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New ADON Job Concerns

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Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

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I started a new job today. It’s for the ADON of a long term facility. During general orientation, the HR manager?happened to throw in that I would also be the infection control nurse and the compliance officer. I also found out yesterday, while speaking to some colleagues, that although I did know that there would be on call responsibilities,?no one discussed with me that I would potentially need to leave my home while being on call and come into the facility. I have been on call before and was under the impression that I would be "putting out fires" over the phone, answering questions etc, etc. They didn't tell me that I could potentially have to come in in the middle of the night. That may not be a big deal, but my husband works at night, so I am home alone with our 3 year old, so leaving the house at night is not even remotely possible. If that was a possibility of this job, and I had known about it, I wouldn't have taken it.??

I don’t feel they were completely transparent about the job (until I got to orientation, and while speaking to other co-workers! ) on what the actual job responsibilities would be.? (having the extra roles and the on-call expectation)? I'm not sure what to do.. I just started on Monday, I hate to leave a job this quickly.?

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

Sounds like a bait and switch. The addition of being infection control, quality management, and ADON would be a deal breaker for me unless you're at an extremely small facility. Since you didn't know about those additional roles, plus the fact that they didn't tell you what all being on call entailed, I wouldn't feel too guilty for thanking them for the opportunity and resign from the position.

Davey Do

Specializes in around 25 years psych, 10 years medical. Has 42 years experience.

After accepting a position, there's still room for bargaining, cmf.

Point in fact: I had been hired?as a NS for Medical Services and a Methadone Clinic at a Community mental Health Clinic back in '02. In reviewing the benefits with the HR Director, I found out?the health insurance deductions were going to be substantially higher than with my previous position.

I said, "I'm going to need $2,000 more on my yearly salary if I'm going to take this position". The HR director immediately got on the phone with the Administrator and I got the salary for which I had asked.

"There's always room for accommodation." -Jello

?

Jedrnurse, BSN, RN

Specializes in school nurse. Has 29 years experience.

They will probably dump more things on your plate as time goes on. If you aren't willing to put up with it, better to get out sooner than later.

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

So this being my 3rd day as the ADON, I haven't actually seen my boss only in passing. After finding out about the added job roles and on call expectations yesterday I went in today set to speak with her about it. When I saw her this morning, I asked if I could talk to her briefly, and she said she would be down to the office. About 45 min later, she appears, but not to talk to me, it was to bring another new employee her preceptor for the day. I thought she would say to me then, lets go talk, but she didn't, she began to walk away... so I walked after her and I asked her again if she had a few minutes to talk to me. She actually told me NO... and I quickly said, I'll just be a couple minutes I promise. At this point, I'm getting more & more irritated because this woman is supposed to be training me, has already told me on day 1 "oh feel free to come to me anytime you have a question", but yet doesn't have a few minutes to talk to me?? So fast forward-- I basically tell her that I have some concerns with the job, being that I didn't find out that I would be covering quality control/compliance, or infection control until my first day during general orientation. And she said, and you have a problem with that why?? I told her that I was concerned about the quality of my work, being overwhelmed with 3 job titles/job duties. And she said "well that's why we we're going to go slow with your training". ***- I couldn't even get you in here for 3 minutes, and you plan on taking your time to train me?! HAHA

When I addressed the on call expectation, I told her that it was not made clear that I would need to be available to come into the facility on the nights I was on call. She didn't really have an answer. She basically said, so what are you saying?? Long story, she had me go speak to HR, who is a total *** btw and asked me, well what did you expect? She?told me that I should have expected & assumed that being on call meant that I may need to come into the facility. I told her, that I have been on call many times for other agencies, and they were very clear up front whether the call required me to leave my home or if it were just telephone triage. And I felt that they needed to make that more clear during the interview process. She said she needed to contact her boss, and actually had me leave the building so she could make the phone call. It's 20 degrees here in NY and snowing! But she asked me to go wait outside! Anyway...long story. I ended up leaving, she said she would call me when her boss got back to her.?

amoLucia

Specializes in LTC.

Sorry, but this is more than a 'bait & switch'. This is more like a big?'scr*w over'. Your DON/Admin needs someone in that position to do tasks that are critical to the facility. Seems like you were a?'nice warm body' that walked thru their door at the right time. Like a 'sacrificial lamb' if you don't work out. And you just might NOT. I think your DON may be trying to evade/avoid you out of her guilt. Or else she KNOWS something!

I'm curious - are they imminently due for survey? Did they just have a bad one? Is the DON's job secure or is it on the line? And they want a spare waiting in the wings? Has the place just been 'bought out' or might it be so. Sorry, but these things truly do happen in shady facilities. Take it from this retired COB.

And I just learned this bit of info by reading it on AN, but there's a new CMS regulation that facilities MUST have a 'certified' Infection Preventionist' for the facility?? I would need to check this out, but this is something you may need to keep in mind.

