cherbRN

Skilled LTC DAYS: 4 nurses plus 1 tx nurse (m-f) 9 CNAs, 2 rehab EVE: 4 nurses 8 CNAs NOCS: 2 nurses 4 CNAs Avg census: 97

Skilled LTC DAYS: 4 nurses plus 1 tx nurse (m-f) 9 CNAs, 2 rehab EVE: 4 nurses 8 CNAs NOCS: 2 nurses 4 CNAs Avg census: 97

A nurse walked out 1 1/2 hours into her shift because a friend of hers also working that day, was terminated. This nurse gathered her things, did a narc count with management and clocked out. Is this nurse guilty of job abandonment? Where can I find this information in Illinois? I searched the Nurse Practice Act. Nothing. Any help or suggestions? thanks

New DON here to, I wouldnt mind a copy as well, PLEASE?? :-)

I just accepted a position as DON. Very excited and TERRIFIED! LOL.. This is at a new facility. I am currently the ADON at a 102 skilled bed facility. The new facility is roughly the same size. I was offered a 28% increase in salary.

Wow, I feel so underpaid. LOL Southern Illinois area....$22.50hr/salary. Take call every other week, (by my request) otherwise it would be every day. 1 more week vacation, and I get the day after thanksgiving off? I guess to go shopping. LOL...I had to beg for the 50cents. I took a paycut coming from a level one trauma center at $26/hr, to a floor nurse on nights at $19/hr. Then when they offered me this position, well, a little at a time i guess. It was a decision I had made to be close to the kids school, otherwise I had almost an hour commute. Now I live 2 miles away. Been ADON for almost a year. And the corporation is now on a wage increase freeze for this year so no more increments for anyone. :-( Morale is down. Needless to say.

Luckily I too work at a place where it is very rare for the nurses to call off. The CNA's are definately a different story. But when I took this ADON position they were "running the show", calling off all the time. Seriously, one of the CNA's has had over 100 call offs in the 4 1/2 years she has been there. Now we definately butted heads when I started because I actually implemented the policy. More than 1 call off a month = excessive and more than 5 a year = excessive 1st offence = documented verbal 2nd = written 3rd = 3 day suspension 4th = termination I called each one in and counseled them, tried to figure out ways to avoid another call off. But this eased the minds of the CNA's that never call off and think that everyone that always calls off never gets reprimanded and the good ones are always having to pick up. At first it really cut down on call offs, I mean we went an ENTIRE month without 1 call off, for me, this was record breaking! LOL Then I slacked off a little bit, i have a really great rapport with most all of my staff and therefore when they have to call off its more disheartening to have to discipline them, but then I noticed the call offs becoming more prevalent again. So the policy is implemented in stone (for the most part) I let all new staff know on hire too. And the girl with over 100 call offs just came off her 3 day suspension. I started new with her when I started, but I wanted to give her an opportunity, she did very well, only up to the 3rd offence in 1 year. Which is miraculous for her. And she completely understood and she still laughs with me and we still have a good working relationship. Bottom line: There has to be ground rules. In the beginning everyone knows them and they decide their own fates. This way they know what to expect, all the time, no question. Peace of mind for some. Otherwise its chaos from what Ive seen and everyone is testing their boundaries, like two year olds. LOL I would like to give the self scheduling a try. I thought about that when I first started this job. But how do you keep the appropriate amount of staff on the days without going over or being understaffed?

We report things like, physical altercation between residents, fall and sent to ER for eval, fall and xrays obtained, alleged abuse, etc ... #1 most likely would not have been reported #2 we have had similar situation, not reported #3 Need more info on what the PT situation was and reason for being sent out & how much time elapsed before next shift assessed. My DON says there is NO SUCH THING as an injury of unknown origin. Everything is investigated (all incidents) within 24hours and usually by observation or probing staff you will find out what happened. Therefore we do not have these types of reportables.

OH! and by being witness i pretty much know how to "NOT" budget effectively. LOL....sorry burn. I think in the position I have been in, I have learned a lot of "what not to do's" my DON is not very informative and does not own up to any mistakes, but she is quick to place blame. But as far as planning budgets, no, i unfortunately do not have that skill yet. Do you think these are things that are acquired/learned through training or something I should be very familiar with before even thinking about this position. Thanks again!

