DON and filling in for staff

How large is your facility? Are there other supervisors that can work or fill in on a rotating call basis.

I work in a small place and corporate got all up in arms if we had to use agency. My last (yep, she left) DON was forever filling in. Too much if you ask me, way to much.

Being new, it might be good to work the floor first hand to see the problems, but you have your job to do too.

How big is the facility? I've been in long term care for 20+ years and only one time in all those years did the DNS work the floor...scary really...she and the ADNS worked an 11-7 on the short term rehab floor. Narcotic count took 30 minutes because she counted EACH pill. I was the nurse manager and had already worked 16 hours on the floor. I've been a DNS for almost 4 years and have never had to push a cart. I will help all I can...I've done admissions and treatments and meetings, but it would have to be a huge emergency for me to push the cart.

My facility does not want one of it's highest paid people passing meds. They pay me a lot of money, and would like me to be doing my work, not other peoples work. They would rather pay an agency, but it does not happen very often.

As Adon

As Adon I work the units twice a week, My DON hasn;t worked a unit in about 4 years and would have difficulty with the meds and stuff, she is too far removed. I am the bridge btwn the units and management. My DON considers it a failure that the Adm reduced my hours and I make it up with 2 shifts on a unit- where the Head nurse is new and weak. As long as I am working on improving quality of life for my patients I am happy.
Depending on your responsibilities and hours, I would pressure your staff to fill call ins themselves or your work wont get done and you will find yourself out of a job. Explain to your staff that if they want a successful work place they all have to pitch in etc.
If your facility is small and there isn't much work for you, than fill in on the shifts to your hearts content!!!

Mercy- First you need to consult the State Operations Manual with the OBRA guidelines and the state guidlines for staffing a LTC facility. Depending on the size of the facility a DON may not be allowed to staff or if they are for only so many hours. As long as the facility is in compliance with the laws they can ask you to do whatever your little heart desires. If you get a salary and notice it isnt a good one or that you work over 40 hours a week you might want to renegotiate your salary so you can get an hourly wage to compensate for all of this work.

Hi,
I was an ADON of a moderate to small LTC facility in Westchester, County. My DON had no difficulty with assigning me to the units on a daily basis. I worked along side the nurses doing dressings, picking up orders, arranging for transportion etc. I should have asked for an increase in salary. This situation can come into conflict with the routine paper work which is required from a ADON. Additionally agency nurses were assigned to the facility periodically.

Freddiebear- you are right- better check the regs...over 60 beds the DON cannot serve as staff.....

I think the DON should be able to fill in an an emergency, but there is no way she should be used on a regular basis. I'm not a DON, but I do have a desk-type job and am often a little frustrated by how many people think my time in the office is unimportant. Sure I can help on the floor and actually do quite a bit, but I still have my job to do.

I also think the DONs need to be paid better...I can work a 60-hour week and take home more than the DON because she is salaried. Not fair.