New DON cleaning house - page 2
I would like to hear stories of people who saw a home get cleaned out of staff because a new DON came in. It happened to me. Great eval's then when she came on I couldn't do anything right in her... Read More
Nov 9, '09Thanks for sharing your story.
I don't understand why this happens in nursing. Nursing is supposed to be about caring for the residents, not about attacking each other. My wife and I have decided that I will probably leave nursing and go back to school for something with less of this kind of stress.
It is a "gotcha" type of environment where you have to watch what you say and what you do and depending on who your friends are may not survive. I often wonder how some nurses stay in facilities as long as they do. What is their secret? I went through the hiring date list at my last facility once just because I was curious, and there were mostly new nurses with a few exceptions.
Is the system set up to cause this problem? I have never had a job before nursing where you had to do everything with a 100% accuracy rate in such a fast moving high resident to staff environment and sign for everything that you do. And even that has to be done 100%
With a fall or an admit, it would be like doing 2 people's jobs without any additional help. Those days sent me through the roof. And if you left a sheet undone, holy heck rained down on you. I would find where other nurses left things undone and reported it, but was criticized by the new DON for that too.
Sad to say, but the LTC is like high school and depending who your friends are is how long you will last. I had wonderful moments in nursing, mostly with the patients I helped, but it also soured me to it as well. Maybe the problem is that many DON's don't have management backgrounds. The one we got was a former DON at another facility at one time, then went to night ER nurse, then to DON at our facility. When I heard that I had a huge red flag go up.
Somebody at the other facility didn't like her, and I knew we got somebody else's trash. Sorry, still venting.
Nov 9, '09Quote from skittlebear. maybe if there were more nurse to patient ratios (say, 15 patients to every one nurse), things would get done the way they are suppose to, nurses wouldn't be so overworked and may come in to actually help cover a shift on their days off, and the patients would get better care overall. i guess i feel as though the biggest problem in most nursing homes is the incredibly high patient load a nurse has.
my pt load was 33 to one nurse who passed meds and 2 cna's. maybe that's normal. i begged for a med aid.
Nov 9, '09I've been a DNS in 3 different buildings. I was never hired to 'clean house'. I have high standards...let the nurses know what the standards were. Tried to help them meet the standards. If they couldn't or wouldn't, usually they left of their own accord. The average stay for a DNS in LTC is less than 18 months. Why? Take a look around. Would you want the nurses you work with taking care of you or your parents? I am held responsible for mistakes other people make and then get the cold shoulder when I try to change things.
Nov 9, '09Nurses are people and people have flaws. We are held to expectations that are set so high that we are almost set up to fail. I would let most of the nurses I have worked with take care of my parents and I know there are some out there who I would not.
I would spend an hour each night going over my paperwork and medex and treatment sheets just to make sure that every t was crossed and every i was dotted. In a workplace where a missed initial can get you fired, it is almost too much to take.
It seems that some nurses are more immune to the rath of the DON due to personality. I never used to believe this thinking that all people treated everyone equally, but that is not true. I can still remember the cattiness of the staff when the new DON was hired. The one who knew her from a past job and had nothing good to say about her was fired a month later. I don't know the details, but she was a good nurse.
The new DON was not perfect and I often caught her mistakes. I can still remember when she first started, and she came in to help with an admit. (I was shocked, I later found out she was required to fill out some of the paperwork, this soon ended as she changed the papers) I got a call from her asking why I didn't write an admit note. I was wondering why she was asking since our former admit nurse, who she had just fired used to do all the paperwork including the admit note.
I was like, "I thought you were going to do it" I told her that the admit nurse used to do it and she said, "I only came in to do part of it." When she left the building the night of the admit, she had left me with a list of items left to do on the admit, and the admit note was not one of them. I was just following the procedure that I had done for the last 20 admits I had done before we had an admit nurse. (they never hired a new one after that cheap ***)
Anyway, of course in her eyes she could do no wrong. She would write her initials on the wrong date in the medex, told me to do a readmit on someone who was not.
The main issue was a spurt in census due to another facility closing and no extra help with all the admits, falls, and skin issues that would arise on a nightly basis. I had 0 extra time in my shift as it was.
Nov 11, '09My DON gig lasted 7 very long months. If it's a good LTC they keep the DON forever and bad ones cannot keep one for more than a few months. My own problem was a very controlling administrator who wanted a yes-woman and not someone who was there for residents/nursing staff. I did not clean house, I did not kiss tosh, so live was miserable. Stayed long enough to not look bad on a resume. Then gone and no more management jobs for me in this lifetime...or the next.
Nov 15, '09Regarding nurse to resident ratio's in LTC, there is just not the money available to provide more staff. Lots of medicaid patients and the reimbursement sometimes doesn't cover the cost of care. For example, in the facility that I work in we have one particular patient that costs us over $6000/month. Our reimbursement from medicaid is $4500. We eat the rest of the cost.
Nov 17, '09Haha,
Guess what? We just got a new DON in our facility who is very strict. She is trying to change EVERYTHING! I'm going to try and stick it out, but I don't know if I can much longer. Maybe she will settle down as she sets in her new role. I will be looking for another job in the meantime, just in case.
Nov 17, '09I have been at the same facility since 1972. The DON, ADON, lasted a year after the administer retired in 1978. Then we had a parade it seemed of administers, DONs and ADONs. In 1995 we got a new female administer who really got along with staff well, the DON retired, so one of the unit coordinators who had been a DON in another facility years back applied and became our new DON. They worked well together and I can not say that I remember any of the house cleaning mentioned. Our administer left last year and was replaced by her assistant. Our DON is leaving next month. I have applied for her job and have my interview on Thursday. I know our staff, our strengths and weaknesses. I have been the inservice director for 3 years and before that a supervisior and floor nurse. I hope that if I get the position I will be able to make a difference in a facility I love and for staff who just need a little direction at time.
Dec 20, '09Where I work, we have had more Administrator turnover than DON turnover. Ive been here almost 10 yrs....been through 4 DONs, and I cant remember how many administrators. The current DON has been here about 3 yrs now...came from Florida to NC....she didnt bring any workers with her but she started immediately changing our policies and procedures to the "florida" way of doing it. She always says "In Florida we did it this way etc etc etc ".....she hasnt really cleaned house though.....she is a talker, not a doer. She will talk about needing to get rid of the bad ones, yet never does until something drastic happens. She just got rid of an aide (I caught her sleeping on the job) who shouldve been gone 2 yrs ago for many many many things among her many write ups. The only reason she was fired is because we have a new ADON who is not going to tolerate such nonsense. The DON however, lets stuff be swept under the rug, she cannot communicate or direct, she doesnt deal with staffing issues big or small til shes backed into a corner, she is a pro at passing the buck (I wonder if thats how she did it in Flordia??) to anybody. I wish she'd do some serious inservicing for some of our aides with nasty attitudes and bad work ethics.
Dec 20, '09I have been a LTC nurse for 16 years and I have seen so many DON's come and go that I lost count years ago.Some come in determined to make sweeping changes. And in the short term they are successful. They raise the hope of the employees when things in the faciity change for the better. better staffing, better staff moral
but ultimatly they run into a brick wall when the people above her start to veto what they want to do because it isnt in the budget. You can only butt up against that wall for so long before you get sick of it and you just give up and resign. Those are the DON's you miss that, that you remember. Then there are the Corporate DON's that
are there only to use the postition as another step up the ladder these don's dont clean house they pretend you dont exist and needless to say their doors arent only not open to you they are LOCKED. These DON"S cant leave quickly enough. It really isnt their fault they are just a rung in the chain.