DUHS Nurse Annual Report

As a result of the Institute of Medicine’s (IOM) “The Future of Nursing” report of 2010, Duke University Health System (DUHS) 2011 Nursing Annual Report indicated an agreement for the implementation of nursing succession. The DUHS Nurse Executive Council (NEC) is comprised of senior nursing leadership, which includes: all unit Chief Nursing Officers (CNO), Assistant Chief Nursing Officers (ACNO), and nurse leaders from ambulatory care units. All units are represented on the DUHS NEC to ensure the team promotes consistency and allocates resources equally throughout the health system. This team is responsible for planning, creating, and implementing nursing priorities every year for 4600 nurses in their health system. In addition, they implemented

However, the military continues it progression up the ladder until the rank of colonel is achieved. At that point, the nurse would have 22 years of experience, and only a 50% chance for promotion past that level. Promotions in the military system are classified as either below-the-zone, in-the-zone, or above-the-zone. Each zone has a specific purpose in the promotion program. First, below-the-zone could be used in the civilian sector as a reward for outstanding performers, as it is in the military. This distinction is given to only a select few, which have gone above and beyond what is required and expected of them. This allows the recipient to promote to the next level in the Clinical Ladder earlier than the mandated time frame. By creating programs that identify and reward superior performers for their work, influences others to perform at higher levels as well in hopes of being acknowledged for their hard work as well. Next, in-the-zone refers to the normal progression of promotion. This zone is where the majority of nurses would be during their climb up the Clinical Ladder promotion system. Lastly, above-the-zone is for nurses that did not make their promotions in the specified time frame allotted by the military. Therefore, it allows nurses one final attempt to progress to the next rank level. According to the DUHS Clinical Ladder CNI requirements, a nurse only has 18 months to progress to the next level of CNII (Duke Nursing, n.d., CNII section). In a like manner, if a military nurse is passed over for promotion again during the above-the-zone promotion cycle, must separate or retire from the military if eligible (Powers, n.d., Promotion times