Q: I am sinking. I am a DON at a 120-bed facility with a census of 118. I have two MDS coordinators and no other leadership. I have a budget for two assistant DONs but am still recruiting. I feel it’s affecting resident outcomes. What can I do?
A: Begin to think outside the box in regard to internal assistance if you can’t hire. How about considering a career ladder and making promotions within your building easier and more desirable?
Ask your medical director to do some lunch-and-learns for staff on a variety of disease states, including dementia, overactive bladder, Parkinson’s disease and falls. Perhaps the maintenance department can do lift training or fire and emergency training, Dietitians can work on fluids and meals, specialized diets, thickened liquids and feeding.
Meet with your staff RNs and LPNs and find out who is good at audits, mock surveys, doing QA audits of the rooms and med carts. Call vendors such as those in hospice, pharmacy, psychiatry or maybe even a consultant on staff, and ask them to do training.
Perhaps you received a deficiency or know through your QAPI program that you have an issue in a certain area. Call a vendor or a department head to present that topic. Compile a list of education topics and develop your clinical ladders to train and assist staff in learning and developing leadership. You will gain respect for recognizing small stars who needed your help to shine a bit brighter.
Break your education into categories so staff complete a certain number of programs before they can move to the next level.
Perhaps encourage certification after staff have accomplished your clinical ladders to enable them to achieve a leadership position. I am positive your clinical outcomes will improve. If staff members are happier, the residents tend to be happier and the families are happy. The surveyors will feel this upon entering your building. Well-oiled wheels don’t typically squeak.
Sherrie Dornberger, RN, CDONA, FACDONA, is executive director of NADONA. Send her your resident care-related questions at [email protected].
From the October 2022 Issue of McKnight's Long-Term Care News