?

Davey Do

Specializes in around 25 years psych, 10 years medical. Has 42 years experience.

4 hours ago, cmf2021 said:

Anyway...long story. I ended up leaving, she said she would call me when her boss got back to her.?

I can appreciate your tact in dealing with the boss and both respect &?support your decision, cmf

3 hours ago, amoLucia said:

I'm curious - are they imminently due for survey?

What a great, insightful question, amoLucia!

I just got through telling my termination story as a NS at a community mental health clinic. Since the information wasn't pertinent to the situation, I did not add this part:

I was fired after the LPN complained?about me to the medical director, who, in turn, complained to the administrator. The facility was undergoing an accreditation process when the initial?complaints were filed, so my termination came about two weeks later, when?the process was completed.

As NS, I was integral to a successful?accreditation, but thereafter, I?was expendable.

The whole thing made me feel used.

And *dirty*!

amoLucia

Specializes in LTC.

Davey - I've seen this happen?in LTC. Another dead-give-away is when a facility seeks to hire MULTIPLE dept heads at the same time.?Like it's a facility in trouble, and something is 'a-brewing' there.

As I became more career savvy, when I interviewed, I would casually ask where they were in their survey window. Of course I tried to do some sleuthing earlier. Interesting.

JBMmom, MSN

Specializes in Long term care; med-surg; critical care. Has 9 years experience.

Sorry it sounds like your job isn't at all what you had anticipated. I hope that you can find something else that will work out better for you.?

SilverBells, BSN

Specializes in Rehab/Nurse Manager. Has 6 years experience.

Without knowing all of the duties?that a ADON,?Infection Control Specialist, or?a Compliance Officer are responsible for, I would say there are many red flags based on your posts. ?I personally would find them to be too many for comfort. ?I’d probably start looking elsewhere if I were in this position. Good luck?

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

On 2/3/2021 at 12:29 PM, amoLucia said:

Sorry, but this is more than a 'bait & switch'. This is more like a big?'scr*w over'. Your DON/Admin needs someone in that position to do tasks that are critical to the facility. Seems like you were a?'nice warm body' that walked thru their door at the right time. Like a 'sacrificial lamb' if you don't work out. And you just might NOT. I think your DON may be trying to evade/avoid you out of her guilt. Or else she KNOWS something!

I'm curious - are they imminently due for survey? Did they just have a bad one? Is the DON's job secure or is it on the line? And they want a spare waiting in the wings? Has the place just been 'bought out' or might it be so. Sorry, but these things truly do happen in shady facilities. Take it from this retired COB.

And I just learned this bit of info by reading it on AN, but there's a new CMS regulation that facilities MUST have a 'certified' Infection Preventionist' for the facility?? I would need to check this out, but this is something you may need to keep in mind.

I honestly don’t know if they are due for survey. I know a lot of the agencies/facilities in my area have been getting visits from the state recently, so that very well could be happening in the near future. the current?DON has been in her role for just about a year. I know from the short time I was there, I had heard that the ADON walked off the job due to being overwhelmed, and they are severely short staffed. When I did talk to her about having the 3 different jobs (adon, infection control & compliance) she stated that she herself was going to continue to maintain the employee health part because she didn’t want to completely overwhelm me. So apparently, this position would usually include employee health as well.?

She couldn’t understand my issue with having all 3 of those roles & when I explained my concerns, she said that was why we were going to go slow with my orientation. Which, is laughable because I had to basically follow her down the hall to her office & corner her to get 3 minutes of her time. This was after I requested to speak with her & she told me she was too busy. (This is my 3rd day on the job remember, and she’s not available to me for questions)

I was then blown off to HR to have them “deal with me”, where she stated “well what did you expect?“ “I would have thought you would have known that if you’re on call, there’s the potential to get called into the facility “ ?I then schooled her on how it should never be assumed that someone knows the full expectations of the job, and that there are jobs where you can be on call & not have to leave your house. Needless to say, they basically said they didn’t have a position there for me if I couldn’t fulfill the requirements of the job.?

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

6 hours ago, Davey Do said:

I can appreciate your tact in dealing with the boss and both respect &?support your decision, cmf

What a great, insightful question, amoLucia!

I just got through telling my termination story as a NS at a community mental health clinic. Since the information wasn't pertinent to the situation, I did not add this part:

I was fired after the LPN complained?about me to the medical director, who, in turn, complained to the administrator. The facility was undergoing an accreditation process when the initial?complaints were filed, so my termination came about two weeks later, when?the process was completed.

As NS, I was integral to a successful?accreditation, but thereafter, I?was expendable.

The whole thing made me feel used.

And *dirty*!

Thank you, I do appreciate hearing that how I handled it was the right way.

and in your situation, being kept around just to get through a survey is just dirty!

