Thinking of taking a DON offer

[suzqpart]

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 position. My children are

all grown and away from home, I love and know the residents, and I

like what I am no doing.

What should I all consider in looking at this position?

Staffing is always an issue...Medicare/QA/Restorative RN is strong

but does not like restorative or QA...Current Skin/Treatment/Staffing

LPN is also strong but does not like staffing.

What should I do??? Any info or ideas will be most helpful.

Thanks in Advance

SU

[ren46730]

Run Far Away And Don"t Look Back!!!!!!!!!

[donlmnh]

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

I 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!!!!

[Neats, BSN]

Wow, 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.

[LTCNurse66]

Dear 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.

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

I 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.:sofahider

[CapeCodMermaid, RN]

Good luck.

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

I start on Thursday. I'm nervous and excited all at the same time.

[gracenotes1]

I 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.

[CapeCodMermaid, RN]

The 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?

[noc4senuf]

I 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.

[Praise,RN]

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.

Hi Tim,

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?

Thanks.

[CapeCodMermaid, RN]

As 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.