DON after hours expectation

[suey421]

Hello,

I recently interviewed for a DON position and liked the facility and position but am concerned about after hour responsibilities. I have a family and an infant, I would not be able to be called in the middle of the night. I am also typically not available weekends due to family responsibilities. I'm not saying I would never be available but by and large I would not be able to come in during off hours. So, I was wondering if anyone who works for a LTC facility could give me some insight into how often a DON is called after hours? There is an ADON at this facility who said she gets calls at 1a from staff requesting vacation days and that would just not work for me. Any insight would be appreciated, TIA :)

[suey421]

You're right! I felt those 1a calls were unreasonable and I will make my expectations for being called very clear. I have a family and a life which I think needs to be respected. Of course I would be there if the staff was in dire straights but I don't see why I need to be called during the night for most things I could just be updated when I come in the following morning. I'm glad to know this expectation isn't unrealistic.

[Orca, ADN, ASN, RN]

I turned down a job as a nurse manager on a hospital gero-psych unit because of the expectations and the pay. I would have been expected to go into the community with the program director to help market the program, schedule and evaluate staff, and be subject to being called in 24/7 if anyone called off. The cherry on the sundae was that on this particular unit, the nursing staff worked for the hospital, but the nurse manager worked for a contract company who ran the unit. The salary that they were offering was about half what the other nurse managers in the house made. Even if it had been equal, I would have turned down the job.

[suey421]

I'm with you, if the expectation is I can be called in 24/7 I will turn it down. My quality of life comes first especially with a family. I'm willing to work hard but I need to work hard at home with my family as well not just at work. There needs to be a balance. I really appreciate all of the input! It helps me get an idea of what is reasonable to expect and what isn't.

[mander]

By law in my state, you are on call 24/7 technically. Our facility has a "when to notify administrator or DON" list. On top of that, she is available for anyone in the building. She comes in when people lose keys etc as she is the only one with spares. We try to rotate on call (I am an ADON). Our unit managers alternate on call and we are above and beyond that. That being said, she still gets a lot of phone calls. It's a 200+ bed facility. You can eliminate some calls by maybe making essentially an algorithm of what to do in certain situations, but for the most part you need great availability where we work. You need to set clear expectations when to be called and for what.

[suey421]

I will have to look up the state law where I live but assume it would be basically the same deal. That is good advice about the algorithm, thank you. I really don't mind phone calls for simple things but being called into work for lost keys would get old..especially in the middle of the night.

[CapeCodMermaid, RN]

I've been a DNS for the past 11 years. Each facility is a bit different but I have always been responsible for what goes on the in the building 24/7. I've had nurses who could handle almost anything on their own and others who called with every little thing. It's not for the faint of heart and most companies expect that you are available.

I've been in an oncall rotation with the expectation I will go push a cart if need be and in other buildings on call but no committment to have to go in an do a med pass. Each facility has its own expectations. I would never have done this job when my kids were little. Some days I get out on time but there are days where I work 12-14+ hours if there are lots of admissions or it's survey time, or like yesterday when there was a huge blizzard. I went in at 8am and came home TODAY at 2 pm after sleeping there. Good luck.

[suey421]

If that is the expectation there is no way with small children, I'll have to pass. Thank you for sharing your experience!

[sallyrnrrt, ADN, RN]

In Texas, a DNR resident in LTC, dies, an RN can and does pronounce death....especially if the resident is not on hospice.

If resident was on hospice nurse was called, and their RN came. In for pronouncement, family support etc, notification to appropriate law dpt., and funeral home designation....

If the deceased resident was not on hospice, and I did not have a RN in the building I went in and took care of requirements.....

I was not called for trivial things......

[sallyrnrrt, ADN, RN]

Cape cod is correct DONs are responsible 24/7