My Journey from Bedside to Beyond: Why Career Lattices Matter
When I first became a nurse, I thought I would spend my career at the bedside. Like many new nurses, I was drawn to the meaningful work of direct patient care and the chance to make a difference. Over time, however, I found myself looking for something different. The long hours, the emotional demands, and the physical toll were real. I began wondering what else I could do with my skills and experience.
The challenge? I couldn’t see a clear path forward within my organization. The traditional career ladder pointed me toward roles like charge nurse, manager, or director—important positions, but not what I was looking for at the time. I didn’t know what other opportunities existed outside of bedside nursing, and because I couldn’t see those options, I left.
I went back to school, explored new avenues, and eventually found my way into a career at Kahuna, where I now help organizations build better pathways for their people.
Looking back, I realize that if I had been able to engage with a career ladder or a career lattice that showed me the range of opportunities available within my organization, my story might have been different. And I know I’m not alone. Many nurses today want to grow, but not every nurse wants to stay at the bedside forever. That’s where the difference between a ladder and a lattice becomes so important.
– Margaret Vaughan, RN, and Solutions Engineer at Kahuna
Table of Contents
What Is a Career Lattice & How Is It Different from a Career Ladder?
Understanding the Career Ladder
A career ladder is the traditional model of advancement in professional development programs, providing a structured, upward progression. It outlines a specific path for an individual, with these growth paths typically being in the same type of role or specialty.
For nursing, a ladder often looks something like this:
- Bedside Nurse
- Charge Nurse
- Nurse Manager
- Director of Nursing
This model provides clarity, recognition, and a defined way to grow within the clinical space. For nurses who are passionate about direct care and leadership in that domain, ladders are incredibly valuable, offering effective insight for specific career trajectories.
But ladders are, by design, linear. They assume the only way forward is “up” within the same type of role. For many healthcare professionals, that no longer reflects the reality of modern career growth.
The Career Lattice: A More Flexible Model for Growth
A career lattice model is non-linear, allowing for more flexible movement throughout the organization. It emphasizes lateral career movement, skill diversification, and cross-functional growth, not just a vertical promotion. Instead of climbing straight up, employees can move sideways or diagonally into different roles or departments. In healthcare, a career lattice framework might look something like this:
- Transitioning from bedside nursing into case management, patient education, or quality improvement
- Exploring opportunities in informatics, operations, or care coordination
- Moving into non-clinical leadership roles where nursing expertise still drives impact
The career lattice recognizes that career growth isn’t always about moving higher. Sometimes, it’s just about moving differently. For many nurses ready to explore professional development beyond the bedside, a lattice can be the key to staying engaged within their organization instead of leaving altogether.
Career ladders originated from Patricia Benner’s “Novice to Expert” theory and laid the foundation for structured professional growth in nursing. As healthcare evolves, nursing advancement programs and tools must evolve too. Whether your system uses a clinical ladder, clinical lattice, or a combination of both, Kahuna can transform these programs into transparent, technology-enabled models for today’s nurses.
Learn More: Climbing the Clinical Ladder in Nursing With A Digital Solution
Why Healthcare Organizations Need Career Lattices Today
Healthcare organizations face extraordinary workforce challenges. Nurse turnover is high, burnout is common, and the pressure to retain experienced talent has never been greater. One of the biggest reasons nurses leave isn’t because they’ve lost their passion for healthcare, but because they often can’t see a future for themselves within their current system.
Research from McKinsey & Company exemplifies this. The study found that of the nurses likely to leave their current roles, 29% planned to continue working in direct patient care, while 35% were seeking a move into a non-direct-patient-care role. Many nurses want to remain in healthcare but pursue opportunities away from the bedside. For organizations, providing visibility into these potential pathways is essential to retaining experienced talent.
By offering both a career ladder and a career lattice, health systems can:
- Retain skilled nurses longer by showing meaningful, flexible career options beyond bedside care
- Improve engagement and satisfaction, giving employees agency over their career direction
- Leverage transferable skills across departments, keeping institutional knowledge in-house
- Develop talent pipelines for diverse roles, from clinical education to operations to quality improvement
- Reduce hiring costs and turnover, while strengthening succession planning
Simply put: when nurses can visualize multiple career pathways, they’re far more likely to stay, grow, and contribute within the organization that invested in them.
What Does a Career Lattice Look Like in Practice?
A well-designed career lattice for nurses strikes a balance between structure and flexibility by using competency-based career mapping. In other words, it aligns an organization’s competency framework with defined career path opportunities to provide clear visibility into the competencies, roles, and experiences a clinician should obtain for their next position.
A career lattice that clearly conveys these requirements enhances internal mobility and career equity, empowering every nurse to explore their next step without leaving the health system. For example:
A nurse educator can see which competencies overlap with clinical leadership roles.
A bedside nurse interested in informatics can view required skills, certifications, and training pathways.
A nurse manager can identify lateral moves into patient experience or quality improvement teams.