Thanks so far for the responses. My official interview is now set up for next Thursday. Can anyone else think of any more good questions to ask? As a reply to an earlier response, I do not feel that I am at all knowledgeable in the plan of corrections brought on by state surveys, I have worked with state surveyors, but no more than helping them locate things and being witness to an observation of a procedure. Like I had mentioned I am not privy to a whole lot of information the DON and Administrator like to keep most things to themselves. I do have some knowledge of state reportable incidents (24hr) and 7 day updates. I dont know guys. Everyone I work with currently believes that I am more than capable of handling this job and its requirements, I still have reservations. When do you know when it is ok to "take the plunge?"

I am currently in the ADON position for a LTC with a maximum bed number around 108. I have been in this position for 10 months. I started as the night RN in charge in January and was offered the position in May. Previously I was a staff RN for a level 1 trauma center / ER for almost 2 years. This has been my career thus far as a registered nurse. Not very much experience as far as a time line, but have obtained many skills and experience, by experiences alone. My life as ADON. I feel that I am missing out on the picture. I am a task/errand girl. I have been delegated the recurring paperwork that is generated and must be maintained on a daily basis such as, fall prevention, uploading incident reports and tracking, verification of investigation/investigation of incidents, post occurrence IDT, CII destruction logs, daily census and staffing, admissions, checking all orders in house against MAR, TAR, POS and making sure POA's have been made aware, entering labs into the computer for lab days, gathering all reports from nurses in the AM for the DON to have for AM meeting, hiring/disciplining/firing of CNA/LPN/RN ("I want her wrote up!"), infection control, infection control log, observing CNA performing skills (ie: peri care, cath care, transfers...), observing LPN/RN performing skills (ie: trach care, cath insertion, Gtube, treatments...), psychotropic monitoring (disclosures, side effect monitoring sheets, antipsychotic drug SE monitoring (AIMS), resident change of condition monitoring (see to it that the MD/POA have been notified and correct plan of action is in place), designated "hall" to monitor for cleanliness, answering call lights in timely manner, seems that I am forever dealing with CNA drama. I do all the CNA scheduling and manage call offs/replacements. I also take "phone" call every other week, which "I" had to set in place because otherwise I was getting at least 15 phonecalls from the facility any given day. "We would much rather call you." And because I am more "in the vicinity" of the facility I may have to go in and start an IV or run an IV ABT because the LPN isnt IV certified or hasnt "done it in years." I am currently working on a presentation and informational about IV's for the nurses so they are comfortable in their craft. And several other things I feel that I am forgetting. Are these the normal delegations to ADON? I get along with all of my staff. My DON has been angry because most of the nurses will come to me with questions instead of her. Unfortunately my DON has a selective memory and only remembers things convenient for her at the time. The rule is good for at least a day because chances are the rule will be different the next time you ask. If you are in a situation with your back against the wall she will throw you to the wolves. Every man for themselves type of deal. And a rule by tyrany or "my way or the highway" attitude that everyone is tired of hearing. Not only by the DON but she and the EDON are "friends" so they buddy up together. Sometimes it feels like I am on a "need to know basis" and am not "privy" to the information that would help me at "my" new craft as ADON. I asked to be trained on MDS/RAPS and was told that the coorperation would send me to the class, then they decided that I didnt need to go. I have been through several "random" surveys and have yet to be incorporated on the plan of corrections. Medicare A/B billing and certs/recerts I have "minimal/moderate" knowledge. Case and Point. I have been recruited to interview for a DON position at another facility. Skilled 65 bed facility. So much smaller. What are your thoughts? Thanks in advance.

St. Louis area >$20.00/hr Base pay $2.50/nights +$2.50/weekends

It is a "Mandatory" 5 month preceptorship/orientation with classes and homework and floor time that is designed to ease you into the scenery. There are many things to know in there and sometimes it can be a little un nerving. Better to be prepared. Did you get accepted into the fellowship?

I am in Trauma/ER and yes I am still here! :nuke:

I started there 1 year ago and went through their 5 months of orientation out of nursing school. I has been a wealth of experience. I think I have seen and been a part of everything I have ever learned about in nursing school and THEN A WHOLE LOT MORE!!:up: