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

On 4/19/2019 at 2:18 PM, nurse4life81 said:

Nurse4life8181 can you please send me the Nurse 3 info? Thanks

[email protected]

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Good Morning,

I'm a new NP (1 year) and getting ready to write my proficiency for Nurse III. Could you help please. My email is: [email protected]

Thanks

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On ‎4‎/‎24‎/‎2019 at 11:36 AM, nurse4life81 said:

Sent

Could you please send it to me as well? I'll really appreciate it. Thanks.

[email protected]

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On ‎6‎/‎1‎/‎2018 at 11:17 PM, SubieRN said:

Having an MSN alone will not result in a promotion to Nurse III. You need to demonstrate that you impact housewide outcomes in each dimension.

It boils down in the wording. To obtain a nurse III there must be data to validate. Identify a problem, get an Interdisciplinary Team together to show you are working across the hospital (SW, Case Managers, Doctors, etc.) get your starting metrics; identify what was done to improve the problem, the outcome and was it sustained.


EX: Patient follow up appts was 24% after speaking with the group we polite one of the primary care areas for 3 months on calling the veteran day prior to appt to assure they would be there. After 3 months we analyzed the data and the veterans keep their follow-up appt increase to 57%. The process of call veterans the day before their appt has been implemented in all clinics and sustained across the facility.

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Could you share with me too? New hire working on mine. Thanks a bunch.

[email protected]

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Specializes in ICU, ER, RESEARCH, REHAB, HOME HEALTH, QUALITY.

To everyone stating they need assistance with their proficiency..

  • Always provide input to your proficiency, when your manager asks you.
  • Answer every question and give an example with a result to the question to show how you improved the unit or the organization.
  • Improving the organization; results in a promotion to nurse III, with a Master Degree
  • Example: Nursing Practice or Education: You completed a article review on stroke, & presented as an in-service to your peers because you noticed neuro vital signs were not being completed on your unit (after the NM mentioned it in staff meeting, ) on patients as ordered. After the in service the neuro vital signs taken on the unit improved by 90% in a months time..
  • You created an instrument to improve patient reporting between your unit and the ED.. what problem did it solve? and how ..
  • This means you have you audit something and use the data to come to some conclusion.
  • This should be completed in conjunction with your supervisor. Some managers are better than others to get their staff promoted.
  • Nursing is about critical thinking, use it, to achieve your own goals for your career.
  • You are the captain of your own destiny and can not depend on others to care about your career goals like you do.
  • Some VA medical centers are not as good at promoting their nurses, but there are over 150 VA hospitals around the country.. transfer to another if possible and find your niche.
  • Opportunities are endless, and get into some of the leadership programs, like LDI,, if they still have it.
  • Nothing else to be said.. good luck!
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I would appreciate a copy as well. [email protected]

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On 6/2/2019 at 3:14 PM, canchaser said:

Whom do ask for this pathway?

Pathways and qualifications standards for the domains are listed on the ONS website

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Hello all! Nurse4life8181 or anyone that can help me with the Nurse 3 proficiency! I'm at a loss. Please share by email at : adukelelemom@gmail.com. Any help I will greatly appreciate. Thank you all?

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Can someone send me an example of a N3 proficiency example it is tough to write, thanks

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Could someone please share their Nurse 3 proficiency example with me? I am currently working on mine and feel that I need help. I would really appreciate it! Thanks! [email protected]

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Specializes in Med/Surg,Tele,ICU,Stepdown, Spinal Cord.

RN4KU, I can't PM. Would you please send me a copy to [email protected]? Thank you

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