I have worked in a couple facilities Francis and I would have to say that many LPN's are more skilled than the RN's. It's scary but true. In one facility, if I were in a crisis, I wanted the LPN's at my side. Many facilities have in their policy that the ADON can be an LPN or RN depending on their qualifications. The DON's I have worked under have always chosen based on the individuals skill and prior history in management or supervision of staff.

As the director of nursing at a LTC, I fully understand why there would be such questions about whether an LPN can be a DON. Most states do not allow LPN's to be supervisors to RN's based on licensure but I think that there needs to be an understanding about experience and Medicare and Medicaid guidelines.

I have 2 supervisors who are LPN's that I rely on heavily to help me navigate the maze of LTC. I have as many RN's who are clinically weak and not able to be a qualified supervisor at my facility.

In short, you can't only look at licensure.

K. Marchand-Singleton, MSN, RN

I assume the ADON has managerial expertise, which is what a facility need, but....having said

THAT, do some of the RNs' have the same qualification, then THEY need to be considered for the roll as per state laws.

I know this is late but it also depends on the facility's policy. I have worked in long-term and acute care and one facility in it's policy stated that an LPN could not be charge of a unit. AN ADON is in charge in the absence of the DON so again, its what the facility's policy is.