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A clinical ladder for the community health-care setting.

The concept of a clinical ladder for nursing is over 20 years old–it has been reported in the literature through the 1970s and 1980s. Initially, reports described only hospital-based programs. More recently, occasional articles describe clinical ladders in a long-term care facility (Kohn & Biache, 1982) and in a medical technology facility (Warren, 1983) for the Licensed Practical Nurse (LPN) (Southmayd & McCollum, 1985), the flight nurse (Helander, 1985), and the emergency room nurse (Brown, 1986). Professional recognition and compensation are of equal importance to the community health nurse (CHN), though implementation of a clinical ladder in a community health facility has not yet been reported in the literature.