Call schedule

The DNS can work the floor. The DNS CANNOT be the charge nurse full time as well as the DNS. If you have to cover two or three times then it is what it is... It means that you cannot do it on a regular basis, ie- no charge nurse and you have to fill the slot full time......

Hello. I have a LTC DON pal who has these on call rotation and heavy weekly work hour issues, too. Are there any guidelines at your facility regarding maximum work hours per week for a DON? In the case of my DON pal, there does not seem to be any protection policy to limit weekly work hours including on call duty. It is my understanding that in some critical service jobs such as fire fighters and nurses there are exemptions from some of the USA federal labor laws. I have learned that in the U.K. there is a labor directive of a "maximum average work week including overtime of no more than 48 hours per week in a 17 week period". Best wishes to you.

I am a DON am new at my current facility. Since this building has opened about 4 years ago the DON has been on call to cover the floor in the case of nurse call offs since the building opened. I am the 3 DON in 4 years! Reckon that is why. I myself am getting kinda fried. I have been looking at solutions to change this, everyone has an important job to do or the position they hold would not be there. I need advice from those of you who have experience as a DON. I have meet major resistance when trying to implement change. I am slowing building a team, which is detrimental to my success. I am researching implementing the dot system which will mandate staff to stay over in the event a replacement cannot be found. Right now if a nurse calls off the DOn is expected to work the shift... I say its can't be this way anymre. This is the reason the last DON was unsuccessful she burnt out, was not able to get her work done because she was always on the floor. I am not going to be like her. Please tell me how you cover the foor... I am on call 24/7 which is okay for clinical issues, BUT I am on oncall 24/7 to cover the floor!!! I need help from the pros! The mds nurses are so busy and overwhelmed I don't want to rely on them but I can't carry this large campus without their assist. Perhaps having a mandatory stay over policy in place will resolve this. Thanks.

I looked in the regs and couldn't find where it said that the DON couldn't work the floor. I have a large campus.

I agree to what Marteyellen said, sounds good. Get the nurses, CNA, CMA to find their own replacement. This way they wont be in such a hurry to call in for stupid dtuff. I've already told my ADON to slow down on trying to try find coverage for all our shifts. She is so worried about this. I think I'll give this a try. Most of the time when I'm on call for staffing, they have already found someone to cover for them when they call me. They know I dont like call ins and tell them that I am watching their attendence. We have a policy that says, if you call if for 3 days in a one month period, you can get written up or terminated. Depending on what the siutation is.

I looked in the regs and couldn't find where it said that the DON couldn't work the floor. I have a large campus.

Perhaps the regulations vary by state. You need to get some more help or surely you will burn out. Team building is great and all, but you're still the boss and should be able to tell your staff what you expect of them. There is no reason your MDS nurses can't take a turn on call.

Everywhere I've ever been, the MDS person is the most respected. No wonder why. They drive the funds

for the facility. This ADM doesnt want the MDS working the floor. I can understand that. But when there are only 3 of us, someone has to pitch in.

Perhaps the regulations vary by state. You need to get some more help or surely you will burn out. Team building is great and all, but you're still the boss and should be able to tell your staff what you expect of them. There is no reason your MDS nurses can't take a turn on call.

I have been the MDS coordinator at my company for 12 years. I have spent many years being in the on call rotation and helping cover the floor for call offs during the week. My current facility is mostly rehab with an average MCR/MGC census of between 40 and 50. I love my facility, my job and the company I work for but with all honesty if they told me I had to be in the on call rotation or pulled me to the floor during the week I would turn in my resignation. Since 3.0 the stress level of MDS positions has increased 100% and for the most part they are unable to be effective in their position at all if any extra "tasks" are added. I know in my building I am working way more hours per week than my DON, ADON and unit managers.....

I have been the MDS coordinator at my company for 12 years. I have spent many years being in the on call rotation and helping cover the floor for call offs during the week. My current facility is mostly rehab with an average MCR/MGC census of between 40 and 50. I love my facility, my job and the company I work for but with all honesty if they told me I had to be in the on call rotation or pulled me to the floor during the week I would turn in my resignation. Since 3.0 the stress level of MDS positions has increased 100% and for the most part they are unable to be effective in their position at all if any extra "tasks" are added. I know in my building I am working way more hours per week than my DON, ADON and unit managers.....

Totally agree with you, IcePrincess....

I get the calls on weekends and for problems on the unit, but Im asking about taking call during the week, like 1 week at a time for staffing call ins. They want me

to take call every 3rd week from monday til the next monday

Since you are on call 24/7, you should not be on a weekend rotating schedule. You are a backup if needed. JMHO

More and more companies and administrators are realizing that the MDS nurses cannot be in an on-call rotation. I look for it to be a law eventually. No one has any idea of what we carry. I am one of 2 in a 200 bed bldg., and am told company policy prohibits the MDS people from being on call, from the time I was hired. One DON tried to put me in the rotation, and she was fired. No joke. That may not have been the only reason, but it was the one they leaned on when they "asked for her resignation."

There are good and lazy MDS nurses. I have one now that is only working 24 to 32 of her schedule 40 hrs per week(of her own admittance) and questions why I am asking her to cut her hours. We are a small facility with only 7 on medicare caseload. The ICP team complete their own sections and input them into the computer. They do their own care plans and even assist in the CAAs. She has it made, so while I understand what you all are saying. It drives me crazy that she is sitting in offices chatting and doing nothing while I am working 50+ hours a week. Sorry just venting.