Inexperienced DON

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Specializes in Emergency.

I accepted a DON position three months ago with hope of making a difference in long term care. The facilitiy was already in bad shape when I took the position. At the time when I made the acceptance, I anticipated getting oriented to the position. Unfortunately, I have not been thoroughly oriented leading to various problems. The facility is in the survey window and I feel it might be put into immediate jeopardy, as there is not much time. I am so stressed mentally, physically and emotionally that I want to put in my resignation. Should I jump ship and protect my license?

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Specializes in Gerontology, Med surg, Home Health.

Your license isn't in jeopardy. Every DNS has has a bad survey and we all survived it. Get used to it. I've been a DNS for a long time NEVER got any specific training or orientation. That's why it's so important to have a DNS who has experience in long term care. You take what you've learned being a CNA and then a staff nurse and then a supervisor so by the time you are the one in charge, you'll have a clue about what you're doing?

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Your license isn't in jeopardy. Every DNS has has a bad survey and we all survived it. Get used to it. I've been a DNS for a long time NEVER got any specific training or orientation. That's why it's so important to have a DNS who has experience in long term care. You take what you've learned being a CNA and then a staff nurse and then a supervisor so by the time you are the one in charge, you'll have a clue about what you're doing?

Yeah, in total agreement. USE your watermelon survey book if DON in LTC (and have a good relationship with your regional nurse) and look at the Assisted living regulations if AL. I also was just in this position, pulled off a fairly good QIS survey in LTC, scared as hell the entire 3 weeks, I have learned SO much!!! I survived AND so did my team. Post any quesitons here, will be glad to help once you are in survey. The rumor that we hear over and over that "survey cites" go on your RN license,...not exactly true, it has to do with WHEN you interview for the next DON job, you are expected to reveal your "proven track record"...in order to be able to get the next DON job. (assuming you WANT the next DON job, lol).

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Specializes in Emergency.

I inadverently did not mention that I do not have LTC experience. This is proably a big factor with the issues I am currently facing.

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I inadverently did not mention that I do not have LTC experience. This is proably a big factor with the issues I am currently facing.

Do you at least have a strong, experienced RN in the Staff Development, or ADNS role? Or as an RCM?

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Specializes in Gerontology, Med surg, Home Health.
I inadverently did not mention that I do not have LTC experience. This is proably a big factor with the issues I am currently facing.

YIKES! Why would you take the job without any LTC experience? A nurse is not a nurse and managing one kind of place doesn't mean that you can or are suited to be the DNS of a SNF.

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YIKES! Why would you take the job without any LTC experience? A nurse is not a nurse and managing one kind of place doesn't mean that you can or are suited to be the DNS of a SNF.

Thanks Cape Cod for saying what I was thinking. No idea how anyone could even FATHOM how to be DNS of a SNF, having never worked SNF before. I would truly consider giving notice before I drowned. I HAVE extensive LTC experience, and the DNS in SNF role, for me, with all of my experience, nearly drowns me daily. QIS is very difficult, staff are difficult and there isn't any easy answer except keep plugging away daily at the stack of concerns, paperwork etc that come on my desk.

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Specializes in LTC, Hospice, Case Management.

My question is why do you think you will be put into immediate jeopardy. If you recognize you have that serious of an issue you need to prioritize and get THAT issue fixed. Use whatever QA tool you have available to you, write it up as a finding and the steps you are implementing to correct the issue and the steps you are taking to prevent the issue from happening again. When surveyors are in the facility and if they discover this issue you will already have measures in place to share with them on you plan to correct and prevent it.

I'm with the others tho. Can't imagine this job with no prior LTC experience. Best of luck. If you decide to tough it out come back and post your questions. We'll try to help you as best as we can.

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