Cute Story

I have been covering as the administrator at a small nursing home for the past 3 weeks. I brought in items from home to use for national nursing home week. Today I decided to put the baskets in my car to take home. I put my purse and other things to take home in the basket and sat it down while I locked my door. In the mean time a resident was coming down the hall and casually looked at me and said "most executives use a brief case" and continued down the hall. I just laughed and gave her a hug. That made my day.

A Change of Role

I have been working as an independent contractor now for almost 6 months. I have had the opportunity to do mock surveys. I have completed the same tasks for facilities I worked for or were part of a company that I worked for, but doing it for a facility I am not an employee of is a little different. I really enjoy the process but also understand the stress it causes. I have had the opportunity to use the abaqis program and electronic records. This method makes the documentation review much easier. There is no trying to read someone's writing ( mine is horrible, I always felt sorry for surveyors trying to read it). The abaqis system mimics what the surveyors use exactly. During the first stage the system uses a computer program to choose the sample to be reviewed. Once this is done it guides you through a chart review that identifies trends that could be a deficiency. During the first stage you also complete interviews with residents, family and staff. Another part of the first stage includes direct observation of dinning, kitchen, medication pass and storage. once this is done it helps determine if additional information needs to be completed. This has been a positive experience for me. I love to teach and I use this process as an opportunity to share my knowledge during the survey as much as possible. I also get the opportunity to develop a plan of action for the facility to implement to correct the issues discovered during the process therefore sharing my knowledge and advice. I feel that facilities should self monitor as an ongoing process but should have someone not connected with the facility do a mock survey at least every other year if they have good survey outcomes and annually if they have problems or management turnover. Self monitoring can be skewed by staff and managers not being completely honest in order to look good on paper for a multitude of reasons:1. fear of what others will think of them,2. afraid of loosing their job, 3 not obtaining a bonus. If a facility cannot afford the abaqis program all of the forms can be printed directly from the CMS web site. Good survey outcomes will help a facility achieve a higher rating in the 5 star program resulting in improved census and community standing.

New Beginnings

I have been working as a temporary manager in assisted living facilities now for 2 months. This is an area I have not worked in previously. This has been a very good experience for me. I am not trying to say it is easier it is just different. Assisted living presents a different type of challenges. It has not all been an easy start but I have discovered once again what it feels like to feel appreciated. The residents are wonderful. Long term has unfortunately changed. The residents are younger and more difficult to deal with due to over use of pain medications and mental health issues with very little support. Assisted living residents are actually older and have health issues and dementia issues but they are easier to deal with. I am looking forward to doing more of this. It is helping me to recognize and improve on my management style. I am looking forward to writing more on my blog as my new career continues to develop.

Changing Goals

As I previously discussed I have taken time off of work to recover and regroup my personal and work goals. I have been working since I was 16 years old in health care. Most of that time has been full time. I have been looking for a position that will allow me to work part time. This time off has been wonderful. If I could I would stay home. I now have grandchildren to enjoy. I have decided to scale back on things financially so that I can do this. The search has been very frustrating. I have had a difficult time interviewing. I feel that this is because I have been a manager for the past 20 plus years and it is hard to just answer questions. I tend to ask too many, which I feel an appear arrogant. I also feel that it is hard for people to understand that I don't want to be a manager full time. They see a resume that shows many years of management that includes multi facility positions. Unlike most people I am ready to slow down (not work less hard) in my work life. I wish I could hear from more people in the same position to help support me. One of my friends has changed her work life to working from home. Another has actually changed roles much like me to work a less stressful position. If you are having the same issues or have advice I would love to hear from you.

A New Chapter in My Life

I recently decided to change my work and life direction. I have been working as an administrator for about 8 years now for 3 different facilities including a large corporation, small corporation and an independently owned facility. All 3 have their positive and negative qualities. I made this decision based on wanting to do something that meets both my personal and educational goals. The main reasons are the hours and being on call 24/7. I am getting to an age where I would like to do something that has more reasonable hours and little to no call. I want to enjoy my grandchildren and work toward retirement. Looking for a job in this day and age has its own set of issues. A positive is that the internet has opened up the search. There are many web sites that help look for positions that meet your requirements. Most companies have an on line method for applying for a job. A negative is that it is so impersonal and you never quite know the status or if they have even reviewed your resume. I have been applying and interviewing for about a month now. I have had 3 in person interviews and 1 phone interview. I have applied for over 20 jobs. This process is very difficult. I have not been chosen for 2 jobs one because they hired someone more local, I don't know why for the second one and decided myself I wasn't a good candidate for the third. Not chosen for several of the on line jobs due to the number of applicants. I did not think this process would be so difficult. I have not had to look for a job since the early 90's. I feel that some of my qualities are also negatives for this type of process. I am very knowledgeable with lots of experience which includes being a regional vice president over 8 facilities and a regional nurse over 9 facilities. I have been a director of nursing and administrator. During one of my interviews for a regional nurse I was actually asked why I went to the dark side. By that she meant went to administration. I guess that should have clued me that she would not pick me. This should be a positive because I understand both rolls. My resume looks like I have a lot of different jobs with companies but in reality because of the changes in ownership I worked for 4 different owners in 1 set of buildings. I am also 54 years old which is not old but a lot of companies are looking for younger people. I actually sent out letters to many facilities offering consulting and educational services. I have not heard back from any of them. I plan to continue to blog my progress as I go. I would love to hear from others having the same problems or any one with suggestions for me.

Things That Make Us Laugh

If you work in long term care there are always those residents that frustrate us to no end with either their words or behaviors. I want to tell a couple of stories about what these residents drive us to. My first story is one that one of my nurses told me. She said that she had had a couple of trying days with one particular resident over the previous week. The night before she said, I had a dream with you in it. My first thought was OMG. The nurse told me that in the dream I told her she could hit him with a broom as long as she used the bristle end not the handle. It was even funnier because the nurse saying this is such a sweet kind person that never raises her voice. I hope to share more stories on the post.

Another Typical Day as a Nursing Home Administrator

Today I decided to go into work a little later because I knew the doctor would be in the building (I am also the Director of Nursing, That's a whole other blog story)and I would have to stay late to put orders on the computer. I got there about 9:30. The parking lot was full. There were 2 people doing the resident satisfaction survey in the building (in the middle of all that was going on). The fire people were there testing the smoked detectors so they were setting them all off throughout the building. The doctor was there. Carpet people were there putting down carpet on one of the units and the dietician was there doing her visit. After about the 5th alarm going off I finally quit jumping a foot in the air. I was sitting in my office and a resident down the hall turned his TV up as loud as it would go. I went to the door and had to yell to be heard and asked him to turn his TV down and he began screaming at me that he would when that noise stopped. The satisfaction people are talking to residents that are very confused (because they have to ask everyone). One resident is telling them I don't want to talk to you. Another resident is over heard saying ( I can't wait till they hear what I told them). The nurse aide I hired or thought I hired failed to show up for her physical. Of course I need to fill 2 nurse aide positions. I worked for an hour putting new notebooks together for the nursing unit to make them look neater and more professional but couldn't get on the computer to make my labels until later just to find that someone had written on one with permanent maker instead of letting me label it. Finally, a resident tells me that he overheard someone calling him a liar that morning (of course before he was questioned about his satisfaction with the facility). Well I am not going to hold my breath that our satisfaction survey results will be very good. At least the day went quickly and I finally left at 6:30PM.