Getting Burnt Out

Specialties LTC Directors

Published

I am a DON, at least that is what my name pin tells me. I run a nursing department of approximately 70 employees and have 7 managers under me. My NHA is an RN who used to be in my position. I have been with my current company for just under 2 years but, am still the newbie since my management team has been there between 10-20+ years.

I have never liked firing people but, have become quite adept at doing it, 5 people in the last month alone, and because i have my documentation in place never lose an unemployment case.

I have been doing the majority of my own staffing as my last coordinator just couldn't get it, and now have a new person my NHA hired that only works 3 1/2 hours a day and won't shut up long enough to listen.

I have a medicare nurse that was continually behind with her RAPS (up to 6 months, 80+ of them). I rode her butt and wrote her up and gave her a deadline. She now handed in her resignation and will be gone in two weeks. I put an ad out but, everyone wants an RN that can do MDS's. My boss told me yesterday that I will have to do her job until I find someone.

The receptionist was complaining to me yesterday that the noc shift was parking in the emergency lane in front of the building. I told her to post a note at the timeclock, otherwise it is a $200 fine and they will just have their vehicles towed as I have told the noc shift already in the past. The receptionist called the NHA and told her the problem, now i am also the parking patrol.... don't even know who drives what.

I am on-call every night during the week and also every 7th weekend. I am now taking St. John's Wort and am about at my rope's end. Lots more issues, but it would take a book instead of this forum. AM looking for a consulting job within the two state area I live.

Specializes in Med-Surg, Geriatric, Behavioral Health.

I also hear the pain...on both sides.

This thread is an excellent place to express our opinions on the subject....as long as it is on the subject...and not on each other. When a member crosses that line, he/she is out of line. Just a friendly reminder.

Moving on with the topic...the issue...a more civil debate.

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I also hear the pain...on both sides.

This thread is an excellent place to express our opinions on the subject....as long as it is on the subject...and not on each other. When a member crosses that line, he/she is out of line. Just a friendly reminder.

Moving on with the topic...the issue...a more civil debate.

Thunderwolf, I am a nurse who has been through alot in the world of LTC, because of these experiences I feel VERY strongly about some statements that are made regarding my fellow staff nurses. I am trying very hard to change some things in the way I can . Maybe I was too hard on the DON in question and if I have hurt anyone personally ,it is only due to my PASSION on the subject of Nursing Home Reform. I like to think of myself as one who cares deeply for my fellow human beings and if I hurt the DON in question, I guess I should feel more sorry than I actually am:innerconf. I guess I have to remind myself that DON's are human too.;) I will try to not direct comments in a way that could be construed as getting personally insulting, thanks .
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Thunderwolf, I am a nurse who has been through alot in the world of LTC, because of these experiences I feel VERY strongly about some statements that are made regarding my fellow staff nurses. I am trying very hard to change some things in the way I can . Maybe I was too hard on the DON in question and if I have hurt anyone personally ,it is only due to my PASSION on the subject of Nursing Home Reform. I like to think of myself as one who cares deeply for my fellow human beings and if I hurt the DON in question, I guess I should feel more sorry than I actually am. I guess I have to remind myself that DON's are human too. I will try to not direct comments in a way that could be construed as getting personally insulting, thanks .

Nursing Home Reform - AHHHH! Now, that's an area of discussion! Just like every other nursing area, you will find staff who are PASSIONATE about what they do and staff who will MAYBE show up and do little or nothing. And then there's the level of administration/management/owners who understand ONLY a black-and-white number at the end of a column of numbers printed on a sheet of paper. And when push comes right down to shove and a choice must be made between resident advocacy and the bottom line - guess who wins that one! Oh, and how about the mid-management level who decides not to make waves with the bean counters upstairs for fear that the "messenger will be killed" and will go to any lengths not to make waves with the employees who are under their supervision for fear that the culture of the care setting will go from bad to worse. And, in the meantime, with all this going on, where is the resident care and advocacy occurring? I strongly agree that nursing home reform needs to start in each individual setting, whether it be an LTCF as a whole, or even a unit in a facility. And, from my experience, if the people who show the PASSION for caring for these vulnerable adults would only be left alone to do their jobs, grass roots reform would quickly take over! IMHO

