Last month I accepted a DON position at a nursing home. The previous DON was already gone. Three days after I started state came in for the survey as well as the fire marshall. Plan of correction is done (that was excruciating) and now I am working on in-servicing staff. It's been a lot of commotion and stress all at once and I am having a hard time reeling the staff back in and calming them down. I have QA/QI reports with numbers trending toward the worse sitting on my desk that I have to develop action plans for and do a presentation this month. I have performance reviews to be done on people that I don't even know yet. I have had to fire two RNs already, one for harassment other for violation of resident care standard, with each of them it was a third strike you're out kinda deal. They freaked out and yelled at me and the admin., even though they knew what would happen with a further violation. I am worried about my tires getting slashed or my kids held hostage. (That might be a slight exaggeration but doesn't seem unfeasable.) I've worked in LTC for most of the past 13 years... but this is ridiculous. During my interview for the job I met with HR, Admin., staffing and MDS coordinator. They all seemed great, said I would be perfect but so far I think the job is terrible. I want to give this my best. What I need is some good coping techniques. Maybe I'm just looking for some reassurance, will it get better? What kinds of resources are there for DONs?
Jan 5, '11
Sorry but I can't give you any hope. I have never worked as a DON. I have worked in many LTC's in the past and it never gets better it just gets worse.It is just one disaster after another. You have worked in LTC for the past 13 years. Have you ever really seen anything get better at LTC? I have seen the DON's blamed and fired immediately after state inspections. It seems the DON is held responsible if things go wrong with the state inspectors. LTC is a no win situation for everyone involved.
Jan 5, '11
I love LTC. would never do anything else. There are some great facilities out there. Once the staff realize that you are there to make it a good place to work and the residents to live, they will follow your lead. Just treat them all fairly. It iwll settle down for you.
Jan 7, '11
Upon reading your post, pielegniarka, I was impressed. It sounded as though you hit the ground running and extinguished the fires as they broke out.
I've worked at LTC's and have been an Administrator at a Home Health Agency and a Mental Health Clinic. I can identify with your situation. In both positions, I took over a rather Chaotic Situation. I worked very hard at getting Things running relatively smooth. After that, it was merely expending energy to keeping Things maintained.
I can't help but think that you have the potential to make That happen in your Position. It sometimes takes months before we can see the light at the end of the tunnel. If you don't loose your mind, you just might make a difference!
Hey- what have you got to loose? Besides your sanity? The world was not changed by quitters. And a hundred years from now, who'll know the difference?
I say, "The best to you, pielegniarka!"
Jan 7, '11
All I can add is to keep a diary for yourself and write everything down (keep copies). If the facility has a history of changing DON's every year, then I would keep my eyes open, if the place is more or less stable, you have a shot.
As to resources, this is the best I can find, there is great support on this forum and great answers- dont be bashful
BTW, are you looking for nurses and where are you located (you dont have to be specific).
Jan 7, '11
I've been in the business for almost 30 years (yikes!) and yes, there are GOOD LTCs. You have to take one step at a time....break the problems down into easily dealt with bits and remember, you can't fix everything at once. Start with any patient care issues whether it's nurses or CNAs. Be very clear about your expectations and don't be afraid to get rid of staff who can't meet them. You have the ability to change the place for the better. Do you have any corporate oversight? Sometimes they are more trouble than they're worth, but sometimes they will really pitch in and help you out.
This is the best place for us to come and look for advice. You might consider joining NADONA LTC but they tend to be a bit based in theory and not so much in the trenches.
Jan 12, '11
The reason I took the job at this place was because their staff retention is great. I did ask during my interview and except for the DON leaving before me all admin. staff have been there for over 8 years. and Wow thanks for the optimistic replies-- that truly made my week! I will take your suggestions and work with them and try not to be a quitter. I do realize that I can help people improve in this position and that is what I want to do. (It's just so many things at once to work on and little time to break it down.) Anchot- I sent you PM in regards to your questions. Thanks again everyone.
Jan 21, '11
Hello. Regarding your question of "will this Director Of Nursing job get better", here's what my nursing home DON pal says: "... the reality is that one can smooth out some of the rough edges, however, a DON position will always be difficult." A year ago when my pal was hired as a DON she had lofty ideas about streamlining her many responsibilities and gradually decreasing her mega weekly work hours. Now, a year later, my DON pal is still working at least 55 hours per week plus weekend on call duties. Best wishes!
Jan 22, '11
Wow, sounds like you accepted the position I just left. They treated me terribly as a DON,
got yelled at all the time by other depts and even my own ADON. Took another position as DON elsewhere,
so much better. Work still hard, but everyone gets along for the most part. Big change.
Feb 13, '11
The one thing that makes you successful as a DON is having a supportive administrator. If administrator supports you in front of everyone, even if you disagree behind closed doors, you can succeed. An Administrator once told me that an administrator and a DON should be like a married couple and never argue in front of the "kids". If you have this relationship with your new administrator, you should hang in there. There will always be fires to put out but as long as you do it together you can make it. AND always find things to make you laugh EVERYDAY.
Feb 13, '11
Last post, well said. This is so true. If your administrator is not on your side, then you will
lose. Mine told me that they will back me up 100%. I was told that I was wanted on their
side and that we should be very close. I can appreciate that, as that told me I was in the
right place. My other ADM was against everything I did and even sided with the ADON as they
yelled and screamed into my face. I was told that I must ride that ADON's coat tails. Say what?
If you dont already have a relationship with your ADM, find some common interests. Talk small chat about
what schools you went to, ask where they grew up, about children and such. see if there are any connections, you might be surprised.
Go out for a meal together. Let them know how much you appreciate them.
Feb 5, '13
The worst thing you can do is threaten the nursing staff with calling the state and feds in when some paperwork is wrong and no narcs missing. That's what happened to me. I had a new DON start and she threatened to call state and feds in because a nurse didn't sign a discharge sheet. She then wanted me to take a drug test and took my keys. She blew everything out of proportion, went through my desk and lied about it. She has started on the wrong foot and is acting like the place is a mess when we have been working hard without a DON. Not a way to start at all. Very hurtful and threatening. Best thing you can do is when you find something not up to par is to teach in a nice way. My situation is a nightmare. I wish you luck. Just try not to put anyone down and keep any negative comments to yourself or talk with ED about it. Remember the ones that have been have probably been doing the best they can.