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



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No. 10
from kids
Old Aug 10, 2009, 11:28 PM

Default Re: as DON/ADON ....do you help or hinder your staff?
I think there are 2 or 3 sides to every story and the view from the floor can be very different.
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No. 11
from sasha2lady
Old Aug 12, 2009, 12:45 PM

Default Re: as DON/ADON ....do you help or hinder your staff?
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.
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No. 12
from rapkeygurl
Old Oct 17, 2009, 03:16 AM

Default Re: as DON/ADON ....do you help or hinder your staff?
you know there is good and bad with LTC, when the residents say I am so glad your on today. It is not all a bed of roses. I have worked on both sides, nurse aide, then LVN, working currently on my RN, I teach the nurse aide class and do mds's/careplans with minimal help from IDT people. Our facility usually does not smell bad. We got a gal in the kitchen that can make a mean plate of enchiladas for $3.00 can beat MCDonald's anyday. I have seen good and bad adon's and good and bad DON's, I have a Don that is a bit on the lazy side, smoke breaks probably more than being actually inside the building. What I started doing is taking her to trainings with me putting out nice notes when I see her follow up on things. I know in a perfect world would not have to do this. But god forbid the last DON come back --- Telling all the family members that medicare pays the whole 100 days period lol. Yes good to vent about it. Yes you probably need more training but do you know her duties?? Has she been trained to train you?? Our RN consultant was stuck at a sister home with an IJ for a month before my boss was even shown our systems. Have to always look at the total picture. I really dont think most nurses get into the job just for a paycheck. The education part is the key. Like getting out there and turning folks to show them how to do it, proper body alignment. Show them how to make rounds, what to look for, teach them time management skills and encourage LESS TEXTING while on duty-- (drives me insane) I have worked in some big cities nursing homes an been afraid of the staff I worked with back when I was a young nurse, so I learned, "ok girls come on I will check these 3 rooms for you if you go get that light over there, then we will go turn them all together" I sure dont have all the answers but seems like more teamwork and less worrying about all the things the management or nurse is doing wrong would help a little. I teach my nurse aides when they come to work you dont have to like each other but while your in the building you have to work for the good of the resident. and some of that stuff like not getting your paycheck correct there are things you can do about that. If your DON is dogging you try to ask for a time to talk about how you can make things better for you and your residents? Conflicts dont get resolved if you dont talk about it. Sometimes if I have been so miserable working with unreasonable Don's, higher up's and could not get a resolution that worked for my own sanity and peace I did change jobs. But I always start a job hoping to stay there at least a year. I feel that is ample time to really see how things are going to be sometimes you have to get out sooner. NOt encouraging any of you to leave LTC-- we need nurses I never was upset with a nurse that came to me and said you know this is just too much I think I am going to work at home health, the hospital etc.. Everyone has a nitch. I want to motivate you to help someone you work with even if just bringing in some candy or fruit or special lotion for everyone to share. Or when they really need to get this guy off to PT but have to fill out meal intakes we go record a couple of intakes or answer a call bell. I am talking about DON's, Adon's Mds people , housekeepers offering to pick up your trash in your office those types of things for us all and you will see good things. We made a board and put thinks like WOW thank you ____ for completing your flow books, Thank you for cleaning out the fridge night shift, etc.. WE give movie tickets on pay day to the ones that are working extra. Kind people rule!!
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No. 13
from rapkeygurl
Old Oct 17, 2009, 03:31 AM

Default Re: as DON/ADON ....do you help or hinder your staff?
one more thing to say, I was doing the supply ordering, I finally got someone else to take task off my back. But I am going to tell you I have a copy of everytime I sent a copy to main office and they would not approve gloves, bed alarms, face masks, things we needed to care for the residents. Usually they are pretty good if you give an explanation but they are feeling the squeeze with the medicare/medicaid cuts. So what we can all do to help the whole total pic is better charting. not grab 40 paper towels when we just need a few. It is getting crunch numbers time and I feel with the new rug rates coming up with MDS 3.0 we will really feel the bite. I have those copies ready for the state inspector next time they come in if they ask why we dont have this or that. So sick of that type of thing when fed regs say you have to provide quality care for residents how without supplies, people to care for them, will not approve for an extra restorative aide adn the list goes on and on..
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No. 14
from davidcrn69
Old Oct 17, 2009, 03:09 PM

Default Re: as DON/ADON ....do you help or hinder your staff?
Reading your eloquent list of complaints against this DON makes me feel better about myself as a new DON. The only thing I could agree with or try to understand is making sure each shift gets out of the building on time to reduce overtime and for maybe understanding the floor staff point-of-view that they have a life outside of the job, unlike mgmt who are free to "live" at the facility. Expecting non-exempt employees to stay over routinely, because the DON does is discouraging to staff, being another reason for high attrition rates. That DON neds to get her scrubs on and help you.
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No. 15
Old Oct 25, 2009, 08:37 PM

Love Re: as DON/ADON ....do you help or hinder your staff?
i am so soory that you do not feel support from your DON. As a New DON myself it particulary bothers me. I came to a facility that has had at least 7 DON's in 18 months. The staff here didn" t feel supported and rightly so. THeir boss was the DON of the week. I finally got all my manager positions filled and then told the managementthat our staff was just as important as our patients. The staff were really surprised to hear I would excuse unit managers from meetings if they needed them on the floor. THey tried it and found out I was telling the truth. Everyone need to be held accountable and the managment has to be consistent wiht everyone. i am starting to see the fruits of my labor and I have been there almost 4 months . Hope things get better for you soon-
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No. 16
from KATTB_RN
Old Nov 01, 2009, 04:15 PM

Default Re: as DON/ADON ....do you help or hinder your staff?
Originally Posted by CapeCodMermaid View Post
I have worked in LTC for most of my long career and am sick to death of people saying "LTC has historically been a mess." The facilities I have worked in have been clean, no smells, conscientious staff, wonderful care, great rehab, plenty of supplies. Please don't keep making broad generalizations about LTC. It's bad enough that most people out there think we do nothing all day...we shouldn't have to keep hearing it from people who work in the business. And about your paycheck...have YOU never made a mistake? Why do you act like the payroll people made the error to aggrevate you or cheat you?


AMEN SISTER!!!!!! I have worked in LTC for 17 years, started as CNA, LPN, MDS/Careplan Coordinator, and now DON. I have worked in some terrible places, and I have worked in some wonderful places. I think the same goes for all different areas of nursing. I love LTC, and will agree with you on this one.
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