Administrators

Specialties LTC Directors

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I am a fairly new administrator in LTC and I am wondering what the general consensus is among nursing about the administrators you work for?

What are some of the things that administrators do that drive you crazy? What are some things that you actually like?

I see quite a few posts that are fairly negative towards "upper management"....I'd like to hear why. Give me some examples of both good and bad management.

Thanks!

Specializes in Gerontology, Med surg, Home Health.

Unless you're an RN as well as an administrator keep your clinical opinions to yourself. MY job is to oversee all things clinical. Your job is the financial. Please don't disrespect the other managers..

Especially the DNS and especially not in public. Although important, yours is not the only opinion that counts. Please remember it's the team not just you and, really at the end of the day, it's the residents who count. One last thing, if you're interviewing someone for a dept head position involve the DNS in the process. Since everyone needs to work together to be successful, the team should have some input. Oh and one last thing, don't sock your DNS on the shoulder because you think it's fun.

Specializes in LTC, Hospice, Case Management.

I am currently very fortunate to have a fantastic administrator. He:

- shows up on the unit at least once a day. I have watched him answer a call light, walk a resident to the dining room and even toilet a resident (part of his A-I-T was to be a CNA).

- So far has showed up to every nurse and aide meeting I have given. I determine the agenda, I run the meeting and he sits down and shuts up. I've only seen him jump in if a question arises that's financial or to thank the staff for what they are doing. And he supplies food for all the meetings. :yeah:

- When the two of us are called into a meeting with a family complaint he never throws my nursing staff under the bus. He seems to have a calming effect to an upset family members and is able to offer solutions that are reasonable. And again, he doesn't make us look bad while doing this.

- Is very supportive of me. He knows this is my first DON job and points out at least one thing each week that he thinks I have handled well. He seems more sure of me/my efforts than I am about myself. Maybe he is just a damn fool - haha.

- I have watched him deal with all department heads in the exact same manner that he deals with me. I see no favoritism.

- His word is his word...today, tomorrow, next week. Nice stable personality.

Unfortunately I have had plenty of bad administrators over the years too....

- The freak I just left recently that couldn't remember what she said/promised from one day to the other. Would tell you to do something one day and the next day be screaming at you in the hall for doing that very thing. Later apologize once she remembered. If this happened once I would gladly accept apology and move on but this was a weekly occurrence.

- The one that spent most of morning meeting talking about her psych issues and her counseling appointments. She was also the one that passed out right in the middle of stand up one day. We woke her up 3 times, she would start a sentence and pass right back out. We just got up and left. How do you take that seriously?

- The one who wanted to micro manage every staff members life. He was the only person in the whole facility allowed to approve a request day or vacation day off. The department heads weren't even allowed to determine this for their own staff. Also the one rumored to be having an affair with another staff, he then just flat out fired anyone that he thought was spreading this. After a couple of months of this, she turned up pregnant. He got fired and they both got a job together somewhere else...hmm

I could go on and on.

Just you caring enough to ask this question says a lot! I agree with the prior two post, it is vital that the administrator allow the DNS to handle the clinicial issues. In my situation, I have a DNS with over 25 yrs experience and plays a large part in helping. The best advice I could give is make sure your DNS is able to lead her department. One thing I love most about my administrator is that she does not allow other department employees go around their manager. There have been times when employees thought they could go straight to her and complain about something they didn't like. Her response is always, "Have you spoken with your DNS?" Can't tell you how much that means to me. Best wishes!

Specializes in LTC, Hospice, Case Management.
There have been times when employees thought they could go straight to her and complain about something they didn't like. Her response is always, "Have you spoken with your DNS?" Can't tell you how much that means to me. Best wishes!

Great point. To the OP this is VERY important. One of the things you will want to keep in mind.

Unless you're an RN as well as an administrator keep your clinical opinions to yourself. MY job is to oversee all things clinical.

I am not an RN, but even if I was, I would leave clinical decisions to my Director of Nursing. Her job is to run the nursing department, and making clinical decisions is part of that. I am involved in the process, but my DON makes the final call.

Your job is the financial.

Yes, but not exclusively. My job is to oversee all departments and to ensure that the facility is run appropriately. There is a lot more to that then financial statements, budgets, etc. I deal with HR, marketing, public relations, resident/family issues, staffing..... However, my DON is involved in the financial process, as well. She is interested in making sure that the facility brings in enough money to operate and to make improvements, give raises, etc.

