DONDenise

Who's head ?? Definately the DON'S....I have been a DON for 4 yrs. (Prior med-surg for 7 yrs.) and I am barely in my office because I am right along side my nurses... But, the minute something happens and the state is innvolved, they go right to the DON, (In fact, if a facility receives to many "Poor" marks by the state, the DON can personally lose or have their license suspended) AND, that's even if the DON had nothing to do with the issue and was not even there at the time etc....And, just as an FYI...I have a boss to who doesn't understand why all of the paperwork crud isn't always up to date, and why I'm always "Tired", and why I'd like to take some time off.....I handle all of the admits (from the decision to take to writing and clarifying the orders, to faxing the pharm.), all of the Discharges (including the DC talk with the pt. or family, and ordering any DME), all of the MD notifications after consultants have audited (Pharm.,Social Services, Medical Records, Dietary etc..), inservicing, staffing, scheduling, care conferences,problem patients AND families, pre admit tours, skin rounds (as well as completing the skin sheets), checking of all MDS' for accuracy....In addition, I carry a pager 24/7 (and its used!!!) and my cell phone last month alone had 4,200 work minutes !!! I'm sorry that you guys have crappy DON's but we are not ALL bad !!

Hi !! Well, I'm a Director of Nursing at a 100 bed facility and we frequently get patient's from acute that have orders stating that they "Do Not" have Mental Capacity....But, at any point, if my staff feel that this is inaccurate, they tell me, and i will meet with the patient. Even if they are occasionally a bit "forgetful", I have my social worker do the mini mental (with me present). I then fax the MD the actual test and tell him what I observed and that i feel that the patient is able to understand etc...Never have i heard that someone needs a CT....and in our area, the ombudsmen is a help...might want to request that the mini mental be done with the ombudsmen present...good luck !!

Funny thing is......The ones that I have met, have NEVER even worked in the SNF setting..... And SNF's are just like people.......There is good and I'm sure there is bad...but, it seems like surveyors (ours anyway) are very prejudiced that all are bad. They will look and look and look, because they have to find something......

Hi !! As a DON, I would like to thank you for the validation that this stuff occurs...some might think that it's all in "our heads" but I didn't think so. I am presently innvolved in a case with the state. Last year we went to court on a case and the team leader for the state did not fair to well, due to numerous inconsistencies in her testimony etc...She then quit the Dept. of Health shortly after. During the trial, her husband became our NEW "Team Leader" and it has been a nightmare ever since...Each surveyor appears to have a different idea about how we should do things, document things, etc...But, where some surveyors are open minded about what's documented etc...our NEW Team Leader is immediately going for the jugular. Can you offer any advice on how to handle this ?? Also, is there any time frames regarding their investigation of a complaint or issuance of a citation ? If an intent to site is issued, how long do they have to actually issue it ? Thanxs for any info. that you may have to offer.....

:angryfire