Helping D.O.N.s

Helping to Improve Long-Term Care, One D.O.N. at a Time

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All nurses in long-term care know what “OOF” means:  Out Of Facility.  I wonder who started writing “OOF” on the MARs when a resident is out of the building?  It sure caught on like gangbusters because we can’t let it go.  Maybe I should put a sign at my office door to signal when I’m OOF!  I probably won’t, but it would be pretty funny if I did.

There are some other “classics” that stick around as abbreviations, and I work hard to keep the nurses in my department from writing them.  Here’s one:  WCTM.  Have you seen this one?  It’s “will continue to monitor”.  I hate it.  The evidence of monitoring is present when you make your next entry in the nurse’s notes, so there’s no need to write “WCTM”.  It’s really bad when a nurse writes “WCTM”, then the next shift has a problem to assess, obtains lots of new orders, or sends the resident out, and the last nurse wrote many hours prior “WCTM”.  Oh - awful - a sinking feeling takes place.

I love documentation, and I love that most every nurse I’ve ever met wants to do really good documentation.

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D.O.N. “Dashboard”

Pee -wee football season is over so I’m back! 

It seems like everything these days has a “dashboard” or “toolbox” or some kind of tech-y place online in which to navigate the data which you want to follow.  There are so many DON “dashboard” items I can come up with that it would make your head spin, but here’s a few I intend to write about as I build my blog, and so impart to you some of my knowledge and experience from the trenches.

Leadership - I must lead by example, build and maintain relationships, and be consistent in what I say and do.  Every day.

Survey Readiness - It’s a 24/7/365 kind of thing.  Every day the stakes are high in what we do.  We can never let our guard down.

Tracking Systems - I will be discussing these along my blog journey.  Various tracking systems keep me organized and (at least) feeling in control of data I must never be out of touch with!  Ditto from above:  Every day the stakes are high in what we do.  We can never let our guard down.

Documentation - Being persnickety about the manner in which care is documented is the core of survey success.  Don’t you want the surveyor to open the chart, find what they were looking for, then shut the cover and move on?  I do!  It’s a beautiful thing.

IDT (Interdisciplinary Team) Functions - Sometimes those dreadful meetings and committees are just what you need to keep tabs on certain areas like behavior monitoring, risk, review of your QIs, falls, skin, etc.

I could go on and on but it’s quiet around here so I think I’ll move on to something non-work-related and write again soon.  Thanks for reading. 

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A D.O.N.’s Life - Part 2

A Director of Nursing in long-term care (or any nurse manager, for that matter) cannot afford to let things “go”.  It might be the fall, the admission, returning phone calls, talking with the staff to see how they’re doing, walking around to meet and greet the new residents/family, spot-checking some systems to make sure they’re being followed, etc, etc, etc.  The list is endless.  EVERYTHING’S IMPORTANT! 

So that’s the frustrating part.  ALL aspects of our DON job matter and you can bet a Diet Coke on it that they also matter to somebody, somewhere, at some time.  I’m not complaining; just making a factual statement.  That “somebody” might be the staff member who needs to talk to you urgently about changing a shift or rotation.  That “somewhere” might mean something that applies in one unit may or may not apply in another, but we’d better find out soon.  That “sometime” might be many months down the road, lurking around the corner, rearing its ugly head, just waiting to get you!  We are not in a position to turn our backs on things for long. 

So now that I’ve established that we cannot take our eyes off of anything, lest it come back to haunt/bite us, I say with all seriousness that these items and the people who need our help deserve our best follow-up. 

In future posts I’ll be writing more about how greater attention to detail is possible in a D.O.N. job and how it can bring about great success.  Contact me with anything going on in your DON job — I will never say “I’ve seen or heard it all” —that’s impossible! 

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A D.O.N.’s Life - Part 1

Anyone that’s been around long-term care knows what a DON is.  A Don?  No, a D - O - N : Director of Nursing.  The most torn, crazy, reprioritizing person in the building.  I’m that person — the one who’s always told that I should write a book, that’s told they wouldn’t have my job in a million years, that’s told I don’t know how you do it.  Some of the things I deal with make me crazy, and some I am just in amazement of how awesome people are and the wonderful things they do for other human beings, especially for some of our frailest.

First of all, God gets all the glory for how I get through it.  After that, it’s the great people I work with every day. 

I want to use this format to write about my passion for long-term care as well as some crazy observations and some practical applications that will help other DONs survive in this ever-changing and hair-pulling industry that we work in every day.