ADON Opportunity - Advice needed!

Specialties LTC Directors

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Specializes in Med/Surg, Surgery, Post Partum, GYN.

An opportunity has risen for an ADON position at a local LTC facility and I am wondering whether or not I should take a chance and go for it?I have been a RN for 10 years and have various experience in surgery, med/surg, telemetry and women's health. I am currently in the process of obtaining my MSN (management concentration). I occasionally act as a relief charge nurse, but other than that, have no actual management experience. I am extremely detail oriented and tend to gravitate toward projects that others would consider "busy work." While I have no LTC experience, I am a quick learner. My interest in this position is to break into management, although my co-workers think I am crazy for wanting to leave the hospital setting. I am not unhappy in my current job as a staff nurse, I just am getting tired of waiting for a managerial position to open up - they have little turnover at my hospital.Any advice from ADONs/DONs is greatly appreciated!

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Specializes in Med/Surg, Surgery, Post Partum, GYN.

As an expansion to my OP, I want to share that this particular SNF/ALF has 223 beds, poor ratings, and is also currently recruiting a new DON (offering a sign-on bonus for DON position). They have numerous complaints and have had issues with skin care, breakdown, care plans, medication administration, etc. I would love to be able to make a difference in this facility and ensure that the residents are given the treatment they deserve.

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Specializes in Gerontology, Med surg, Home Health.

If you want my honest opinion, people with no long term care experience should not be a supervisor, ADON, or DON. How can you possibly manage what you do not know?

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Specializes in Med/Surg, Surgery, Post Partum, GYN.

I appreciate your opinion as I know that you have a lot of experience and are very passionate about this field. I have read a lot of your responses to others and have found them very informative and honest. I do understand your reservations about someone with no LTC experience being in a supervisory role - it doesn't make sense because I don't have a full understanding of the MDS/RAI processes among other things. interestingly enough, my interview went well - they liked my patient care experience from the hospital and said "you can pick up on the other stuff easily enough." Honestly, this is frightening to me. Thank you CapeCodMermaid for your input.

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Specializes in LTC, Hospice, Case Management.
As an expansion to my OP, I want to share that this particular SNF/ALF has 223 beds, poor ratings, and is also currently recruiting a new DON (offering a sign-on bonus for DON position). They have numerous complaints and have had issues with skin care, breakdown, care plans, medication administration, etc. I would love to be able to make a difference in this facility and ensure that the residents are given the treatment they deserve.

As usual, I agree with CapeCod - this is probably not a good idea for you. I have a feeling this will frustrate you beyond belief and I'm not positive it is a good move for the facility.

With that said, if you do choose to accept this position, you will really want to study the regs related to skin care (pressure ulcers), careplans, med administration, etc. Also study the facilities policies and procedures related to the same. You can know the regs inside out but if you don't follow the policies you will still get tagged.

If you take the job don't hesitate to come back for support when needed.

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Specializes in retired LTC.

BE CAREFULl. This sounds like a facility in crisis! Wonder what the Social Services, Activities and the other depts survey status are? And your staffing is probably suckee!

In the absence of the DON, YOU wil be acting as DON and you will be taking the heat for all the problems coming down. You have very good credentials, and you have good intentions. But to a troubled facility, you may just become a sacrificial lamb.

LTC has its own ebb & flow. New incoming management will be like Major League Baseball/Football/Basketball. It takes more than one season to have a winning season for a new Head Coach and his assistants. That's part of the turnover.

Whatever you do, good luck.

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1. i am extremely detail oriented and tend to gravitate toward projects that others would consider "busy work." while i have no ltc experience, i am a quick learner.

2. i would love to be able to make a difference in this facility and ensure that the residents are given the treatment they deserve.

