NEW ADON

Specialties LTC Directors

Published

I have been a Nurse for 9 months and I work in a LTC/Sub acute facility. I was a floor Nurse for 3 months before I was appointed the Night shift Supervisor. I have been a Supervisor for 6 months and now I have just been appointed the Assistant Director of Nursing. It came as a surprise but I think I am prepared for the challenge. Pls I need input, suggestions, and advise from versatile ADON & DON on what I need to do as I commence my new position next week. My facility have several Nurses with long experience & fresh ones.

Appointed? It's "promoted"

In this case ,bamboozled. Ask yourself and your colleagues why you were placed in this position.

Specializes in Med/Surg, LTACH, LTC, Home Health.

It does seem rather suspicious that, with less than a year of total nursing experience, you're ADON. Do they need a 'fall guy' for an upcoming visit from state surveyors? I've seen this several times during my 20+ years as an LPN. However, if they are on the up-and-up, congrats on the new position even though I would not have taken it, realizing that there is still much that I need to learn myself before I can lead others....don't get lost in the shuffle. ;)

Falls - interventions in place, documentation for at least 72 hours? Event notes complete

Decubs - measure weekly, document thoroughly.

Insulin Errors - biggie

Coumadin Errors -biggie

Restraints

Antipsychotics

Infection trends - enough equipment on hand in case isolation required. Ancillary staff knowledgeable regarding donning ppe

Hospital readmissions esp MI, Pneumonia and CHF

Medication errors

Recerts done in a timely manner - nightmare for me. Set up a spreadsheet for recert times.

Family issues

Employee issues

Inservices up-to-date?

TBs up-to-date

Licenses up-to-date

One I am having serious problems with is wound identification on admission with a TREATMENT IN PLACE from day 1. Mine think the "next shift can do it". Remember, if it is not found in 24 hours, it is YOUR WOUND.

Monitor the dining room. Are the residents actually being fed? Check their plates.

Be sure meal documentation is being entered. BAD, BAD, BAD if it is not recorded when there is weight-loss involved.

Are residents being turned. Heels floated?

Enough staff to cover shifts? Check for yourself. Many times the staffing coordinator thinks the shift is covered when in fact, it is not.

OMG and don't forget to make sure your QA meetings are up-to-date. Many times it is difficult to get the medical director in the bldg. Nag, nag, nag and document when you called if they are reluctant to come.

I got this list of things to monitor from another post on here by geriatricRNBSN hope this helps somewhat :)

Specializes in retired LTC.

When is your next survey due? Familiarize yourself with your most recent survey and its Plan of Correction for compliance as you may become responsible for it.

If you've a union, know the contract and when it's up for negotiation.

Re immunization - flu vax (pts and staff) and pneumovax for pts.

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