Thinking of taking a DON offer - page 2
I am currently the MDS/POC RN in a 65 bed SNF/NF facility in Central Iowa. Our DON gave notice on Thursday (she will be greatly missed). The ADM asked on Friday if I would consider the DON... Read More
Oct 28, '07Joined: Oct '07; Posts: 1Quote from Nancy1I agree with you on this one. I am only in my 20's and I have been in a long term care facility now for 7 years. I started out at the bottom as a CNA, then LPN, now RN and the DON. I always said that I would never take this position better yet no administrative job, but the DON before me moved up to the adm. job and talked me into trying the DON job for a while and I LOVE IT!!! I can't see me doing anything else at all. Yes I was afraid about the deal with them firing the DON over a bad survey, but we had our first survey since I took over a year ago and we got deficiency free. The thing about it is great team work, if you have that it will be just fine. I love itat our place because the adm is a RN as well and we get along so good. I want lie it does have it's bad days but you just have to think about the residents and you are there to make sure that they get the best care possible. I think you should consider taking it if you have a great staff working with you!!!!After reading all of these negative remarks, I am almost afraid to be positive.
I personally feel the reason many crash and burn may because there is no support within the organization. Many times nurses take a DON position without having any training. A good nurse manager moves up in an organization without having a strong knowledge base for the job.
I would recommend asking for a copy of the job standards, if your organization has them. Look at the job description. Is there a LTC DON group in your community? Do you feel that you have strong personal and professional backers?
I am currently an ADON, and I am very much looking forward to moving up to DON within my current organization as we build another facility. I have been getting strong support and leadership opportunities from my current DON because she know I want her job, and I feel that she is helping me reach that goal. We make a good team.
If you have a good solid team you can be successful.
I truly believe that you will get more ngative replies simply because it is our nature to report bad experiences than it is to report positive ones.
Good luck with your decision, I know the decision you make with the information you have will be the correct one for you, Nancy
Oct 31, '07Joined: Oct '07; Posts: 593; Likes: 1,070Wow, these replies make you think. As a LNHA and studet nurse with a year to go I can say a good NHA and DON can provide great services to the LTC community. I have never fired a DON for bad surveys as it is a team effort. A team effort for all staff. We fix the issues and improve. It is hard work and you must have boundaries.
I have heard bad outcome stories about both DON and Administrators who for one reason or another cannot meet the standards and have been fired, LTC is a business and we must meet our budget.
Both Administrators and DON's are "managers" your client contact will be reduced but you will still have some depending upon the size of your facility. All I can say is you will never know until you try.
When I graduate I plan on going back to LTC as an Administrator/BSN Regional Director. I like geriatrics.
Jan 26, '08Joined: Jan '08; Posts: 2Dear SU,
In the right situation being a DON can be a great experience. I do believe though as great as it is to promote from within, it is not always the best for the Canidate and the facility. It is difficult to change from a staff person to a leader in the same building, but it can work in the right circumstance. I know of a lot of horror stories about DON experiences but I also know a lot of great experiences. I was DON in many buildings and most of them were good experiences. I now have my own LTC consulting company and place interim DON's and nursing support persons on a National Level, this would not have happened without my DON experience. I would be glad to chat with you further if you would like, Good Luck.
Jan 29, '08Occupation: RN Clinician-United Biosource Specialty: 30 year(s) of experience in Pediatrics, Geriatrics ; From: US ; Joined: Feb '03; Posts: 1,237; Likes: 16I just accepted a DON position at my LTC. The place is falling apart at the seams. Morale is poor, call in's are rampant, resident care is marginal. I think I will be very busy. But I am looking forward to try and improve things for my residents.
Jan 30, '08Occupation: RN Clinician-United Biosource Specialty: 30 year(s) of experience in Pediatrics, Geriatrics ; From: US ; Joined: Feb '03; Posts: 1,237; Likes: 16I start on Thursday. I'm nervous and excited all at the same time.
Feb 14, '08Occupation: Writer/Author Specialty: 20 year(s) of experience in Director of Nursing Long Term/Subacute ; Joined: Feb '08; Posts: 16; Likes: 12I would take the job. Just remember that the job length expectancy of a DON in LTC is about 5 years.
But, you will learn so much!!! And I have heard of DONs staying in their jobs for a very long time. It will be the experience of a life time. There will be problems but where can you go that there aren't any?
Personally, I would take it.
