Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Human Resource Education and Workforce Development

First Advisor

James W. Trott, Jr


One solution to overcome the shortage of hospital nurses is to establish and implement clinical career ladder programs. The purpose of this study was to examine hospital clinical nurses' perceptions of ladder programs as a job enrichment strategy and to determine individual and work-related variables contributing most to nurses' participation or nonparticipation in available clinical ladder programs. A random sample of 600 clinical nurses employed full time in five regional medical center hospitals located in Louisiana and Mississippi were the study subjects. Respondents were 106 (88.3%) of the 120 ladder program participants and 385 (80.2%) of the 480 nonparticipant nurses. A three section instrument was used for data collection and analysis: perceptions of clinical ladder programs; the Job Diagnostic Survey (JDS); demographic information. Section one was researcher developed to measure nurses' perceptions of three factor areas of clinical ladder programs. The JDS measured the motivational potential of the clinical nurses' job according to selected core job dimensions. The demographic section identified clinical nurses' individual and work-related characteristics. The Chi square and t-test statistical procedures revealed that subjects by ladder program participation status were more alike than different on the demographic characteristics of gender, ethnic group, educational level, nursing practice unit, patient care delivery method and years' clinical experience. However, significant differences were reported between nurse groups by program participation status and the variables age, shift worked, hours worked per shift and years present clinical position. A comparison between nurse groups by participation status and perceptions of clinical ladder programs showed significant differences in the factor areas of intrinsic and extrinsic outcomes, need for a ladder program and criteria for program advancement. Also, a t-test showed significant differences in the two groups' JDS means task identity, feedback from agents, growth need satisfaction and job security. Using discriminant analysis, a model was found that correctly classified 75.69% of hospital nurses by program participation status group. The results suggest implications for nursing practice and future research studies of hospital clinical nurses and clinical ladder programs for job enrichment. A replication of this study to test the model was also recommended.