Nursing home administration
July 30, 2019 5:34 AM Subscribe
Has anyone transitioned from bedside nursing to nursing home administration? Or know anyone who is an administrator? I'm currently an ER RN and it's fun but I miss my geriatric days. I'm starting to get burnt out by institutional problems effecting nursing home residents and I want to make big-picture differences.
I have five years of experience as a nurse in long term care / assisted living / skilled nursing and going on three years of experience in emergency nursing. It's cool but I'm looking forward and it seems like ER advancement is either - becoming an ER manager and I HATE MANAGEMENT, getting my CEN and teaching ACLS or trauma competencies, or getting ICU experience and becoming a flight nurse which is not my deal.
I have always really enjoyed working with the elderly but I don't want to go back to being a clinic nurse in assisted living or a floor nurse in a retirement community. I am thinking about going back to school for nursing home administration. I have no business experience but I have a lot of "passion" (I hate that word when applied to work, but nothing else fits) about elderly people in the healthcare system both from the long term care nursing perspective AND the ER nursing perspective.
Is this an idea worth pursuing or will I be handling budgets all day? Also I am hoping it would be one step above managing CNAs and RNs (instead, just managing the care managers) because I HATE that and am terrible at it. I emailed the administrator at my first nursing job to pick her brain so there is that.
There is an open position near me for a clinical supervisor at a very nice nursing home nearby overseeing the assisted living and independent living medical staff and operations (not memory care or skilled nursing). I am thinking about applying but if I even get it I am worried I will hate being a manager and I will lose all my skills. Also, I like being an ER nurse and I would be sad to leave but this might be a potential "two steps forward, one step back".
Sorry for the word vomit. My question is, am I headed in the right direction regarding making this decision? If you have experience in any of these areas, do you see any gaps or things I might not be considering?
I have five years of experience as a nurse in long term care / assisted living / skilled nursing and going on three years of experience in emergency nursing. It's cool but I'm looking forward and it seems like ER advancement is either - becoming an ER manager and I HATE MANAGEMENT, getting my CEN and teaching ACLS or trauma competencies, or getting ICU experience and becoming a flight nurse which is not my deal.
I have always really enjoyed working with the elderly but I don't want to go back to being a clinic nurse in assisted living or a floor nurse in a retirement community. I am thinking about going back to school for nursing home administration. I have no business experience but I have a lot of "passion" (I hate that word when applied to work, but nothing else fits) about elderly people in the healthcare system both from the long term care nursing perspective AND the ER nursing perspective.
Is this an idea worth pursuing or will I be handling budgets all day? Also I am hoping it would be one step above managing CNAs and RNs (instead, just managing the care managers) because I HATE that and am terrible at it. I emailed the administrator at my first nursing job to pick her brain so there is that.
There is an open position near me for a clinical supervisor at a very nice nursing home nearby overseeing the assisted living and independent living medical staff and operations (not memory care or skilled nursing). I am thinking about applying but if I even get it I am worried I will hate being a manager and I will lose all my skills. Also, I like being an ER nurse and I would be sad to leave but this might be a potential "two steps forward, one step back".
Sorry for the word vomit. My question is, am I headed in the right direction regarding making this decision? If you have experience in any of these areas, do you see any gaps or things I might not be considering?
Best answer: Sorry I'm late on this, but I am in nursing home administration. While a lot of administrators do have clinical nursing backgrounds, and that would help you in the field, I recommend that you look in another direction.
Being a Nursing Home Administrator is, in my decade of experience, almost entirely about what you say you hate: managing budgets and managing front-line staff. I worked at one of the largest continuing care retirement communities on the West Coast, and no one in our administration, from my department manager level all the way to the Executive Director, had so much high-level work to do that we would work only with upper management. In my division, Health Services, I would estimate that we spent roughly 50% of our administrative time on staff management, with budgeting and controlling taking probably 20ish%. With the high rates of turnover in the industry, you are constantly hiring, training, certifying, scheduling, evaluating, disciplining, and hiring again. The remainder of the time is spent in billing, family communications, and putting out fires. And, of course, working daily on compliance; you'll have a variety of regulatory agencies to deal with, and a truly staggering body of law that applies. Most of the NHA training and certification is concerned with mastering regulatory compliance. You'd eventually lead a team, but you'd still be involved at a granular level at any facility I'm familiar with.
Being a Care Manager will be similar, with less time spent on budget and much more time obviously spent on compliance. But you will still have to interact with front-line staff routinely.
I am not a nurse, but if you are interested in advancement without being a manager, I would suggest considering discharge/admissions. Titles vary widely, but the position is similar on both the acute care and long term care sides. As a nurse, you'd probably excel as an admissions coordinator. Your job would be to evaluate those seeking care (where the nursing side would really help in understanding conditions and medications), network with and schmooze discharge planners to get referrals, and probably doing some marketing and care planning. There would be a ceiling beyond which it would be difficult to advance without becoming a manager of some kind, but I honestly don't know of a job in the field other than Physician where that wouldn't be the case. You could maybe transition to community health or research afterwards, I know some people who took that journey.
Sorry for the wordiness, and I hope you find your dream job, but I really doubt it's going to be nursing home administration. It is a bureaucratic management job that requires a lot of patience, lots of really finicky paperwork, lots of personnel management, and careful budgeting within very narrow margins. If you want more specifics, please feel free to MeMail me, and I'll be happy to help. Good luck!
posted by skookumsaurus rex at 8:55 AM on August 4, 2019
Being a Nursing Home Administrator is, in my decade of experience, almost entirely about what you say you hate: managing budgets and managing front-line staff. I worked at one of the largest continuing care retirement communities on the West Coast, and no one in our administration, from my department manager level all the way to the Executive Director, had so much high-level work to do that we would work only with upper management. In my division, Health Services, I would estimate that we spent roughly 50% of our administrative time on staff management, with budgeting and controlling taking probably 20ish%. With the high rates of turnover in the industry, you are constantly hiring, training, certifying, scheduling, evaluating, disciplining, and hiring again. The remainder of the time is spent in billing, family communications, and putting out fires. And, of course, working daily on compliance; you'll have a variety of regulatory agencies to deal with, and a truly staggering body of law that applies. Most of the NHA training and certification is concerned with mastering regulatory compliance. You'd eventually lead a team, but you'd still be involved at a granular level at any facility I'm familiar with.
Being a Care Manager will be similar, with less time spent on budget and much more time obviously spent on compliance. But you will still have to interact with front-line staff routinely.
I am not a nurse, but if you are interested in advancement without being a manager, I would suggest considering discharge/admissions. Titles vary widely, but the position is similar on both the acute care and long term care sides. As a nurse, you'd probably excel as an admissions coordinator. Your job would be to evaluate those seeking care (where the nursing side would really help in understanding conditions and medications), network with and schmooze discharge planners to get referrals, and probably doing some marketing and care planning. There would be a ceiling beyond which it would be difficult to advance without becoming a manager of some kind, but I honestly don't know of a job in the field other than Physician where that wouldn't be the case. You could maybe transition to community health or research afterwards, I know some people who took that journey.
Sorry for the wordiness, and I hope you find your dream job, but I really doubt it's going to be nursing home administration. It is a bureaucratic management job that requires a lot of patience, lots of really finicky paperwork, lots of personnel management, and careful budgeting within very narrow margins. If you want more specifics, please feel free to MeMail me, and I'll be happy to help. Good luck!
posted by skookumsaurus rex at 8:55 AM on August 4, 2019
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