New DON, seeking advice

[Mrs_Momma_RN]

Good morning y'all

So I have just accepted a position as an Interim DON in a very small facility (currently 31 residents). When their other girl finishes her RN degree in a few months she will take over and I will move to MDS work. I'm totally cool with that. I have been part time/PRN my whole career so far with just over 2 years experience in LTC. I had never thought i'd be doing this particular job, but due to recent family issues i'm the one going back to work full time and my wonderful hubby gets to be a SAHD for a while! Of course he thinks this is a good idea.. I love seeing the look on his face when I remind him it's likely only temporary. This was literally the only fulltime day job currently available in my area that would match the salary we lost from his job. I'm VERY nervous! There is no DON to orient me. However there is a wonderful administrator and MDS that will assist in my training. They took me on knowing I am inexperienced and were willing to provide training (I think they may be desperate). However I am so very thankful for the opportunity to have this training in a small facility. The facility and staff are clean and presented nicely. I know several of the nurses and aides because this is just a small part of Oklahoma where everyone knows everyone. I'm sure there are problems and I am willing to tackel them as needed. Especially since their survey will happen during my time as DON here.. Yikes!! I understand I have a LOT to learn and am curious as to what YOUR daily routine is. I am not sure how I should start my day to maximize my efficiency, if someone could please clue me in as to how you structure your day, I will have something to model to get me through the first several days until I begin to establish my own routine. Thank you so very much. I look forward to hearing your suggestions!

[CapeCodMermaid, RN]

Wow....good for you! The good thing is the facility is small. I would first look at last year's survey to make sure any issues were fixed and are still being taken care of. I make rounds on all the units every day so I know first hand what's going on with the residents. Do you have Medicare or Managed Care residents? You need to know the documentation is there to support the skilled need.

My day-get to work and check email. Answer any that need to be answered. Check the messages on the phone...same thing. Answer the most important ones and make a list for later in the day of any that can wait. Make rounds...check the green book for falls, incidents, and major changes in status. Then off to morning meeting. I make rounds with the wound doctor weekly, have a behavior meeting weekly with social services and psych, have Risk meeting weekly where we discuss falls, weight loss, skin issues.

It should be doable with so few residents in the building. I like to audit the charts and the MARs/TARs on a regular basis, too...especially new admits. Good luck. I hope you love it.

[Aaranha]

Any update on your routine? I am a new ADON and new to LTC. I would love any pointers you may have, especially for learning resources/tools. Ours is 170+ bed facility and we usually have about 135-140 on census. Thanks!

[Leeees23]

I think time management and (attempting) to be organized are a must.

I check the report and our computer dashboard for what has happen since I left. I check if any assessments are behind and what is coming due that day. I check email, then phone messages. Intervene as needed. I make lists of what I need to accomplish as I go. I have a weekly planner so I know what meeting I need to attend.

On Fridays, I make time to assure things are in order for the weekend, in my office and then plan for the next week. I have taken time management classes and they help so much! 5 to 15 minutes in planning, and just making yourself stop and think saves so much time.

Good Luck!

[Tippyrn]

You sound like you have no idea what you are doing.

[CapeCodMermaid, RN]

You sound like you have no idea what you are doing.

Ah, a pot stirrer