New ADON needs advice

Specialties LTC Directors

Published

I have accepted a new position as an ADON in a 84 bed LTC. I have worked LTC several years ago but have been in the hospital setting for the last 5 years. I am nervous because I have so many questions and need resources to help me. I want to be successful and not come across as being totally clueless. I am a fast learner but have so many questions ranging from what am I supposed to wear to job responsibilities. I have been told that I will be responsible for infection control, all new employee orientation, PPD's, nursing inservices, on call once a month, and attending meeting. My DON seems very approachable but I'm hesitant on going to her because I don't want to appear as though I know nothing. I am very resourceful and would like any suggestions. Any help will be greatly appreciated.

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Specializes in Gerontology, Med surg, Home Health.

Didn't you meet the DON when you were interviewing for the position? Ask for a clearly defined list of duties and start from there. If you don't ask, you'll never find out. If you think you'll look clueless.....would they have hired you if you truly ARE clueless?

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Thanks for your response. As I stated in my original post, the DON did specify specific job responsibilities such as employee inservices, infection control, daily rounding, new employee orientations, etc. The problem is the DON is very frazzled. She has only been in her position for a short time and is all over the place putting out fires. To be honest, I don't think she even knows how to gain structure. For me I feel my best need is to get up to speed with state regulations such as infection control. I have never participated in a state survey and we are in the window. It will be my luck state will come in the week I start. I have joined NADONA and AALTC for support and resources, but I was hoping to get a better insight into what an experienced DON wants and needs in her ADON. Also, where to go to get regulations from. Finally, is there an art to writing MAR and TAR? When I worked LTC before there always seemed to be problems. I never had that experience in the hospital setting.

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Sounds to me as if you would be more comfortable starting with a staff nurse job. MARs and TARs are basic, look at what is already in place. For that matter, spend some time looking at other filed away documentation, such as inspection reports. Go around and look at and observe the facility operation. Talk to staff. Find the most senior nursing staff and see what you can glean from them.

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Thanks for your insight. I have just completed my Master's Degree in Nursing Administration and was a Charge Nurse in LTC 5 years ago for 4 yrs. I am familiar with basics such as med pass, admissions, transfers, etc. It's the whole management arena I'm nervous about. I'm sorry if I'm coming across as being naive, but having been away from LTC for 5 years and now going into management I just want to start off on the right foot. As far as MAR and TAR's, the last LTC facility I worked for was always adding to how they wanted the MAR written. For example, they changed from not requiring a dx to needing dx added when writing an order. Is that universal or facility preference? There's just so much to know and any advice is greatly appreciated.

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Specializes in Med surg, LTC, Administration.

Wear, what she was wearing. Some dress up, some wear scrubs, most business casual. You sound like you will be doing staff development. If there is a SDC thread, go there. They can tell you which manuals to find info on infection control, PPD etc. Most companies have their own policy and Manuel. Those morning meetings are crucial to you. Get the census and take report on all residents. Ask questions till you know who they are and why they are there. Stay on top of their appointments, doctors orders, immunizations, INR etc. Morning meeting is a full of information. Be confident in talking to the staff, they don't need to know you are new to LTC. Staff can be cruel. But get report from them daily on what is going on in house. Find the movers and shakers. Make friends with MDS, they will become your best friend and are your peer. Get a feel for the culture, you will be fine. Most DON and ADON work together, I hope you develop this relationship. Please don't fear, asking her questions, she knows you are new. Just show some initiative and you will be fine. Be kind to thee! Peace!

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Specializes in Med surg, LTC, Administration.
Thanks for your insight. I have just completed my Master's Degree in Nursing Administration and was a Charge Nurse in LTC 5 years ago for 4 yrs. I am familiar with basics such as med pass, admissions, transfers, etc. It's the whole management arena I'm nervous about. I'm sorry if I'm coming across as being naive, but having been away from LTC for 5 years and now going into management I just want to start off on the right foot. As far as MAR and TAR's, the last LTC facility I worked for was always adding to how they wanted the MAR written. For example, they changed from not requiring a dx to needing dx added when writing an order. Is that universal or facility preference? There's just so much to know and any advice is greatly appreciated.

All dx are printed on every page in the MAR. when you do an admission, you only have to write them on the first page. We don't write them with each med, just the page. Narcotics and antipsychotics we may?? Just check the mar when you start and you will see how they do things. As for the culture, you will observe how they do things. Again, morning meeting is crucial for understanding the culture. You will be fine.

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Thanks so much for your input. I will take your advice. It's always hard starting as the newbie in a new facility.

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