I have been a nurse for 24 years. I obtained a MSN and CCM in 2014 and I am having a difficult time obtaining a leadership role. The last 8 years I have been a hospital case manager. In this role I did utilization review and case management activities related to decreasing readmissions and care coordination. I have past experience in long term care as a MDS Nurse and I coordinated the care conferences. Additionally, I worked as weekend shift supervisor 12 hour shifts for about a year for a group of nursing homes.
Well, since I have not landed a manager of case management position, I am considering getting back into long term care. I have an interview at a facility tomorrow for an ADON position. I would like to know the drawbacks of this role.
This facility does not utilize agency. The regional director of nursing is covering the building now and the new DON starts soon. I did speak with the new DON on the telephone, she has been a DON for 15+ years so I think she would be a great person to learn from.
Lastly, the medicare.gov rating at the nursing home is 2/5. With 5 deficiencies on the last survey. I asked why the last DON left and was told poor work ethic. They told me they were seeking a new management team that could build the team up and show some employee appreciation. Currently, I have a transitional care nursing role at the hospital working for a group of doctors and I do not fill challenged.
Thank you in advance for your comments
You have very good credentials, education & experience. That should fare you well in any position you hold.
I will tell you, though, my ESP radar is pinging. The fact that the 2 top nsg positions are simultaneously open in a 2 - star facility concerns me.
My questions to you would ask 1) how large is this facility; 2) are any other dept head positions open; and 3) are there other nsg mid line staff (UMs, SD, IC, MDS, supers) in place to support you?? Do you know what the 5 deficiencies entailed, and when Survey may be expected to return? Is there a union (negotiations due)?
I had several years LTC and I always found that the ADON position required the wearing of many hats. A lot got delegated to that position.
So you could be facing a big challenge ahead. An ADON position always seemed to be a hands-on, fixer-upper position.
Now you will have an experienced DON coming in (good) so the opp'ty for learning is great. So the chance to move up in LTC hierarchy is quite possible (DON, corporate, LNHA).
I'm naturally wary, so I would want to really see what I'd be moving into. Like the big picture so I'd be minimizing the chance for any surprises.
Good luck to you.
Quote from BahaMamamaRN
I have been a nurse for 24 years. I obtained a MSN and CCM in 2014 and I am having a difficult time obtaining a leadership role. The last 8 years I have been a hospital case manager. In this role I did utilization review and case management activities related to decreasing readmissions and care coordination.
Well, since I have not landed a manager of case management position, I am considering getting back into long term care.
I have no advice related to LTC for you, but I want to say good luck and good for you for making such a move! I too returned to an earlier specialty of my nursing background to receive an Assistant Department Management position (a promotion) because the case management specialty within the hospital setting lacks such opportunities for advancement due to very few openings. Also, I landed my promotion at a facility that was not the best of the best and as an ANM I am also the hands-on patient care and middle manager, where I take on the brunt of much of the staffing, quality, safety, etc. issues. I am hoping you will have more people to spread the love as the above poster points out!
amoLucia's comments seem dead on to me. The fact that both of the top positions in the facility are open at the same time indicates that working conditions are probably not great. It's a shame that you can't talk to the prior incumbents of these positions to find out why they left. From the facility's standpoint, it's easier just to put the blame on the employees, who aren't there to defend themselves or give the other side of the story. The fact that the facility would tell you that it was a "work ethic" problem raises red flags to me.
My background in long term care isn't extensive, but it was long enough for me to know that I wanted nothing to do with it as a career. Pay is generally low, and those places tend to lean very heavily upon their managers (perhaps why these positions are open). Since the pay and working conditions are often poor, they have a lot of vacant positions for line staff - which they often call upon their managers to fill in for. Those same managers are then blamed because the facility can't find or retain personnel. The last such facility that I worked at, I was under four DONs in a 90-day period. Considering that I was the only RN on a 125-bed unit (and I was also filling in for vacant LPN positions and passing meds to 40 patients), I didn't wonder why nurse managers didn't stay.