lpn as ADON? - page 3
Lpn as ADON? Just wondering how that works. Are they in charge when the DON is gone? That doesn't make sense because legally a lpn can't supervise Rns. Just wondering how a lpn can get by with... Read More
Sep 4, '11Quote from pixie120Excellent post, I too filled in and had every role, as an LPN. I supervised RN's all the time, and never had a complaint from the staff that I supervised. I agree, if the facility will allow it, why are RN's so resistive? IT's because of the RN resistance, over the years, that LPN's were never allowed to simply challenge the RN NCLEX based on experience, say worked as an LPN for say 5 or 10 years, should be able to simply challenge NCLEX, in my opinion.
As an interesting side note, when I got my RN last year, it was the LPN's that I know that were congratulatory, the RN's I know, not so much. As a DON/RN in SNF...RN's gave me the worst time, seriously, many failed to recognise DON is the primary leader in SNF, many went over my head (they didn't last long) to ED, a lot of testing from even the new 2 year RN's/new grads (Do we really have to do this....why can't I lie...Why can't I falsify...WHy can't I call in, leave early and text continously". I attribute this to young age however since these particular RN's knew me first asn LPN, I think they lacked common respect based on my newness as an RN (seriously?). It is an interesting thing to have people challenge me because I am/was a "new grad". Pretty funny actually.
I was a LPN for 19 years before becoming an RN. I found out I passed the RN NCLEX and was a RN while sitting in the facility I had worked at for most of my career. I've got to say, it turned into an instant "party". I never ever ever felt like one group of people were happier for me then the other - RN's, LPN's, the cooks, the housekeepers were all hugging me and while all of that was going on the secretary was announcing it overhead which brought a lot of residents out to the hallways too.
I also don't believe I should have been allowed to challenge the RN NCLEX. There are dues to be paid in life - that is just how life is.
Sep 4, '11Quote from Nascar nurseDon't get me wrong, they were just as happy for me when I found I passed RN. That was a great day. But, to turn around less than 10 months later and be the DNS, not so happy, for a few unhappy nurses. Again, I really attribute it to age rather than degree.I was a LPN for 19 years before becoming an RN. I found out I passed the RN NCLEX and was a RN while sitting in the facility I had worked at for most of my career. I've got to say, it turned into an instant "party". I never ever ever felt like one group of people were happier for me then the other - RN's, LPN's, the cooks, the housekeepers were all hugging me and while all of that was going on the secretary was announcing it overhead which brought a lot of residents out to the hallways too.
I also don't believe I should have been allowed to challenge the RN NCLEX. There are dues to be paid in life - that is just how life is.
Sep 4, '11Quote from CapeCodMermaidWHen I was ADON as an LPN (twice) I filled in for the RN /DON in all roles EXCEPT RN for state purposes. We either used the regional RN or a floor RN for that portion. The DON was rarely gone, and only if she were out of state did that come into play. I supervised all types as LPN, depends, in this state, what the facility policy is, and I never supervise ANY nurse with regard to his/her scope of practice. I do supervise all with regard to facility policies, state and federal policies and patient care, but as ADON, reporting directly to the RN/DON.It's a bit of a fine line I guess. I only had an LPN challenge me in 10 years, interestingly enough.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.
Sep 5, '11Many years ago, when I was an LPN, I worked as an ADON; but, my title was "Director of Nursing Assistant" instead of "Assistant DON". The reason was that I could NOT step into the role of the DON, if needed. I could only do tasks as her assistant (although the duties were essentially the same). I am now a RN at a LTC facility where we have an LPN as ADON. She does not show professionalism nor does she have enough clinical expertise for which this position requires...She & I have disagreed on many occasions, of which I am always reminded that (even though I am management as well) she IS my supervisor... I still speak up as patient advocate when needed because of my personal ethics...I do not think it is so much an LPN/RN thing, but personal experience with critical thinking, problem solving, clinical skills, and rapport with the staff
Sep 9, '11Quote from Nascar nurseHa 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!
this is so funny to me my old administrator watched house and would quote of things she saw and turn around and say she saw it on house and that was supposed to justify everything she said and don't call the doctor... examples hey focused mrs smithwind says she is constipated she hasn't had a BM today can you give her an enema now and at bedtime and then tell them to give her one in the morning too. i dont want her to get impacted . mind you mrs. smithwind has had 2 BMs today and she obsesses about her bowels. and my all time fav. hey focus mr. adams is so confused i think he has a uti can you give him cipro? mind you no UA/C+S, NO MD, and he has an allergy mr. adams is 75 yrs old and in end stage alzheimer's disease and has thought for the last 4 years i have worked with him that is toothbrush is his walkie talkie or a knife he uses in battle to call for help or cut the ropes. smh priceless.. and she wondered why i just looked at her and then asked before i knew it if she was serious.
ohh administration the joy they can bring when out of my presents lol
Sep 21, '11I know of a ADON in California who is an LVN but acting DON. The actual DON of this facility is actually the DON of the hospital district so I don't think she (RN/DON) has any part in the actual day to day operation/oversight of the SNF.
