You are serving on a committee of nurse–managers and staff nurses to develop guidelines and job descriptions for a new pay structure based on differentiated nursing practice. Several members of the committee are resistant to change. Your committee is now looking at four clinical levels of RNs, with different salary ranges for each level. Some believe that both education and expertise should be required for advancement from one level to the next, and others believe that it should be based only on expertise. So far, the committee has agreed that nurses who wish to advance to the next clinical level must (a) apply for an open position at that level, (b) be recommended by their immediate supervisor and one other nurse of an advanced clinical level, and (c) possess the expertise and education necessary to fulfill the job functions. It is the third requirement that you are having difficulty. You cannot agree on the type (formal or certifications) and amount of education necessary for each level or on how you will document expertise. ASSIGNMENT: Write a proposal for differentiating practice at the unit level. Will you use education, years of experience, or skill level to differentiate your career ladder, or will you use some combination of the three? What would you name each of the four levels of nursing? Will your minimum requirements for each level be fixed, or will you allow for individual variations?


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