Michelle, I worked as an interim DON in a 50 bed LTC facility for about 5 months. I had to help on the floor or I was bored to death. We had two charge nurses and 6 CENA's for dayshift. I also audited and thinned every chart, rewrote all the care plans
, and helped with MDS's...and I was bored out of my tree.
I'm currently in a 160 bed skilled facility...and I never seem to be caught up. There isn't enough hours in the day to do what I want to do. I give very little help on the floor except for answering call lights I pass. Most of my day is literally directing, educating and nurturing staff, patients, family and the physicians, and consistently monitoring that systems are in place and functioning properly.
F Tag 354 states that an RN must be on duty 8 consecutive hours a day 7 days per week. If your DON is not there 40 hours, she has to have someone designated as sharing the responsibility of a DON. A DON can work as a charge nurse if under a 60 bed facility. Over 60 beds, even if the DON would work the floor she's not counted as being there for patient care. Actually this is a good law and helps from a facility running a DON ragged and skimping on there RN coverage.
Usually an interim DON is just a "figurehead" to get by state regs. Usually interims are there to keep things running at a even keel. When a DON takes a position she should be constantly and consistently leading, pushing and educating to take the staff, facilty and residents to their maximum potential while following state and federal guidelines.
Well anyway...I'll quit here. I could write a whole essay..but I'll spare you