[voodoosgirl]

Hi ALFie nurses, this is my first post but I have been lurking in the shadows for awhile now. I have been searching for a forum of nurses that work in a setting similar to mine and from the sounds of the previous posts I may have found what I have been looking for. It gets lonely out here in ALF-land when you are the only "medical model" person in a sea of social workers (no offense to social workers).

Have you found yourself explaining to the clinical team what IM means? CBC? NPO? I get tired of explaining the simplest terms or concepts to people who are making life-changing decisions about a resident but have so much disconnect and disdain for the so-called "medical model" they don't even know the terminology. (sense my frustration?)

As an introduction.....
I am the RN for 6 group homes that serve adults with mental illness in an assisted living setting. We have 38 residents, 50 staff and are regulated by so many different entities it spins the brain. I am the ONLY nurse in the residential program. I coordinate the medical and psych care of the clients and act as a liason for the medical and psych providers. The job does not assign me direct care duties but I do them anyway when needed. So in some ways my job is somewhat different than most ALFs as I function as more of a coordinator/consultant.

I am also the clinical supervisor for the 6 group home administrators who are mostly licensed social workers. The staff are wonderful laypersons (unlicensed assistive personnel) that are trained in the state's medication administration course. Yes, unlicensed people transcribe and administer all medications. (See why I don't sleep) This is the way it is in Maine. Not enough nurses, LPN's or CNA's and not enough money to pay them.

I love what I do. (Read that as passionate) On my worst day, I would not walk away from these residents and the staff.

I really do miss the nurse mentoring and consulting. I have had to learn the regulations, laws, policies, procedures blah, blah, blah, all on my own. I hope to find some nurses to converse with and trade wit, wisdom and insight. I realize each facility and state are different but I feel the nursing process and ethics are the same everywhere. Thank you for this thread.

[AmyD_RN]

What is your job title? I am wondering cause I have an interview coming up for "wellness director" at a local ALF.

Thanks
Amy RN

Originally Posted by voodoosgirl

Hi ALFie nurses, this is my first post but I have been lurking in the shadows for awhile now. I have been searching for a forum of nurses that work in a setting similar to mine and from the sounds of the previous posts I may have found what I have been looking for. It gets lonely out here in ALF-land when you are the only "medical model" person in a sea of social workers (no offense to social workers).

Have you found yourself explaining to the clinical team what IM means? CBC? NPO? I get tired of explaining the simplest terms or concepts to people who are making life-changing decisions about a resident but have so much disconnect and disdain for the so-called "medical model" they don't even know the terminology. (sense my frustration?)

As an introduction.....
I am the RN for 6 group homes that serve adults with mental illness in an assisted living setting. We have 38 residents, 50 staff and are regulated by so many different entities it spins the brain. I am the ONLY nurse in the residential program. I coordinate the medical and psych care of the clients and act as a liason for the medical and psych providers. The job does not assign me direct care duties but I do them anyway when needed. So in some ways my job is somewhat different than most ALFs as I function as more of a coordinator/consultant.

I am also the clinical supervisor for the 6 group home administrators who are mostly licensed social workers. The staff are wonderful laypersons (unlicensed assistive personnel) that are trained in the state's medication administration course. Yes, unlicensed people transcribe and administer all medications. (See why I don't sleep) This is the way it is in Maine. Not enough nurses, LPN's or CNA's and not enough money to pay them.

I love what I do. (Read that as passionate) On my worst day, I would not walk away from these residents and the staff.

I really do miss the nurse mentoring and consulting. I have had to learn the regulations, laws, policies, procedures blah, blah, blah, all on my own. I hope to find some nurses to converse with and trade wit, wisdom and insight. I realize each facility and state are different but I feel the nursing process and ethics are the same everywhere. Thank you for this thread.

[voodoosgirl]

Hi AmyD,
My title is "Residential Nurse Specialist". We sort of made it up actually! I work exclusively in the residential program. The position requires me to oversee medication administration procedures, write policy/procedure, advocate and supervise administrators.
I guess if I were going on an interview where the job title was "wellness director" I would have a list of questions about the exact details of the job, what would I be responsible for, who do I answer to, who answers to me. I might ask what a "typical" day would look like.
I can see you are giving this a great deal of thought. Good luck and keep in touch.

[VivaLasViejas]

Nice to see some new "faces" on this thread! Welcome!!!

