new DON

Specialties LTC Directors

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i just became the director of nursing at a small rehab facility. i am going to a seminar next month on how to be a don...now i feel a bit overwhelmed! i have been swamped with paperwork, per corporate rules, scheduling and a state survey any day!

please offer some advice!

ty:wink2:

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Moved to the DON/ADON forum for more feedback.

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Specializes in Gerontology, Med surg, Home Health.

Congratulations on your new position! I'm sure you are excited and terrified at the same time. Ask for a thorough orientation from your corporate people...get a clear list of expectations. Don't try to fix all the problems in a day. Don't worry so much about the upcoming survey. You've only just started so certainly you can't be blamed for any citations you may receive. Join the NADONA-LTC...a wonderful group for DONs in Long Term Care.

Who is giving the seminar? I just took an 8 week class given by the state Extended Care Federation. I wished I had taken it when I first became a DON.

Keep us posted.

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Specializes in A&E, District Nursing, & Aged Care.

Clear expectation i agree, and ask corporate office what KPI (key performance indicators) are for the position.

When you see an issue / oppurtunity for improvement, log it on you continuous improvement plan or just write it down. You cant deal with everything in the first week.

After a week or so put a memo out to the staff and introduce yourself, talk about your leadership style, open door policy etc. You will find staff race up to you in the first few weeks with their slant on the situation, and it's hard to gague staff in the first instance, so listening skills are very important. Write down there issues and tell them you will get back to them in due course.

When you have a survey and you can show you have identified the issue, you cant be blamed for it! I guess from what people are writing a survey is similar to what we have an australia, as an accreditation visit from the independant watch dog.

Ensure you have a mentor so you have someone to talk to as it can be lonely up the top...

GOOD LUCK!!

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Specializes in Gerontology, Med surg, Home Health.

I am curious....did you take the job? Is it what you expected? I'm starting a new job next month and I am very excited about it. I'm not a new DNS but this job will be different than any other I've had...a combination of skilled, assisted living, and independent living. Beautiful facility, great salary and benefits and the company is non-profit and has a stellar reputation.

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Get to know your staff. Sounds easy to do and you mentioned that you are in a small facility, so....... I think that is the biggest reason the faclity I work in is in a funk. ADM and DON really don't know the staff. You don't need to like them or be their friends, but get to know all of them....including the weekend and evening staff.

Moral stinks in our place. So much us vs them betwen shifts and levels of staff. Conduct a few meetings and just introduce yourself to staff and residents and family. Let them know a bit about yourself (you don't need to get personal). Make staff feel valued. This doesn't cost money...just shoot them a "Hey...thanks for your opionion or xyz"

Wear a uniform like the rest of the staff. Even if you are not on the floor all the time..staff feels like you are one of them and not an office person (this might not work for all DONs)

Get to know your regional director or support person.

Ask, Ask, Ask questions!

Hold staff accountable. Trust me...the rest of the staff will welcome this.

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Specializes in A&E, District Nursing, & Aged Care.

Kaliausten

I'm interested to know how much DONs or ADONs get paid in the US. As a director of nursing in australia I recieve the equiv $US 75,041.84. I have 60 clients and 40 staff that I manage in a residential care setting/LTC. .

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Specializes in Gerontology, Med surg, Home Health.

The pay varies greatly by geographical area, the company, and the experience of the DNS. My old DNS was making close to $100,000 for a 140 bed skilled building. I've had head hunters tell me they could get me a 6 figure income...yah...the building is in the worst part of town and needs to be fixed from the ground up. My co part in one of the other buildings this company owns makes $10,000 less than I do and she's been a director longer! My building is much bigger than hers so maybe that's why she makes less.

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thank you all for your responses, i have a nurse consultant from corporate, and she is a big help,also a wound consultant, the skins issue is out of hand...that is my priority now i hired 2 skin nurses...i do know my staff well, as i was a floor nurse 2 years before being don, i make about 100,000/yr in northern california....each of your input has helped me and again i thank you

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Specializes in acute care and geriatric.

all this talk about getting to know staff and the side issue of salary etc., is only one part of it- try remembering that we are here for the patients- their quality of life- and for their families as well - to help them get through and make the most of this trying period of time.

As DON you are responsible for the macro and not the micro- you must always have the big picture in mind, the state regulations and the demands of your superiors, the moral issues- patients rights etc. you have to get to know your staff but you must identify first and foremost with your patients because the staff might try get by doing the least.

it isn't good to be too close with one staff member- you do not want to give the impression that you play favorites.

being fair with your staff is your best tool.

and lastly- my DON always tells me that a good DON never sorts how and counts how much work each person contributed- focus on the group successes rather than individual ones- we each have our strengths altogether we conquer projects. It is distructive if you start counting how many showers this one did or how many patients that one fed.

I do wish you the best of luck- this kind of job just completely takes over your life- discourage phone calls to your home- even if it means delegating. take your regular vacations- you will need it!!! All the best,

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The first day I took over as the DON State showed up! I made it through that one and have seen a few more go by. You can too! The thing that I have learned during this experience is treat your aides fairly, listen to them, and make sure you don't let them down, but first and foremost it is about the people who live in your home don't let them down. There are so many regulations it is crazy. I would also advise you to read the Long Term Care Survey Guide. I know it looks like a lot and it is but it will be your best resource, along with your consultants. Don't be afraid to ask questions. At first it may seem overwhelming but if you put the time an effort in it can be very rewarding! I wish you the best of luck.:wink2:

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