Nursing Care

The five phases of professional growth described by Benner are as follows

• Novice: beginner with no experience
• Advanced Beginner: possesses a working knowledge of key aspects of practice, demonstrates acceptable performance
• Competent: begins to see actions in terms of long-range goals or plans. Typically, a nurse with 2-3 years experience in the same area.
• Proficient: understands situations as a whole, perceives the meaning of situations in terms of long term goals, deals with complex situations holistically.
• Expert: maintains an intuitive grasp of clinical situations; performance is fluid, flexible, and highly-proficient.

At BID–Needham, the Clinical Nurse Advancement Program provides an opportunity for qualified clinical nurses who practice at the level of proficiency and beyond to apply for advancement to Clinical Nurse III.

This packet was developed for the purpose of describing the clinical advancement process at BID–Needham and providing guidance to nurses who seek advancement. You are encouraged to contact Heidi Alpert, RN, Chair of the Clinical Nurse Advancement Review Board or any other members of the Review Board for additional information and guidance throughout the advancement process. Below is a list of the topics addressed in this packet.

• Applying for advancement to Clinical Nurse III
• Eligibility for advancement to Clinical Nurse III
• Application process
• Criteria for Clinical Nurse III
• Guidelines for Clinical Nurse III portfolios
• Required documentation/checklist
• Your portfolio
• Application for clinical nurse advancement
• Guidelines for letter of recommendation for advancement to Clinical Nurse III

Applying for Advancement to Clinical Nurse III

Advancement to Clinical Nurse III provides recognition for advanced clinical and leadership skills, an increase in compensation and a change in title. Each year, all nurses who have been advanced to clinical nurse III in the previous twelve months are recognized during Nurses Week.

When transferring to another unit, clinical nurses will retain the title of Clinical Nurse III. During the annual performance review process, nurses who have advanced will be evaluated according to their Clinical Nurse III level of practice.

Eligibility for Advancement to CN III

• Minimum of two years of nursing practice
• Must have worked in a budgeted benefits-eligible position (20 hours a week or more) in current unit/department for at least 1 year
• Must have endorsement of current unit nursing director
• Must meet criteria for Clinical Nurse III in the areas of clinical practice, evidence-based practice, education, and leadership

Application Process

Advancement to clinical nurse III is initiated by a qualified applicant with the endorsement of his/her unit Nursing Director. There is no set schedule or deadline to complete the application process. The review board, which is comprised of nurses who represent a variety of clinical areas, meets every month to review portfolios and make decisions regarding individual nurse advancement.

The application process is based on defined criteria and requires the creation of a portfolio. The portfolio consists of the following components

1. Application for Clinical Nurse Advancement (see attached) including Director endorsement
2. Two letters of reference written by peer colleagues (see guidelines for Letter of Recommendation)
3. Director endorsement via a narrative summary of most recent performance evaluation
4. Self-evaluation of professional performance
5. One Clinical Exemplar
6. Minimum of 3 professional goals
7. Professional Resume or Curriculum Vitae