Clinical Career Ladder System and Nurse Career Dynamics: A Qualitative Study on Career Plateau and Turnover Intention at JIH Hospital Yogyakarta

Ahmad Wahyu Setiadi; Nabila Kharimah Vedy

doi:10.63922/ijebir.v5i03.3955

Ahmad Wahyu Setiadi Department of Management, Faculty of Business and Economics, Universitas Islam Indonesia, Indonesia.
Nabila Kharimah Vedy Department of Management, Faculty of Business and Economics, Universitas Islam Indonesia, Indonesia.

DOI: https://doi.org/10.63922/ijebir.v5i03.3955

Keywords: Clinical career ladder system, Career plateau, Turnover intention, Job embeddedness.

Abstract

The high resignation rate of nurses, particularly newly graduated (novice) nurses, amidst the implementation of the nursing clinical ladder system policy has become a strategic issue faced by JIH Hospital Yogyakarta. From a regulatory perspective, the career ladder system established by the Ministry of Health Regulation Number 40 of 2017 is designed to serve as an instrument for professional development. However, practical observations reveal a disparity in career ladder distribution, notably a significant accumulation of nurses at the Clinical Nurse (PK) III level and a complete absence of personnel at the expert levels (PK IV and PK V). This study aims to explore the implementation of the nursing career ladder system and analyze its implications for the perception of a career plateau and turnover intention. This research employs a qualitative approach using a case study design. Data collection was conducted through direct observation of the work environment, a review of internal documents, and in-depth interviews with three informants representing the management, senior nurses, and junior nurses. The findings reveal a disconnect between professional development policies and institutional support capacity. This condition reflects the suboptimal fulfillment of hygiene factors (low initial incentives) and motivator factors (stagnation at the middle level), which triggers high turnover intention among junior nurses and perceptions of a structural career plateau among senior nurses. Nevertheless, these impacts are successfully mitigated by strong job embeddedness stemming from an Islamic work culture and social support among peers. The study concludes that while the career ladder system is administratively operational, it suffers from a functional bottleneck. Management is recommended to restructure the non-degree competency equivalency system, adjust the Medical Service (JM) incentives for novice nurses, and formalize a mentorship program.

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