<![CDATA[Background: In healthcare systems worldwide, the implementation of structured career advancement mechanisms such as career ladders has been increasingly recognized as essential to ensuring workforce motivation, retention, and quality of care. However, empirical evidence on how these systems are perceived and their impact on nurses’ job satisfaction particularly in decentralized or resource-constrained hospital settings remains limited. Objectives: This study aimed to examine the correlation between nurses’ perceptions of career ladder implementation and their reported levels of job satisfaction. It specifically tested the hypothesis that a positive perception of the career ladder system is significantly associated with higher job satisfaction among nurses. Methods: Using a quantitative correlational cross-sectional design, the study surveyed 100 registered nurses selected via total sampling. Validated questionnaires were employed to measure two key constructs: perceived implementation of the career ladder system and levels of job satisfaction. Data were analyzed using descriptive statistics, cross-tabulation, and chi-square testing to determine the strength and direction of associations between variables. Results: Results indicate that most nurses were positioned at Career Level III (49%). While 54% perceived the career ladder implementation as effective, 46% did not. Job satisfaction was reported by 65% of participants. Notably, there was a statistically significant correlation (p = 0.000) between positive perceptions of career ladder implementation and job satisfaction: 81.5% of nurses with positive perceptions reported satisfaction, compared to only 45.7% among those with negative views. These findings affirm international research highlighting that clear, well-communicated, and equitable career structures foster motivation, retention, and satisfaction among healthcare staff. Conclusions: The findings suggest that the presence of a career ladder system alone is insufficient. Effective implementation supported by institutional leadership, transparent communication, and staff engagement is critical to realizing its benefits. ]]>
