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

Hello is there anyway you can PM your proficiency, trying to get to a nurse 3. thanks in advance.

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Specializes in Psychiatry.

Central office still has my appeal and I've received no word back. Has anyone else gone through an appeal, and if so, how long did it take from the time it went off to the time word was received back?

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Mine took about 6 months. No joke. And Central denied it, too. It's really crazy because the first time I submitted, I met certain criteria but not all. Then the appeal met some different criteria but not all. Then the appeal to Central met different criteria yet again. There was no consistency in the eval of my submission. The process is very flawed and subjective and needs revision which may be happening but probably not before I leave.

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RN4KU -

Greetings! Can you pm me a nurse III proficiency that I can use as a guide as well? I have been stuck the in the land of II forever.

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I'm seeking Nurse III promotion. Can you send me your example as well?

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Thank you for the webinar link. I found one for Nurse I-3 and Nurse II. I had no idea how to write my proficiency so this helps. It is unfortunate we have to write for pay and grade increases. It should be automatic especially if you going to school to further your education to get a higher degree.

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Hi, Can you send me your proficiency so I have an idea how to write mine. Thank you so much in advance.

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Specializes in Nursing Informatics, Home Health, Telehealth.

RN4KU Can you send me your proficiency as well? I'd appreciate it!

Jordan

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Boy, do I have experiences in this area. I recently have been shot down for promotion to Nurse II. I wrote a very similar proficiency to another coworker (whom had less time in the VA), and was shot down. I also found out that my former unit manager sat on my review, which I thought was prohibited. My third appeal has been sent to the VISN, but I'm already 1-2 months away from submitting my proficiency for my third year.

My current manager has been supportive and feels confident that this will be a success this time. I'm not so sure, as I feel the system is more about subjective than the objective.

One thing is for sure, it has dampened my enthusiasm to work. I still work 100% for the veterans, but when I see yet more hoops to jump through, such as more TMS learning stuff, changes to ACLS/BLS, I almost shrug it off.

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Boy, do I have experiences in this area. I recently have been shot down for promotion to Nurse II. I wrote a very similar proficiency to another coworker (whom had less time in the VA), and was shot down. I also found out that my former unit manager sat on my review, which I thought was prohibited. My third appeal has been sent to the VISN, but I'm already 1-2 months away from submitting my proficiency for my third year.

My current manager has been supportive and feels confident that this will be a success this time. I'm not so sure, as I feel the system is more about subjective than the objective.

One thing is for sure, it has dampened my enthusiasm to work. I still work 100% for the veterans, but when I see yet more hoops to jump through, such as more TMS learning stuff, changes to ACLS/BLS, I almost shrug it off.

The process is very subjective and discouraging and wrong. Did you know you can request a meeting with the person in charge of the board that denied you the promotion? Not that it is a sure-fire way to get the promotion but it may help. I did this my first time w/appeals and was assured that if I used certain words and terminology, it would be approved. No, it didnt't fly.

My manager has been almost as frustrated as I through this whole process. She knew I deserved the promotion. The second time through, two years later because of the ridiculous amt of time the whole first run took, the board again denied. We went straight to the same person who headed up the board the first time. I was very firm, stating that my mgr and I knew I deserved the promotion and asked again EXACTLY what and how we needed to write the damn thing. Person in charge said, "Well, this has been a hard one. We have to get this pushed through." She acted like she also wasn't sure why things hadn't moved forward. She recommended very slight rewording, a joke really, on some areas. I sent it to that person again for review after making these changes. She said it looked good and we sent it back to the board.

One month later, I asked my mgr for an update. She emailed. Low and behold, I was finally approved. 33 yrs of experience, 3.5 years at VA, 2.5 years trying for Nurse II. Found this out on Tuesday. Unreal and very demotivating process. Good thing I like my mgr and co-workers or I would have left by now.

I do wonder now if the person in charge of the board pushed someone she knew on another board to push mine through. It can be a real thing of who you know in my facility.

Good luck and keep fighting. Get your union involved. Ask for specific wording. Did you know you don't have to resubmit the whole thing on the first appeal? You just have to submit the areas they said you didn't meet. Who knew? Ugh, the process is awful with so little direction. Some mgrs know how to write it for approval, others don't. And the RN gets shafted.

I hope you will post again with an update. I wish you the best.

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Specializes in Utilization Review.

I am so sorry for anyone that asked to see my Nurse 3 prof. I am more than happy to share it because I understand the frustration. Not only do i deal with frustration from leadership, i have co-workers that literally DO NO work, they just don't care, and they get away with it because they have somehow lost their ethics. I could do a lot less work and probably have less stress and annoyance but its just not who I am. My leadership is horrible and sad, demoralizing and nothing will ever change but yet I am still here 6 years later. I think the job has taken a toll on my mental and physical well being. Its so psychologically exhausting because of the backstabbing and poor leadership, I wish i could just shrug it off but i can't seem to quit trying to fix it. I have had a coworker tell me she has 6 years left and she is literally doing no work because there is no point they will eventually pay people overtime pay to do her work. We have no accountability for work completion or quality.

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Hello RN4KU, I think it is so sad that I am at a completely different VA and I am living your post everyday and can completely relate. It is so frustrating to have to carry a heavier load in order to give veterans their 5-star care and me mindful of doing it without showing face. I too am in the process of writing my proficiency now attempting to get Nurse III or at minimum two steps as there are so many people around me who get paid more and do so much less. Would more than appreciate any advice or a look at some of these famous "key words" everyone states is needed for an ideal proficiency. Oh union lets hurry and revamp this thing.

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