An administrator who's ready for culture change.

After reading last fall's article "Pioneering Culture Change" (by Susan Misiorski, RN, BSN, October 2003, p. 24) several times, I felt drawn to start something. I don't even know where to begin, but I know that something different must happen.

I am in my ninth year as an administrator of a long-term care facility. I believe that spending any amount of time past three years in long-term care gives someone tenure. I have seen many ups and downs. I've handled problems I didn't even know existed until I saw them. I have done things for the good of others that I said I could never do. I stopped saying long ago, "That's amazing"--I now say, "That's amusing."

It is very difficult to describe to someone what I do for a living. Most responses receive comments like, "How do you do that?" or "I couldn't do what you do for a living." Yet I like what I sort of backed into as a career.

In comparison to most LTC facilities, especially those located in our area, I am extremely proud of the services that we provide and the level of care and concern for our residents that our staff' demonstrates. This is the best situation as an administrator that I could imagine at this point in my career. I have at least seven departments with strong leaders who have given me an opportunity to plan and not just serve as "fireman" for the day. We didn't start this way; only through gnashing of teeth, firing and hiring, nurturing and mentoring, admitting mistakes, and capitalizing on the good in others have we arrived at this new place in our organization. Yet I know that we are just now scratching the surface on being a truly resident-centered organization.

I believe that the articles I keep reading on culture change set a new standard of where we should be as an organization and an industry. It is no secret that LTC organizations and the industry as a whole do not meet the needs of their customers. The current status quo will not cut it in the future. Consumers demand and competition dictates that we must change our perspective to not just survive, but to serve and meet the needs of others.

I am excited about where I am as an administrator today. Yet I have many frustrations. I have said many times, "There has got to be an easier way to make a living." I have wished that I could find that easier way (or that someone else would find it for me). I have prayed, I shamefully admit, that my children will not follow in their father's footsteps.

I have come to realize that maybe, just maybe, the easier way to make a living might be just where I am right now--by creating an environment in which it is easier to exist, both as a resident and as a caregiver.

So, where do I begin?

Hill Fort is Administrator of the Muscogee Manor and Rehabilitation Center, a 242-bed skilled nursing facility in Columbus, Georgia. To comment on this editorial, please send e-mail to [e-mail]