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

1 hour ago, SilverBells said:

Without knowing all of the duties?that a ADON,?Infection Control Specialist, or?a Compliance Officer are responsible for, I would say there are many red flags based on your posts. ?I personally would find them to be too many for comfort. ?I’d probably start looking elsewhere if I were in this position. Good luck?

Thank you, I felt the same way. I didn’t like the way I found out about it either. Being told on your first day that “oh yea btw you’re also the compliance & infection control nurse “ I was like, what?!

TheMoonisMyLantern, ADN, LPN, RN

Specializes in Mental health, substance abuse, geriatrics, PCU. Has 14 years experience.

Wow, they completely snowed you. That is just too much for one position, no wonder the ADON walked off. And having you wait outside the building? What is up with that? Yeah, that place sounds like a dumpster fire.?

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

9 hours ago, TheMoonisMyLantern said:

Wow, they completely snowed you. That is just too much for one position, no wonder the ADON walked off. And having you wait outside the building? What is up with that? Yeah, that place sounds like a dumpster fire.?

Yea, I went in a little blindsided to say the least. I think they wanted to fill the position, so they left out some key details about the job. And yea..just go wait outside in the cold while I make a phone call... I had to pick my jaw up off the floor!! LOL? Needless to say, another lesson learned!

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

16 hours ago, JBMmom said:

Sorry it sounds like your job isn't at all what you had anticipated. I hope that you can find something else that will work out better for you.?

No, it certainly was not. Which is unfortunate. I just wish these employers would be more transparent during the interview process so we know what will be expected of us when we start. It's such a waste of everyone's time for things like this to happen.?

Thank you ??

amoLucia

Specializes in LTC.

Wait! Wait! Wait! Wanna bet they didn't tell you that you'd prob have to plug into the weekend/holiday MOD (Manager on Duty) sched?!?! That's?when all admin dept heads take turns at coming in on those days to be the House Admin. They could do their in-house hours and then get comp-time.?

Thing is, all the other dept heads could lock themselves into their offices to 'catch up' on projects & paperwork. But Nsg usually had to jump in for floor duties, like 'charge desk' or all admissions, etc. Never had MY chance to catch up on my stuff. Just curious - who did MDS & Staff Devel?

But TBH, the ADON position in NH/LTC?is multi-functional. I have done that position with all those responsibilities. Usually depends on how many bed your place had. The bottom line is that were not up-front with you for al you'd be taking on.

And for you, the on-call responsibilities would be super problematic. I'll bet they have a significant problem with staff coverage that you'd be expected to cover - not a lot of time for alt Plan B for you. Also I hope you lived close by locally, because in bad weather, you'd be expected to be there! If staff must come in, so should you.

In today's Covid time, just the Inf Cont piece will be all time-encompassing.? Not something I'd be wanting to do.

If you've moved on, good luck to you, Hope next interview will be more honest & up-front.

cmf2021

Specializes in Case management, Home Health, Nursing Supervisor. Has 16 years experience.

15 hours ago, amoLucia said:

Wait! Wait! Wait! Wanna bet they didn't tell you that you'd prob have to plug into the weekend/holiday MOD (Manager on Duty) sched?!?! That's?when all admin dept heads take turns at coming in on those days to be the House Admin. They could do their in-house hours and then get comp-time.?

Thing is, all the other dept heads could lock themselves into their offices to 'catch up' on projects & paperwork. But Nsg usually had to jump in for floor duties, like 'charge desk' or all admissions, etc. Never had MY chance to catch up on my stuff. Just curious - who did MDS & Staff Devel?

But TBH, the ADON position in NH/LTC?is multi-functional. I have done that position with all those responsibilities. Usually depends on how many bed your place had. The bottom line is that were not up-front with you for al you'd be taking on.

And for you, the on-call responsibilities would be super problematic. I'll bet they have a significant problem with staff coverage that you'd be expected to cover - not a lot of time for alt Plan B for you. Also I hope you lived close by locally, because in bad weather, you'd be expected to be there! If staff must come in, so should you.

In today's Covid time, just the Inf Cont piece will be all time-encompassing.? Not something I'd be wanting to do.

If you've moved on, good luck to you, Hope next interview will be more honest & up-front.

I don’t know about the MOD, but who knows maybe that would come up on week 2!?
there is a separate MDS nurse, but staff development was my responsibility as well.?
The HR woman asked me if I could find a sitter on call for when I was on call & needed to leave the house. Which is not something that we can do. And she did tell me a lot of times because they are so short staffed I would be called in to cover a shift that they couldn’t find coverage of.?

and no I do not live close by, a good 35 minute drive in good weather. So not very convenient to just jump in my car & go.?

But like you said, if they had been up front with me, I would’ve known the job just wasn’t for me and I wouldn’t have ever accepted it.?

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