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

Hi RN4KU,

I know you may be overwhelmed with the number of people requesting your assistance. I am yet another one Lol. I would appreciate any information you can share or provide, that helped you to obtain a NUR 3. I was just offered a job with the VA and was sent information to submit for my grade consideration. I believe it is easier to go into a grade rather than to ask for a promotion at a later date or am I wrong in my assumption. I have an MSN in informatics, post masters in nursing education and 14 years of experience in various areas of nursing. I was hoping to get a III, but I am greatly discouraged this will happen. Thank you and to anyone else who is willing to share information.

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Specializes in Utilization Review.

Is there anyone that I did not reply to with a PM? I am so sorry if I did not get back to anyone please PM me or let me know. If anyone has had any success let us know!! Good luck to the rest of you, I hope you can find more enjoyment and passion as a VA nurse than I have been able to find. I am currently in the process of opening my own Nursing and home care business, and I finally feel excited again about being a nurse. Please let me know if anyone still needs a sample of an appeal

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RN4KU,RN,BSN,MSN

I could not send you a PM, but Thank you. You responded very quick to me. I really appreciate your assistance and I will make sure I pay it forward to other nurses in the future. I am very excited for you starting your business. It will allow you great freedom and opportunity as to be an entrepreneur. Good luck and thanks again. You are appreciated.

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Specializes in Utilization Review.

Your so welcome it makes me happy to be able to help others.

RN4KU,RN,BSN,MSN

I could not send you a PM, but Thank you. You responded very quick to me. I really appreciate your assistance and I will make sure I pay it forward to other nurses in the future. I am very excited for you starting your business. It will allow you great freedom and opportunity as to be an entrepreneur. Good luck and thanks again. You are appreciated.

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It is much better to come in as a 3 than to try to get it later. My facility is supposed to be setting up something to help new applicants with the Nine Dimensions process for boarding. I don't know if it has happened yet. Have you asked the recruiter or HR for assistance? I had no idea I could ask for help and was really stymied by the document I needed to provide. They rated me lower than I should have been. You can appeal it before you accept the offer in some facilities but I didn't know that. Google Veterans Administration Nurse Proficiency and you may get some help. There are a couple Youtube videos out there done by VA RNs. Keep in mind they want to see hospital or system-wide impact in all 9 areas for Nurse 3.

it's great of you, Trumi241, to offer help.

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Do you mind sending me the your proficiency please

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Hi pfchang,

Thank you for the feedback. I did ask for. assistance. They do not have anyone who helps with the process. After reviewing the information needed, I feel that if you are not in management it is hard to meet the criteria for a 3. I've truned down and avoided management positions my entire career and now I'm feeling I may have hurt my chances obtaining opportunities by not. Promotions should be based on your education and years of experience. They've found a way to not promote people. In any other hospital I wouldn't have to prove my deserving a raise.7

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Hi pfchang,

Thank you for the feedback. I did ask for. assistance. They do not have anyone who helps with the process. After reviewing the information needed, I feel that if you are not in management it is hard to meet the criteria for a 3. I've truned down and avoided management positions my entire career and now I'm feeling I may have hurt my chances obtaining opportunities by not. Promotions should be based on your education and years of experience. They've found a way to not promote people. In any other hospital I wouldn't have to prove my deserving a raise.7

It feels that way at my facility. I do hear of a few other facilities where mgmt is actively developing and encouraging RNs to seek promotion. Other places it's the opposite. VA pushes the idea that they want Nurse 3s at the bedside and 3s do not have to be only in mgmt but try to find them at the bedside. Its really hard.

Even if you managed a project or just a couple people for a short while, expand on that with the keywords in the dimensions. I can not emphasize enough how impt it is at my facility to use the keywords. You can say the same thing in different words and they say you didnt meet the criteria. Change it with the verbage from the dimensions and you meet it. It is unreal and a very flawed process.

Also, show the impact of the project or effort. They want to see outcome measured, even if the effort was unsuccessful. Use numbers, like 5 mins saved per _____, or improved documentation resulted in________, or etc, etc, etc. Even if you don't know exactly, estimate it but don't say it's an estimate. Be as specific as you can with the info available to you.

I have never been as frustrated with an evaluation system as I have with the VA's and I am old! Good luck to you.

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Specializes in Utilization Review.

I wanted to love my 6 almost 7 year career at the VA and try to understand that I am helping the veterans, but the longer I stay the worse it gets. I tried to fix the somethings and attempt to just enjoy the nice benefits and be happy with that, but the more you try to do the more you end up in hot water. At least where I am they don't value intelligence they want YES ppl. I am hoping there are some nurses happy in the VA with their leadership, but I don't hear about too many nurses happy with their job, not because of the veterans but lack of leadership and poor communication.

It feels that way at my facility. I do hear of a few other facilities where mgmt is actively developing and encouraging RNs to seek promotion. Other places it's the opposite. VA pushes the idea that they want Nurse 3s at the bedside and 3s do not have to be only in mgmt but try to find them at the bedside. Its really hard.

Even if you managed a project or just a couple people for a short while, expand on that with the keywords in the dimensions. I can not emphasize enough how impt it is at my facility to use the keywords. You can say the same thing in different words and they say you didnt meet the criteria. Change it with the verbage from the dimensions and you meet it. It is unreal and a very flawed process.

Also, show the impact of the project or effort. They want to see outcome measured, even if the effort was unsuccessful. Use numbers, like 5 mins saved per _____, or improved documentation resulted in________, or etc, etc, etc. Even if you don't know exactly, estimate it but don't say it's an estimate. Be as specific as you can with the info available to you.

I have never been as frustrated with an evaluation system as I have with the VA's and I am old! Good luck to you.

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I'd appreciate any tips, key words, phrases, etc you could help me with. I've been trying to get this Nurse III for years. I came in the VA as a Nurse II in the 90s, then went to IHS. Came back in as a Nurse I, became a manager as a Nurse I, finally promoted to Nurse II, finished my MSN in 2014 and still can't seem to get this Nurse III.

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Can you please send me your proficiency sample as well? Thank you in advanced!

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Please send me a copy of the Nurse 3 RN prof. I am appealing the whole darn thing because my previous manager told me to writer to a nurse 2. Well...we all know how that went. I am already a nurse 2, so not sure why he told me to writer to a nurse 2 ?!?! I am re-writing to a nurse 3.

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