Ladders in Nursing Careers Program

An RWJF National Program

Dates of Program: July 1992 to January 1998

Field of Work: Career advancement and health care work force education in nursing.

Problem Synopsis: In the late 1980s and into the 1990s, the nation's nursing work force was overwhelmingly white and female. Although upwards of 25 percent of US residents were minority, only approximately 18 percent of RNs were non-white. However, studies had shown that when nursing caregivers and patients were from similar cultural and ethnic backgrounds, patient outcomes improved and patients' perceptions of the quality of care also improved. During this time period, the demand for nurses increased such that despite increases in nursing school enrollments, nursing supply shortages persisted across the nation.

Synopsis of the Work: Originally conceived and rolled out in New York City in 1988 as Project L.I.N.C., Ladders in Nursing Careers provided financial resources and support services to qualified low income and minority, entry- and mid-level hospital and nursing home employees to help them advance into licensed practical nurse (LPN) and registered nurse (RN) positions. Because of the original project's positive results, in 1992 the Robert Wood Johnson Foundation (RWJF) decided to expand Project L.I.N.C. to a national scale.

Key Results

  • The national program's eight sites—Georgia, Iowa, Maryland, Minnesota, North Dakota, Rhode Island, South Carolina, and Texas—had the following accomplishments:

    • Projects enrolled 934 participants. At the close of the program, there were 365 graduates, 328 of whom were in nursing (263 in nursing and 65 in advanced nursing) and 37 in allied health professions.
    • When the program ended, more than 150 students were on track to have graduated by June 1998.
    • Projects increased minority recruitment in geographic areas that had failed to bring people of color into these professions. Nearly 40 percent of participants were minority (24% Black, 5% Hispanic, 4% Native American, 4% Asian, and 1% Mexican).