One last thing, if you're interviewing someone for a dept head position involve the DNS in the process.

I involve ALL of my dept. heads in the process of hiring a new dept. head. We need to work together as a team, and so they should have a say in who they have to work with.

The best advice I could give is make sure your DNS is able to lead her department. One thing I love most about my administrator is that she does not allow other department employees go around their manager.

I agree! I often have employees in my office complaining, and the first thing I want to know is if they have talked to their supervisor. If not, then I tell them that they need to do that first. If they have, then usually I ask to meet with both the employee and supervisor to get both stories. Right now, the nursing staff in my facility is in an uproar over time changes for med passes. Instead of talking to the DON (she's fairly new to the facility), they are coming to me. I can't solve this problem for them! I refer them to the DON.

Thanks to everyone for the responses! I appreciate it!

It's great that you are already not allowing staff to do staff splitting. That is the number one cause of trouble, appear unsupportive of your DNS, allow her/his staff to come to you for complaints, and the team is sunk.

Don't have an affair with your DNS, or any other staff, don't play favorites (particularly with your marketer), don't allow your marketer to interrupt the entire team all the time, yes prioritize admissions, but within reason. ATTEND all the required meetings and participate (not reluctantly, but eagerly) in all parts of the clinical process (the best administrator I ever worked for attended skin rounds, he didn't do it every week, but he took a real look at the wounds himself). DOn't allow families and residents to complain about nursing without a nursing representative present, preferably the DNS. Don't smooze up to the nurse managers, behind the DNS back, and although you technically supervise MDS and Staff Development, make sure they know you expect full alliegance from them, to the DNS.

Just the fact that you are asking means you are ahead of the game!!

OH yeah, even if you are an RN/Administrator, remember you decided to be the Administrator, NOT the DNS, so support your clinical director/DNS.

I am a fairly new administrator in LTC and I am wondering what the general consensus is among nursing about the administrators you work for?

What are some of the things that administrators do that drive you crazy? What are some things that you actually like?

I see quite a few posts that are fairly negative towards "upper management"....I'd like to hear why. Give me some examples of both good and bad management.

Thanks!

I am not negative towards any part of management, and I think your post is very thoughtful and you seem to be truly interested in building a good team for your facility. The best thing that you can do is maintain an open line of communication with the DNS and always, without fail, support the nursing team. If you ever feel the need to NOT be supportive, speak in private, and set goals/deadlines for performance improvement for your DON/DNS. Don't favor the SDC over the DNS, or any of the RCM's, or any of the floor nurses. There is no reason whatsoever to NOT be supportive of your nursing team.

If the time comes that the DNS needs to go, it should NOT come as a surprize to him/her, it should be done just like any other staff, as part of a very clear progressive discipline path. It is very important to remember that the nursing community is a very small community and nurses all talk, if you get labeled as a "bad" boss, all the nurses will know that and vice versa, so keep that in mind when holding ALL your staff accountable. I worked with an administrator years ago,that never acted on anything, just talked like she/he will, letting bad staff work months and months and not do anything AND be rude to the nursing staff, and says this "Well, if you finish strong....I will give you a letter of recoomendation". Finish strong? didn't do anything but undermine nursing for the last 2 months,but because it was the nurse's fault, it's ok. Not the first time I have seen an administrator do this either. It never made sense then and it doesn't make sense now, if the support staff aren't not supportive, why would anyone let them continue "working"? If it was a poorly functioning nurse, we wouldn't tolerate it for long, so why would it be ok for the administrator to allow poor performance and hostile work relations against the lead craft, nursing?

I actually admire mine. She's tough, but she's honest and I see her jump in and get her hands dirty.

Specializes in LTC.

Best advice I can give you

1) don't forget about your night shift workers...they are very often left out the loop/activities/rewards/inservices...it's kinda like a kick in the teeth

2)keep you word. If you say you're gonna do it...Then you better do it...If you can't do it...Don't avoid it, let people know why you can't do it.

3) and NEVER EVER NEVER EVER scream "tornado, get everyone inside"....then jump in your car and drive away

Specializes in LTC, Hospice, Case Management.
3) and NEVER EVER NEVER EVER scream "tornado, get everyone inside"....then jump in your car and drive away

Oh there has got to be a good story with this one. Can only imagine what this person must have put your team thru.

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