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Thunderwolf, I am a nurse who has been through alot in the world of LTC, because of these experiences I feel VERY strongly about some statements that are made regarding my fellow staff nurses. I am trying very hard to change some things in the way I can . Maybe I was too hard on the DON in question and if I have hurt anyone personally ,it is only due to my PASSION on the subject of Nursing Home Reform. I like to think of myself as one who cares deeply for my fellow human beings and if I hurt the DON in question, I guess I should feel more sorry than I actually am. I guess I have to remind myself that DON's are human too. I will try to not direct comments in a way that could be construed as getting personally insulting, thanks .

Nursing Home Reform - AHHHH! Now, that's an area of discussion! Just like every other nursing area, you will find staff who are PASSIONATE about what they do and staff who will MAYBE show up and do little or nothing. And then there's the level of administration/management/owners who understand ONLY a black-and-white number at the end of a column of numbers printed on a sheet of paper. And when push comes right down to shove and a choice must be made between resident advocacy and the bottom line - guess who wins that one! Oh, and how about the mid-management level who decides not to make waves with the bean counters upstairs for fear that the "messenger will be killed" and will go to any lengths not to make waves with the employees who are under their supervision for fear that the culture of the care setting will go from bad to worse. And, in the meantime, with all this going on, where is the resident care and advocacy occurring? I strongly agree that nursing home reform needs to start in each individual setting, whether it be an LTCF as a whole, or even a unit in a facility. And, from my experience, if the people who show the PASSION for caring for these vulnerable adults would only be left alone to do their jobs, grass roots reform would quickly take over! IMHO

SO TRUE. I bet you have been "around the block" too in the world of LTC. There are many corporations that have made thier fortunes on the backs of hard working folks, but to make their fortune misusing both the caregiver and the ones who need care is reprehensible. I have seen these nursing home owners and thier bulldog lawyers up close and personal, most nurses have NO idea of how underhanded and dirty these nursing home corporations truly are and at what risk they are in when working in LTC. A DIRTY UGLY business.
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Specializes in Geriatrics, WCC.

I worked for a small town facility where every resident had family that had lived in the town for generations. Everyone knew everyone else. It was like one big happy family. We would have cookouts and dinners where residents, families and the staff with their families were invited. Lo and behold, a large corporation bought us out. It took them 3 months before they changed out our NHA that had been at the facility for 20 years. This was a woman that would sit on the floor to talk to the residents and fix a broken wheelchair at the same time. She would also dress up in full makeup and costume at Halloween for their party in the afternoon. They waited 6 months until I had trained in the new NHA to all the inside happenings of the facility and then replaced me with "one of their own".

I now work for a non-profit church affiliated facility. It is quite large, including having elderly apartments, meals on wheels program, it's own hospice and homecare and an adult day care service. I'm not saying they are flawless, as no one is in this world. But, I do work along side the nurses and CNA's whe nI see they need an extra hand or just because I am on their floor. All department mangers work along with their staff. my NHA is an RN and has passed pills and toileted people when she is asked to do so.

The reason I am getting tired of the job is because I do pitch in and don't leave myself the time to do my own paperwork. Staff leaving? I can't count how many times, someone has come to me and said they are cutting their hours due to school, and then when they get their next degree they come and say they are leaving. I had one LPN tell me that I should know that all LPN's want to go on to school to become RN's and then they don't want to work in LTC. What???? After all these years, I had not heard that one. If the LPN's ALL want to go on to school and the RN's don't want LTC, who does that leave to take care of our deserving elderly? I do not have any qualms with firing staff that consistently mess up with their job, but this is after retraining hasn't worked. I also will let them go if they can't seem to abide by the attendance policies. I do NOT just fire on a whim. We have many staff that have been there 10 and over 20 years.

