Signed ADON behind my name today

Specialties LTC Directors

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Specializes in LTC, Hospice, Case Management.

Wow.. what have I got myself into. From MDS's to ADON. Hope I am ready for this, but excited to have a new challenge. Anyone with advice... would be much appreciated.

What do they say about keeping your head low? Congratulations and hope you enjoy the new job.

Very cool. Good luck and all the best in your new role!

Specializes in acute care and geriatric.

See post : Taking a new ADON position from 2006. I wrote there:

Re: taking a new ADON position

1. As a fellow ADON I have learned to start quietly, be charming, respectful, professional and supportive and don't institute new policy changes right away- observe first. remember people are always listening and talking. Staff love to gossip any faux pas of yours (and if they do- don't overreact remember that peoples memories are very short, just ride it out)

2. Learn to read your DON's colors and take your lead from her. Quietly determine her strong points and weaker points and help her strengthen her weaker points. For example my DON goes into panic whenever a nurse or CNA call in sick last minute because we can't call in an agency staff service (a policy I support). She finds it stressful to find replacement staff. Unfortunately our head nurses are not as successful getting replacement staff as they identify too much with the staff and want to respect their off-time. I took an attitude that "the show must go on" and we must have staff to provide the top notch care that we are so proud of -so I call, flatter. charm, beg, make 'deals' and sometimes arm wrestle the staff to make sure that we have very few understaffed shifts. I am highly respected for it and my DON is grateful.

3. Anyway, you must always remember that you are the assistant and you don't set policy, you are there to support the DON's policies and make her look good! Even if it means giving up the credit on your idea or your work. Don't worry she will know the true source of the idea and you will get rewarded in other ways.

4. CONTINUE your education, maintain your skills and stay abreast of whats going on in our field so you sound informed. I love http://WWW.Medscape.Com for info (Have you got other good sources?) Don't be afraid of asking experts- you're not expected to be an expert at everything.

5. In time you will see what projects need your attention and I have lots of ideas if you need help

6. Make one area your expertise. For example I took on Pressure Sores and I do weekly round, reports, inservices, I let the staff know that I will be breathing down their necks to make sure that turning and positioning gets done etc

7. lastly- be a good example and don't overwork yourself to the point of stress. use your vacation days, pace yourself and take care of yourself. Pamper yourself when possible it shows that you respect yourself and others will respect that.

Good Luck!!!

Specializes in LTC, ER, ICU, Psych, Med-surg...etc....

That was a beautiful reply achot chavi! And congratulations to you Nascar Nurse! With your years of experience and MDS knowledge, you will be a success!

Great thread, and great advice!:yeah:

A few more thoughts--

As a part of "upper management", you will be exposed to, and be "in on", situations you never thought possible amongst professionals in a "caring" environment. Professionals who use controlled substances instead of turning them into refuse. Professionals who think an "I-centered" care plan is an approach which directs the client to the local Pearle Vision Center. Professionals who profess limitless concern, yet limit their concern...to less and less...

Sometimes, management will ask for your opinion--sometimes yours is the most needed. Unlike others, your opinion is less biased by "baggage." You may not know or understand "the history behind this situation", but you may know and better understand the situation presented today.

Keep your eyes and mind open--share what you see and feel.

Expect the best, accept the possibility of the worst--learn from either/all.

Good luck!

Specializes in LTC, Hospice, Case Management.

Just checking back in to let you know how I am doing. I went in today at 7am and fired an aide by 7:10am. 11-7 nurse reported she was sleeping most of the night.. to the point of being curled up/covered up in an empty bed and wouldn't get up. Aide didn't even deny it!! Unbelievable - jeez. What a fun job this is gonna be.

Appreciate all the advice.

Sharon

Specializes in acute care and geriatric.
Just checking back in to let you know how I am doing. I went in today at 7am and fired an aide by 7:10am. 11-7 nurse reported she was sleeping most of the night.. to the point of being curled up/covered up in an empty bed and wouldn't get up. Aide didn't even deny it!! Unbelievable - jeez. What a fun job this is gonna be.

Appreciate all the advice.

Sharon

Chances are now that you made a clear example of that aide, others will learn from the incident.

My contract states that once a month I have to do a surprise inspection of the night staff (for which I am paid decently so i dont mind) and I once found a male nurse in his "nest" and couldn't wake him. He was fired the next day. Since then, I have found my staff all awake and alert all night long even at 3am.

I am just surprised that you fired her without having to discuss it with your DON, I have fired staff but only after discussing it with my DON. There are legal implications etc.

I would also question the 11-7 nurse as to why she allowed this aide to sleep all night , it is her job to awaken her and keep her busy. A nurse should NEVER let a staff member sleep in a pts bed.

My first night on a night nurse job I found a CNA sleeping in the bed with a pt!!!! His head by the pt's feet and his feet by the pts head. I pulled him out immediately and in the morning I reported it. The head nurse went to bat for him admitting that she knew he did this but ... "what can you do".... Well not under my watch!!!

Does your facility have cameras to monitor the halls? that is another useful tool for supervising the night shift. Three nights ago a pts diamond ring was stolen off her finger- (yes she was warned that we bore no responsibility for it) and through the cameras we saw who went in and out and who stole it.

Good Luck- looks like a fun job!!!

Specializes in LTC, Hospice, Case Management.

Oh, I did talk with the DON prior to terminating the CNA. The DON and I have been friends for years (lucky to be very comfortable with her!). I knew she was on her way in, but she lives some distance away and the CNA would have been long gone by the time the DON made it to the facility. DON told me on the phone that they have actually had multiple problems w/ written warnings since the aide started about 6 weeks ago and to let her go as long as I felt comfortable handling it - which I did. We are an "at will" state and I already knew the aide had been employed less than 90 days.. but that doesn't make much difference either in an "at will" state... so my bases were covered legally (but still appreciate you making sure I was aware).

And, the night nurse did wake her up and make her get out of bed as soon as she discovered she was sleeping (didn't mean to imply that she slept ALL NIGHT, just that the nurse had a difficult time arousing her to get her up)- the night nurse is the one who alerted me to the problem to begin with.

No cameras in our halls and probably never gonna be any.

Thanks for the input

Specializes in acute care and geriatric.

Yeah never thought there would be cameras here too- and guess what- I love 'em!!

Family complains that Mom called on her call bell for 3 hours all night and noone came to her. Nurse swears they were in her room all night. Hall cam verified the patients version, nurse had egg on her face and learned a lesson she will never forget.

BTW in a previous (lousy) facility when I complained to the DON of a CNA who skipped rounds to sleep under blankets etc., the DON rolled her eyes and said that is the best she's got- so I'm glad you took a firm stand and showed people your strength of conviction,.

Specializes in ICU, CM, Geriatrics, Management.

Belated congrats, NN!

Thanks for sharing your excellent thoughts, AC.

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