Any LTC DONs out there??

dtweed · Sep 22, 2001

I am an ADON in LTC. I have read some of your other posts. Yes people view management differently. We all have a job to do. No job is more important than the others, just different. My DON and i have been doing some soul searching trying to come up with ways to make things better. We also would like to talk with other DON's. One of our local agency's is putting on a DON to DON day which we plan to attend. I just returned form SOUTH DAKOTA ASSOCIATION OF HEALTHCARE ORGINZATIONS. SDONE is part of that. I was wondering if there is an orginzation for Long Term Care Nurse excutives. LTC is so different from acute care. But everything revovles around acute care. We need more info and resources for long term care. Do you know of any info out there.

catskillrn · Sep 22, 2001

I am a DNS in NYS. I belong the the National Association NADONA. They publish a magazine called the DIRECTOR. They also have local chapters. I live in a rural area so it is difficult to attend the local chapter meetings. We just started survey yesterday (on a Friday) team went home for the weekend and will be back on monday. We were over due- one week past 15 months. Say a prayer. I know we work very hard and give good care. The stress is incredible. Glad to chat with you anytime.

MaineNurse67 · Sep 24, 2001

I am glad there are some out there with the need for support!

Survey time can be sooooo stressful... something an acute care nurse will never understand. I feel your pain. My survey is due in December. Not looking forward to it at all!!

OneThunder, BSN, RN · Sep 26, 2001

I am a former Director of Nursing Services in LTC. I resigned my postition last year to persue my BSN.

I hope to return to the postition someday, after I have completed my education. I now am a 3-11 supervisor in a LTC facility.

I worked as a rent a nurse this summer in a hospital, and if that doesn't send you scurrying back to long term care, nothing will.

My first love will always be geriatrics.

MaineNurse67 · Sep 26, 2001

Hey... I wish more of those rent a nurses would come "scurrying" back to LTC!!!

Is there any place online that DONs gather?? Like to chat and vent their frustrations??

Would be nice to have some support from out there in the world!

I know we could all use it... sometimes it really helps to know that you are no worse off than anyone else! :)

Peace to all... Tim

marymack57 · Sep 29, 2001

hello, i am d.o.n. in new mexico long term care facility. three years is all. current issues in our building: nursing shortage, cna retention, owning company in chapter 11. sounds awful when i put it all in one sentence, huh?

MaineNurse67 · Sep 30, 2001

Sounds familiar! Same issues as everywhere else, I guess.

What kinds of interesting things are you doing for CNA and other nursing staff retention?

Anyone with any good ideas should share... we have just set up a CNA clinical ladder program. It has taken months of work, but I have already retained a few folks with it. It is not a lot of maintenance either. The hardest part of the whole thing has been the establishment of it and getting it to pass through senior management... otherwise, I am in hopes it will work out to be a great asset to the facility.

We have several other things going too... any other good ideas out there?

Tim:)

marymack57 · Sep 30, 2001

i am currently using Careworks Career Growth program for cna advancement, written by Paul Wray. there are three different "steps" that can be taken. the Bridge Mentor is a little harder to teach than others, mentoring isn't something that comes easy to some of the cna's. as for retention of licensed nurses, we did manage to squeeze in a sizeable pay raise before the shortage got so bad in our state, now working on shift differential for nurses...and doing a lot of praying. i have no prn nurses at all, just one nurse for every position, if someone gets sick, it's over time. biggest problem we have as i see it is the hospitals, ltc's, etc. in the larger cities are draining small communities of their nurses. we cannot compete with what they are paying and offering for benefits. let me know if there's any advice for us.

MaineNurse67 · Sep 30, 2001

My biggest issue in the way of retainment is Temp Agencies!

I cannot compete with what they pay. Although, they do not provide the stability that a facility does.

We have just implemented a corportate policy that any staff that leave us for the agency are not allowed to work at the facility in the capacity of agency staff. That has helped a bit. The staff were thinking that they would get done, take a job for more money and then sign up to work at the facility, where they already know the routine, etc. When they find out that this is not going to happen, it does make them think.

We pay one of the highest rates in the area for LTC... both CNA and licensed staff, yet we still rely quite a bit on agency use. It is such a major expense. We are looking at somehow starting our own agency within our company... not quite sure how it will work, but it may provide us some way of capping the rates that the agency charges us. Who knows?? Will keep you updated.

We have a great "Service Excellence" program in place, as well. That makes a difference. Each department has established a set of values and standards, which are reviewed frequently and give some guidelines as to expectations. It also provides a way for staff to "thank" each other for what is done. They make out "Service Excellence" cards... they are posted for all to see in the hallway coming into the facility. At the end of each month we tally the cards and give away a gift certificate to the one with the most or the most impressive recognition. I also review attendance before every monthly staff meeting. Those who have not missed any time, get placed into a drawing for movie tickets, gift certificates, prizes, etc. This is a fun way to recognize good attendance. I also read the list of names in the drawing so that everyone gets recognized, even if they do not win a prize.

So... any other ideas?? Would be glad to hear them.

Tim

OneThunder, BSN, RN · Sep 30, 2001

I used to work for a corporation that had the Careworks, but at the time I left, it was not for "union" facilities. I have since learned that they modified it to suit union approval.

I have always said the corporation should start it's own AGENCY. I have said that for years.Not only can you cut out the middle man, but make up for a few bucks supplying the facililty down the road who isn't in the corporation. To me, it looked like a win/win situation, but you know how SLOW good ideas go thru the corporate heirarchy-about as FAST as bad ideas have to be implemented!

As long as I'm on the soapbox, who started the "corporate" rumor that staff really don't care about wages, they care about a good work environment? If that were true, why do the good facilities loose staff to higher paying hospitals? eh?

marymack57 · Oct 1, 2001

we don't have any agencies operating in our town, if we have to use registry they come from Albuquerque, about 200 miles away. our corporation is also attempting to set up it's own registry, i haven't heard lately how that is coming along. we use various incentives for attendance, longevity, etc. we also have no unions around here, should we be glad or not? n.a.g.n.a. is active in our facility, the aides have a lot of fun with things related to that. within a 20 mile radius there are 4 ltc's, one hospital and 2 home health agencies that are still afloat and we have to be pretty aggressive in keeping our pay scales competitive, right now we are at the top of the chain. We have an RN program at the local college, however it is very cheap compared to some of the larger colleges in the state so they train a lot of nurses who promptly move back to wherever they came from, so the 30-40 they pump out a year aren't available to us for hire. i've always wondered if i would have an easier time of it if i were d.o.n. in a larger town, but i guess it is just the same problems with a little different twist.