Reaching for the stars: Career advancement and the registered nurse


  • Kim Walker RN PhD

    Corresponding author
    1. Practice Development and Research Coordinator, St Vincent's Private Hospital, Sydney, New South Wales, Australia
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Kim Walker, St Vincent's Private Hospital, Nursing, Sydney, NSW 2010, Australia. Email:


Clinical nursing has long struggled to secure the place of primacy it deserves in the profession's hierarchy of importance and worth. It is ironic that, even at the beginning of the 21st century, a clinical nurse is generally not as well-recognized, rewarded or remunerated as a colleague working in nursing management, education or research. Until the profession recognizes and takes serious action to remedy this situation, the crisis of recruitment and retention in nursing currently ravaging the globe is likely to continue. In this paper, I present a discursive account of an exciting initiative by a leading private, acute-care hospital which addresses this very problem. A new ladder for clinical nurse specialists (CNSs) introduces a rigorous and systematic approach to the appointment of three classifications of CNS, each requiring evidence of successively higher levels of competency, and which are accompanied by fiscal reward and stronger peer recognition.