DNS advice - page 2

by pixie120 1,727 Views | 11 Comments

Hi everyone, looking for experienced DON/DNS advice. After survey now, QIS, lots of tags, one G, lots of attitude and pointing of fingers, difficult regional (at best prior to survey) now non-existant, suspect the end is near.... Read More


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    There is so much turnover in LTC that I'm always surprised when I visit a facility (to evaluate a prospective resident, or assess one of our own for his/her readiness to return home) and find the same management people I spoke with the last time I was in their building.

    Right now I'm consulting in a sister facility whose survey was 118 typed pages of horror. Their nurse had only been on the job for 3 months when the surveyors came in, and they barbecued her---I'm actually amazed that she didn't quit. It's kind of sad that people come into AL nursing thinking "Oh for Pete's sake, it's assisted living, how hard can it be?" and then they FIND OUT how hard it is by getting skewered in the survey process. This particular nurse came from a home health/hospice background, so she really doesn't know what she's doing....and what's worse, there is no sense of urgency in working on the plan of correction on either hers or the facility administrator's part.

    So now the VP of clinical operations, a DNS from another building, and I were going through the residents' charts, which are an unholy mess......while the nurse and the administrator BOTH were out doing move-in assessments. Really??! They aren't doing a decent job of caring for the residents they already have; I can't imagine the State allowing them to move anyone else in at this point. Not with med aides who leave the diabetic MARs in the med room while giving insulin because "I know all of their sliding scale insulin orders" and upgrade mechanical-soft diet textures to "regular" without either notifying the nurse or MD "because the resident wanted it". YAAAAAAAAAAAACCCCCCCCCCK!!!!
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    Quote from Nascar nurse
    Oh, how heart breaking for you! It is hard but try not to take it personally.

    I warned my family when I accepted this DON job (my first) that all to often I hear of DON's getting walked out the door for little to no reason. In my part of the country tho it is so odd how it doesn't seem to have any affect on future employment. It is so common that one can easily go down the road a day after being fired and get hired into a new DON position.
    Yeah, its rampant here, yet...there are 8 DNS positions open and some in Assisted Living. The trend now is to put in an "interim" work her/him to death and then hire maybe in 6 months a real DNS, then that DNS gets fired, it's ridiculous. There for awhile, the survey WAS not an issue and DNS's stayed in buidlings for long periods of time, which resulted in beter and better surveys. BUT now it is QIS, and it's going back to the old way, fire and hire, fire and hire. It's very hard on the line staff, doesn't make for safe nursing care and is of no use to resident care, period. It defeats good care. It will take awhile for the pendulum to swing back to the correct focus, patient advocacy. Thanks very much for your kind words, very very much appreciated.


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