DONS working the floor in LTC?

Specialties Geriatric

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I haven't been a nurse for that long and my facility has just hired a new DON. She stated in our meeting the other day that she will not and does not cover the floor. She stated that i already have a full time position and doesn't have time to cover the floor. She says that all of you guys need to work together to get the hours covered. We have a lot of call offs and our turn over rate is really high.

So my question is is it standard that most DONS don't cover the floor?

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No it is not the standard. DON's rarely have to cover the floor but sometimes they do have to do it for various reasons. I even worked in a nursing home where a DON had to come in and she had to work the floor as a nursing assistant because we were so short of help. Sounds like you need a new DON.

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Specializes in Hem/Onc, LTC, AL, Homecare, Mgmt, Psych.

One time on night shift I had to look for replacements for 2 nurses that were "ill" and called in for days. I was not able to locate any other floor nurses or office nurses at 4am (imagine that), so I was mandated... leaving one opening yet. I called the DON with my predicament and she came in at 6am to work the floor until the clinical mgrs were able to get in then they had to take over for her. I think it's in the DON job description that they may occasionally be required to perform patient care duties. DON has to be available, what else would I have done? I guess the administrator makes the finaly decision based on how desperate the need .... if they are willing to hire her with those stipulations... well whatever.

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:lol2::lol2:Yes and no.

I've been in the DON position (temp) and have also been screwed as the nurse that gets mandated etc. First and formost, the DON is a nurse. They should be able to walk the walk so that they can talk the talk. I've had many a DON that was so far removed from the clinical aspect of nursing that they really couldn't work the floor. Sad, huh?

On the other hand...they also have a job to do and let me tell you..it ain't 9-5 and if they don't finish what needs to be done...it will still need to be done. Yes...the DON should be aware that they have 24 hr call and sometimes that might mean...bite the bullet and help out on the floor.

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Specializes in Home Health, Psyc, OR.

The DON at my facility has not worked the floor in the year and a half that I have been there. There have been times where we were so short staffed that 3 or 4 people get mandated, shift after shift after shift. The DON walks around and makes sure that the people know that they are mandated but she has never offered to cover. I wish sometime that she would just to show us that she is willing to pick up extra shifts and do what is needed because we are expected to pick up when we have time. I understand your frustration.

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I think every RN manager should be required to work on the floor one shift a month. Then they could find out if what they ask the regular nurses to do on a daily basis is actually reasonable or not.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

At all of the nursing homes where I've ever been employed, the DON has been required to be in the on-call rotation every few weeks. However, the DON has always been able to wiggle out of her responsibility whenever she is needed to work.

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Specializes in Gerontology, Med surg, Home Health.

Perhaps you all should have to be the DON for a day to see how much work it really is to run a building. The scheduling, the budget, dealing with 135 patients and their families, dealing with the DPH, the DEA, the staff and all the rest...yeah..you do what the DONs do for a while and then see if you'd have time to work the floor.

I've done it while running a building. Honestly if you haven't given meds in a long time it is safer for one of the floor nurses to do the med pass. I certainly do not hesitate to help out on the floor when I need to but when no one offers to help me finish MY work and they all leave on time....well you get the picture.

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Specializes in ER, PACU, Med-Surg, Hospice, LTC.

When I worked in LTC, the DON never assisted with anything related to direct patient care. She would usually be doing one of three things:: walking the halls (criticizing employees), sitting in her office (yakking and laughing on the phone) or be out of the facility getting coffee, errr, I mean, running errands for the facility ;).

I still remember the day that we were severely understaffed. It was right around the holidays. We really, really, really could have had some basic help from her. Just redirecting someone or getting someone a snack, anything....but no. She was too busy putting up Christmas clings on the windows and sliding glass doors. She was at it for hours.

We were working non-stop, frustrated and angry. I remember a CNA quit shortly after that stint.

After that day, I lost all respect for that particular DON.

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As a former DON I can tell you I had to fill in alot, at all hours of the day and night. However, there is no benefit to being a DON if you are on call 24 hours a day, and expected to come in without even trying to cover it. The more I picked up on the floor, the less they tried. If you are doing this, ther is now way you are going to last long term. Hense, one of the reason for such a high turn over. As just a PRN nurse now, I have NO respect for a DON who won't at least help out on the floor. If they are going to tell me what to do and how to do it correctly, they better be able to do it themselves. Otherwise, I won't even consider listening. You have to practice what you preach.

Laura RN :nurse:

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Specializes in LTC, Med-Surg.

In the LTC facility that I work at, if we have call-ins and no replacement can be found and the DON has to cover anything, she usually covers charge nurse so that nurse can go cover one of the wings. This is rare, but I've seen her do it before. Fortunately, we have RNs who work primarily as resident care coordinators (they do admissions/discharges/care planning, etc) and if someone calls in, they get pulled to the floor first. However, we have had situations where nurses have been mandated and then the DON covers charge nurse duties because there is no one else to do it.

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Specializes in Geriatrics, ICU, OR, PACU.

I'm with CapeCodMermaid. If you haven't been a DON, it's highly doubtful you have ANY idea what we do in a day. I know that when I was a charge nurse, pushing a cart (in the same building I am now DON of), I thought the DON didn't do a darn thing, except write people up for excessive overtime (I got written up, LOL).

I got promoted to admin (risk manager), and boy, where my eyes opened. I couldn't believe all the stuff *I* had to do in a day, and realized that I had vastly underestimated what ANYBODY in admin did on a daily basis.

Back to the topic, I do take staffing call along with my nursing admin team. Fortunately, I have a large staff of pool nurses, and last pushed a cart on New Years Day. I did that so one of my nurses could have the day off to be with her out-of-town family. I also have a full time staffing coordinator, and between us, we keep a tight rein on both the PPD and overtime.

I swear, one of these days, I'm going to start having the charge nurses shadow me for a day. Maybe then they'll realize that the DON job isn't the "easiest job in the building."

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