Director of Nursing- When is enough, enough.

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Hi everyone.

I'm director of nursing for a company (in Developmental disability division), and I love what I do, however I have no assistant, and I supervise 20 nurses, and over see the complete medical care and well being of over 300 individuals.

I'm on call 24/7, and it seems to me that I have an open job description that never ends. Every other day a new task gets added to my job description.

This is my first experience in this position so I have not to complain (and quiet honestly, I'm afraid to complain), but I can't help but feel that I am being taken advantage of. I don't quiet know what to do (Im definitely not quitting).

I just wish I had more understanding of what the limitations are, so I can focus on doing my job effectively.

I'

Specializes in M/S, LTC, Corrections, PDN & drug rehab.

There was a reason the person before you left. If you can last a year, bless you. But the Vice President will probably work you like a dog & my guess is you will burn out before your year is up. Good luck to you.

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Specializes in Developmental disability, Psychiatry.
There was a reason the person before you left.

Yes, the job was too much, but she hid it well, and she had me to help her with most of her job, because even as field nurse I was doing so much more than what was required of me.

I still keep in contact with her, and I asked her how she did it? Her response to me was that she thanks God for sending me to her, because she didn't know how she would of to last with out my help.

Her advice to me, was to hang in there and get as much experience as I could and then "do what I have to do". But in 7 month in this position the agency has grown by 100 new patients, and still growing.

I will definitely do my best not to be burn out....But I guess even posting here, is a reflection of the internal frustrations that I currently have.

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Specializes in CVICU.

The VP laughing at you when you requested more assistance is inexcusable. You say you 'need' this job right now. How badly do you need it? Can you not find a new job? Perhaps I am a bit of an egoist but if my supervisor laughed in my face when I presented a genuine concern, he would be bearing witness to my departure sooner than the realization of his mistake could set in.

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Currenltly, OP, how many field nurses do you have? Do you have the ability to hire a few more, and use some of them to specific "administration time"? Meaning that you helped the former DON with various tasks. Can 3-4 of your field nurses do the same for a couple hours a week each? And they are scheduled per week for administrative functions?

Additionally, can you have your field nurses share call amongst everyone, with you being available via phone if it is something that can not be dealt with by a nurse on the field?

Finally, do you have CNA's that can do some of the office tasks, other tasks that do not require nursing judgement? Can you have a lead CNA who helps with scheduling the other CNA's?

Or even an administrative assistant who is a CNA, so can pitch in if you need it? OR for that matter an LPN or RN that does mostly administrative tasks, and helps with the scheduling/supervising of the CNA's as well? And any and/or all of these positions can be PRN in nature.

There seems to be a push to "hybrid" positions in many organizations. I hope that you are being paid handsomely for your time and energy put in this position. But with an end date as far as you are setting it all up, now start creating other job descriptions for other staff to come into the picture, hybrid where and when you can, and on that one year mark, ask to bring in some of the other positions you have created.

I am sure the executive VP of the company is a business person. Bearing that in mind, the way to discuss anything with him/her is by that language. Patients are units, each unit must bring in "X" amounts of money. With all that being said, money is gained by maximizing care that is billable. And more people who hybrid is increasing profit, as you are having caregivers that bill/document, etc. "I know that this company is growing. And growing means more profit. In order to maximize profit, we really need to hire and retain personnel. I am invested in the success of the organization, but am mindful of the clinical component as well. And clinically, we need more nurses who can take on administrative tasks as well. If I create a timelined plan with specific goals, can we discuss this in next month's meeting?"

Best wishes!

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Specializes in hospice.

I agree with sjalv. Plus, your stated attitude that you are going to stick this out no matter how hard they make it, that you will succeed no matter the cost? That's the one that lands people in hospitals wondering where all these digestive and cardiac problems suddenly came from.

There are more important things than proving yourself at work against impossible odds and sticking it to the jerk boss.

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Start looking elsewhere. Your health isn't worth working for a company like this.

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Guarantee they need you more than you need them. If you leave, they will have to explain to new applicants about the turnover in this position. Tell the guy who laughed at you, in writing, that the job description is as far as you are prepared to go and you will accept no further responsibilities unless you get some help, specifically (What? Dedicated secretarial support, someone to delegate a particular responsibility to, etc... Your call). Cc his boss on it, and that will turn some heads in your direction.

Also suggest you get in touch c the AONE and some peers in the area so you have comparables and a source of support from more knowledgable people in your specialty.

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Specializes in Registered Nurse.

It sounds like a job I would hate. Actually, I am currently in a low level nursing position which is part-time, and my job description says they can add duties as they want....and they do. If it gets too much....I'll be

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Specializes in Developmental disability, Psychiatry.
You say you 'need' this job right now. How badly do you need it? Can you not find a new job?

The problem is I am new to being a DON. I need at least 2 years experience in that role to build a strong resume. I worked very hard to get the position, that is why I can not just give it up.

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Specializes in Developmental disability, Psychiatry.

Additionally, can you have your field nurses share call amongst everyone, with you being available via phone if it is something that can not be dealt with by a nurse on the field?

Your absolutely right. Thats exactly what i'm doing right now, but its also time consuming having to train and build morale of these nurses. Most don't care or wish to do more, because they feel unappreciated.

I have made a lot of progress since I started in my role as DON, but the "clean up" its taking quite sometime and energy.

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Specializes in Developmental disability, Psychiatry.
Guarantee they need you more than you need them. If you leave, they will have to explain to new applicants about the turnover in this position.

Your right, If I should walk out today, they wouldn't know what to do with themselves. There would be no one to even train someone for my position.

The problem I have with reporting my supervisor is that the company is a "tight knit" group. I'm the outsider, they all have been in the company for 30+ years, everyone knows each other, goes to each other house for BBQ etc. it would come off as "Who's this lady think she is complaining to us". I quiet literally have no one to speak to.

There are Coordinators of Residential services, and they appear to be silently suffering too. Everyone is afraid to speak up about the overwhelming workload.

Just to make it additionally clear....I'm not afraid of hard work at all, but this is beyond ridiculous. ( I literally have my work laptop next to me right now, so I can respond to emails).

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Your right, If I should walk out today, they wouldn't know what to do with themselves. There would be no one to even train someone for my position.

The problem I have with reporting my supervisor is that the company is a "tight knit" group. I'm the outsider, they all have been in the company for 30+ years, everyone knows each other, goes to each other house for BBQ etc. it would come off as "Who's this lady think she is complaining to us". I quiet literally have no one to speak to.

There are Coordinators of Residential services, and they appear to be silently suffering too. Everyone is afraid to speak up about the overwhelming workload.

Just to make it additionally clear....I'm not afraid of hard work at all, but this is beyond ridiculous. ( I literally have my work laptop next to me right now, so I can respond to emails).

Why are you being so passive?

Pretend you are your own patient. Advocate for yourself.

Nothing will change until you force it, either by refusing to be the idiot that does everything for everyone, or until you leave and they realize they will have to hire three people to do the job.

I know that sounds harsh, but it sounds like you are in DEEP denial and need a verbal slap to wake you up.

YOU ARE ALLOWING YOURSELF TO BE TAKEN ADVANTAGE OF.

My God, just look at all of the excuses you have posted already that would prevent you from changing.

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