Running head: ORIENTATION PROPOSAL
Long Term Care Management Orientation Proposal
Lori Steele
American Sentinel University
ORIENTATION PROPOSAL
Long Term Care Management Orientation Proposal
Effective nurse managers are extremely crucial in the present day’s health care climate.
Nurse managers, whether effective or inadequate, influence not only employee satisfaction, but
also patient outcomes and the financial solvency of an organization. Research has shown health
care managers routinely gain their expertise on the job and frequently do not have a satisfactory
awareness of the job they are performing. Formal management orientation or training is often
incredibly limited or totally nonexistent. (Swearingen, 2009). Many nurse managers fail related
to this lack of an effective orientation program. The objective of this paper is to recommend a
strategy for the development of a successful long term care manager orientation program.
Management Orientation Program
The long term care nurse manager has many responsibilities including but not limited to
ensuring high quality, safe patient care, motivating staff, assuring appropriate staffing levels,
securing adequate supplies, maintaining compliance with countless regulations, and interacting
with physicians, residents, families, and staff. If the manager does not receive adequate training,
the facility is electing to allow the manager in all probability to fail.
A successful management orientation program must encompass many of the tasks the
manager will be responsible for. It is essential to understand orientation of a manager will take
time; unlike the customary three days of training typically allowed for other staff. The following
proposal will be a framework for the facility program. It is necessary to realize nurse managers
will be diverse and may require specific emphasis on particular categories (McAlearney, 2010).
The program will be assessed and re-evaluated on a routine basis. It is imperative that the
participants of the program as well as executive director be allowed to evaluate the effectiveness
ORIENTATION PROPOSAL
of the program. As with all aspects of healthcare, the orientation process is a dynamic, everchanging practice.
Topic
Job Description


Facility Mission
and Vision


Rationale for
Inclusion
Objectives
A clear and

concise job
description
establishes the
framework for the
new manager; it
should be
considered a
starting point, not
a static document.
It needs to be
reviewed
routinely.
The job
description
informs the new
manger of the
facilities
expectations of
the position
(University of
Illinois, 2009).
The facility

mission statement
directs the
manager’s
behavior when
determining
actions and
decisions
(Vandijck,
Desmidt, &
Buelens, 2007).
The vision
statement reflects
the facility’s
philosophy and
culture, setting the
facility’s ethical
Facility Manger Job
The manager
Description document
will have an
understanding
of specific tasks
required of
position and
facility’s
expectations for
the manager’s
role.
The manager
will be familiar
with Facility’s
Mission and
Vision
Statements in
order to
promote the
facility’s
purpose, goals,
objectives, and
philosophy to
those being
supervised.
Possible Resources
Facility’s Mission and
Vision Statements
ORIENTATION PROPOSAL
Workplace
Diversity
Leadership
Fundamentals



Delegation
Managing and
Coaching
Employees
Team Building
Charge Nurse
Orientation





tone (Nursing
Management,
2010).
Facilities and
managers must
deal with
maintaining a
diverse workforce
while managing
the trials of
potential
harassment,
workplace
mistreatment, and
discrimination
(Clapp, 2010).
The majority of
managers fail to
receive proper
orientation.
Leadership
training is
essential to ensure
effective
management
techniques
(Swearingen,
2009).
A manager
functions
predominantly
through others
and must
precisely
understand
relevant
circumstances to
ascertain the
proper
interventions
(Cathcart,
Greenspan, &
Quin, 2010).
If a manager is to
be successful and
lead the team they



Diversity
training will
assist new
managers in
identifying
obvious,
ambiguous, and
unintentional
discrimination
practices
(Miranda,
2012).

The manager
will integrate
positive
management
techniques
while
supervising,
motivating, and
coaching
employees.

The manager
will be a
positive role
model when
able to
demonstrate
competency in
basic job
responsibilities
of those being
supervised.






