Offered DON position, questions about duties/pay

Specialties LTC Directors


:nurse: I have been offered the DON position and seek advice about moving from MDS Coordinator to DON. We are a small facility in a small town, so options are limited. What duties should I expect to have, and does anyone have advice or tips? I have many ideas for improving patient care, charting, etc., but want to make sure I know what to expect before jumping in. Thanks!
Specializes in MDS/Office.

Have you ever been an ADON?

Going from MDS to DON.....

I would think twice before doing something like that.

Just remember, as the DON, you are responsible for everyone under you.

It's a Big Responsibility for you and your License..... :twocents:

I have been doing the work of the ADON for the past six months or so. Our DON was in poor health, so our nurse manager took over, and I ended up picking up a lot of the miscellaneous duties. I am Safety, QA/QI, patient advocate, Rehab nurse supervisor, instructing aides on charting, checking off new aides on skills checklists, ensuring destruction of meds, addressing care needs of residents, Nutritional Risk committee, Bowel and Bladder, Behavior task force, etc. I wondered if this all falls under MDS or if I am essentially doing the DON stuff as it is now. Pretty much we have had no other qualified applicants and our care is faltering without leadership. I have an MBA and was a captain in the army with management experience in my former life, so I feel that I am qualified in the management arena. It is the 20 years of nursing experience that I am short on...I have just 3 years in LTC.

Specializes in Geriatrics, WCC.

Nursemom.... sounds like you have been doing quite a bit of it already. Add to the list.... medical supplies, bills, etc. When I was in a smaller facility (65 beds) i also cleaned out the garage, tore down a ceiling, cooked, shampooed carpets..... what ever needed doing. Jack of all trades.

Thanks. I seem to pick up everything and would like to have the official title and a little more pay to go with it. They offered $1 more an hour. I said, "No thanks." They countered with $1.50. I am sticking firm with $3.50, which is still below the average wage for an RN in our region of Montana--which is already significantly lower than everywhere else. My hubby is reminding me how much this change will affect our lives and children. BTW, thanks for being willing to send me info. Dori

Specializes in Gerontology, Med surg, Home Health.

It's not an easy job to be the DNS. You are responsible for an entire building. I, too, have done it all. It's hard to say Take the $1.50 since we don't know what you're starting at. I am salaried and on an average week work at least 45-50 hours. Can you play Let's Make A Deal? Take it on a temporary basis with the stipulation if you don't like it, you can return to your old job? It really is a 24/7 kind of job. I can't imagine doing this when my kids were little.

I currently make $21.50. I tried to negotiate even for $24 with a 50 cent increase after 6 months, but was told no. (Average wage for RNs in our region of the state is $25.46--the lowest in the state.) Our facility is floundering and the list of major errors and violations I gave to the CEO with recommendations for improvements has not been addressed. I also asked for the freedom to make drastically needed changes, and was told I would need to run all changes through the management team (CEO, COO, CFO) before implementation. I declined the offer today, after reaching the conclusion that my ability to make changes would be restricted, and the increase in responsibility would be putting my license and family life at risk. Sad about not being able to influence better care for our residents, but happy with my decision. I chose to stay in my current job.

Specializes in Gerontology, Med surg, Home Health.

It sounds like you made a wise decision. Some of my staff LPNs make more than that. It's not all about the money, but when you are held responsible for everything on one hand but not given the freedom to make changes on the other hand it seems like an impossible situation. Hold out for the right job for you at the right time. Good luck with everything.

Thanks for your words of wisdom. I know I would be frustrated, but I still have the desire to fix what will surely be major deficiencies on our next survey. I have to remind myself to focus on doing my current MDS job to the best of my abilities.

Specializes in Geriatrics, WCC.

I agree with CCM.....

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