[suzqpart]

I am currently the MDS/POC RN in a 65 bed SNF/NF facility in Central
Iowa.
Our DON gave notice on Thursday (she will be greatly missed). The ADM
asked on Friday if I would consider the DON position. My children are
all grown and away from home, I love and know the residents, and I
like what I am no doing.
What should I all consider in looking at this position?
Staffing is always an issue...Medicare/QA/Restorative RN is strong
but does not like restorative or QA...Current Skin/Treatment/Staffing
LPN is also strong but does not like staffing.
What should I do??? Any info or ideas will be most helpful.
Thanks in Advance
SU

[Tim-GNP]

As a licensed NHA, I give unto thee, the best advice I can give: "Run... don't walk, from you administrator's offer... DON's are cannon fodder!"

One bad Department Of Health [DOH] survey and the Director of Nursing usually gets fired... it's the NHA's answer to the DOH deficiencies. Especially if you like your job, and don't want to leave your facility. Offer to be the interim DON, and offer to orient the new DON, but run from being the full-time DON. I have seen too many wonderful nurses who occupied the DON slot fired to save the NHA's a-- with the board of directors. Granted, a few of them deserved it, but the majority were fired due to circumstances beyond their control. Here is a good example of the "devil and the deep blue sea":

The DON must staff facility at the minimal Dept. of health staffing numbers. The only way s/he could do it is with overtime. The NHA sees that the $$$ in overtime is going to ruin his chance for annual bonus. He puts his foot down, NO MORE OVERTIME. Staff complain to the DOH's "1-800" 24 hour hotline, DOH gives a deficiency for 'inadequate staffing' NHA answers deficiency as "we fired that DON who couldn't handle staffing..." Can you tell I have seen crap like this before????

Be careful, and weight your decision carefully.

[bettyfay]

Keep the job that you enjoy!!!! The DON
position will put you on antidepressants
within a month. I speak from experience!
It is true that one bad survey winds up as
your fault and out the door you go! When you
are lucky enough to find a job you like, don't give it up.
Betty

[MacNat]

Please, listen to these people!!! Don't even take the job on an interim basis!!! I left a DON position of 8 years because I couldn't take any more. Had deficiency free surveys yearly. I had great staff with the usual daily problems but I was burnt out. I took a marketing position at a new facility. I t was wonderful!! 40 hours(really 40) no oncall, no weekends!! That lasted 3 months. They had a bad survey the DON was ousted and I was asked to take over "temporarily." I said I'd do it for three months to give them time to find a replacement. That was 7 months ago.The job market is awful and no one in their right mind wants a DON position so they can't fill the position. I feel bad for the staff who are working so hard for me and the residents but I gave my resignation last week. I now have lost a job I really loved. By the way, I've been doing BOTH DON and admissions for the last 7 months. Yea, I have sucker written on my forehead! Maybe your facility is different but after 20 years in LTC, I'm sorry to say I'd doubt it. Good luck!!

[terriv]

Give this offer very serious thought. You will no longer be a nurse. You'll be administration. You will have little or no contact with residents. Sounds like you are happy with your current position and are a careing person. Are you willing to take that risk?

[mustangsheba]

I shouldn't even answer this as I have never actually worked as a DON. I have, however, stood aside and watched really good nurses crash and burn in a few months. The last one I watched was doing a wonderful job for the nurses and patients were happy. She resigned after about three months and later was fired - no one knows why for sure. I suspect that old virus, scapegoat. It's very seductive, isn't it? We hope that we can do something that is going to make a difference. I hate sounding cynical, but experience has indicated to me that it's an exercise in futility UNLESS you have really strong polititcal connections, everything in writing with an especially strong, tightly written contract of your job description including the decisions you will make regarding staffing, quality assurance, etc. I wish you the best of luck. Personally, I would rather go to an isolated island to treat lepers.

[mustangsheba]

Nancy: It was good to see a positive comment here. Best of luck. Sounds as if you're working for a good company.

[Nancy1]

After reading all of these negative remarks, I am almost afraid to be positive.
I personally feel the reason many crash and burn may because there is no support within the organization. Many times nurses take a DON position without having any training. A good nurse manager moves up in an organization without having a strong knowledge base for the job.
I would recommend asking for a copy of the job standards, if your organization has them. Look at the job description. Is there a LTC DON group in your community? Do you feel that you have strong personal and professional backers?
I am currently an ADON, and I am very much looking forward to moving up to DON within my current organization as we build another facility. I have been getting strong support and leadership opportunities from my current DON because she know I want her job, and I feel that she is helping me reach that goal. We make a good team.
If you have a good solid team you can be successful.
I truly believe that you will get more ngative replies simply because it is our nature to report bad experiences than it is to report positive ones.
Good luck with your decision, I know the decision you make with the information you have will be the correct one for you, Nancy

[Nancy1]

After reading the posts tonight, I have know I work in a great place, thanks.

[carolk]

Originally posted by suzq@pcpartner.net:
I am currently the MDS/POC RN in a 65 bed SNF/NF facility in Central
Iowa.
Our DON gave notice on Thursday (she will be greatly missed). The ADM
asked on Friday if I would consider the DON position. My children are
all grown and away from home, I love and know the residents, and I
like what I am no doing.
What should I all consider in looking at this position?
Staffing is always an issue...Medicare/QA/Restorative RN is strong
but does not like restorative or QA...Current Skin/Treatment/Staffing
LPN is also strong but does not like staffing.
What should I do??? Any info or ideas will be most helpful.
Thanks in Advance
SU

I am currently the Director of Nursing for a 120 bed facility in Florida. I have been in same position in South Carolina prior to moving here. I am now getting out of this position and never intend to go there again. I am taking a pay cut to do something different. Everything the others have said is true except it gets worse! Not only can you end up fired for a bad survey, in Florida they threaten your license. It is considered "neglect" if the survey team find fault that they consider to be harmful or jeopardy as the regulations state. No room for human error, no trend, only one mistake from a human being and bang, your license is in limbo!! I have been in geriatrics for 30 years now, most of it in NY, and am leaving it. I wish you well but would stay in a position where I was happy and "safe". Good luck to you.
Carol


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