Facility Diversity &
Discrimination
Policy and
Procedure
United States
Department of
Labor
Illinois Department
of Labor
EEOC
Facility Leadership
Orientation Manual
Carrots and Sticks
Don’t Work: Build a
Culture of Employee
Engagement with
the Principles of
Respect by Paul
Marciano, 2010.
Facility Policy and
Procedure Manual
Charge nurse job
description
document
ORIENTATION PROPOSAL
Quality Assurance










Infection Control
Accidents/Incidents
Restraints
Medication Errors
Psychotropic
Medications

Pressure Ulcers and
other Skin Issues
Urinary Catheter
Use
Weight Loss
Pain

Budget basics




Personnel/payroll
budget
Nursing supply
budget
Capital budget

must know what
the jobs entail.
Quality Assurance 
(QA) Program
assists in assuring
safe, high quality
resident care
(Lundqvist, &
Axelsson, 2007).
The QA audits are
completed on a

monthly basis and
the findings and
trends are
reported to the
Quality Assurance
Team.
The Quality
Assurance team
meets quarterly to
identify issues
with respect to
which quality
assessment and
assurance
improvements are
necessary.
Facility success

can only be
achieved and
preserved when
the nurse manager
is fiscally

accountable while
providing high
quality care
(Hader, 2006).
Superior
managers are able
to successfully

and efficiently
control all
resources which is
essential to
optimize patient
The manager
will be able to
analyze and
interpret
available
Quality
Assurance item
data.
The manager
will be
comfortable
with presenting
the pertinent
information as
well as plans of
correction to
the QA team.












New manager

will be able to
execute and

preserve current
budget limits.
The manager
will produce

new fiscally
responsible
budget as
required (at
least annually).
The manager
will be aware of
importance of
supply
inventories
prior to orders
IDPH Quality
Assurance
Regulations
Facility Quality
Assurance Policy
and Procedure
Facility Incident
Report Policy and
Procedure
Resident Care Plans
Skin Report
Weight Loss Report
Employee and
Resident Infection
Control Logs
Psychotropic Med
Pharmacy Report
State Operations
Manual
Agency for
Healthcare Research
and Quality
American Health
Quality Association
Illinois Healthcare
Association
Facility’s Current
Budget
Department’s prior
and current monthly
Profit and Loss
statements
Nursing supply par
level specifics
ORIENTATION PROPOSAL

Hiring basics





Recruiting new
staff
Interview process
Reference checking
Background

requirements
care (Cohen,
2006).

An organization
must have
effective leaders
who are
financially savvy
to proactively
manage their
resources while
communicating
and engaging the
staff they lead.
Effective leaders
can maintain a
positive budget by
recruiting and
retaining quality
staff (Goldberg &
Petasnick, 2010).
The manager is

responsible for
maintaining
appropriate
numbers of
employees.
The manager is
responsible for

following strict
hiring policies.

Conflict management
and Service Recovery

Conflicts are

commonplace
involving patients,
families, staff
being placed.
The manager
will be able to
assess current
par levels with
current needs
and resident
census to
maintain
adequate supply
quantities.
Manager will
be aware of the
basic labor
laws, interview
process, and
pre-screening
regulations.
Manager will
have basic
understanding
of recruiting
methods.
Manager will
construct wage
comparisons
with other
facilities
annually to
remain
competitive
when hiring
new staff.
New manager
will have a
enhanced
understanding




Facility Policy and
Procedure Manual
Illinois Department
of Public Health
Administrative Code
Bureau of Labor
Statistics
Facility Leadership
Orientation Manual
ORIENTATION PROPOSAL

Public Health Nursing
Home Regulations


nurses,
physicians,
professionals, and
other employees
reporting directly
to a manager
(Brinkert, 2011).

