as DON/ADON you help or hinder your staff? - page 3

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... Read More

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    I am a floor nurse at in a LTC facility. I believe the best thing you can do as management is encourge and compliment. People work harder for you, if they believe you see the good in them. My best and favorite supervisors, managers and DON's have made it a point to compliment staff.

    I know there is a lot of poor performers around, but even they might improve with a bit of encourgement. When I work, I have 4 CNA's. I try to find something each one does well, and compliment them. They then usually make a point of showing me that they are doing this again. The compliments run the gamet from, "Wow, I am impressed at how well you handled that patient when he was verbally abusive" to "You always bring your vital signs to me within the first hour, it makes this place run so much smoother". I often see CNA making a point of showing others how good they are in this area, esp when they think I am watching. It's interesting and fun to watch. It also makes the times I have to give them a little talk about their slip ups and attitudes a little easier, ...and a little more distressing for them.

    I had a Unit Manager who carried a book with every nurse and every CNA's name. Each month she would try to give everyone a geniune compliment about our work. Then you would see her pull out her book and check your name off for that month. It was not without it's humor, but I really looked forward to her feedback, and loved the compliments.
    tiredbeatupRN and pixie120 like this.

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    Wow, your story seems quite similar to my LTC experience. It is sad but can be true at times, DONs not caring and letting others get away with things, that you would not be allowed to. I can only say work exactly by the book, in my experience I wish I would have tried harder to do this, because unfortunately I was fired but my DON still has the same job, in which she has had encouraged nurses to falisify documentation because state surveryors were coming in, did I say anything when I caught all the things she was doing, no I never did, because I was afraid for my job. Because they wanted me gone, I was fired along with two other nurses and two CNAs. Funny thing was my state board of nursing dismissed everything against my license and basically wanted to know who I had ticked off. In the past two years there has been close to probably ten firings at that facility, scary isn't it.
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    Only 10 firings in two yrs??? I let people go every month. In two months, my staffing dept hired 9 CNA's and I let 6 of them go. I will not tolerate any abuse, theft, lies, absentee problems, etc. we have a great facility and I plan on keeping it that way. I have nurses and CNA's that have been there since the 80's and newer ones also that just love it. I definitely appreciate my staff for the hard work they put in, and let them know every chance I get.
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    You sound impressive as a boss, tough but fair. I can see that you are consistent and do not show favortisim between your CNAs and Nurses. Which is something I cannot stand, in my situation, the CNAs were always right and nursing staff was always wrong. I have witnessed nurses being extremely disrespectfull to the DON and even almost cursing her to her face and it was allowed. I will tell you my experience, I was employed six years, was working as a nursing supervisor, and was terminated for allowing a CNA to work out of scope. The aid was working on a day I was not even working and was caught drawing blood. Now after a full investigation myself and two other nurses were fired along with another aid. I was termed for teaching the aid to do it. Here was what I explained to the board I did not teach her anything I answered questions as HOw do you know what tubes to use? and this aid also helped to hold patients while drawing but I never stood over her and taught. She also helped me in putting in a foley catheter and I had to have her to insert the water in the balloon. 30cc, patient in side lying position, very combative. Now I completely explained this to the board and they fully understood that you do what you have to in the real world of nursing and said CNAs ask questions all the time that is how they become nurses, if the aide was dumb enough to try it then that was her problem not yours.

    Now my problem I had with DON was she had a well liked nurse in our building to make a completely new TAR after we circled that a tx had not been done, because not all of the nurses had been instructed on how to do CPT, this was told to us that it is a nursing measure and should have been implemented, I could have done it myself because I had seven years experience as a Respiratory Therapist. Last time I checked CPT is not a nursing measure and cannot be done without a doctors order. So she destroyed the TAR and just made a new one, completely destroying part of residents medical record. Last time I checked to that would be considered illegal. I have been a nurse for fifteen years and this almost destroyed me, because I had married myself to my job and thought I was doing a good job, only to have it taken from me. I have lost my drive over the last sixteen months but have finally went back to work, after a seven month lay off from another job, and will be taking my RN boards in three months after being out of school for over a year, this also almost cost me furthering my career.

    It is nice to see that you can run a tight ship, the DON I worked for has lost respect from many of her coworkers, and lacks professionalism, but I have let it be a humbling experience for me and have tried to rethink my strategy and really figure out to improve myself as a person and a nurse and all you can do is learn from your experience, and remember that you have to protect yourself and your license and hold an extremely high standard for yourself, and dont be afraid to speak up when those higher up are doing wrong.

    Keep up your good work!
    tiredbeatupRN likes this.
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    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!
    pixie120, JacknSweetpea, and noc4senuf like this.
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    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.
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    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.
    pixie120 and virgo,student nurse like this.
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    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.
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    Quote from CapeCodMermaid
    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 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?
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    Quote from sasha2lady
    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 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 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 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?

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