VA Proficiency

Writing your proficiency is not fun. You basically have to talk about yourself, which is not easy thing as a nurse. When the manager lets you know your proficiency is due they should have included information for your current nurse level and the next nurse level. There is like 10 different things you must hit on to go to the next step. It is a process to get the next nurse level whether you just received your BSN or not. Usually you have at list meet all the requirements within the proficiency. Each facility also offers a class on nurse level requirements. you can get this class information from the education department.

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Yea they suck. Its hard for me because I currently work in an outpatient unit so I don't feel like I hit some of the questions.

Discuss the Situation, What you did about it, What was the Outcome.

Another way to put it...

Highlight what you have done, why you did it, what was the impact?

For example. For a Nurse I Level I to work towards Nurse I Level II, this is under the Professional Practice Category.

"Nurse Betty identified a Hospice patient declining condition made it difficult for the patient to swallow oral

pills. She notified the provider and pharmacy of situation and recommended discontinuation of any unnecessary

medications and to change the necessary medications to liquid form in which the patient had demonstrated he

could swallow. The medications were changed to liquid form by the provider as a result, resulting in improved

patient compliance with meds."

This is an Example of a Nurse I Level II to Nurse II Statement for Practice:

Betty the Bomb Nurse applies the nursing process to improve care, and manages complex care. Ms. Betty showed this in evaluation of a general surgery patient s/p abdominal surgery with long post op course, initially post operatively the patient was

on Telemetry, but after several days MDs discontinued monitoring as pt had no events (history of MI); an EKG was

obtained before d/c of telemetry which was normal sinus rhythm -- this was performed on day shift. Working a PM shift Nurse Betty was

providing care to the patient, and had worked with the patient previously the past few days and determined something was ‘off’, but she

couldn’t put her finger on it which warranted continued observations/assessment. Nurse Betty's through assessment and

intuition determined the patient had a new onset of atrial fibrillation. Patient was started on cardiac meds, and converted

back to normal sinus rhythm within 24 hours of Nurse Betty's assessment. Nurse Betty's assessment and subsequent

interventions resulted in prompt treatment of atrial fibrillation, and resulted in patient not having to be anti-coagulated for

the rest of his life.

Think of all the examples where if you were not working your not sure if the same thing would have occurred. Think of the times when your on the phone and really advocating, or having difficult conversations with the disciplinary team. Think about the ah ha! moments where your like thinking about why you are a value or asset to the VA, that is what they are looking for!

I agree with the other posters, Your facility should have information about this process and examples. The examples above are for just one example for one dimension.

Ask for your next highest "Nursing Pathway" that has concrete examples of what they are looking for.

Best wishes.

Your first year you can get up to two step increases so I would spend a lot of time on it!!!

You likely won't get to be a Nurse II until year 3. Nurse II is someone who is beyond the unit and focused on things hospital wide beyond the unit or service. Starting out Year 1 your just focused on your assigned patients, year 2 your more in your unit and on committee's etc. Not many people can meet criteria for Nurse II that early. Focus on getting a performance increase based on doing ABOVE your current pay.

Hope this helps. Best wishes

Thank you very much!

Thank you so much! reading this just made my weekend.. Im actually trying to finish mine

Hi that is an untrue statement, I started at the VA as a nurse I level 3 step 12 because I was two weeks from my graduation date. I got my BSN two weeks after starting. That next year when I did my annual proficiency I got promoted to Nurse II step 4. You do not need to wait two years.

The reason you were moved to nurse II was because you were a nurse I level 3. If you are a nurse I level I you must go through all the levels prior to getting your nurse II. As a nurse I level 3 becoming a nurse II was your next step since there is no nurse I level 4. This is policy and can be found on any VA proficiency writing tools. "An RN must advance/promote sequentially through each grade/level established at Appointment, Nurse I through Nurse III. This means that an RN cannot "skip"a grade from Nurse I through Nurse III because Nurse I thru Nurse III is rank-in-person. Example: RN appointed at Nurse I/Level 2 cannot be promoted to Nurse III until he/she has first been promoted to Nurse I/Level 3 and then Nurse II". I hope this helps anyone who is confused.

Hi everyone, 

I'm currently working on my nurse 1 level 3 proficiency, and I'm having trouble writing one. This is my first time having to do this and my mind doesn't know what to do.

Is there any one who can help?

Please email any help to: [email protected]