The Experiences of Intermediate-Titled Clinical Nurses' Promotion to Senior Titles: A Phenomenological Study

Nurses show low enthusiasm for senior title promotion despite its career benefits. Understanding their experiences and difficulties can inform more effective policy implementation.

The nurse promotion system directly affects remuneration and work enthusiasm. Mobilizing nurses' initiative within this framework remains a key challenge for policymakers and hospital administrators.

To explore the views and experiences of clinical nurses with intermediate titles on the promotion system of senior titles.

A descriptive phenomenological study was conducted. A total of 13 clinical nurses with intermediate professional titles from 11 different departments (the average years of obtaining the intermediate title were 7.54 years) participated in face-to-face semistructured interviews. The data were analyzed using Colaizzi's seven-step data analysis method (1978). The COREQ guidelines were followed for reporting. Rigor was ensured through member checking and peer debriefing.

Five categories emerged: Escape (perceived inadequacy, clinical/family burden, and lack of guidance/role models); Transform (clinical influence, environmental impact, and enhanced self-awareness); Challenge (research learning, degree hurdles, and trial/failure); Reflection (early career planning, perseverance, and continuous self-growth); and Expect (career/psychological support, research environment, and diversified criteria). These categories formed a cyclical process from Escape to Transform, interrupted by Challenge, leading to Reflection, and culminating in Expect for systemic change.

Nursing managers and educators should attach great importance to the promotion experience of nurses, promptly address their promotion needs, and provide career planning training and guidance as early as possible.

By planning career development in advance, actively learning and enhancing professional and research capabilities, the comprehensive ability and professional pride of nurses can be strengthened, and the promotion rate of senior professional titles for nurses can be increased.

Nurse managers, policy makers, and nursing schools should jointly design a career development framework including mentorship, protected research time, methodological support, career planning workshops, diversified criteria, and innovation-friendly environments. Context-tailored implementation may enhance nurses' promotion enthusiasm and success rates.