DON with no authority

[stella789]

I recently took over as DON where I was previously ADON and then Quality nurse for over 2 years. The executive director changed the organizational structure of our facility (prior to me taking over as DON) so now there are 2 Operations managers who are essentially the administrators-one over LTC and one over rehab. DON is supposed to be “equal” but this really is not the case. The operations managers are meant to deal with the “people” and the DON the regulatory. All of the nurse managers report to the OM, not the DON. MDS, staffing coordinator, nurse educator, and off shift supervisors report to DON. Last week I was told I’m “too involved” and they will pull me in as needed. I should also mention that of the 3 of them, none of them clinical.

I literally know nothing that’s going on except what’s discussed in our morning meeting. Today state showed up on a complaint and I know absolutely nothing about any of it and was not included on anything. Instead of the nurse manager down on the unit where the complaint was, she was upstairs working on printing paperwork the state rep requested and doing other things.

Im really just looking for some opinions on this situation regardless of whether you agree with the structure or not. I know there are so many knowledgeable and experienced nurses here and I’m interested to hear opinions from someone who has held the DON seat before but also just someone else clinical.

[Hoosier_RN, MSN]

This sounds very peculiar. Like a great way to get tossed under the bus peculiar

[Golden_RN, MSN]

Agree with Hoosier above. Very strange. I find that non-clinical people "don't know what they don't know." Non-clinical staff shouldn't be supervising the unit managers in regards to clinical issues. That seems inappropriate.

Are you supposed to work with unit managers on a Plan of Correction after the state visits? Or is that "too involved"? The lack of communication to you makes me uncomfortable.

I'm not a DON but I've worked in a variety of RN positions in LTC. In all of my jobs, the unit managers reported to the DON.

[lukesbaby]

One Director of Nurses is responsible for the 24 hour oversight of the entire nursing staff I.e. RN, LVN/LPN, CNA, in a facility. So it depends on who the DON of record for the facility is in regards to what tasks can be assigned.