ADON misleading title? Rant from DON

Specialties LTC Directors


Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

Iam currently the DON at a facilty with census of 62, I have only been there a little over 2 months. Never having been a DON before. We have a Tx nurse, PCC who does careplans, and a ADON.

I was recently told that I could not delegate duties because of the "extra positions we have in management". Because before there were only the DON and ADON who did it all. Now I shouldn't need to delegate, "eveyone has their own duties".

The only ones salaried are the ADON, myself and the PCC. I was told that the ADON title was a misleading title and that it did not mean assitant director of nurses. Just what does it mean then, if not just that. I did a lot of research online before taking this position through TASHA website, and learned that if you do everything yourself, you are dead in the water without delegation. The ADON does all the MDS, the PCC does the careplans, the TX nurse, well;; does just that. Where does that leave me.

Doing all the 24 hr report checks, investigation of all the incident reports, taking calls and calling hospitals and pt families on all new referrals. Doing all the interviews ,new hires orientation, making the schedules for the month, approving and staffing fill ins for PTO. Daily nurse/cna schedules. Keeping up with license and certification dates of all CNAS, CMAS, and nurses. SOC meetings and minutes, QA meetings and minutes. I have to take these home to complete them, I work 10- 12 hrs per day.Attending all stand up meetings. Do rounds on 4 halls by myself, check wounds twice a week and make sure Tx nurse is keeping up with documentation. Pass out trays at dinner time. Attend careplan meetings when family request. Address all complaints with family and/or staff, filling out and investigating all complaints. Keep logs on all narcotics discontinued or expired until they can be distroyed. Check timesheets daily for missed punches. (feels like an HR job to me). Answering call lights and expected to fill in when there are slots that cannot be filled and the ADON or PCC is too busy.I also take call for one week a month I thought that the DON per regs could not work the floor with census over 60. Humm.. . I was told this was also a false fact. I am overwhelmed. I feel like I have not seen my 14 y old son in 2 months.

BTW, Iam a single mom recently, my husband left. but no one knows this. I did not want to bring my problems to work. Any time I try to delegate to the ADON or PCC, they tell me they are too busy and one actually starts to cry. She tells me ,"I am so overwhemed." With what? She gets an hour lunch break, while I get no lunch break at all, rarely ever leave the facility and have lost 22 lbs in 2 months.

She took her personal problems to the Administrator and cried to him telling him that I dont do anything and that she has to do all my work. I have a job description of what each of us are supposed to do. Am I being taken? Just how stupid do they think I am? I guess as stupid as me putting up with it because I truly love the facility and my residents.

The administrator sided with them I guess because I'm new and they have been there longer? He told me to grow a thicker skin and dont let it get to me because " Im sitting in a great position"> Not from where I see it.

Specializes in OB, Peds, Med Surg and Geriatric Nsg.

Sounds like your facility need to hire more people to fill in these positions. Do you have union? Tasks like scheduling, certfications of staff, etc should be delegated to a staffing coordinator. MDS paperwork should be done by an MDS nurse who specializes in this area. In my facility, all discontinued and expired narcotics are disposed stat with 2 nurses. As a DON, you are rarely on the floor so there is no sense for you to be monitoring this when your staff can do so. It's all about delegation. Nursing management would be more chaotic if delegation is not included. Good Luck!

Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

No union here in Tx. But if the ADON and PCC would pick up extra responsibilities and I was allowed to delegate, there would be no problem. This is totally crazy. I am just trying to ride out the storm, because I cant afford to lose my job, but Im losing my sanity in the meanwhile. I feel like the ADON has more say so than I do, just because she has been there longer. Has anyone ever heard of this nonsense? What do they want, just my lisence on the wall. If so, I will just kick back and do nothing, as Im being accused of doing.

First of all your adon is an adon or a mds nurse.

Stop right now. You work 40 hours a week, more if needed ie; state is in house etc...otherwise you are being paid 2 dollars per hour. Do what you can in those 40 or even 45 hours...I would put the treatment nurse on an assignment if staffing was challenged and the nurses would do their own treatments. Do you have a central supply clerk? If she is a stna make her assist with the scheduling. Before I am pulled to the floor all of the staff under me in other positions will be pulled first. Your job is everything to do with delgegation, you cannot possibly do everything yourself. The mds/adon is probably overwhelmed with mds 3.0 there needs to be clarity on her position and title. The administrator can take over following up on family and resident concerns/complaints, this is not just for the DON and the adon can assist. YOU ARE BEING TAKEN ADVANTAGE OF. I would immediately cut my hours back and start spending more time at home period. Your adon/mds nurse sounds like a crybaby to me. Your PCC needs to assume of the duties as well she could probably help more with QA and patient rounds, then your rounding could be focused more on the staff. IF you can't get some of these folks to take the slack get out!

Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

Thank you, I knew I was right, but am getting backed against a wall. I try to do it the nice way, and then I try to be firm and assertive,but it backfires on me. I can find no happy medium. The administrator wants me to "hug on the ADON and "ride her coat tails", his exact phrase. Could I be taking all of this wrong and reading into it.

Specializes in Gerontology, Med surg, Home Health.

Apparently some people here are laboring under the misunderstanding that unions can fix everything. What needs to be fixed in your situation is the administrator. Ride on someone else's coat tails?? Ridiculous. I am thankful to have a wonderful ADNS. We work as a team...there is a huge pile of work to do and while we each have our own 'things', we never hesitate to pitch in and help each other out.

Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

wow , the other night I actually had to work the 10p to 6a shift as a charge nurse. (only nurse in faciility for 61 residents with 3 aides. They tried to write me up for missing a med dose at 0600. In my defense, I was never oriented to working nights and was told by the nursing coming in at 0600, that she would give all these meds. I love the residents, but this is making me insane, every day that goes by, someone finds fault with something I do to complain. Dont they understand Im learning, and when I ask questions, they look at me as if Im stupid and should already know. They ask, just what do you not understand? I believe the problem lies with my faultering relationship with my ADON. Tomorrow I am going to sit her down and get to the root of the problem. Im tired of this being swept under the rug,when she says "I just dont feel good" I know she is angry with me, but I dont know why. I dont know what I have done to offend her. As for the other PCC who crys all the time, has been out for 8 days now, and no one can tell me when she is coming back of if she even is. I try to call her , email her, but get no response.

Oh, and to top it all off, today I was told that the vents in my office allow the ADON (yes she is in her own office) to hear every thing I say; just like an intercom situation. So to be careful of what I say. I just cant believe this!

Has anyone heard of such crap. Are they hazing me, or trying to get me to quit? Why not just put in a hidden camera?

Specializes in LTC, Hospice, Case Management.

Who is the "they" that were trying to write you up? The only one that should even have the authority to do that is the administrator.

When our team starts feeling a little disjointed and someone starts feeling like they are carrying a bigger load than the rest, my DON starts writing all the duties that need completed by the nsg management tearm. She writes our names next to the obvious duties we have and then the "open" duties gets picked liked Xmas presents until all duties are assigned out. Highest seniority gets pick first. We all get stuck with extra duties...we all claim we don't have time for them...but in the end it does seem to be pretty fair. Hard to complain that I got stuck with more than the other guy when I am responsible for my own pick.

As DON are you not the one in charge of nursing? How about taking a look at the job descriptions and sitting down with the ADON and PCC.

That write up is nonsense. Are they trying to retaliate? Have you written others up for the same thing?

Specializes in LTC, ER, ICU,.

american train, if i may be blunt, it sounds as though "they" don't want you there or at best "they" don't want you as the don.

you may need your clinical nurse above you to get things resolved if this is a coporate building. i would, as suggested, speak with the admin, adon in private and air these differences.

please have all your facts in writing so you may be effective with dates, times, etc. as well as all job descriptions in hand.

i really do wish you well.

Specializes in ICU, ER, MS, REHAB, HOSP ICE, LTC DON.

Iam planning on holdig a meeting with ADM and ADON next Monday to "air things out". I cant take it any longer.

I feel like they need to be honest with me if they dont want me or if Im not working out. Say the word, and I'm gone. Never look back. There are many jobs out there for me. I just feel like maybe this is a hazing period, a way of trying to weed out the weak. I keep going back though. Today, I felt I made a small step towards gaining some respect. At least from the other dept heads. I have my resignation letter all made up, and I carry it in my car at all times. Just need to change the date. I'd rather it not come to this, but if it has to be done, oh well. Next week will be a lightening experience Im sure when everyone has to tell their own side of the story. I dont have anything against anyone until they start puting me down and telling lies behind my back.

Specializes in Long term care-geriatrics.

The assistant DON title in the facilities I have worked in never does the MDS unless the MDS nurse is out sick or on vacation and the MDS nurse also does the care plans that allows for continunity. The PCC nurse (Patient Care Coordinatoor) should be taking up the slack. I also agree if your facility is with a corporation, you need to talk with the corporate nurse. You need to talk with the administrator with the ADON and the PCC. You need to have everyones job description and you may even need to do a time study for the things you do. It sounds time consuming, but in the end it will proof a point. If your administrator does not support you, you may need to be looking for another job. My question is why didn't the present ADON take the DON job, was it even offered to her? Good Luck. You have 61 patients, I did it all, but I had good staff that supported me and helped me when I needed help.

+ Add a Comment