The career ladder is one of the powerful strategies for retaining nurses in hospitals. When nurses are clear about career development, it can be one of the factors of self-actualization. This study aims to evaluate the results of the change agent-internship studentsin the career ladder process. The research design included a pilot study involving the change agent and the followers who are the Head of the Nursing Department, Kosapel SDM, and the Chief of Nursing. This research used purposive sampling involving 21 nurses. The troubleshooting process used the PDCA cycle (Plan-Do-Check-Action). An innovation program was implemented by creating guidelines and Standard Operating Procedures (SOP) for career ladder mapping and designing a career ladder based on nurse competencies. The mapping used the instruments of self-assessment and assessment verification for professional competencies as well as levels of education and length of employment. The change agent was actively involved in the whole process. After the mapping process was socialized and written interviews were conducted, 99% of the participants at the hospital responded positively to the guidelines and SOP. The Director of Nursing has been greatly assisted by the career ladder mapping instruments based on the nurses competencies, as the results will have a positive impact on them in preparation for accreditation and the implementation of remuneration based on career ladder levels. The Head Nurse and nurses in the pilot project ward provided various responses to the instruments. On the one hand, they claimed that these instruments were very helpful in giving daily assignments because the description of competencies is very complete, but they need more time for completing the instrument. On the other hand, they complained that they were tired of the process of assessment because of the many items that had to be answered and a high workload. The hospital needs to consider using career ladder levels based on the expertise of the nurses.

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P. M. Sandehang and R. T. S. Hariyati, “Mapping a career ladder as an initial step in the retention of nurses,” International Journal of Health and Medical Sciences, vol. 3, no. 2, 43-49, 2017.