Managers must be
comfortable in the
role of conflict
management and
service recovery
by developing and
expanding their
capacity to
efficiently and
successfully
intercede when
discord occurs,
whether it is with
an employee,
physician,
patients, or patient
families (Brinkert,
2011).
Long term care is 
a highly regulated
entity (Dana, B. &
Olson, D. (2007).
Long term care
facilities are under
great public
scrutiny as
families review
the advantages
and disadvantages
of potential
facilities when

evaluating each
for appropriate
services prior to
placement of
loved one
(Centers for
Medicare and
Medicaid
of conflict
management
and increased
interaction
tactics and
skills
The manager
will be able to
assist and
support
employees in
finding their
own resolutions
rather than
taking “charge”
requiring the
manager to
ascertain the
solution to the
conflict.
New manager
will develop a
basic
knowledge of
the current
Illinois
Department of
Public Health
(IDPH) Skilled
Nursing
Administrative
Code.
Nurse Manager
will explore top
ten most cited
IDPH
deficiencies and
will analyze the
possibility of
receiving one
or more of




Illinois Department
of Public Health
(IDPH)
Administrative Code
IDPH official
website
Illinois Healthcare
Association
Illinois Nursing
Home Administrator
Association
Newsletter
ORIENTATION PROPOSAL
OSHA compliance
Training


Services, 2011).
these
deficiencies.
A safe work

environment will
lessen risks and
dangers to
employees
(Occupational
Safety and Health 
Administration,
2012).
OSHA
compliance will
result in decreased
number of
employee injuries
resulting in fewer
workers’
compensation
claims, decreased
absenteeism, and
even a potential
for fewer patient
injuries (Conn,
2012).
The manager
will be aware of
the importance
of OSHA
regulations and
compliance.
The manager
will have
understanding
of requirements
for maintaining
documentation
related to
employee
injuries.






Facility Orientation
Program Manual
Facility Policy and
Procedure Manual
Occupational Safety
and Health
Administration
(OSHA)
OSHA Recording
Keeping Tutorial
Website
OSHA Ergonomic
Guidelines for
Nursing Homes
National Institute for
Occupational Safety
and Health
Conclusion
Effective managers are essential to a facility’s survival. Research has revealed that staff
usually leaves their manager, not their position (Cowden, Cummings, Profetto-McGrath, 2011).
ORIENTATION PROPOSAL
A successful nurse manager can increase staff retention by motivating and connecting with those
employees being supervised. Staff turnover is extremely expensive; the total turnover
expenditure of replacing a long term care RN is estimated to be $65,000 (Department of
Professional Employees, 2011). The turnover cost to replace a manager who decides to leave
because of poor or the total lack of training is many times over the cost of replacing a floor RN.
Superior leaders are made, not born (Riggio, 2009). It is necessary to produce and
maintain an effective manager orientation program to assure successful nurse managers which in
turn will assure employee, patient, and physician satisfaction, as well as fiscal responsibility.
Organizations must give their leaders and managers a fighting chance. This writer believes the
proposed manager program will do just that.
ORIENTATION PROPOSAL
References
Brinkert, R. (2011). Conflict Coaching Training for Nurse Managers: A Case Study of a TwoHospital Health System. Journal of Nursing Management, 19(1), 80-91
Centers for Medicare and Medicaid Services. (2011). Your Guide to Choosing a Nursing Home.
Retrieved from www.medicare.gov/Pubs/pdf/02174.pdf
Clapp, J. (2010). Diversity Leadership: The Rush University Medical Center Experience.
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Cohen, S. (2006). Best of the Basics. Take the Fear Out of the Figures. Nursing Management,
37(4), 12.
Conn, E. (2012). Preparing for an OSHA Inspection. Hospital Employee Health, 31(6), 64-65.
Cowden, T., Cummings, G, & Profetto-McGrath, J. (2011). Leadership Practices and Staff
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Goldberg, A. & Petasnick, W. (2010). Managing in a Downturn: How Do You Manage in a
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ORIENTATION PROPOSAL
Hader, R. (2006). Positive Outcomes? Good Is Not Good Enough. Nursing Management, 37(4),
8.
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html#VALUESTATEMENTS
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from https://www.osha.gov/law-regs.html
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www.uic.edu/depts/hr/compensation/Guide%20to%20Writing%20Effective%20Job%20
Descriptions-combined.pdf
ORIENTATION PROPOSAL
Vandijck, D., Desmidt, S., Buelens, M. (2007). Relevance of Mission Statements in Flemish
Not-For-Profit Healthcare Organizations. Journal of Nursing Management, 15(2), 131141.