Thinking of taking a DON offer

Specialties LTC Directors

Published

I am currently the MDS/POC RN in a 65 bed SNF/NF facility in Central

Iowa.

Our DON gave notice on Thursday (she will be greatly missed). The ADM

asked on Friday if I would consider the DON position. My children are

all grown and away from home, I love and know the residents, and I

like what I am no doing.

What should I all consider in looking at this position?

Staffing is always an issue...Medicare/QA/Restorative RN is strong

but does not like restorative or QA...Current Skin/Treatment/Staffing

LPN is also strong but does not like staffing.

What should I do??? Any info or ideas will be most helpful.

Thanks in Advance

SU

Specializes in nurse manager, community nursing, hospit.

the DON position is extremely stressful, you are blamed for EVERYTHING. the position takes away from your spouses and kids. You are always stressed as you work 24/7. the key to all of the above is a fair/considerate/understanding/team play of an Administrator! without that, you are shark meat waiting to be eaten.

Specializes in nurse manager, community nursing, hospit.

the average DON stay is 2 years in NY. Shortage of staff, underpay, and the neglect of your family and the need for psychiatric intervention at some point is the reason for the short length of stay in that position. Plus its seldom you find good people to work with. someone is always blaming you or trying to get you fired. DON is a horrible position. But surprisingly to me, its what i want to do (I love administrative work and a nice office) it usually takes me about 24hours and i forget the Bull chit and horrible people that i work with and I am back to enjoying what I do. (thanks to some Ativan). I think what i need most is a support group of other DON's:twocents::banghead::argue:

Specializes in Case Manager/Administrator.

I agree with Upstate NY DON in saying that team work is the key. As a LNHA and student nurse I stay out of my DON's way and ask what can I do to make your job easier? Sometimes it is bringing my DON my homemade chicken tamales.

I've been in good facilities and facilities that need improvement. Even the good facilities had challenges it just wasn't so bad when you work with great people.

I applaud anyone whose position is ADON or DON you are worth your weight in gold.

Specializes in ICU/ER/Exec..

WOW! You're scaring me folks. I'm thinking of accepting a DON offer because I'm pretty burned out in acute (many years in ICU/ER/management) and thought it would be FUN! Can anyone here tell me what they like about their job? I mean, staffing and personalities can always be a challenge but their must be decent administrators out there??

Specializes in ICU/ER/Exec..

I mean 'there.' LOL

Specializes in Pediatrics, Geriatrics, Call Center RN.

I have a great Administrator, but the job is not "fun". It is a very hard and stressful job. It may be better if you get a decent orientation. Good luck.

Specializes in Case Manager/Administrator.

As I read the replies I see so much bias against LTC it saddens me as we all are going to be there some day, some faster than others. We as nurses and me as a Licensed Administrator I can see and feel the frustration and joy of our industry.

If you are considering a DON position look for an Administrator who had a great relationship with the prior DON. If you can speak to the leaving DON do so and ask questions. Go out to lunch with the Administrator, get to know the person. You do not have to agree on everything. Again I run the facility my job is to see to it the DON has everything they need to do their job. If the Administrator bad mouths the prior DON I would say run fast, very fast and do not look back. I and some of my fellow Administrators have had nurses follow us to other facilities so yes there are good Administrators out there.

Also look for an Administrator who has been at a facility for at least 2 years or longer. This tells you the Administrator is functioning well or do not go into a facility unless the new Administrator has over 8 years of experience. Again both of these demonstrate stability of sound management skills and the ability to get along with people.

Hope this helps.

Specializes in Gerontology, Med surg, Home Health.

No offense but if you think you can go from acute car to being the DNS of a skilled facility without any long term experience you're delusional.

Oh sure parts of the job are fun...being held responsible for anything that goes wrong in the building, being on call 24/7, being everything to everyone.

The average length of stay for a DNS in Massachusetts is 17 months. Does that tell you something?

Specializes in ICU/ER/Exec..

Update: I just had a very long conversation with the administrator on the phone and they're going to fly me over for a visit. I fully expect this to be a challenge but isn't that what life is all about? No risk no gain. Right? (applause)

Specializes in Geriatrics, WCC.

I agree with CCM. If you have never been subject to LTC, then it is probably going to be tough going and an uphill road for you. It takes a long time to get to know the state and federal regs, it doesn't happen overnite. Just as i have ever known LTC and wouldn't begin to know or understand enough to run a nurisng unit in a hospital.

Years ago, I took a position as a unit manager and my co-worker was also new in her position as a unit manager. All of her experience was that of a hospital nurse (E.D.). Within one month, they asked her to become the DON, since she had years of experience. She did not know the first thing about LTC. and I ended up in her office daily teaching her. After a year of this, she moved on and i decided to go elsewhere and become a DON myself and have never looked back.

Being a DON is a rewarding job, but as mentioned before, it is very stressful at times even knowng the ropes.

Specializes in Geriatrics, ICU, OR, PACU.

Acute care straight to DON of a SNF? I'm sorry but I'll have to agree with CapeCodMermaid--and say that I think you're setting yourself up for failure. I came from acute care, spent a year as a staff nurse, 3 years as risk manager, and have been a DON for 3 years. I'm still learning every day, and I have an administrator that is second to none.

What are you going to do if state walks in on a complaint investigation on your second day? You won't have the first clue about the regs, and there are something like 543 of the Federal ones, not including the state regs.

I'm not trying to warn you off of working in a SNF, but start smaller, and work your way up. Give yourself an opportunity to learn to love it, like I do. If I had taken the DON job out of the gate (even WITH the most wonderful administrator in the world), I'd have lasted no time at all, and I sure wouldn't have loved it.

Best of luck, whichever way you go.

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