University of Virginia Health System

Diagram of the Clinical Career Ladder

Brief Description of Each Role's Behaviors

For a more detailed description, see the Behavior documents for Clinician I-IV and Advanced Practice Roles.

CLINICIAN I
Entry-level professional nurse, focused primarily on developing knowledge and skills. Provides safe patient care at a basic level and shows growth in ability to care for increasingly complex patients. Requires consultation with more experienced clinicians and benefits from feedback.

CLINICIAN II
Capable clinician, focused on expanding knowledge and skills. Consistently provides effective direct care as part of the interdisciplinary team, to a variety of complex patients. Seeks as well as provides feedback for improved clinical practice. Assumes a beginning leadership role but seeks mentoring in this process.

CLINICIAN III
An experienced and highly skilled clinician who is recognized for knowledge and skills by their peers. Utilizes an interdisciplinary approach to patient care service delivery across the continuum of care. Has an emerging leadership style and functions consistently and autonomously in this role. Is learning to negotiate the healthcare system to maximize the delivery of quality care and to minimize cost of patient care services.

CLINICIAN IV
Baccalaureate-of-Science-in-Nursing-prepared clinician with well-developed clinical expertise within a defined specialty, recognized by peers as a leader within the institution. Works predominantly with patients, families and nursing staff. Has aggregate responsibility at the service center level for nursing care, incorporating current literature and research. Identifies the strengths within the service area and takes the opportunity to develop and or mentor others to promote professional growth and improve patient outcomes. Has demonstrated expertise in chosen scholarly activities focused towards the advancement or promotion of the profession.

CERTIFIED NURSE PRACTITIONER (CNP)
Masters-prepared, nationally-certified clinician (nurse practitioner, midwife, anesthetist) that manages the care of a defined patient population as a dominant aspect of the role. Promotes professionalism in self and others. Coaches or guides others in clinical decision-making and problem-solving. Serves as clinical consultant in area of specialization.

ADVANCED PRACTICE NURSE 1 (APN 1)
Masters-prepared, nationally-certified expert clinician in an advanced practice role that manages the care of a defined patient population as a dominant aspect of the role. Recognized as an interdisciplinary leader within the service area. Consistently demonstrates core competencies of advanced practice in a defined specialty:

• Consultation
• Research skills
• Clinical and Professional leadership
• Collaboration
• Ethical decision-making
• Expert coaching and guiding
• Critically analyzes the healthcare delivery system to maximize the delivery of quality, cost-effective patient care services.

ADVANCED PRACTICE NURSE 2 (APN 2)
Masters-prepared, nationally-certified expert clinician in an advanced practice role that manages the care of a defined patient population as a dominant aspect of the role. Designs, implements, and evaluates creative approaches to patient care and patient care systems, thereby contributing to the body of nursing knowledge. Promotes professionalism in self and others. Coaches or guides others in clinical decision-making and problem-solving. Serves as clinical consultant in area of specialization.