Feb 17, '08Joined: Nov '02; Posts: 6,056; Likes: 9,194The man who owns the company I work for stated a national statistic that the average length of stay for a DNS in the same building is 17 months. Says a lot, doesn't it?
Feb 22, '08Occupation: DON-LTC; WCC Specialty: Geriatrics, WCC ; From: US ; Joined: Sep '05; Posts: 685; Likes: 406I was at my last DON position for 4 years, until the single owner sold it to a large company. They wanted their own people in there. I have now been at my current facility for 2 years.
It all comes down to how well the communication is between everyone in the whole building. AND.... being able to laugh during high stress periods.
Mar 20, '08Occupation: Professional Nurse Specialty: a variety ; Joined: Mar '07; Posts: 65; Likes: 16Quote from Tim-GNPHi Tim,As a licensed NHA, I give unto thee, the best advice I can give: "Run... don't walk, from you administrator's offer... DON's are cannon fodder!"
One bad Department Of Health [DOH] survey and the Director of Nursing usually gets fired... it's the NHA's answer to the DOH deficiencies. Especially if you like your job, and don't want to leave your facility. Offer to be the interim DON, and offer to orient the new DON, but run from being the full-time DON. I have seen too many wonderful nurses who occupied the DON slot fired to save the NHA's a-- with the board of directors. Granted, a few of them deserved it, but the majority were fired due to circumstances beyond their control. Here is a good example of the "devil and the deep blue sea":
The DON must staff facility at the minimal Dept. of health staffing numbers. The only way s/he could do it is with overtime. The NHA sees that the $$$ in overtime is going to ruin his chance for annual bonus. He puts his foot down, NO MORE OVERTIME. Staff complain to the DOH's "1-800" 24 hour hotline, DOH gives a deficiency for 'inadequate staffing' NHA answers deficiency as "we fired that DON who couldn't handle staffing..." Can you tell I have seen crap like this before????
Be careful, and weight your decision carefully.
Exactly what is the the role of the administrator over the DON in a long term care facility. How much say so does the administrator has over the nursing department? Lastly, are administrator's saleries higher than the DON? What is the salary amount of administrators who work in skilled nursing facilities?
Mar 20, '08Joined: Nov '02; Posts: 6,056; Likes: 9,194As a DNS I can tell you that the administrator in my building does not run the nursing department. I do. We discuss the issues of the facility every day both clinical and financial. She has the final say on finances, I have the final say on clinical matters.
We have only worked together for 6 months but have huge respect for each other. She is very supportive and is trying to convince me to become an administrator for "when being the DNS becomes too much." Most administrators I know, and I've worked with close to 15 of them, all say the DNS has the harder job.
Mar 20, '08Occupation: DON-LTC; WCC Specialty: Geriatrics, WCC ; From: US ; Joined: Sep '05; Posts: 685; Likes: 406I agree with CCM. I run the nursing department and usually go over financial matters with the NHA. I have in the past, worked with an NHA that was an RN and the previous DON ..... she micromanaged the nursing dept terribly and I almost left but, she is the one that left.
Mar 20, '08Joined: Oct '07; Posts: 593; Likes: 1,070The role of an Administrator vs DON
As an Licensed Nursing Home Administrator my license goes on the facility wall. I sign the survey, and am responsible for the facility operations. Now the DON is responsible for the nursing department and I DO NOT interfere with those operations I do however ask for reports to ensure policies and procedures are being upheld (mostly finances). I have the upmost respect for nurses as I am a student nurse as well. I too think DON's job is tough but can be rewarding if you have support and a good facility.
An Administrator also works closely with Dietary, Housekeeping, Billing, Activities,Social Services and other department areas as we are trained in all areas of the facility operations. My job is to make sure all employees have what they need to do their job correctly to the best of their ability, and to ensure that the facility is safe and all provide competent quality care. Think of the Administrator as the conductor. It takes at the very least a Bachelor Degree in Business preferred Health Care Administration to become an Administrator. You take a national exam and alot of those questions deal with nursing issues. Some states also require a state exam. It is not easy and more common than not most LNHA have a Masters Degree in Business or Health Care Administration.
Long Term Care is the second most regulated industry in America....
the first regulated industry is nuclear energy.
Salaries depend upon experience and size of facility you can go out to web sites and get info but I average for a 120 bed facility 100,000 annually working average 12 hour days no overtime.Last edit by Neats on Mar 20, '08 : Reason: Add text