VA Proficiency Nurse III Frustration & Appeal

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I am feeling frustrated with the entire VA NPSB proficiency process. At my hospital, it is a good old boys system in which board members promote their friends and the other managers and shut the door on others. I am a staff RN with a MSN and years of experience. I applied for my nurse III after completing a hospital wide project and doing other work that met the 9 dimensions.

This whole process has me frustrated beyond words. My profIciency has been lost by HR multiple times. My initial NPSB review said I didnt meet 7 of the 9 dimensions. Before submitting my proficiency, I had it reviewed by 3 former board members who all said I would meet for a 3. I submitted a request for reconsideration after the initial denial, and suddenly I met 6 out of 9 dimensions. I am now appealing my denial to VACO. Has anyone ever done this? What was he outcome, and how long did your appeal take to be answered after it was sent off?

I have been repeatedly been told by my own manager "you cannot get a 3 without working in management" and "it takes multiple submissions to get approved". I do not think this is correct. It may be harder to find the time and get approval for a project, but staff RNs cannot be essentially "blocked" from promotion. The dimensions are black and white, yet a subjective system is used to approve or deny proficiencies. It seems so unfair at my hospital. I've seen other nurses get promoted who were friends with board members, while other truly deserving RNs who meet the dimensions and make lasting changed within the hospital are shut out.

Any guidance and other nurses experience with this would be greatly appreciated. I love working with our Vets, but the good old boys club and the oppressive bureaucracy had me ready to bash my face into something. I feel defeated. Thanks all

RN4KU- can you please send me any info you have on getting to a nurse 3. I am a Nurse Manager and have tried twice without luck. I would love to read one that was accepted. It seems to be similar to the Golden Ticket...it's out there somewhere but nearly impossible to find! Thanks in advance.

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RN4KU can you please send me a copy of your proficiency for UM that you used to get your nurse III. I am a UM reviewer @ the VA and trying to write my proficiency. Please email to [email protected]. I would appreciate any help you can give me.

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HI RN4KU. Would you or anyone else on this string who has achieved Nurse III be willing to send me their proficiency and key words that need t be used??? I have an MSN, on 4 committees in which I hold chair, co-chair and secretary positions, have hosted multiple hospital wide events and was the lead on a clinical trial yet am having trouble achieving Nurse III because I am not a "manager"!! It is so disheartening that hard work does not pay off in the VA system!! My email is [email protected]. Any help would be greatly appreciated!!

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Specializes in Utilization Review.

I am having issues at work, I am not sure the rules on sharing my proficiency, it should not matter but where I work anything is possible. I am really sorry its a very difficult time at my job, I have never felt so helpless, frustrated, or fearful to lose my job. The tasks we are asked to do are impossible and if you attempt to protect yourself, work hard, or speak up management will make you life hell. I have been in the same position for 7 + years and made many mistakes in the past 6 months because I am trying to keep up with the work. It is easy to say you have the union or the EEO to protect you but where I work it does not stop management from harassing you. I am stuck the salary and benefits are amazing, but it is a toxic environment. I am going to have to remove myself at this I am paranoid I could get in trouble. Please feel free to distribute just without my name attached.

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I observed a boad hearing recently. The most important thing I saw was to obtain the checkoff sheet they use when evaulating your proficiency. Use the most important words in each sentece followed by how you determined the change, the rrasearch or background of the change overview of steps that implemented change followed by data showing what outcome. Use same information slightly changed to show sustainability. How a unit manager can reach 3 for program or facility change seems almost impossible to me at this time. I have been involved with medication policy change throughout the facility, assisted with education of said change. Have data showing outcome but no dice. I also was involved in opening a new unit for specific gender treament modalities (not my unit) and have data showing useage outcome in terms of $$$ still no go. I am in this same boat . Unit change and outcome is easy...

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I was actually a member of allnurses for a very long time and somehow got locked out. I am in desperate help with writing my proficiency for a Nurse III. It is such a challenge to write my proficiency to reflect the work I do.

I would be appreciate if you can email me your example that helped you get your Nurse III. It is awfully nice of you to help us. You can sell your copy and be rich! :)

My email address is [email protected].

THAANNKKK YYYOOOUUU!

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Specializes in ER, ICU.

Hi there RNK4U. I as well would be interested in viewing your successful submission for NIII. I have recently experienced the same as many posters among this group. Having a graduate degree with 15+ years nursing experience and a national certification in a nursing specialty does not make the grade within the system I currently work. The most recent declination I received indicates 'In general, the scope of impact of the Nurse III level is to lead change and improvement across whole service lines or programs'.

My personal email address is [email protected].

Thank you.

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I really don't know anything about nurse progression at the VA as I have accepted employment but am vacationing before I begin.

However, I did have to submit a narrative for the four dimensions of nursing. I'll start a non-administrative advanced practice position as a nurse III step 5. I'm aware to be a IV or V you have to apply to that specific grade which I plan to do as the time immediately becomes available. I checked the III 5 thing in my offer letter before I posted.

Problematically, I don't believe the majority of rank-and-file nurses ever get to do anything that adequately addresses the four dimensions of nursing with the VA. Bureaucratically, one might believe that it's difficult to penetrate the various barriers to achieve something remarkable to move up. Then again, I have no idea what the VA expects because I'm only sort of a employee-elect, lol.

In my case, if the III - 5 thing is actually meaningful (and I don't know that it is other than more numbers = higher pay), I might be blessed or cursed depending on how you look at it. I never did anything noteworthy as a RN. I was a great student, but the day I became an APN I took an independent APN job. That demanded I learn some about everything there is to learn to run a practice although it only takes tangentially relates to the VA. Really, I only got lucky. The blessings kept me from killing myself or anyone else!

In hindsight, maybe this post wasn't helpful although it was meant to be. I only came to the forum to learn about being an army reserve nurse, lol.

With my Benadryl, I wish you good night.

í ¾í´—

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Hello RN4KU, I know this thread is old, but if you see this message can you please send your proficiency to my email [email protected]? Or if anyone see this message who RN4KU sent her proficiency to could send it to my email it would be greatly appreciated!

Thanks in advance

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Sorry to hear you are going through a rough time. Hoping you find peace in your situation.

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Hi sj2002, if you received the info from RN4KU could you please send it to my email [email protected]?

Thanks in advance

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Hello,

Is it possible you can send me RN4KU proficiency to my email [email protected]? It will be greatly appreciated Trumi241!

Thanks in advance

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