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

Specializes in RME Coordinator.

RN4KU, will you PM me a copy of your proficiency as well? My email [email protected].

Thanking you in advance!

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Specializes in RME Coordinator.

I really need help with my nurse 3 proficiency. My email address is [email protected].

Thank you!

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Hello, I am like so many other nurses trying to get my nurse III. I have worked on multiple projects but they have not been enough to get my nurse III. I think it is all in how it is written. If anyone is willing to share their nurse III proficiency, it would be appreciated! I only want to review how it is written.

[email protected]

Thank you for any assistance!

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Hello, When writing for a Nurse III the NPSB wants to see that your work is not a project (self-limited) but at the program level (sustained). You will want to demonstrate your assessment of the problem, your research, your leadership and collaboration in finding solutions, your leadership for interventions to solve/improve the problem(s), and your sustained leadership in evaluation/following of the interventions for results. It takes a lot of leadership and sustained work to make Nurse III. A Nurse III demonstrates how he/she consistently functions beyond the unit level to impact multiple units or the hospital in his/her nursing practice. A project with a beginning and an end, however good, does not meet the criteria. The NPSB board members should make themselves available for coaching and clarification of questions. The process is complex and takes years to truly get a handle on what works and what doesn’t. Also, include qualifying key words and how you have used the nursing process in meeting the 9 dimensions of nursing. Make it as easy as possible for the NPSB to see how you meet the qualifications for each dimension. Hope this helps a little. I don’t think this is new information, but possibly put in a way that helps someone to better understand. If you are a member of NOVA (Nurses Organization of Veterans Administration) they will critique your write up and give suggestions!

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Thank you for the advice. This is helpful information. Where do we find the "qualifying key words" that you mentioned?

Thank you again!

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Thank you very much.!

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https://ninedimensionsofnursingpractice.blogspot.com/2011/08/template-for-va-npsb-nurse-professional.html?m=1

The above link links to a document prepared by a VA Nurse Recruiter and gives clear guidance with examples for meeting criteria for qualification standards within the 9 dimensions of nursing for VA (Grades I, II & III). This is what the NPSB is looking for in your proficiency and you can use the verbiage as you describe your accomplishments. Also, know that if you receive a non-promote letter, you can submit for reconsideration to your local VA NPSB within 30 days of signing the letter. You can resubmit for only the dimensions you didn’t meet (and only those). I recommend starting with everything you submitted initially for those dimensions and adding data, dates, details of leadership and collaboration, results, etc. Don’t skimp. Add any new examples to exemplify meeting the criteria and provide details. Use the nursing process as you describe your work. At this point I would go overboard with examples if you have them. If your local NPSB still finds that you do not meet criteria for promotion, you can appeal to VA Central Office (VACO), but they will only review the documents submitted to the local board, no new documents can be provided at this time (so include everything that helps you meet the dimensions when you re-submit locally). Hope this helps! Best of luck to all of our hard-working nurses!

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Hello EricaR202,

If you could share a copy it would be most appreciated. I am a Program Director and Nurse Mgr who was hired as a Nurse 2 related to not having my MSN. Thanks in advance. [email protected]

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Specializes in RN BSN.

Have worked at the VA as RN-BSN for a year and my first proficiency is now due. Need examples of the keywords to use in the proficiency and any examples of a valid proficiency as a guideline. Most appreciated!! [email protected]

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Specializes in Primary Care/ Trauma.
30 minutes ago, kettlecorn60 said:

Have worked at the VA as RN-BSN for a year and my first proficiency is now due. Need examples of the keywords to use in the proficiency and any examples of a valid proficiency as a guideline. Most appreciated!! [email protected]

What setting do you work in? What is your grade/step?

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Specializes in RN BSN.

CLC I’m a Nurse 1 (step 9)??? I surely hope to attain nurse 2 (which they probably would have started me at) but I had only been a RN for 2.5 yrs at the time of my interview and when I started my orientation it had been 3 yrs. So they based it on the interview time and started me at the lower level. Soooo frustrating!

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