set up for failure

Specialties LTC Directors

Published

Specializes in er,med-surg, telemetry,long term care.

I need to tell you all a story because i have read some other threads of some nurses dealing with a decision i once had to make. I have worked in long term care for almost 15 years. I started out as a CNA in long term careand went back to nursing school and received my associate degree in nursing. I have worked in the er and telemetry/med-surg but decided to return to long term care because I feel good skilled nurses are desperately needed plus it is what i have always loved. I have been a nurse for 5 years. I worked as a RN supervisor but was approached to consider the job as DON. At first I thought maybe i needed to work and get more experience first, but it was my dream to become a DON at some point and time so I accepted the opportunity because I wanted to make a difference. Well it did not turn out how i planned. I know now I was not prepared for this challenge just yet. I still don't know where I went wrong, but nothing went right. I felt as though even though I was the DON none of the decisions were made by me but corporate. And when the #### hit the fan the responsibility fell on me. It got to the point where i could not depend on the staff that was hired to do a job could not be depended on to do their job which put more responsibility on myself because i wanted it done right and so did my boss. After leaving the position I was devastated because I have never failed at anything like this before. I take so much pride in my work and wanted so bad to succeed. Where did I go wrong!!??? Is my dream of being a DON over???

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Specializes in Gerontology, Med surg, Home Health.

Don't give up. I worked with a DON who had been fired 3 times. Honestly, she was a great DON...taught me all sorts of things. She was outspoken and tried to get the nurses to step up...they didn't want to. Some companies stand behind their directors...some don't. If you want it badly enough, you'll find a place where you fit.

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OH that is such great advice Cape Cod, In my facility I have been the ADON, but after my son was born I told them I could not do that so no one else can catch on the MDS so I am doing that and teaching the nurse aide class. I can not be on call and I realized that 24 hours a day with a child with downs syndrome, therapy you know the drill. I too got burnt out and was so tired of feeling like am I the only one around here that ever charts, gives pain meds when someone hurts, does the treatments when I had to cover a shift etc... We currently have state in our building, I am so glad tomorrow I am home with my son to cuddle him and he has therapy and I can get some studying done ( I am working on my associated degree in nursing now) I started back at this job in 2005 and we have had 12 different DON's need I say more about corporate dragons!!! The few that were good they would run off because they would not let us have the things we needed to care for the residents including staff and wages. I stay loyal to the resident and giving new cna's information to do the job safely and too feel appreciated-- they know to come to my door I always spend 20 bucks a week on my candy bowl lol.

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Specializes in Geriatrics, WCC.

Evette, I don't know what is available for facilities out there but, try a small(er) one, maybe non-profit and try to stay away from large corporates. They are in it for the money and will eat their young. Make sure you become best friends with your NHA... to have them in your side pocket makes the best team. The first facility doesn't always work out, try again.

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Specializes in er,med-surg, telemetry,long term care.

Thank you for the advice

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Specializes in LTC, geriatric, psych, rehab.

I had never been a DON before when I was handed the job 4 yrs ago. It was certainly not my dream to be one. But I did the best I could with it. Dearly loved my residents, and the staff and I worked great together. Increased census from 50% to 85%. Went from losing $ to making $. Got a new adm not long after I took the job, and he was wonderful. Corporate could just not be satisfied. They just kept criticizing. I finally had enough. I resigned last month. The staff has been so upset that they are now leaving. That seems to be what corporate wants. Guess they want all new people. Now the adm has resigned. I don't feel like I failed. I gave it my best, learned alot, and my residents got the best of care when I was there. As long as you give it your best, that is all you can do. There are plenty of DON jobs out there if you want another one. You can do whatever you want to do, so do not give up if that is what you want.

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Specializes in LTC, Memory loss, PDN.

Evette, the best mountain climber in the world would most likely not be able to get to 3000 ft with their hands tied behind their back, their ankles shackled and someone constantly throwing obstacles in their way. Your heading says it all. Obviously I've never been a DON (I'm an LPN), but I've seen numerous wonderful nurses attempt the impossible, do a tremendous job and bring about many improvements, only to be walked all over by corporate. It just makes me want to scream, but often times corporate prerequs for a good DON are directly opposed to what most of us would consider necessary traits for a good nurse. It's probably fair to say: They don't deserve you. And also a huge thank you to those DON's who'd rather change jobs than sell their soul or sell out their staff. If I am any good at what I do, it is largely because of some of the DON's I had the privilege to work with.

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oh gosh I wish I could work with you guys, would love to work with nurses that still give a dang for a change.... yes seems like corporate loves to throw you under a bus many times. I have been begging for training for months and all I hear is we dont have enough money. -- but if they train us we will make the money for them dang they are dumb...

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Specializes in LTC since 1972, team leader, supervisor,.

Keep your dream, I am sure you would do well as a DON. Remember each facility is different. I have been lucky to work full time in the county nursing home, where we have no corporate bosses. The downfall to that is when there is a problem and you have to work out the solution, there is no one but you to make the ultimate decision--you can work with the administrator and the unit coordinators, but ultimately you are left holding the bag. I think that is why I am so worried about appling for the position, and now I have my interview at 2:30 tomorrow. This week we had a hot line call from an incident that happened a year and a half ago. The resident since has passed away and we had to think, just given a scenerio from the surveyor who she was here to investigate. We received 2 tags from her visit( no reporting condition change to family, doctor, and assessment). The resident had an emesis and the nurse did not call the family or doctor immediately, the next shift nurse called and had her sent for an evaluation 4 hours later because she continued to vomit. The first nurse only had that the resident had an emesis and her temp--no other vitals, no abdominal assessment--nothing! The surveyor told me that if only the first nurse had done and charted the assessment and a full set of vitals we would not have these tags. This incident really has me concerned--everyone in LTC knows that if you didn't chart it it did not happen! So now because of poor assessment and charting we are in trouble. If I get the DONs position, I want to have a meeting with the nurses and tell them they are going to be held accountable, it is only fair--taxpayers will now have to pay the fine--the nurse who did not assess, call, or chart is scott free, the DON is doing nothing, not even talking to her--I have to do the education because that is my current job but that is fine, I am just upset she is not going to be held accountable am I looking at this the wrong way? Would that put me in the same category as the DONs who house clean?

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Specializes in Gerontology, Med surg, Home Health.

Is there more to the story? I can't imagine calling a doctor and a family because someone vomited once.

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gees we finally got our final POC back from state, they took our nurse aide class away?? for 2 years--- gosh this is upsetting I dont see how we can function without having nurse aides in the building. Very fustrating. I teach this class and so now that is extra days will be cut from me and They only allot so much time for MDS- which is stupid because that is where you get money but they just hired ADON and they use to have me doing it but I refuse to do both-- because my children need me and I am in school so they got someone else but she has not been trained to do MDS and I will not train someone again and just stay home and in a few months ahve to come back adn clean up the mess-- I see the writing on the wall need to get my Resume up to date!! Sad been there a long time now. We never had this type of severe fines and punishments in the past but seems like now we do. The DON says just keep on teaching the class like I have been of course I will until I am officially told to stop -- this is the dumbest thing I have ever seen b/c nurse aide training is what is needed -- I train exactly according to the state guidelines -- my stomach is just sick over this one.

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Specializes in Geriatrics, WCC.

Then your tag level must have been at a "G" or higher. When that occurrs, then yes, you do lose your ability to have classes in-house.

Is there soemthing else you could be doing within your facility to offset the hours that you would have been instructing the class? Just a thought.

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