lpn as ADON?

Specialties LTC Directors

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nd deb

65 Posts

From what I see there is a fine line.. The place I work at the ADON is in charge when the DON is gone on vacation.. I can't see how she is able to do initital assessments, supervise RN staff nurses. Another interesting thing I have seen as well is you got a patient who has a unstable angina diagnosis and you have a lpn working as the nurse who is in charge of the shift when the RN's are off duty.

montinurse, BSN

220 Posts

Specializes in lots of different areas.

Are you saying that some ADON's actually work in a clinical way (working the floor, admission assessments, etc) LOL-

CapeCodMermaid, RN

6,090 Posts

Specializes in Gerontology, Med surg, Home Health.

Yeah....that's exactly what I said. I worked the floor as the ADON doing admissions, discharges, transfers to the hospital...and guess what...I'm the DNS now and I STILL do those things when the nurses are busy.

My DONs have always been very involved and can take a med cart with the best of them.

Dixiecup

659 Posts

In Missouri, LPN's are hired as the ADON very frequently and pretty much supervise the RN's in every capacity in some facilities. Although, I really don't think this is legal other than in the administrative capacity, I don't think it ever gets checked out very often. And let me tell you, a lot of them get the swelled head real quick.

What really irks some RN's is when an LPN gets their administrator's license, becomes an administrator, and then can legally supervise everyone.

The facility where I work, the staff development person is also an LPN and frequently does write ups on RN's if need be, is in charge of their schedule, and numerous other things. I don't really agree with this but that's the way "it's always been"!

CapeCodMermaid, RN

6,090 Posts

Specializes in Gerontology, Med surg, Home Health.

The administrator's license does not confer any clinical skills to the administrator....so they cannot really 'supervise' nurses. They have the final say in the operations of the building, but the CLINICAL aspects belong to the DNS.

Specializes in LTC, Hospice, Case Management.
The administrator's license does not confer any clinical skills to the administrator....so they cannot really 'supervise' nurses. They have the final say in the operations of the building, but the CLINICAL aspects belong to the DNS.

Ha Ha Ha... try telling that to some of the administrators and some of the AIT's I've been blessed to work with. They know it all, just ask them!

Dixiecup

659 Posts

You got that right! Our administrator doesn't hesitate to try and control every aspect of the building including nursing.

Hello thinkers.

I am an LPN and have been for almost 27 years. I have done just about anything in my nursing career and one of those things was as an ADON of 4 different LTC facilities in Texas over a period of 14 years. Now, what I am wondering is if JACHO has no problems with us being an ADON why do the RN's?

In my role as ADON, I did supervise all staff including RN's, did evaluations and inserves for all of the medicals staff as well as some of the other departmenst. I did most of the hiring and the firing while I was ADON and no one had an issue with this and that inclued our RN's. I was not one of those nurses that sat behind a desk and gave out orders and never got my feet wet taking care of the residents. I worked the floor as well as did my office duties many, many days because of being short staffed. My staff nurses rarely called in and that was not becasue they were scared of me or were threatened but that I made their job less stressful by helping them and I do not remember ever having an RN comment negatively about having an LPN in charge or one giving out assignments. I have never had an RN quit while I was ADON and I think that should say somethings about LPN skills.

It is a a little different in an LTC care faciliy than it is in a hospital when it comes to what an LPN can and cannot do. Now, I do agree that there are facilities where an LPN should not be in charge such as hospitals and as far as I know they are not. I have worked with many LPNs that could work circles around the RN's and some were much more clinically experienced than the RN's working. Many time we do the same job and always get paid less. I take pride in being an LPN and if there are facilities that have no phobias about allowing an LPN to perform the ADON duties then why not allow them? There is not any nursing department in the hospital setting that I have not worked in the last 26 years and I have done so because I proved my skills as an LPN and there are many more of us out there that are not given the chance to do the job. What a shame. The hospital I now work (for 10 years) on a telemetry unit, has RN's that tell everyone that I am really the one in charge but that the RN carries the title...LOL including the RN in charge many days. I am the only certified preceptor for our unit and was chosen to do so by my peers both LPN and RN. I think it is funny because I think they actually feel that I am. Why? I have more experience than most of them and there is not one job duty that I have not filled in including monitor tech and unit secretary. Go figure!

I will close with this: when I interviewed for my first ADON position not one person in that facility knew me and there were 23 applicants ahead of me which were all RN's and I still got the job and that was becasue of great references, hard work, and my prayer that God would open the door to what ever job he wanted me in and he did just that.

Thanks for listening to an LPN who has filled this position successfully and who is still called to this very day by LPN and RN's from those days as an ADON. Dont let your biased opinion keep you from learing from someone who just may be a little more experienced that you even if that is and LPN/LVN.

Dana

tewdles, RN

3,156 Posts

Specializes in PICU, NICU, L&D, Public Health, Hospice.

I just dealt with an LPN DON of a ALF last night on call. All I can say is, wow. The lack of professionalism was astonishing. Her comments reflected her annoyance, her inconvenience, and her anger. That the patient was cared for was not important to her, it was more important that the care was not according to her experience, expectations, or satisfaction. She literally yelled at 3 different people between 130 am and 230 am on the phone. It started all over again this morning with her "follow up" phone calls. I should say that the patient is fine, comfortable, resting and was within 2 hours of my involvement.

Now, having been in this profession for more than 3 decades, I understand that I cannot expect that this incident reflects on all LPNs who may function in that role...but, wow.

CapeCodMermaid, RN

6,090 Posts

Specializes in Gerontology, Med surg, Home Health.

Again, it all depends on the state you work in. In Massachusetts, an LPN CAN NOT supervise an RN in any clinical area and since the DON must be an RN, the ADON who is often called to fill in for the DON must be an RN.

noc4senuf

683 Posts

Specializes in Geriatrics, WCC.

same here

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