New ADON feeling overwhelmed

Specialties LTC Directors

Published

This is only my 2nd week in my new position as ADON of a 212 bed non-profit SNF. I'm very excited about learning new things and hoping to be a positive influence on staff, but our survey window is opening up and I'm getting flooded with information and I'm starting to second guess myself. Any advice would be much appreciated! Help!

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Specializes in Psychiatric Nursing/Case Management.

What type of doubts are you having?

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Specializes in retired LTC.

Re your upcoming survey - ask your admin for a copy of last survey's results. You usually can use that as a guide to see where attention is needed, esp that old problems have been corrected accdg to your facility's Plan of Correction.

At least that's a starting point for you to start focusing on.

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What type of doubts are you having?

Tasha, we have a lot of nurses that are not very thorough at my facility, and they are resistant to change and learning new things as well. I suppose I am just doubting my ability to get them to do what they are supposed to do. I want to be a strong leader and have my nurses want to perform well. It seems like they just don't care, and I'm not sure how to approach this.

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Respect is earned. Show them that you do care by getting your hands dirty. Answer lights, help with the dining room or food trays. I'm not saying this is an everyday thing, but it helps them realize that you're a nurse first and making sure the residents are being taken care of is your # 1 priority. When you get there in morning, walk the halls and see if staff is doing ok. Say good morning to the staff. I had a housekeeper thank me once for saying hello to her. She said in the 10 years she has been working at this facility, not one member of upper management ever said hello to her. Trust me this works!! Showing that you're a team player will open their eyes and also make your job much easier. Hope this helps!

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.
Respect is earned. Show them that you do care by getting your hands dirty. Answer lights, help with the dining room or food trays. I'm not saying this is an everyday thing, but it helps them realize that you're a nurse first and making sure the residents are being taken care of is your # 1 priority. When you get there in morning, walk the halls and see if staff is doing ok. Say good morning to the staff. I had a housekeeper thank me once for saying hello to her. She said in the 10 years she has been working at this facility, not one member of upper management ever said hello to her. Trust me this works!! Showing that you're a team player will open their eyes and also make your job much easier. Hope this helps!

This is dead on. In a lot of places like this, the only time that staff hears from management is when something is wrong. A little encouragement goes a long way - as does a little walking in their shoes.

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Thanks for the inupt thus far. As a matter of fact, the approach that tkt and Orca recommended has been my approach to subordinates throughout my career and one I continue to practice in my new management role. So far I think think it is working with the STNA's, but as I mentioned before, many of the nurses really just don't care. We just fired a nurse for refusing to care for a resident in distress because she was on her lunch break, and she's filed a grievance and is fighting to come back, just to be spiteful. We daily battle through poor charting and incomplete incident reports and wound grids even though they have been repeatedly educated. One nurse told my DON that she wasn't going to do something because "I'll be here long after you're gone." Now, not all of the nurses are this way, thank goodness, but my gosh the shame! They should want to do things properly and thoroughly for our residents! After all, that is what it's all about.

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Unfortunately I have no tidbit of info to offer you, but I will say that we are a resourceful and fast-learning profession as a whole-- I'm sure you can handle it. You won't be perfect, but push through this time and I'm sure you'll get better and better.

Sorry to sound so cliche lol

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Specializes in ICU, CM, Geriatrics, Management.

It's a tough gig for sure. Management's gotta give ya at least 6 months to a year to learn the job, depending on your background, experience, education, and other learning / personal factors.

Did this job, and it seems there was never enough time to complete everything. Unit manager spot was similar (maybe worse). As a result, neither had much satisfaction... for me, and I ended up leaving for a supervisory position.

Good luck!

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The way the job market is i bet you can find some nurses that really care and are job hunting...

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.
So far I think think it is working with the STNA's, but as I mentioned before, many of the nurses really just don't care. We just fired a nurse for refusing to care for a resident in distress because she was on her lunch break, and she's filed a grievance and is fighting to come back, just to be spiteful. We daily battle through poor charting and incomplete incident reports and wound grids even though they have been repeatedly educated. One nurse told my DON that she wasn't going to do something because "I'll be here long after you're gone."

Unfortunately, you're reaping some of the "benefits" of ineffective leadership that preceded you. A friend of mine took a DON spot in a facility where the techs basically ruled the roost. It took a long time, a lot of perseverance and I'm sure a fair share of headaches, but she has it mostly reeled in now and the facility is running like it should. Stick to your principles. Your nurses need to know that you are acting in their best interest in the things that you are putting in, not just trying to get them to do more work. I have been sued before, and my documentation saved me. Theirs may too, someday, but only if it is done right.

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Unfortunately, you're reaping some of the "benefits" of ineffective leadership that preceded you. A friend of mine took a DON spot in a facility where the techs basically ruled the roost. It took a long time, a lot of perseverance and I'm sure a fair share of headaches, but she has it mostly reeled in now and the facility is running like it should. Stick to your principles. Your nurses need to know that you are acting in their best interest in the things that you are putting in, not just trying to get them to do more work. I have been sued before, and my documentation saved me. Theirs may too, someday, but only if it is done right.

Hiring and firing and insubordination make up about 75% of your job. Like Orca said stick to your principles. Work with the staff who cares about coming to work everyday and caring for the residents. I am very good to my staff and my door is always open to them, but if they're not meeting MY expectations (not theirs) in quality of care I don't want them working on my team. My famous line,when I see staff not working that 100 %, is, "punch out and go home, otherwise get busy." Mind you, I don't say this everyday, but my staff knows when I mean business. I always try to make their days fun, not so routine. I like them to think outside the box and teach me something too!! I also haven't had any call ins in 8 months. I'm very positive in my facility. I have the we can do it attitude and never talk down about anyone (even though I would love too) This took me a long time to make it work. It won't happen overnight, but in the end you'll sit back at your desk and say "what a great day today." One day at a time. Good luck!!

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