3. interestingly enough, my interview went well - they liked my patient care experience from the hospital and said "you can pick up on the other stuff easily enough."

i really hope you didn't repeat the above comments in your interview, they sound very contrived. it is quite obvious though that you are not in the know with nursing home politics. they sound desperate and would hire anyone that will work there because nobody wants to stay and deal with the nonsense. if they can't find anyone and need to offer a sign on bonus, run don't walk. if they are habitual code violators then more than likely they have no money and their budget is poor. why do you think they have gone through all those people prior? any facility that would even consider someone with no experience is quite disturbing. the interview you went on went well on their end. the line they gave you was the bait they give newbies. i am not doubting your good intent but when people think they have the magic way to change care in a s.n.f. they don't have a clue.

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Specializes in retired LTC.

TO Pam - Thank you for expanding further on what I was thinking also.

To OP - I deleted/rewrote some of my post that I DID NOT enter. Along the lines of being 'a warm body with a license'. This is a moderate-sized facility with problems. I'd love to see their last survey and Plan of Correction. That the 2 top nursing positions need replacement makes me question WHY???

Makes me return to my professional sports analogy, ie when a team is losing, the head coach and assistants are let go. The problems are then left for the new guys to deal with and everybody expects miracles! As others have posted, recognizing the need for a broad-based LTC background is a very real concern. We work with different pressures under conditions, rules & regs, etc that do NOT exist in the acute care setting and would make their heads spin! (Had a MAJOR issue last position with a 17 yr experieinced L&D PRN part-timer - sentinel event reportable to DOH but she had no idea until I asked further.) And the family called the State themselves.

Also, I don't know the level of education the DON has/will have, but advanced degrees in LTC nsg management vary. It will look good to Corporate, but with a future MSN (in mgt) on your resume, you may be expecting a high level of administrative practice. Many ADON positions are CLINICAL down&dirty trouble shooting, cleanup, delegated fix-it, supervisor positions with little regard for your career expectations. And it can be overwhelming, frustrating and non-fulfilling (esp if you're the new kid without LTC). I've seen it before with newly hired ADONs, Staff Developement and/or Infection Control nurses with strong education but no LTC. They freq DO NOT last long for several reasons.

And finally, if this is a union facility (as many are with CNAs & LPNs, and hskpkg & dietary), you'll need to be up on the contract, esp when negotiations are due. I've been in these positions in various capacities. This is the reality of LTC. Background is truly desirable for the upper level in today's LTC environment. As I've said, been there, seen it, done it - won't do it again.

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Specializes in critical care, LTC.

Although I have read and respected CapeCodMermaid and Nascarnurse's posts in the past, I have to say I disagree with them this time. I was in your position 2 years ago. I had very little (a short few months several years prior and as an LPN) LTC experience and worked in critical care in the hospital setting for 22 years, I applied for an ADON position. I have been in this position for over 2 years now (and hold the record for ADON's at this particular facility!). It was totally different than the hospital. The policies, the mindset, the whole culture. But I love it. Most days. I act as the DON in her (many) absences and have been told by her boss that, in the event of her departure, I am the "logical choice." Sometimes, you have to take a leap of faith and follow your heart. You also have to remember that it IS totally different than the hospital. Short budgets, few "standing orders", it IS all about the money and that is what frustrates me most. But going into a management position where you don't know anyone is much easier and better than trying to manage current co-workers and "friends." I am friendly with my staff and partipate in "girl talk"--to a point. I don't socialize with them outside of work, though I have been offered many times. At the end of the day, you are still the "boss" and have to remember those boundries. I am also a "working nurse", which apparently the former ADON's were not. I do help toilet and transfer residents, have worked nights as a CNA and floor nurse. The first time I was in a room with a CNA with a resident who needed pulled up in bed, the girl started to walk out and I asked where she was going. "To find help to pull her up" she said. "What am I?" I asked. She said she wasn't used to management helping. HA! I love my residents (some more than others, of course). I don't miss the hospital. I make noise about leaving occasionally when I get frustrated but I know, as do they, I'm a lifer. . . .

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