This doesn't seem to make the state surveyors any difference because I am positive that they are aware of the set up. The facility is strictly long term and would not have any IV therapy or rehab.
From my observation, it appears that she does a fine job in keeping everything together including a deficiency free survey.
In my limited observation the difference between LVN and RN is very minor. To me the difference lies in the individual nurses experience and personal motivation to learn. I know LVNs that have much better assessment skills, knowledge base, etc. than some RN's that I have worked with in LTC.
Sep 22, '11The educational and experiencial differences between LPNs and RNs can be vast...just because some can function effectively in the same role does not mean that they are not differently trained and differently skilled and capable in another setting.
Sep 22, '11Quote from tewdlesI think I agree with you. but...The educational and experiencial differences between LPNs and RNs can be vast...just because some can function effectively in the same role does not mean that they are not differently trained and differently skilled and capable in another setting.
What is the purpose of the different training? Why not omit the LVN/LPN training and have one licensed nurse? The individual nurse will then develop skills based on the job requirements, their individual learning ability, individual skills, on the job training etc.
What I learned in school only seems to be a basic foundation. What I needed to function as an ICU nurse taking care of immediate post-op CABG, Intra-aortic balloon pumps, and Continuous Renal Replacement Therapy was all a result of intense hospital based classroom and orientation/mentoring.
Sorry to diverge from the original post. I am sure this issue has been hashed out many times in these forums, but I just recently began participating rather than just reading the weekly emails.
Oct 20, '11Quote from bbdbldbabe62You write very well!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.
I too am an LPN/ADON, soon to be an RN. I have worked for my facility many years, and was told when I was promoted (from Unit Manager) that I had been chosen for the position because of my ability to get on well with the staff, as well as the fact I had proven myself worthy of the job. In LTC things are a bit different than in the hospital setting. The RN's and LPN's exist together, no one pays that much attention to the letters. Many of our RN's are new and inexperienced- there are many tasks they have never done alone. (Many have graduated without even having put in a foley on their own!) The LPN's are experienced, many of them with 20+ years under their belt- now logically, I don't care what your letters are. If you have the experience, you are who I want to train me. There are good and bad nurses period, no matter what their letters say behind their name. RN does not make you all knowing- not one of us are- RN, LPN or otherwise.
I am the ADON, and I do get out on the floor EVERY single day- I help the nurses write orders, work on the daily scheduling, give baths, feed, do wound care....all of it. How else can I know what is going on in the building? How else do you get your staff to relate to you well, and gain their respect?
On a final note, when my DON was out of the country, I dealt with the State on a complaint, and did just fine thank-you!
Oct 20, '11Quote from caliotter3Agree. When I first read of LPNs being in charge at some LTC facilities, my thoughts were similar. Beyond the LPN scope of practice and taking advantage of the LPN in order to get around paying the person who has the appropriate license. Administration in any facility belongs at least in the RN role. Next, they will be having those CNA medication aides running the show to save even more money.
Really? I am currently the ADON/Unit Manager/Wound Nurse- and I AM also an LPN. (In fact, our other 2 Unit Managers are also LPN's) I EARNED my spot, having been in nursing longer than most of the people in my building. In our state, it is perfectly legal- I know my regs, policy and procedures very well I can assure you. We do have RN's floating around our building, many of them are new, coming out of school without even having changed a foley on their own- or having done a med pass to 30 residents- and we even have those "CNA medication aides" around to help train them! So, I am guessing if the State Board of Health doesn't have a problem, why does everyone else? I agree with another poster here who stated that nursing should go with one certification- period. Then people would be hired by their proven worth and merit- not just because they have the right letters behind their name. Work together, get the job done. LTC is a whole other world.
Oct 20, '11Quote from CapeCodMermaidWouldn't it be nice if we had ONE board of nursing vs 50? It really would simplify things.It may be 'a whole other world' but in Massachusetts, at least, the ADON MUST be an RN.
Oct 27, '11Quote from CapeCodMermaidYeah....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.
I'd love to come work with you