Ask the nursing expert

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Ask the nursing expert
Ask the nursing expert
What do you see as unexpected “obstacles” that I might encounter as a new director of nursing?

The most challenging residents are those who are younger and perhaps have behavior or psychiatric issues, including addiction problems. 

Census is very important, but you have to weigh the risks and benefits of each referral. I have seen referrals as young as 18, and one was a woman with exacerbation of her MS, no family and pregnant. She needed long-term care, but I know very little about delivering babies in long-term care. (We had to decline her admission.) 

Another obstacle might be the number of employee issues you will have to deal with on a daily basis. They will range from family crises to not getting along with co-workers. Just when you think you have seen it all, another issue will come your way that you have never experienced.


My licensed staff goes outside the facility for continuing education and they desperately need to stay current with their practice. Any suggestions?

It is very important to have a strong staff educator in your facility – for all departments. Our vendors are always willing to provide training about the products that you use. 

You also can make a list of some topics you would like to have presented and ask a few of your stronger nurses to pick a topic from the list and present it to your staff. I also feel that competency testing goes hand-in-hand with education.

A return demonstration of a task is nearly always an opportunity to reward a staff member on their approach to a task. Some facilities also have “modules” and self-learning packets of information for staff.

All nursing leadership staff need to show participation in ongoing education, including dealing with staff issues. 
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