growth as a professional nurse according to personal goals and stage of demonstrated nursing practice.  Each level of the ladder is associated with behaviors that represent increasing expertise, responsibility, and authority.  Those wishing to advance on the Clinical Career Ladder must demonstrate to a panel of their peers that they consistently perform next-level role behaviors through a portfolio and interview process. 


This empowering shared governance model is fundamental to the Professional Nursing Staff Organization’s operation.  The CCL evolves to meet the needs of the nursing organization and is evaluated annually by the CCL Chairs, panelists and candidates. This framework also encourages behaviors and activities that support the achievement of organizational goals.