Nurse leaders' views on clinical ladders as a strategy in professional development.

Objective: To investigate nurse leaders' views on clinical ladders as a strategy in professional development of nursing.

Background: Hospitals worldwide have implemented clinical ladders to boost professional development and improve quality of patient care. At ward level good leadership is vital in creating a learning environment and using nurses' new competence.

Methods: The design was explorative and data were collected in focus groups with 19 nurse leaders at the ward level and 24 executive nurse leaders at hospitals with several years of experience with clinical ladders.

Results: Most nurse leaders did not think strategically in promoting clinical ladders at the organizational level. Nurse leaders who considered clinical ladders a tool in developing nursing quality found motivational work challenging and rewarding. Not all nurse leaders managed to utilize clinical specialists' new competence.

Conclusions: Further investigation into nurse leaders' actions as strategic managers of development and use of nurses' competence is warranted. Implications for nursing management It is important that managers see the close connection between professional development of individuals and development of quality and high standard in the ward. A prerequisite is therefore to engage in the strategic planning of competence at all levels of decision in the organization.