Considering DON job in Another State - Advice?

ainz · Oct 10, 2003

Well if you enjoy jumping into the fire and like the heat, then go for it. I don't say that to be sarcastic, I like it, except for days like today.

The trend in hospitals is for the DON to be elevated to a true executive level reporting directly to the CEO. Administration has decided that the leader of the largest and most expensive department, and the department that has the greatest impact on the success of the hospital should, after all, have a voice and be heard!!

My advice would be to see if you would report directly to the CEO, if you would not, that says something about how much they value nursing and how much they will value your opinions about the nursing department.

Second, find out about where nursing is in terms of meeting staffing goals and being within budget. If it is bad then you will be walking into a mess and be expected to clean it up, but you may like challeges like that, I certainly do.

Third, negotiate a good relocation package that will get you and your family moved with minimal disruption and minimal, or no, expense to you. That will say alot as well about how much you will be valued as a member of the executive team. Make sure they understand that it will be difficult to dive in and be focused until your family and your stuff is all under one roof in your new area.

Next, go for the salary that you feel lke you need, don't take less. Remember, as you have probably already learned, there are few things in this world that are truly non-negotiable.

Oregon is beautiful country!! Good luck with it. And if you pass on this one, there are many, many openings for CNOs, and believe me, good ones are hard to find and hospitals are increasingly willing to pay for them, but, you HAVE to produce or you will be replaced.

rn 2b lnc · Oct 10, 2003

Originally posted by ainz
Well if you enjoy jumping into the fire and like the heat, then go for it. I don't say that to be sarcastic, I like it, except for days like today.

Thank you for the rapid response!

The positions I'm looking at are in Long term care. They answer to "many bosses," such as the administrator, regional nurse consultant, and regional director. Sometimes those people are at odds :rolleyes: .

Thanks for the advice on budget... I hadn't even thought of that, duh! I seem to recall some of my DONs fretting over that, borrowing from Peter to pay Paul. My personal favorite is rationing disposable briefs. I'll have a lot to learn in that area.

I don't even know the corporation name, so I can't do a search on them. I can guess which facilities and look at them on the watch-lists (maybe), but I may still walk into a mess. And my hair is still smoking from the last leap (see posts under Walked Out).

I just have to do a lot of soul-searching before I make a decision; I know I have a lot to offer and would be dedicated to the facility, but am I really ready?

As far as salary, what he's hinting at is far more than I've made even as interim DON; I know the places that I've worked at in the past are cheap cheap cheap so I don't really have any info on what's "usual." I do know what I need to make. The problem is, if I give a number, will they say Yes then laugh their butts off over getting me so cheap?

A lot to ponder....

Thanks again, ainz! Are you a night-owl, too?

ainz · Oct 10, 2003

If you are using a head-hunter, they will tell you the name of the company. Most of them will say that they can't tell you the name because it is confidential--malarky!!

Be sure the recruiter knows you will be interviewing the company as hard as they will be interviewing you, for, as the buzz word is, a "good fit." I would absolutely insist that they tell you the name of the company so you can do some preliminary research so as not to waste your time or theirs, they will come across with it because they don't get paid unless they produce someone that their client will hire. You really can tell alot from reading the tired mission statements, vision, etc. Many corporations post their corporate leadership's background. Read it and read between the lines to get a feel for how bottom-line oreinted they really are. Publicly traded companies are more bottom line oriented than those that have not made a public offering yet. They will be very focused on stock prices and perceptions of the "Street" (Wall Street analysts).

Some guidance on how to determine what salary to ask for. Look at bed size, net revenue, and operating margin. Bed size is obvious, it tells about the capacity they have for volume of business. Net revenue tells about payor mix and profit potential. The larger the net the more potential for profit, they higher the salary they can afford. A 100 bed, for-profit organization that is heavily dependent on Medicare and Medicaid (as will probably be the case in long term care) should have a net revenue of around $70 million annually. Any less and you will not be working with much. Operating margin can tell you how cheap they are, or how focused on cost control. The recruiter may want to tell you about EBITA or pre-tax profit, but insist on knowing the operating margin in terms of a percentage, not a dollar amount. The higher the maring percentage the more focused on cost control they will be. A margin of around 20 to 22% is reasonable. If their margin is 25% or higher ( especially with a high Meidcare/Medicaid mix as is common in long term care) I would RUN from because they will not give you the resources you need to run a nursing department.

Ask the recruiter for this information, they will give it. If they don't then the recruiter has not done their homework and is simply taking the "shotgun" approach in trying to send them candidates. You have a right to know what you are getting into. It will also impress the recruiter and the company searching for a DON that they have someone that knows what they are doing.

So if you have a high net revenue, with a large bed capacity and a decent margin, then you can expect a higher salary. Hear what salary range they are talking about, go for the interview (if they meet your criteria), size the place up, make sure it is a good fit for you and your skill set (don't set yourself up to fail) and if you like it and they like you, then bump their offer by about 10%, they will probably go for it. If your recruiter is good, they will know the limit and will get it for you.

Hope this is not information overload for you. I just finished a 6 month long job search myself and I use recruiters heavily. I am looking for a DON now ourselves in an LTAC in southern California. You can PM me if you want to talk more about this, so we don't bore everyone on the BB.

rn 2b lnc · Oct 10, 2003

Originally posted by ainz
Hope this is not information overload for you. I just finished a 6 month long job search myself and I use recruiters heavily. I am looking for a DON now ourselves in an LTAC in southern California. You can PM me if you want to talk more about this, so we don't bore everyone on the BB.

Thanks! You've been an incredible help. :saint:

jolmstead · Oct 17, 2003

Hope you have not given up on becoming a DON - one of the most satisfying (and frustrating) jobs there is. Prior postings very accurate. Also, check HPPD for staffing ratios. Again, if they can't tell you that, then walk away. If you don't know how to calculate, PM me. DONs must learn to stick together and support one another. We need to utilize each other as resources out there. No one DON has all the answers - it's impossible. Also, ask how frequently you will be "on call". Who else will assist you with call? Why did the last DON leave? How many DONs in last 5 years? Why isn't the ADON being promoted, etc. Lots of questions giving lots of information. Be happy to talk in PM if other questions. Take care.