lpn as ADON? - page 3

by nd deb

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 doing resident admissions,... Read More


  1. 12
    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
    Syrenia, LTCNS, SE_BSN_RN, and 9 others like this.
  2. 0
    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.
  3. 2
    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.
    SuesquatchRN and noc4senuf like this.
  4. 0
    same here
  5. 6
    I worked at two LTC places in NJ and they had a LPN as ADON and they did a good job at it too. Too much focus on the letters behind your name, if you know your stuff, you know your stuff(lol)
    Syrenia, LTCNS, SE_BSN_RN, and 3 others like this.
  6. 1
    Quote from bbdbldbabe62
    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
    Excellent 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.
    student forever likes this.
  7. 4
    Quote from pixie120
    Excellent 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.
  8. 0
    Quote from Nascar nurse
    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.
    Don'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.
  9. 0
    Quote from CapeCodMermaid
    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.
    WHen 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.
  10. 1
    Many 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
    student forever likes this.


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