Bailing out of LTC

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Specializes in Hospice, ER, Telemetry.

Well I resigned my job as DON of a 112 bed LTC today. I have been an RN for 11 yrs; all of that experience has been in acute care. I started this job in February. I liked it at first but the first week I worked over 60 hours. Some days were good but most were bad with never enough staff, incompetent staff or staff that just didn't do their jobs. And then there were the families that were never happy or the doctors that hated being bothered by the nursing homes, so they were ugly acting. Always on call, long hours, short nights, son ignored for hours on end while I was at work, all the stupid questions........etc. There was the nurse that reconstituted a med with distilled water she boiled in the microwave. Of course that was reportable to the state. State investigated and tagged us because I hadn't reported her to the state nursing board (was told not to by my consulting RN who had a case of amnesia when confronted about it). Oh did I mention that I had been there 2 weeks when all this occurred?? The icing on the cake however is the new administrator. Fresh out of administrator school. He knows everything there is to know about everything, just ask him and he will tell you all about it. Had a reportable 2 weeks ago and rather than concern himself with the paperwork that he would need to deal with if he was on call, he chose to rearrange the furniture in his office. Gave the family a copy of the incident report even!! Today he admitted a resident with a diagnosis of psychosis on anti-psychotics and NO PASSR!! Then wanted me to clean up the mess and deal with his screw-up!! I finally said ENOUGH!! Told him that he would be the ruination of the nursing home and to shove his job up his orifice!! I know the staff and most family members liked me and respected me. I know there are quite a few of them that thought I did something right. Call-ins decreased drastically and the turnover rate is nearly nonexistent in nursing. Only one employee has quit this month and that is because the hospital dangled more money and a scholarship in her face. We only have 2 residents with wounds in the house and neither one of them developed inhouse. Infection rate isn't bad, falls were cut in half from May to June and no major weight losses. We had room for improvement as far as patient care was concerned but there is always room for improvement when you're dealing with humans. We were actually staffed pretty well about 80% of the time and the residents were pretty well cared for......they were happy at the very least. So what do you think, did I bail too soon?? I was not happy there and I couldn't see it ever getting any better. I feel sadness and regret but I also feel relief. I am wondering though if maybe I didn't give it enough time (6 months). Any thoughts or feelings would be greatly appreciated. Thanks for letting me vent at least!!

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Theresa

You did the right thing. You've got to act on your instincts. It probably wouldn't get any better. It would be another day/another situation/family/administrator. Don't look back. You will feel tons lighter without all that responsibility.

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It sounds to me like it was already getting better under your leadership. I have been a don in two different facilities. The first year in each, I was at work more than I was at home. I have been at the place I am now for four years. It is a thankless job most days. But, those days when a resident wants to hug me out of the blue and tell me how they love me, where else can I go to work and get that kind of "pay?" I still work a lot of extra hours...was there til midnite last nite. I just made a committment to myself when I started, because I had sworn when I left my first DON position that I would NEVEr take that on again, lol, that I would stay one year. That gave me a goal. I will say that without a supportive administrator, you will always be limited in what you can accomplish and the moral of your staff. Maybe you could speak with someone above your administrator? If you are having doubts about your decision, maybe you should stick it out just one more month. Long term care RESIDENTS need nurses like you.

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i wrote a memoir about the highlights of my 27 year career in ltc, i recall the day i saw an lvn break open a vial to give an im med then taped it over, etc. whenever i reported these things i never got any support and was made to feel like i was being critical. it sounds to me like you were a very dedicated effective don and what took you 5 months to figure out took me 27 years (like what was i thinking?). the trail is littered with people like you who have given their all and have walked away with nothing not even a good feeling for it in return. you mentioned you have a son. ltc don is not compatable with family life. your story is famaliar, one that we can all relate to. i am proud of you for telling the administrator off and sending him the message that you were above sticking around and putting up with anymore of his foolishness. in california a don can not be held liable for a ltc facility until she/he has been there at least for 30 days. i think you spent more time than you should have at that place and did not leave a moment too soon!!!!!!:imbar

