Stressed DON Please help

[Carrie162]

Six months ago I took a position as a DON at a 40 bed LTC/rehab unit within a CCRC. My previous experience is in LTC as a unit manager and MDS nurse. This is my first DON position, and I wonder if I made a mistake. Lots of teamwork issues, Nurses out to get each other, some clinical competency issues. CNA's are pretty good but I feel like I neglect them dealing with all the other nonsense. I'm also the SDC, and I haven't put together a good plan; I really neglect the education part. There's been no supervisor on weekends but i'm about to hire. It's pretty busy on the unit, but staffing is good; there's just some serious accountability issues. I miss the quiet of the MDS. There's a position available in another building that I'm considering; I gave my notice this week and Admin. agreed to add an SDC 20 hrs to help out; they think it's coming together and want me to stick it out. Any advice? I'm tempted to stay and I'm tempted to go.

[donmomofnine]

WOW! You really have your plate full. One thing I did that helped enormously was to have another nurse in charge of all the nursing assistants! I dropped having an ADON/SDC and made a position of primary care coordinator. Now I am responsible for all the training/competency/fueds and bickerings of the licensed staff and she takes care of all those things for the NA's. This has been terrific for both of us and for the staff. Perhaps that would be something to do with your 20 hour person?

It takes a lot of time to sort out messes, such as staff competencies, bickerings etc. I have been a DON here for only a year now and still am working on those issues, through coaching and counseling, the disciplinary process and yes, I even terminated someone last week as a last resort. But, I can really sit back and look at the overall picture and say that things are so much better with my staff since this time last year. It takes time to make things better and patient persistence will pay off, I believe. Sorry to ramble, but I wish you all the best!:)

[Carrie162]

Thanks so much for your response DONMom. I have been thinking long and hard, and I love the place where I work, I love the CNA's, the administrator, the ADON, but I just don't think I'm a DON type of person. I think the headaches and the churnings in my stomach say a lot. I don't know if I have the constitution to take the 24 hour accountability. I've seen a lot in my career, but it hasn't all been on my shoulders before. I know I've made a lot of headway; I've had to use the disciplinary process a LOT, and I don't like that side of my personality. It's a great building; pay scales are low, but we have the best staffing ratio in the area, and the patients aren't that acute. I've just got a big decision to make before I throw in the towel. I enjoy your posts!!!