How Career Lattices Improve Nurse Retention
By aligning career frameworks with validated skill and competency data, organizations not only build clearer pathways but also create trust and engagement in the career advancement process.
One study in the International Journal of Nursing Sciences highlights a strong connection between professional development opportunities and improved outcomes, including higher job satisfaction, greater retention, better quality of care, and increased productivity among nurses.
A career lattice provides the structure for that kind of growth, giving nurses visibility into the skills, competencies, specialty certifications, and experiences for these new roles, while also helping them track their progress along the way.
Career lattices also:
- Encourage continuous learning and skill diversification
- Support workforce readiness for emerging roles
- Enable leaders to identify role readiness and match talent more effectively
What Are the Benefits of a Career Lattice Approach?
Implementing a career lattice model offers significant benefits for both employees and organizations. Unlike traditional, vertical-only advancement, a career lattice in healthcare supports growth that reflects the real-world opportunities individuals have across the organization, rather than solely in their specialty or role type.
Benefits of a Career Lattice for Nurses
- Career Transparency and Mobility: Nurses gain visibility into both vertical and lateral opportunities across the organization, from bedside care to education, quality, or leadership roles.
- Greater Ownership of Career Development: A lattice empowers nurses to actively pursue the skills, certifications, and experiences needed to move into new positions.
- Continuous Learning: Nurses can develop diverse skillsets that prepare them for evolving care models and patient needs.
- Increased Job Satisfaction and Confidence: Clear expectations and transparency into progress help to build trust for both leadership and the organization during the career advancement process.
- Reduced Burnout and Turnover: Opportunities for meaningful change and professional growth help nurses remain engaged and connected to their purpose in healthcare.
Benefits of a Career Lattice for Organizations
- Increased Retention and Satisfaction: Nurses who can see multiple career paths are less likely to leave the organization, helping reduce both turnover and hiring costs.
- Enhanced Nurse Mobility: Career lattices encourage diverse skillsets and can make it easier to mobilize nurses across specialties or departments when patient needs shift.
- Stronger Alignment with Organizational Goals: Individual growth plans align with system-wide priorities for safety, quality, readiness, and continuous improvement.
- Higher Engagement and Morale: Transparent development opportunities encourage participation in learning and development programs.
- Preservation of Institutional Knowledge: By keeping experienced nurses in the system, the organization can maintain expertise critical to high-quality care.
How to Build a Career Lattice in Your Organization
Creating a career lattice framework for healthcare starts with understanding the specific skills, competencies, and certifications that define each role, as well as how they connect across specialities and departments. A lattice should reflect both patient-care delivery needs and professional development pathways, giving nurses clarity on how to move within or beyond their clinical area. Some of the key steps of this process include:
Assess Current Competencies and Readiness
Use validated skill and competency assessments to establish a baseline of clinical capability. This provides visibility into where staff excel, where gaps exist, and which skills are transferable across units or service lines.
Map Lateral Pathways
Identify how roles relate between specialties. For example, how ICU experience might translate into procedural care, or how patient education competencies align with care coordination or quality roles.
Create Transparent, Consistent Competency Matrices
Build matrices that define the required competencies for each role and show how they transfer across settings. Use consistent terminology so nurses and educators can easily navigate between ladders and lattices.
Enable Digital Tools
Digital career lattice software solutions like Kahuna make competency, qualification, and experience requirements transparent for each clinician, and ensure individuals can see their progress, required learning, and readiness for new roles in real time.
Communicate Opportunities
Keep development visible for all clinicians with ongoing conversations and mentoring programs. Reiterate that career growth isn’t limited to bedside roles, but that it also includes lateral moves for clinical expertise in education, leadership, informatics, and operations.
Effective career lattice implementation depends on leadership engagement and continuous iteration. Start with one department or unit to pilot the model. Gather feedback from nurse leaders, educators, and staff to refine processes before scaling system-wide. Establish clear metrics for success, such as internal mobility rates, time-to-fill critical roles, and improvements in engagement or retention to demonstrate impact and maintain the momentum in program adoption.
How Kahuna Supports Career Lattices and Ladders
Kahuna’s digital professional advancement product, Kahuna Ladder, enables organizations to design, operationalize, and scale both career ladders and career lattices, giving them the ability to orchestrate a development program that reflects both the traditional career ladder AND the flexible career lattice.
With Kahuna, organizations can:
- Build customized ladder structures that map advancement within specialties (e.g., med-surg, ICU, pediatrics)
- Design career lattices that connect roles across service lines so a nurse can identify opportunities in case management, informatics, quality improvement, etc.