well i resigned my job as don of a 112 bed ltc today. i have been an rn for 11 yrs; all of that experience has been in acute care. i started this job in february. i liked it at first but the first week i worked over 60 hours. some days were good but most were bad with never enough staff, incompetent staff or staff that just didn't do their jobs. and then there were the families that were never happy or the doctors that hated being bothered by the nursing homes, so they were ugly acting. always on call, long hours, short nights, son ignored for hours on end while i was at work, all the stupid questions........etc. there was the nurse that reconstituted a med with distilled water she boiled in the microwave. of course that was reportable to the state. state investigated and tagged us because i hadn't reported her to the state nursing board (was told not to by my consulting rn who had a case of amnesia when confronted about it). oh did i mention that i had been there 2 weeks when all this occurred?? the icing on the cake however is the new administrator. fresh out of administrator school. he knows everything there is to know about everything, just ask him and he will tell you all about it. had a reportable 2 weeks ago and rather than concern himself with the paperwork that he would need to deal with if he was on call, he chose to rearrange the furniture in his office. gave the family a copy of the incident report even!! today he admitted a resident with a diagnosis of psychosis on anti-psychotics and no passr!! then wanted me to clean up the mess and deal with his screw-up!! i finally said enough!! told him that he would be the ruination of the nursing home and to shove his job up his orifice!! i know the staff and most family members liked me and respected me. i know there are quite a few of them that thought i did something right. call-ins decreased drastically and the turnover rate is nearly nonexistent in nursing. only one employee has quit this month and that is because the hospital dangled more money and a scholarship in her face. we only have 2 residents with wounds in the house and neither one of them developed inhouse. infection rate isn't bad, falls were cut in half from may to june and no major weight losses. we had room for improvement as far as patient care was concerned but there is always room for improvement when you're dealing with humans. we were actually staffed pretty well about 80% of the time and the residents were pretty well cared for......they were happy at the very least. so what do you think, did i bail too soon?? i was not happy there and i couldn't see it ever getting any better. i feel sadness and regret but i also feel relief. i am wondering though if maybe i didn't give it enough time (6 months). any thoughts or feelings would be greatly appreciated. thanks for letting me vent at least!!
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there is typically a high turnover of dons in ltc because of all the bs you mentioned. furthermore the administrator sounded very out of touch with what the genuine needs of the facility were. it's thankless, perpetually stressful and filled with so many regs that you don't know if you're coming or going. i wouldn't touch that job for all the $ in the world. so to answer your question, no, you did not leave too soon. should you ever reconsider taking another don position in ltc, you may want to interview the administrator and adon. interviews work both ways. also you can get a sense of how well managed these facilities are by previous state surveys. wishing you well.

leslie

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You did the right thing. I had same experience as DON and stayed same length of time. I have been phoned by

the state about occurrence during time I was there. So,

be sure and keep your notes and be aware that you may

hear about that 6 months for a long time to come.

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I'm also located in Oklahoma. My guess is that you did not bail out any too soon. Trust me, all you had in your future was more of the same. I left LTC/DON about six years ago and I could have written the exact posting that you did.

Seven or eight months from now you will see your old job advertised in the newspaper again.....and every seven to twelve months thereafter etc. You'll see the pattern as one by one each of the major nursing chain's facilities need to fill their DON positions almost as if by a predetermined rotation.

I wonder what the true turnover rate is for CNAs, LPNs, RNs in Oklahoma LTC.....as if the industry provided numbers aren't bad enough.

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I've been in LTC since I became a LPN. I'm ready to bail too....there's GOT to be something more out there! Somethign that will deal with my school schedule and not kill me? If I could find a decently run nursing home with decent CNA's and decent nurses and staff NOT being overloaded to the point of not being able to finish everything, yet being yelled at to cut down on the overtime, I would stay....but, is there such a place? No. I don't think so.

Any ideas anyone?

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I have found being a DON to be compatible with family life! It depends on where you work and the administrator you have, as well as support services~ such as administrative assistant, etc! I do appreciate the position I have, and:) it is worth the headaches to feel that I can make a difference for my staff and residents. There really are nice LTC facilities to work for. It is still hard work, but some are better!

I do have to keep talking about cutting down on overtime, but when I read about staffing levels discussed here, I think my nurses should be able to get out on time. Twenty two residents per nurse on 7-3, and a treatment nurse, and a supervisor and a unit clerk and three awesome nursing assistants doesn't seem to shabby....one tube feeding, no IVs or anything high tech.

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Specializes in LTC, assisted living, med-surg, psych.

Sounds to me like you got out in time, before your health or family life ended up in ruins or your license was endangered. Good for you!

Donmomofnine: You are most fortunate to be working where you are......Lord knows there aren't very many DON or RCM jobs like it, or the turnover rate wouldn't be what it is.

There is an incredible amount of things fundamentally wrong with LTC. Until those things change at both state and federal government levels---as well as in upper management---I don't see much improvement in the LTC nurse's lot in life. Sorry to be such a downer, but my health and career were very nearly wrecked by working in such an environment, and yes, I think there are more bad corporations than good......it's all about making profits, but somehow those profits never quite trickle down to the residents, let alone the staff who are struggling with ratios that were established in the 1970s when most nursing-home residents were still ambulatory.

'Nuff said. :stone

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Specializes in Hospice, ER, Telemetry.
I have found being a DON to be compatible with family life!

I envy you!! I wanted to succeed at this job more than anything in the world. Honestly I feel like a failure because I couldn't handle the pressure.

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Good for you on getting out. You worked too hard for that license to have it jepordized from someone elses mistakes.

I am only an aide/medaide and walked out recently. i was told by teh aides to do something I felt unsafe and would not do it. I was then treated like crap from all my coworkers for having the guts to stand up for resident safety and that of myself. I dont think I will ever work in LTC again unless as an inspector trying to clean things up.

There are now "reportcards" available online in some states about citations, but that is not good enough. I just read where Senator GRassley is trying to get teh feds to crack down on state inspectors cause many citations are overlooked or minimalized so things dont look so bad. Until the truth is publicized about LTC things wont change.

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