as DON/ADON ....do you help or hinder your staff?

[sasha2lady]

I am an LPN in LTC. We got a new DON from out of state 2 yrs ago...who has since made tons of changes that originated from her home state. when she makes a change she says the same thing all the time "Its per corporate"....which half the time is bull. She made up an attendance policy that she herself doesnt adhere to or follow. She is an intelligent nurse...but she has this "i dont care" attitude about staff and residents. she takes it upon herself to cancel residents appointments if she thinks they dont need them....she changes meds and diets if she thinks they arent right. She never helps us with admissions or paperwork or with short staffing issues. She doesnt explain new things...she leaves notes and tells us to sign it. She has made families think that us other nurses are incompetent and that we dont know what we are talking about or doing....not good. She doesnt deal with staff issues such as : constant chronic call ins (its usually the same ones who call in or dont show at all...all the time and still have a job), the lack of teamwork in some nurses and cnas as well....the poor training that new nurses and aides get including sloppy orientation, she tells the day charge nurse to "get out of here" all the time and tells her to pass on her 4 to 5 hours of leftover orders, labs and consults to me (i do charge on 2nd...but i run a cart, tx's, charting, assessments etc) and i dont have time to dotheir work plus mine. The day nurse always gives it to me instead of splitting it...i think that if its going to be passed on...pass on whatever you have to the nurse in charge of that particular pt instead of me all the time. if we end up short on a shift..she or the adon dont help us...they tell us we have to stay over and expect us to be back the next day....the call ins never even get a word said to them...i had to fill out 5 med errors in one night d/t not having meds for 5 diff pts....the pharmacy didnt send them til after 3rd shift was there......she came to me and told me that they were just misplaced...i know they werent there..i checked 4 x before i ever filed a med error sheet on them....what she did was use that as a way to get out of reporting that to corporate in her wkly reports and not only was it a falsification....but it made me look like i overlooked something that absolutely wasnt there....my ? is this..as don / adon...how would you deal with each of these scenarios? do you help your nurses? or leave them hanging?

[CathiP, ASN, RN]

As a fairly new (4 months) ADON in a Rehab/LTC facitlity (and years since I worked LTC), I can say that our management is tops. So do the LPN's and RN's who work with us. Our DON has been at this facility only 2 years but brought it from 16 tags (some critical) to only 6 tags (only 3 nursing) and all were cleared in the revisit. We are "working" nurses. We answer call lights, put residents on bedpans and toilets, clean them up, etc. My staff wasn't used to that when I started and are quick to tell me the last ADON wouldn't touch a resident. All department heads take turns on call for weekends, even the Administrator. From reading the other posts, I guess I lucked out in finding the right facility who actually cares about the staff and residents!

[KHowesLPN]

I am just now getting back to reading this and it seems that you have found the right facility to work. Teamwork approach sounds really great there.

[JacknSweetpea]

The truth is....I don't really care about what the DON where I work does or says. I was hired to do a job as she was, and hopefully I'll continue to be employed as long as I'm holding my end of the bargain. It is disheartening at times for nurses to see DON's hiding out in their offices or going to lunch with other "office" people. Could care less. I do my job and try to do it correctly, and go home.

[VeronicaWileyRN]

I have worked as a DON for over 20 years. I have helped the CNAs, passed meds, pulled 3rd shift because there was no one else. I have helped with admissions and discharges. The DON job description is long and complex. Most staff have no idea what the DON is responsible to do. The administrator should be chided because he/her aren't looking at the problems or they live in their office. If the facility is part of a corporation, I suggest you contact the corporate people. They may help or not. If not I suggest you look for another position, but remember if you move to another facility things could be just as bad or worse.

[pixie120]

I am a DNS. Have been an ADNS, supervisor,SDC,nurse manager,staff nurse, and nurse's aid. We are not all evil ,uncaring people. If we are short staffed I help the aides. If there are multiple admissions, I do the orders so the nurses can concentrate on the new patient. I argue with corporate over salaries, benefits, and staffing. YOU get paid for all of your time. I am salaried which means when I am there on a Friday night helping with admissions I'm not getting paid for that. Please don't paint us all with the same brush.

