Start up of a new facility - Did I get myself into a hot mess?

Specialties LTC Directors

Published

Looking for guidance from any DON's experienced in opening a new facility. Help me prioritize please!

I'm 4 days in. When I got there Monday there were 20 residents. This is a 100 bed facility that has been open about 2 months. (This is a beautiful place and the newest hot spot in my county. Everyone now wants to move in yesterday). I was absolutely thrilled to be offered this opportunity and hoping I don't regret leaving my nice cushy DON job where everything ran like clock work.

From what I can tell corporate has turned on the heat and they expect us to step it up on accepting admits. Also, it would appear that the facility has fallen behind on the hiring process and is not prepared to keep up with the pressure of 2-3 admits/day everyday! The team of staff I have have all come from different places, all have their own ideas (some with pretty bad ideas too) and everyone seems to think I'm going to make it all work...like yesterday. Heck I haven't even been trained on the computer system yet!

It has been an exhausting 4 days and I just want some input from someone who has been there, done that! I CAN do this and i WANT to do this but after 4 days I would like it if someone could tell me where to start and what is priority when everything seems to be priority. (maybe I'm just tired and whining :confused:)

Specializes in Care Coordination, MDS, med-surg, Peds.

I am sorry to hear that.... Try MDS if you can, Not as stressful, although it is stressful in its own way. You may be on call sometimes, but NOT 24/7. Best wishes!!!!

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Specializes in LTC, Hospice, Case Management.

Thanks you guys. I was an MDS coordinator for 10 years & it might be time to brush up on those 3.0 rules that I'm not as familiar with.

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Specializes in Gerontology, Med surg, Home Health.

How about staff development?

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Specializes in LTC, Education, Management, QAPI.

Nascar Nurse - I too have read a lot of your posts, many have inspired me and kept me motivated when things get rough (which in DON world is like every day). No matter what you do, I am sure it will be great. Do not ever stop posting, you have no idea how much it affects others, even those that you may never know. Thanks, and I look forward to seeing some posts when you accept your next challenge!

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Specializes in LTC, Hospice, Case Management.
Nascar Nurse - I too have read a lot of your posts, many have inspired me and kept me motivated when things get rough (which in DON world is like every day). No matter what you do, I am sure it will be great. Do not ever stop posting, you have no idea how much it affects others, even those that you may never know. Thanks, and I look forward to seeing some posts when you accept your next challenge!

I wish you knew how much this really meant to me on this particular day! I'm down to only 2 days left and had another absolute miserable day again. I've worked in this field for many years and I have never been so miserable and felt so underappreciated by both the administrator and some of the staff. If I had not had so many previous success in this career I would seriously question my abilities at this point. It's down right scary how a few people and a few situations have been able to rock my confidence in such a short period of time.

I have an interview scheduled tomorrow for a hospice manager. Not sure I really want to be a manager after the last several months but I have a very good friend employed at the same company that was a former LTC DON and she promises me the position is a piece of cake compared to what I've been through.

Thanks again NurseGuyBri - you are an angel today for making me feel just a little bit better.

BTW - I have every intention of calling off these last 2 days with sciatic pain. After all, the boss informed me just this afternoon that I will NOT be getting the weeks paid vacation that I was promised at the time of hire. Figured I might as well take my sick time then.

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Specializes in LTC, Hospice, Case Management.

Update...I start Tuesday as a hospice case manager & had a 2nd interview with Point Click Care as a trainer. Bye bye LTC but yet still with direct involvement. Could be the best of both worlds.

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Nascar Nurse....

I have worked in LTC most of my 20 years and I know as much as I can without doing it what a DON does. It is an impossible and thankless job and I have seen so many incredibly intelligent, talented, competent and caring nurses eaten alive by the expectations placed on you by the regulatory bodies, corporate, staff and residents/families. Most recently my present DON who took the building I work in from a limping, completely disorganized mess to one with the best state survey it's ever had in one year. She is leaving at the end of the month and I am so sad.

Please don't let this episode undermine your professional confidence and belief in your abilities. As I said, it is a completely impossible job for anyone. LTC has been so difficult and is getting worse because of so many trends...but, in my opinion mostly because of the change in acuity levels, changes in reimbursement with emphasis on staffing and support resources lagging so far behind and the bigger emphasis remaining on the almighty bottom line.

Hospice and/or Case Management is also looking good to me...but I will need to finish my RN first. Onward and upward!

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Specializes in MDS/ UR.

Good to hear! Best of everything to you!

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I enjoy your posts as well! and if by your name you love nascar them Im really a fan! we just implemented pcc at our facility....a mess because I was only one training but I like the program.

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