- Highlight transferable skills that show how current competencies prepare employees for new opportunities
- Create transparent, validated career development plans aligned with organizational priorities
- Eliminate manual processes and the paper chase for both nurses and leaders, with a streamlined process for gathering documentation, assessing proficiency, and keeping track of each nurse’s accomplishments
Say Goodbye to Manual, Disconnected Professional Development with Kahuna
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Automated, Transparent Career Progression
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Customizable Advancement Requirements
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Streamlined Review and Feedback
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Integrated Development and Compliance
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Guided Growth with Real-Time Scoring
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Actionable Analytics and Reporting
For nurses, this means clarity, flexibility, and empowerment. They can see exactly what skills or requirements are needed for the next step, whether this means moving up in their specialty or moving across into a different domain. For organizations, this means improved retention, stronger staffing pipelines, and a workforce that’s not only skilled and qualified but empowered, for whatever comes next.
Leaders gain immediate visibility into who is qualified for key roles, while employees benefit from personalized dashboards showing progress and readiness across both career ladder and career lattice structures. Kahuna’s digital view transforms nursing professional advancement from a manual, cumbersome process into a dynamic, data-driven, and engaging experience for nurses and leadership.
Looking Back & Looking Forward
When I left bedside nursing years ago, it was because I didn’t know what other opportunities existed for me within my health system. Had I been able to see a career lattice of options in education, operations, or informatics, I might have chosen a different path. Instead, I left, and my organization lost a nurse who still wanted to grow.
Today, I’m proud to be part of Kahuna because we’re helping healthcare organizations ensure nurses don’t have to make that same choice. With the right tools, health systems can build career ladders and career lattices that keep their nurses engaged, supported, and thriving, whether at the bedside, across service lines, or beyond clinical care.
Not every nurse wants to stay at the bedside forever. And that’s okay. With Kahuna, organizations can honor that reality and give their nurses the visibility, flexibility, and empowerment they need to find fulfilling careers right where they are.
Frequently Asked Questions About Career Lattices
A career lattice is a modern approach to professional development that enables employees to grow in multiple directions—upward, laterally, or across specialties—based on their specific skills and interests. Unlike a traditional career ladder, which focuses primarily on linear promotion within one role family, a lattice connects related roles and competencies across the organization, helping individuals explore a more diverse career path while remaining within the same health system.
A career lattice in healthcare helps clinicians visualize how their skills transfer across departments and disciplines. For example, a bedside nurse might move into education, informatics, or quality improvement, applying clinical expertise in new contexts while continuing to advance professionally.
By linking validated competencies to visible career pathways, organizations give clinicians a clear view of what’s possible and a more engaging development experience. A career lattice supports a more flexible, yet structured approach to growing talent, increasing internal mobility and retention, while building a clinical workforce that continues to deliver high-quality patient care.
A career ladder is a traditional, structured framework for advancement that focuses on vertical progression within a specific role or specialty, such as moving from bedside nurse to charge nurse, to manager, to director.
In healthcare, a career ladder helps nurses deepen expertise and gain recognition for advancing within a single specialty or clinical domain. It’s ideal for those who want stability, mastery, and clearly defined advancement criteria.
A career lattice, on the other hand, supports development across domains. For example, a nurse might move from bedside care into education, quality, or informatics to apply clinical expertise in new ways. This model emphasizes skill diversification, adaptability, and internal mobility, helping clinicians stay engaged and organizations retain experienced talent.
Most modern healthcare systems are finding success with a hybrid approach in maintaining structured ladders for clinical excellence while using lattices to encourage flexibility, learning, and movement across the continuum of care.
Healthcare organizations can implement a career lattice by shifting from title-based advancement to skills- and competency-based development. Start by assessing workforce competencies and mapping how clinical, educational, and operational roles connect. Define transferable skills and build clear, competency-based pathways that link bedside, support, and leadership roles. Provide opportunities for cross-training, mentoring, and job shadowing to help staff explore new areas. Use digital career lattice software tools like Kahuna Ladder to make skills and career options visible, track readiness, and align growth with organizational needs. Finally, communicate often, celebrate internal mobility, and reinforce that lateral movement is progress, not a detour.
Adopting a career lattice model helps healthcare organizations build a more flexible, skilled, and engaged workforce.
For clinicians, it provides visibility into new career paths, such as moving from bedside care into education, quality, or informatics without leaving the organization. This promotes skill diversification, professional growth, and long-term satisfaction. For organizations, lattices strengthen retention and workforce readiness by connecting validated competencies to real advancement opportunities. They also encourage collaboration across departments and innovation by allowing staff to apply clinical expertise in new settings.
Overall, a career lattice supports a skills-based culture that values continuous learning, adaptability, and internal mobility, which creates stronger teams and improves patient care outcomes.
Healthcare organizations can support internal mobility by using a career lattice to make skills, competencies, and advancement opportunities visible across the system. Start by mapping how clinical, educational, and operational roles connect, then use validated competency data to show how employees qualify for new positions or lateral moves.
Provide tools for self-assessment, mentorship, and cross-training so clinicians can explore new paths without leaving the organization. Digital platforms like Kahuna make these pathways transparent, allowing staff to see open opportunities and track readiness for new roles.
Finally, celebrate internal movement and ensure leaders view mobility, whether vertical or lateral, as a measure of organizational strength and workforce resilience.