I can't explain why some directors are the way they are. I've had every job there is to have so I know what you all are going through. But,unless you've been a DNS, you probably don't have a clue what MY responsibilities are...to the staff, the DPH, corporate and on and on.

Yep, well said. I care a great deal about all of my staff. I started in a building with no other managers, my nurses are kind and supportive, the corporation not, but I have had to hold ALL of my staff accountable, I never leave before 6 or 7 pm, andthen am on-call for the rest of the night and weekend, and every mistake can come back on me, my license. I cannot authorize overtime, nor would I want to,and either you have teamwork or you don't. Iwould encourage you to speak up, learn to say no (politely) and ask for more teamwork all the way around.Why are you specifically blaming the DNS, of all the nurses?

[pixie120]

well.. first off....Im not nor have i downed every DON/ADON...I simply stated how the one I work for is ....compared to the other ones we have had in the past....this one seems to take the cake. And regardless of our extreme differences....I do know alot more about what SHE does than she knows about what I do.....I know about the corporate meetings...the corporate calls that are done daily and weekly, I know about the RUG scores and how our facility makes money with medicaid, medicare and pvt insurances, I know about how we get billed for certain meds that come up short, I know about our staffing issues and the lack of attention to what our policy says should be done with that....I know about how the DON has to account for staff to patient ratios related to our census reports every 24 hours.....Im not oblivious to the fact that she is salaried and I am not (which IM glad of!) but salary or hourly pay...it shouldnt make a difference in whether or not management helps us when we need it. Ive worked tons of double shifts due to the fact that she didnt listen to me when I told her "xyz nurse wont come in tonight..what are you going to do about it? you need to go ahead and call so and so to see if it can be covered before they make plans".....not one time has she ever listened to me on these kinds of issues....thus...me and my shift gets stuck picking up the slack...for nights and for day shifts. we have had good DONs who have been so good to us .....thats why her tactics are so hard to deal with. And as for the administrator..he just does whatever she tells him to do.....there is poor poor poor communication that starts with all our management staff. Then...the fallout of that always comes down on us....the nurses who are stuck dealing with the new admits....the new families ....the new meds...the pharmacy...therapy...all of it. And in a prior reply talking about the pay....as far as that goes it just further proves my point ....its always about MONEY....and I also know that our DON and administrator get quarterly BONUSES for keeping us under budget.....and how that happens is 1. cutting our nursing hours 2. cutting our supplies 3. cutting our staff 4. cutting our yearly raises 5. cutting our benefits etc etc.....I cant tell ya how many times I havent had GLUCOMETER STRIPS!!!! ...or batteries, or OTC meds like IMMODIUM, OSCAL, TYLENOL, MOTRIN, COLACE, FISH OIL, or how about when we are out of cath kits? gauze pads and gauze rolls for our dressings and tx's???? our backup runs out of vicodins, ativans and darvocets b/c the DON hasnt reordered them ? or how about how we end up with no med cups or spoons or applesauce for our meds? Or when we run out of trash bags? gloves? cups for ice? Maybe Im old fashioned or somethign but the way I see it is that regardless of title...DON ADON MDS..whatever....RN is still behind that persons name which should mean they hold some kind of obligation to the patients and the staff to make sure that things are in order.....Without the patients...there would be NO paychecks to any of us. I know personally that I am more than grateful for any help I get with an admission or whatever.....but I have to draw the line somewhere. The DON even tells the aides not to change the incontinent ones as often b/c we "are going through the briefs too fast"......ummm......are you kidding me?????? ...She has also told us nurses not to give any prn pain meds or prn ativans. She has also cancelled important appointments for our patients b/c she felt that they didnt need them.....I think thats a little too much like playing God. And as for my own personal paycheck...I work nonstop for every last cent thats on it.

My goodness, this DNS must be a super woman, she seems to control and manipulate all. If you ever walked into my office and said "XYZ nurse isn't going to come in tonight, what are you going to do about it?" I would be flabbergasted. and why is it the DNS's job to reorder the ekit from the pharmacy? These are not DNS duties.What title do YOU have behind your name, just out of curiousity?