lpn as ADON? - page 5

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

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    Quote from CapeCodMermaid
    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.
    Well at least you help out. My management doesn't do any of that. They expect the floor nurses to do it all and then some, with very unrealistic expectations. They don't take the floor unless there is ABSOLUTELY no one else to do it. And that is a bad idea. Then they harp on teh floor nurses for doing the same thing they do. Hmmm....guess that is why the facility is only 2 stars. Bummer.

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    As an LVN that is also the ADON I just have to say that there are some very uninformed opinions on this thread. Especially when it comes to "scope of practice".

    A good RN will and does stop to listen to a good LVN (or even CNA for that matter), if the RN believes he/she can learn something while listening. A good nurse will leave his/her attitude at home and learn from anyone on the team that knows what they are talking about. I am thankfull my facility has good nurses that don't have some of the attitudes I see at this thread. Our LVNs and RNs work together and leave the alphabet at home when we come to work.

    The ADON enforces policies and protocol, gives inservices, INFORMALLY reviews the performance of the RNs and asks the RNs to do things differently if appropriate. If the RN resists, then the DON gets involved. As an LVN, I regularly give inservices to RNs on everything from wound care to charting, facility protocol and even reminders of how to do the basics like caths. I can do these things only because I have been in the environment longer than alot of the RNs, have more experience and also because we have mature RNs without attitudes.
    Something I find interesting is that when the RNs start applying to hospitals after getting some experience at our facility, they usually ask me for a letter of referrence to put in their resume. Only because my title has ADON in it and not because of the LVN. Sometimes I wonder what an RN that only has hospital experience thinks when they see a letter from an LVN written for an RN. Must not hurt anything because I have only seen one RN that hasn't been able to get on at a hospital after working in our facility.

    If you ever wind up with an LVN supervising you, you can be sure of one thing; It is within the LVN scope of practice or your facility wouldn't allow it.
    LTCNS and focusedvalpn like this.
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    At least in the state where I practice, there is no such thing as an LPN supervising. That is beyond their scope of practice per our Board of Nursing. I know many wonderful LPN's they just don't have the authority of an RN.
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    In Massachusetts LPNs can NOT be the ADON. I don't write the rules, but I do make sure they are enforced.
    noc4senuf likes this.
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    In NC a lpn can not manage or supervise a rn nor can they educate a rn, not because they do not know, or have the experience, but because it is not in their scope. Again we didnt make the the BON did.
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    This is just sickening! First of all, I know many LPN's who out nurse many RN's! I work in a facility with the best ADON I have worked with in 12 years of being a nurse. I think it is pretty pathetic that some RN's are so insecure, they have to convince themselves that nursing skills, roles and responsibilities shouldbe based on the number of college credits one has. Many LPN's have ACLS and many years of clinical as well as management experience. Most nurses PERIOD, dont have that. Many states allow LPN's to practice as an ADON. And, it's just like undereducated RN's to not be fully aware of the scope of practice of a LPN. LPN's act as Charge nurses in many places, with RN's working as the Unit Nurse. What I dont understand is how an RN may never even have taken an IV class, yet is allowed to perform this invasive procedure. Many states require that LPN's have IV certification..... Underestimating the skills of a LPN, and being ignorant of the scope of practice for LPN's, is a mistake made by many RN's (especially those of the less paid, and northern states). I am proud to say that many LPN's are paid more than some RN's working in the same facility, and have better clinical skills. :-)
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    In Massachusetts LPNs can NOT be the ADON. I don't write the rules, but I do make sure they are enforced.
    You sound very hostile. I'm thinking it is you who is insecure. I know some excellent RNs and some crummy ones. My SDC is an LPN and she is one of the smartest nurses I know. Again, it is outside the scope of practice in Massachusetts for an LPN to be an assistant director or a director in a skilled facility.
    noc4senuf likes this.
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    As CCM said, we must follow the laws of the states we practice in.I also know of wonderful LPN's and poor RN's, but the law is on the side of the RN in many states.
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    Just have to add my 2cents! What it boils down to is this: An LPN cannot supervise a RN in a clinical capacity. I know many LPNs with more experience than I. I ask questions. We work as a team. But the regulations in my state do not allow a LPN to manage a RN in a clinical role. Period.
    nowim clean likes this.
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    This is an interesting thread. I am a new Grad RN but worked as a nurse supervisor at a LTC facility in Massachussetts while I was in school. I have never seen an ADON that was a LPN but have seen several functioning ADONs that were LPN's that were given the title of "House Manager". At the facility I worked in this was a cost savings and also given to a strong LPN that was well liked. She is being taking advantage of financially and because she feels "lucky" to have this post, she is working herself ragged.

    I didn't realize how far out of the scope of my LPN practice I was asked to be until I entered the bridge program and got a reminder from a very nice instructor who was concerned for me. I had been an LPN for many years and had slowly started to pick up more and more responsibility as asked by Management. I can tell you that I did more of the admission assessments that any of the RN's, to include patient teaching, etc.. I can tell you that almost all initial assessments of new admissions in to LTC facilities in far western Massachussets are done by LPN's. I brought this up to a friend of mine who is a DNS at a facility where I pick up agency shifts and she said that it is a fine line and covered legally by the way the admission assessment form is worded. She stated that also there is a place at the end of this 9 page document for an additional nurse to sign if necessary.

    I think we will see more "House Manger" positions open up as a cost saving going forward.


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