DON on cart

Specialties LTC Directors

Published

I've the ADON at my facility for just a week and the DON just walked out because she refused to work the cart! Is this unheard of? DON ON CART? Should I except the position?

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Would you be the director and a floor nurse? If that's the case, no way ...one job or the other would be plenty to do. Combined, I don't see how they'd be manageable.

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They are just short staffed and would want me to occasionally work cart if i take DON

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They are just short staffed and would want me to occasionally work cart if i take DON

It would have to be very occasionally ...be very cautious. Why can't they retain enough staff to work the floor(s)?

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Specializes in LTC, Hospice, Case Management.

I work in a small rural facility. We've had a few staffing challenges over the past couple years with times that nursing admin had to take a shift. As DON, I usually mark myself last to get pulled into the coverage schedule but it's not been unusual that I've had to push a med cart. Maybe 2-3 times in a 6 month period.

Truth be told, I don't mind that amount. I make a big deal about how slow I am because I'm not use to it just to give everyone an opportunity to laugh with me but I have to admit - I kinda like it in that amount. Forces me to look at the carts, gives an opportunity to review orders for completeness, gets me out working side by side with aides I don't normally work with (and they tend to have a lot of respect for me for doing it), etc. I'm fortunate that one day on the cart doesn't put me too far behind and I've got a boss that willingly gives me an extra day off during the week if I push the cart on the weekend.

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Just make sure this is a VERY once and awhile thing. Getting asked to do both roles isn't easy when it becomes a frequent thing. In my current role I also work outside of my leadership role to help fill a need when we are short staffed. I don't mind it either, but I make sure my boss knows I'm not superwoman. If I work the floor, my leadership activities won't be getting done that day.

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Specializes in Case Manager/Administrator.

I occasionally work the floor (maybe 3-4 times annually) as the DON just to keep abreast of anything new, and to keep me current with my skills when I was doing this type of work. I once went into a troubled facility as the LNHA they had no ideal I was a nurse too. Usually the 3-4 times I do work the floor are when the nurses really could not find anyone for their floating holiday I allowed for nurses day. Most times the nurses find coverage.

I find it interesting that a DON will quit over working the floor. To me it is important to know what is going on in the facility and what better way.

As a LNHA I have asked a DON to work the floor 3 times that I can recall and they were all weather related. None had any issues with it.

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Specializes in Gerontology, Med surg, Home Health.

I was a DON for 12 years. I never had to work the cart because I always convinced someone else to do it! I helped with every admission often staying till 8 or 9 pm to get them done. I went in on weekends if they were getting a lot of admissions. So the staff would help me out when I needed it. At the facility I'm at now, everyone is expected to help in a crunch. I haven't done a med pass in 15 years but we had 3 open slots tonight so I stepped up and did it...and got an admission to boot! The newest trend is for the DON to take a cart when absolutely necessary.

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Specializes in Geriatrics, Dialysis.

I can't say how other facilities manage but for for us the process to fill a nursing hole is to first try filling it the normal way..phone calls, begging, whatever works. If there are no takers which is usually the case the hole is filled by mandating a nurse to stay from the previous shift. Sometimes there is just nobody that can be mandated either because those nurses are already working a double or one or more of them has a medical restriction limiting their hours. When that happens and there is literally nobody on regular nursing staff that can fill a need then management is pulled to work the cart. When that happens a chain of command is followed. First to get pulled would be one of the unit managers, they are paid hourly and will at least get the overtime pay if they can't just take a different day off. Last resort is the ADON and then the DON, partly because their regular workload makes it difficult for them to take a different day off but mostly because they are salaried positions and any hours they spend pulled to work a cart are pretty much extra hours and they are working for free.

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Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

Please excuse my ignorance as I've only worked critical care and ER. What does "work the cart" mean?

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Specializes in school nurse.
I can't say how other facilities manage but for for us the process to fill a nursing hole is to first try filling it the normal way..phone calls, begging, whatever works. If there are no takers which is usually the case the hole is filled by mandating a nurse to stay from the previous shift. Sometimes there is just nobody that can be mandated either because those nurses are already working a double or one or more of them has a medical restriction limiting their hours. When that happens and there is literally nobody on regular nursing staff that can fill a need then management is pulled to work the cart. When that happens a chain of command is followed. First to get pulled would be one of the unit managers, they are paid hourly and will at least get the overtime pay if they can't just take a different day off. Last resort is the ADON and then the DON, partly because their regular workload makes it difficult for them to take a different day off but mostly because they are salaried positions and any hours they spend pulled to work a cart are pretty much extra hours and they are working for free.

It's sad that "filling it the normal way" includes mandating, and that "calling the agency" is not mentioned...

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Specializes in M/S, Pulmonary, Travel, Homecare, Psych..

When I managed a unit, I never took cart (specifically). I did other things to allow the floor staff to have a more manageable task load though. Admits, QC rounds (the fridge temps and such, the ones that never get done), crash cart checks, discharges..........

I picked tasks to do that in the end helped me more. A med pass is either done right, or not. On the other hand, with admits and discharges..........you can do a lot of things to help yourself (as a DON) out later on. I had to audit every admit and discharge so, doing them myself meant less audits later on.

Work smart, not hard. I'd never stick with a facility that had to "pull" management to do floor nurse duties on a regular basis. They get on a roll with it and before you know it.......it becomes the expectation. Considering that I was salary and already doing fifty hours/week......I was not going to get out even later due to having to be a floor nurse too. They'll always be *in a staffing crisis* if they know Superman (woman) is coming in and will let them get away with it. Best not to get trapped into a situation like this.

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