VA Proficiency Nurse III Frustration & Appeal

[Sarah918]

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

[Clarisa Jones]

Hello JPN17 can you email me a cooy of your nurse III proficiency. [email protected]. Thank you.

[SueB.]

 Accepted, does that mean you have been promoted to a Nurse 3?

 

[email protected]

[Bookworm419]

JPN 17,

I would appreciate an email copy as well. I could use all the help I can get.

[email protected]

[SueB.]

VA Proficiency 2021 Susan Bucino MSN RN CCRN Promoted Nurse 3 Step 11 (1) (1).docx

[JESS53]

RN4KU

Please can you send example of ethics you use  for your nurse III

I am in dire need for example . I have tried different example and have other ideas but want to know the example yo use.

[email protected]

Thank you

 

[Clarisa]

Hello, 

I am working on my DNP project soon. My education department director sends me a couple of forms to fill out. I am not sure how this information pertains to me. From reading the forms, it looks like it implies that I will be doing hands-on clinical at my site. This is not the case; my project will be a retrospective study. Has anybody had to submit such forms? One is called an application for health professions training; the other is a request for a dual VA employee trainee appointment. The other is called the TQCVL List of Health Professions Trainees (HPTs), meeting all trainee's VA Requirements, and last, The Trainee Qualifications and Credentials Verification Letter (TQCVL) See attachment.

2021TQCVLTemplateFINALv.4_OAA (003) (002).docx

REQUEST FOR DUAL VA EMPLOYEE WOC TRAINEE APPOINTMENT (002).pdf

vha-10-2850d-fill WOC.pdf

[JESS53]

Please am a NP at VA with OCL Ortho

I have worked as NP for 3years now. Been a nurse for more than 30yrs and work education dept did alot of presentation develop some policies and other

I started writing fir nurse 3 as a floor nurse and was told by manager I cannot get it as floor nurse

I just received my second proficiency  and they are asking me to resubmit ethics for reconsideration 

Please can someone help me with good example that they use for ethics

I don't know what else to do. My last proficiency I sent it to my APRN chair person to read proof but that did not help at all

Help me I have only 10 days toc resubmit the ethics

My email address is [email protected]

Thank you in advance

 

Please email me copy of the proficiency [email protected] 

Thank you

[JESS53]

JESS53 said:

RN4KU

Please can you send example of ethics you use  for your nurse III

I am in dire need for example . I have tried different example and have other ideas but want to know the example yo use.

[email protected]

Thank you

 

 

[SueB.]

Ethics:

Example: RN Bucino has provided leadership in identifying and addressing ethical issues that impact patients and staff, including initiating, participating, and advocating for all patients. She treats every patient and their family members with dignity and respect while incorporating the patient's/family knowledge, values, beliefs and cultural background into the delivery of care for our veterans. As an RN Care Manger, she consistently demonstrates leadership, in protecting the health, safety, and rights of patients.

   Mr. R. who has a metastatic spinal tumor and requires pain management, decided that he wished to proceed with a surgical intervention which was scheduled to follow extensive radiation treatment. The initial process was immediate pain management for the symptoms relating to the pressure on the spinal nerves from the mass.  Mr. R. previously met with a Resident physician during an appointment in the pain clinic.

Problem: During a confidential conversation with Mr. R., he informed RN Bucino that he felt uncomfortable discussing his plan for surgical intervention with one Resident physician which he previously met. Mr. R. stated that indirect statements by the provider/Resident insinuated he disagreed with the veteran's choice to treat his pain, receive radiation therapy, then proceed with surgical intervention.  This resulted in the veteran being uncomfortable expressing his desire for treatment. Mr. R. was contemplating refusing pain management from the VA if he was to be assigned to the Resident. The veteran stated the Resident physician discussed at intervals Hospice care without regard to the veterans chosen path of care.

Action: RN Bucino spoke with the veteran and his spouse discussing his right to autonomy in his decision for care. She encouraged the VA philosophy of patient-centered care, and explained to Mr. R. he has the right to direct his health care, and apologized for his uncomfortable experience with previous Resident. RN Bucino contacted the Pain Clinic RN Manager and initiated a change in the resident physician during the consultation and obtaining the opioid contract. RN Bucino to be present to support his decision regarding treatment. The primary care provider, Dr. K. and RN Bucino joined the appointment via telephone conference to encourage the veteran and his wife in their choice of care, and emphasized ongoing collaboration of both teams.

Outcome: The veteran signed the opioid contract, agreed to the pain management plan outlined by Dr. O. and Dr. K., and was appreciative the Resident physician which may unintentionally interjected his personal belief for best care of the veteran was not in attendance. The veteran proceeded with his patient-centered care as promoted by the VA Greater Los Angeles Healthcare System (VAGLAHS). The communication of the pain management and primary care team resulted in open communication of the patient, PCP, and the Pain Clinic providers. This practice of collaborative appointments should be incorporated into each initial session for all patients in GLA regarding pain management to support and promote continuity of care for the veteran and family members. providers, and patient-centered care is one of the core principles for best patient outcomes, and should be incorporated in the coordinated care of all patients, especially throughout the VISN.

[Saba Yifter]

RN4KU said:

I am a nurse 3 step 3 now. I work as a your nurse at the mid south consolidated patient account center.

I am a BSN, MSN, I came in as a 2 step 2 with 8 years and an MSN. I am more than happy to send you my proficiency that got my promotion to Nurse 3. I don't know how I just basically figured out you need key words. Send me a PM and I will send you anything. IT ALL SUCKS my leadership SUCKS. but my pay is great where I work in south texas.

Can you please email it to me. [email protected]

[SueB.]

Hi,

  I am a Nurse 3/Step 12, but thank you for the offer. Most on this thread were initially asking me for a copy of the proficiency which promoted me from a 2/12 (after 5 years with the VA, and 35 years in the private sector).

 

 Sue

[huganurse820, MSN]

I am a Revenue Utilization Review nurse and I finally got my Nurse 3 and here's the information I submitted. Hope it helps

Nurse 2 to Nurse 3 promotion proficiency.pdf