taking a new ADON position

Specialties Geriatric

Published

I worked in long-term care in Iowa before moving to Illinois. I both loved and hated it, as most people do. When I cam to Illinois I took a hospital position for the experience but after six months I really miss the LTC environment, even with its troubles. I have now accepted a position as ADON fo a 90-bed skilled, rehab and LTC facility. I start next week and would love some helpful suggestions or feedback. Thanks.

Specializes in Nephrology, Cardiology, ER, ICU.

Hi and congrats on the new position. Whereabouts in IL do you live? I know in my area (central IL) there seems to be a huge turnover for LTC staff.

I'm in Central Illinois also, In Peoria. And you?

Any suggestions or feedback out there in cyberland?

I guess I would just say that for the ADON position, more than any other, you need a clear job description/task list. That's because, in my experience, the ADON is a catch-all kind of job with seemingly unrelated odds and ends. Sometime this would be infection control, restorative nursing, staff development, wounds, clinical issues, falls etc. "and all other duties as required by the DON"..... as we love to say at the end of the job description! Some personality/work types don't do well with such a diversified role with many different projects and resposibilities. But then again, it's never boring! Best wishes to you!

hi and congrats on your decision to take this position. I find it encouraging that you are open to suggestions on how to be successful. As an LPN in a LTC setting, I can tell you first hand that you MUST be in touch with your staff. Listen to them, ask THEM for advice on how to reach solutions. INCLUDE THEM. Unfortunately, because of the weight of your position's responsibilities, such as state surveys, many DONs become solely focused on rules and regulations, and how not to get cited that they become merely rule enforcers, punishers, and over all, someone to avoid. Don't just say you have an open door policy...you need to walk the walk. Respect your staff members the way you expect your residents to be respected, care for them and their rights just as you care for the rights of your residents. Do this and I can guarantee your staff will give you all the support you need for an exceptionally run facility, and passing a state survey will never be something to fear.

Specializes in acute care and geriatric.

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 stressfull 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.

LOL,

As a former ADON, I say good luck. It does seem like a catch all position. I remember having to do infection control, fall assessment and tracking, doctors rounds, in general being aware of what was going on with residents, weight changes, treatments for wounds, investigations into allegations of abuse, chart reviews, and many others tasks that I can't (don't) want to remember. My DON at the time was very good at delegating tasks to me and I didn't get along well with the administrator at the time. I was not very good at delegating. I quit after about 1 year. Too stressfull for me. Hope you do well and enjoy it. One of the other posters had wonderful advice.

Specializes in acute care and geriatric.

Yes the ADON position is a catch-all one that includes a whole host of responsibilities. I have good news and bad news for you- the CNA, the LPN, the RN, the PCC and the DON are ALL catch all positions that are dynamic and challenging etc. The DON delegates to you but don't you then turn around and delegate to the PCC or the RN or the CNA? ...and the poor CNA has tasks delegated to her/him by the LPN, the RN, the PCC, the SW, the PTand OT and ST, the families, the dietician, the doctor, the ADON and of course the DON not to mention the patient her/himself!!!

At least the ADON has fewer bosses throwing tasks her way!!!!

Don't let 'em scare you, take it all easy and it will be fine (of course you're free to say "I haven't had a chance to complete that task but it is under control....")

I agree, catch-all job. My job title was charge nurse, I do all MD calls, orders, charting, family updates, admissions, discharges etc, etc. It involved working 10 - 12o/day. The admin, didn't like paying me the overtime but no matter what I tried to do to cut down my overtime it didn't work. Multi phone calls, MD's, families and interruption continued. The admin decided to salary me and give me the title of ADON. Now I can work 60 hrs/week and get paid the same amt, which stinks. I just can't leave my work for the next day, orders have to be written etc. I love my job, but resent the fact I am not paid for the overtime I put in. I get very little help or sympathy from the DON or admin, all day long it's do this, did you do this do, do, do!!!. Just venting, anyone have the same situation.

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