Roles of DON/Nurse Manager

[whoamiRN]

If any of you DON's out there can help me out, I'd really appreciate it. I am currently the Nurse manager of a 30 bed dementia unit in a LTC facility in NY. We total 126 beds, there are 2 other Nurse Managers and a MDS coordinator, as well as a new DON. The problem we are having is that our new DON was put in place by the hospital that recently bought us out. She has NO LTC experience. In addition to doing all rounds for skin, MD, assessments (only RN for the unit on Day shift), all admissions, care plans, MDS's and care conference, dealing with staff issues and doing all their evals, we have been given some new duties which i am not sure I should be responsible for. Do your Nurse managers attend ALL meetings, including interdisciplinary every morning, Safety, QA/QI and Department Head meetings? I have also been told recently to develop the budget for my unit for next year, as well as do monthly Variance reports and staffing for my unit. We are also interviewing ALL incoming CNA's. To top it off, when the Evening shift is short, we are mandated to stay! I am trying to keep this in perspective, so any comments will be appreciated!

[Mrs. M.]

What you are describing sounds pretty much like what our managers do. Don't ever let someone else do your budget if you can avoid it - you are the one who is going to be held accountable for it, so you want to be the one to create and control it!

[kathi yudin]

i am don of a ltc facility in newport beach california.. i am originally from ny.. born and raised!!.. i have a 96 bed facility.. i do admissions.. sign off on the mds's.. do skin rounds weekly.. daily stand up meeting.. wgt meetings.. safety meetings.. psychotrophic meetings.. deal with the doctors.. and family problems.. dept head meetings.. qi meetings.. do the scheduling.. when we are short.. if i have to ( and i rarely have to do this).. i offer bonus's to my day staff to stay.. usually i just give them the schedule and they fill in the blanks!!.. they love overtime.. especially at holiday time.. i do not do a budget... lucky there.. i don't have an assistant don.. am on call 24/7 and work approx 60 hrs/wk!!!.. hope that this helps..

[LauraF, RN, ASN, CNA, LPN, RN]

I am a new DON for a LTC facility. I am expected to be at the QI meeting, dept Head Meeting, Medicare A meeting those are the weekly ones. I am also responsible to have a written presentation for QA with the doctor once a month. I have someone else do the schedule but I am responsible for maintaining, and am responsible for making assignments. I am responsible for dealing with family members, and staff problems. I sign off on the MDS's, I try to make time to go to Care Plan meetings, I have to do physical assessments on all new residents, I do the screening when necessary for potential residents. I keep track of the falls and handle the investigation of them and when necessary call them in. I do the paperwork that needs to be handled after it has been called in and mail it in.

I have yet to have an orientation but am learning by trial and error. I like to go to the Care Plan meetings so that I can address nursing issues and know where and what my residents are doing or not doing.

[bluefaire]

I worked in a LTC facility in NY for a few years. I was the assistant unit manager. I spent most of my days working the floor due to short staffing yet was still responsible for a huge amount of assessments. As her assistant I did the rounds for skin, MD, admission assessments, and helped with admission care plans.

The unit managers at this facility did the MDS's themselves, there was no coordinator. The unit manager did 95% of the care plans and I did the rest. I worked two weekdays (12 hour shifts) and every other weekend. On the weekend I was responsible for all units and all departments in the building, including call outs and scheduling.. as well as the med passes & treatments for 42 residents.

Yes, the unit manager attended ALL meetings, including interdisciplinary every morning, Safety, QA/QI and Department Head meetings. She nor I was responsible for variance reports or staff interviews. If nursing was severely understaffed then she would have to work the floor because the facility did not want to pay ANY overtime if they did not have to. However, since this nurse manager was salaried she was was being paid less than her assistant because I was eligible for overtime pay and she was not.

This facility had an ADON and a DON. The ADON did the majority of the interviews and scheduling. I worked there 4 years and to this day and still unclear as to what the DON did (who I saw and had lunch with daily).