I know both sides of the fence. I started out as a CNA in the 70's and still know how to do that type of work and do. I did not hire a nurse i was interviewing several months ago as she came right out and stated that she does not do hands on care because "she was not trained for that". Not a candidate for our facility. I have also been union myself in th past. Some facilities have them and some don't, I guess I have been lucky where the facilities that did not have them, there was not a reason to.

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Nursing Home Reform - AHHHH! Now, that's an area of discussion! Just like every other nursing area, you will find staff who are PASSIONATE about what they do and staff who will MAYBE show up and do little or nothing. And then there's the level of administration/management/owners who understand ONLY a black-and-white number at the end of a column of numbers printed on a sheet of paper. And when push comes right down to shove and a choice must be made between resident advocacy and the bottom line - guess who wins that one! Oh, and how about the mid-management level who decides not to make waves with the bean counters upstairs for fear that the "messenger will be killed" and will go to any lengths not to make waves with the employees who are under their supervision for fear that the culture of the care setting will go from bad to worse. And, in the meantime, with all this going on, where is the resident care and advocacy occurring? I strongly agree that nursing home reform needs to start in each individual setting, whether it be an LTCF as a whole, or even a unit in a facility. And, from my experience, if the people who show the PASSION for caring for these vulnerable adults would only be left alone to do their jobs, grass roots reform would quickly take over! IMHO

You know, the minute I went to my first nursing home (first clinical setting) I knew I wanted to be a geriatric nurse. What can I say - I like old people :wink2:. The things they've seen and the history they've lived through is amazing.

But this is corporate America. I think there is a feeling of hopelessness and even fear in nursing homes. I like to believe my DON and her management staff care about our residents and that they go to bat for us during 'budget' time, but even if they really do the fact is that the bottom line is all that matters to the people who actually give out the money.

That environment just breeds dissent. Everybody needs someone to blame. Management blames staff and staff blames management. I think that change must come from the actually staff. If nurses formed an organization to lobby for change, to fight large corporations who want to make money off poor old people who just want to live the rest of their live with a little dignity then maybe something would change. But - I think many people are scared that standing up for what's right would get them fired or 'black listed' from the industry.

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Specializes in Geriatrics, WCC.

I'm a little surprised that this thread was still around. So, I thought I would add an update.

The NHA I had at that time handed in her resignation in Dec and left in Jan. Wow, what a difference. In hindsight, we have all noticed how much she micromanaged the facility and none of us could do anything about it at the time. The current NHA allows me to handle everything as he is not a nurse.

My nurse postions are now full except for a .3 on nocs. I am adding more CNA staff to the TCU floor due to acquity levels, am in the process of looking for a HUC for that floor also. I have purchased more equipment, as now I don't have to ask permission. Everyone seems to have gone through the transition quite nicely.

We are now in the process of scrutinizing the med records person as the old NHA had put him in that position without formal training. He makes errors with everything he does and was protected by her. He is now on a timeline with specific goals to improve his work or else and that is one that i don't have to handle as the current NHA is taking care of it himself.

So, I let pass by an opprotunity to quit and go to another facility for another $20K per year, since i really do like the people i work with and that means a lot to me.

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Specializes in med-surg 5 years geriatrics 12 years.

My hats off to anyone who takes a DON job and can stay with it. I wore that hat for a very long 7 months....worked with an administrator from Hades. Will NEVER do it again. The experience has come in handy; when my CNAs complain I can explain it from another point of view. Bless all of you who perservere.

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Specializes in geriatrics.

Congrats on sticking it out! I work in an ALF and I basically do the same thing, I never ask my staff to do anything I myself won't do. I have a wonderful boss and he is very supportive of the decisions I make. I think healthcare is a very hard field to be a manager in. You are dealing with staff and with the residents, family, doctors ect. Before I was a nurse, I worked as a group leader in a factory and I thought THAT was difficult! I really love what I do and your passion for what you do comes across well. Keep up the good work

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