[ddzwalker]

Hello-
I am a new LPN and have my first interview tomorrow at an ALF. Do you think that a new nurse can successfully work at an ALF. From all that I've read, this is exactly the type of environment I want to work in. It seems to involve so much more patient contact and holistical treatment of the patients.
Any advice would be helpful
Thanks
Dot

[voodoosgirl]

Hi Dot,
I am replying rather late so you may not read this until after your interview. The only caution I would offer is ask alot of questions about what your responsibilities would be. New nurses have to start somewhere so why not ALF. The down side to ALF is that you may be on your own more than you would be in a more traditional medical setting. Again, I would suggest questions about who is "in charge", who you answer to and who you might be overseeing.

There is much to learn about being a nurse by working with other nurses in a supportive setting. Speaking for myself, the real learning began when I started working. It is absolutely a journey, not a destination. Good Luck, be strong.

[ns lpn]

hi,
I currently am responsible for 22 residents. I work 8-4 and not on hollidays their is no on-site staffing after I leave or on weekends. The apartments are attached to a nursing home and after my hours an RN from that nursing home is responsible for any emergencies that arise, any non-emergency situations are suppose to be the NOK's responsibility. Is this the way these facilities normally operate? If anyone works in a similar place please let me know, I have questions on how you deal with certain issues.

[LadyMonteCarlo]

Hello all,

So finally I have found myself a new home. Just 5 short weeks ago I became the new Resident Services Director of a assisted living community. Our capacity is 112 residents and we are 98% full at this writing. We also have a Special Care Program for dementia and alzheimers residents.

It's difficult coming from SNF into this type of environment to say the least. For the last few weeks I have been attempting to determine just what my "real" role is here. For the first 2 weeks I was running all over the place making like "Nancy Nurse" for all of the very needy residents. Also, I was being directed by other management team members to perform in this fashion.

However, over the past week I am now beginning to realize my true role in this community. Put simply my role is oversight of the wellness program. This does not mean I need to personally attend to every medical complaint that a resident has in the community. I was driving myself into the ground attempting to meet the needs of the "patient". This is by no means to indicate that if there is a bonafide emergency situation it would be ignored. I will be and have been right in the middle of it all.

I must, through education, help staff, residents, and families understand my role in this community. I know that with time this can and will come together. Unfortunately, the former RSD of 3 years was rather unsuccessful in her endeavors for very obvious reasons.

As any of you that are in an ALF know the paperwork is like almost nothing you have ever seen before. Licensed staff are at best minimal. In fact, at this writing I am the only licensed nurse in the community where there should be 3.

I would apprieciate any feedback those more experienced than I may be interested in sharing with me. Right now I'm just attempting to take it one day at a time and beginning to draw lines in the sand hoping not to alienate anyone.

[CapeCodMermaid]

Originally Posted by mjlrn97

Nice to see some new "faces" on this thread! Welcome!!!

Here is another new face. I am contemplating making the move from long term care (I'm the DNS) to assisted living as a Resident Care Director. I anticipate fewer regulations and much less stress. 1. Am I deluding myself?
2. Anyone know anything about the BenchMark Company? and, finally, and most importantly.............
so sorry mj.....thePATRIOTS will beat the Chargers today and win the SuperBowl too!!!

[LadyMonteCarlo]

1. Am I deluding myself?


I don't know anything about BenchMark, but I am a new RSD with one of largest assisted living corporations in the USA.

In short, by background was SNF as an ADON for 12 years. Quit it because of the stress and spent 5 years in office nursing. After being told from many, many sources that assisted living wasn't nearly as stressful I applied and was hired.

True the acuity level is not the same. However, the real core of what made me leave SNF is still very much in AL. The ongoing staffing needs, though while not licensed nurse issues are still staffing needs and you just might be working as an aide more times that you ever counted on doing, continuous after hours phone calls for petty reasons, angry/guilty family members, disputes between nursing and dietary, constant pharmacy issues, and at least 3 times a week acute exacerbations of chronic conditions requiring immediate intervention. One of the real biggies is the fact that the MD's that come to ALF seems to be unreachable failing to return calls for days at a time and for the most part substandard to put it nicely. You are on your own much of the time. I'm lucky to get 4 hours of sleep at night. In 7 weeks on the new job I haven't had a full 24 hours off yet.

Deluding yourself? YEP!

The biggest difference is the salary with little to no additional licensed staff to provide you with any relief whatsoever. Stress is no different in IMHO.