Interview with an Assistant Director of Nursing

What is your job title and what industry do you work in? How many years of experience do you have in this field?
My title is Assistant Director of Nursing and Care Plan Coordinator. I am a Registered Nurse, and I work in Long Term Care. I graduated from Syracuse University in 1997 with a BS in Nursing. I have been working as a nurse for 14 years.

Would you describe the things you do on a typical day? Are there any common misunderstandings you want to correct about what you do?
There is no typical day in the nursing field! We strive for consistency, but we have to be extremely flexible. Patient needs always trump meetings or paperwork.

A normal day for me starts at 6:30 A.M. I arrive and receive a report on our residents. The report consists of anything that happened overnight. By 7:00 A.M. it is time to get the patients up and out of bed for breakfast. While this is happening I prepare for care plan meetings. My mornings are meeting times for patients and family members. I review their plan of care with them, and we work together to devise ways to get the patient home.

My afternoons are spent evaluating our new admits. I give them a head to toe evaluation and develop a care plan for them based on my assessment. My day ends around 6:30 P.M. unless it is my week to be on-call. Every third week I am on-call 24/7. During that time, I am responsible for all scheduling, staffing, the 120 residents who reside with us, and any emergencies that may crop up day or night.

I think the biggest misunderstanding about nurses is that we are just glorified waitresses or uneducated handmaids! Nurses have college degrees. We know as much about medication as any pharmacist. We genuinely want to help people. We do not enjoy giving shots!

On a scale of 1 to 10 how would you rate your job satisfaction? What might need to change about your job to unleash your full enthusiasm?
That is a tough question! I love my job. I do feel immensely satisfied with where I am in my career. I would give it an 8 out of 10. In any job, I believe there is always room for improvement. To unleash my full enthusiasm, I would need more staff. Long term care has a high turn over rate. It is a high burn-out profession. Some people just can not handle the day to day dealings of a nursing home.

If this job moves your heart – how so? Feel like you found your calling or sweet spot in life? If not, what might do it for you?
I absolutely found my calling in life. As hard as some days are, I go home every night knowing I worked hard to improve someone’s quality of life. I can not think of anything more rewarding than that.

Is there anything unique about your situation that readers should know when considering your experiences or accomplishments?
I have Systemic Lupus. Having a chronic illness gives me a point of reference with my residents. I can empathize with them on a level that others can not. I am acutely aware that someday I will be residing in a nursing home. I treat my residents exactly the way I will want to be treated, with respect, compassion and humility.

How did you get started in this line of work? If you could go back and do it differently, what would you change?
My grandmother had early on-set Alzheimer’s Disease. My grandfather made the very difficult decision to kept her at home. Seeing her every day, made me realize that I wanted to help people for a living. That is how I became a nurse. I would not change anything. Nursing is exactly what I was meant to do.

What did you learn the hard way in this job and how did that happen?
You can not please everyone all of the time. You can only do your best, all of the time. I learned this very early in my career.

What don’t they teach in school that would’ve been helpful to you?
In school, they teach absolutes. Sometimes there are no answers. You have to learn to be OK with that. You have to come to a place where you just accept that you can not always fix the problem.

What’s the strangest thing that ever happened to you in this job?
After a patient had completed his rehabilitation, he proposed to me. Ring and all! I was so flattered, and touched that I had made that much of an impression on someone!

On a good day when things are going well, can you give an example of something that really makes you feel good?
Seeing people smile. Even in the worst of circumstances, after a stroke or an accident, to see someone smile and walk again is just phenomenal. To be a part of that every day makes everything else seem small in comparison.

What’s the most rewarding moment you’ve experienced in this position? Of all the things you’ve done at work, what are you most proud of?
I’ll call her “Mrs. M.” Mrs. M had a stroke and was aphasic. She could not speak. She was angry at everyone. She had a notebook that she wrote in to try and communicate her needs. She would often throw it at us when she was upset. She liked to draw angels in her notebook. I saw an angel pin one day while I was out. It was a simple, crystal pin and did not cost much. I bought it for her. When I gave it to her, she cried and wrote, “I love you” in her notebook. We became extremely close. She crocheted me a beautiful blanket that I still have many years later. Mrs. M will always have a truly special place in my heart. I’m proud of this story because I broke through her anger and frustration. I had showed her that we all genuinely cared about her. She never threw the notebook at us again after that day.

When nothing seems to go right, what kind of snafus do you handle and what do you dislike the most?
Hands down the most difficult thing to deal with is an angry family member. It is a high-stress situation for the family when a loved one is in a nursing home. They want and expect everything to be perfect. If they are not satisfied, I’m not doing my job well enough. It is very difficult to be admonished, but it is harder to know we have failed a resident or their family.

What’s the most challenging moment you’ve experienced? What would you prefer to forget?
The most challenging moment I have ever encountered was the first death I experienced. I was very young, only twenty. I walked into that room a child and came out an adult. In those moments of preparing her, I realized that the most profound moment in life is death. It is a privilege and honor to be with someone as they leave this world. I cried the entire time. As much as I would like to forget those moments, I do not think I should forget them. Remembering those moments keeps me humble. It keeps me grounded when someone in that moment needs me.

How stressful is your job? Are you able to maintain a comfortable or healthy work-life balance?
My job is hugely stressful. It took me a while to find a healthy balance. I make sure to get enough sleep and do a lot of yoga.

What’s a rough salary range for the position you hold? Are you paid enough and/or happy living within your means?
The salary depends on where you live. In a large city, my position can pay upwards of $80,000. In smaller cities, $65,000 would be a starting point. I think its a fair wage, and I live comfortably.

How much vacation do you take? Is it enough?
I try for two weeks, but with staffing the way it is, I usually only take one. No matter how much vacation time you get, I do not think it is ever enough!

What education and skills do you need to get hired and succeed in this field?
Nursing is a limitless opportunity. You can go to a technical school and become an LPN to get your foot in the door. For a better-paying job with more flexibility, an associates degree in nursing is a great thing to have. The further you advance your education, the further you can reach career-wise.

What would you tell a friend considering your line of work?
I would tell a friend to make sure that they have a strong stomach and tough skin. Nursing is not for wimps!

If you could write your own ticket, what would you like to be doing in five years?
I would love to go back to school and complete my masters degree and become a nurse practitioner. I would continue to work in long term care, just in a different capacity. As a nurse practitioner, I would have more freedom to chose treatment options. My secret dream job is to become a life flight nurse, but for now, I’ll be keeping my feet firmly planted on the ground!