Health care facilities that hire nurses always have a licensed nurse who is ultimately in charge of the nursing staff. This head honcho is usually called the director of nurses, or DON, although titles such as chief nursing officer or chief nursing executive may be used. In large hospitals, the position often includes a vice president ranking, as in vice president of nursing. The job description varies according to the size and type of facility.
A director of nursing is the highest in the chain of command for nurses. She must answer for the activities of all of her staff, as well as bear responsibility for seeing that the workplace is safe. Any problems in patient care or a lack of adequate staffing ultimately fall on her shoulders. She must see that those under her are doing their jobs properly and have adequate training and continuing education. She also stands up for the nurses to those in higher places.
Education and Experience
While education and experience requirements vary according to the type of facility, most DONs are required to have supervisory and management experience plus experience working in the type of facility they wish to manage. Their education should have included management classes. The bachelor of science in nursing degree is the minimum degree requirement at many facilities, as bachelor-prepared nurses typically have classes in nursing management. Larger facilities may require a graduate degree, such as a master's degree or doctorate. Smaller facilities or facilities with a small nursing staff may hire a registered nurse with an associate degree or even a licensed practical nurse to run the show.
Chain of Command
A DON is responsible for all nursing staff, including registered nurses, licensed practical or vocational nurses and the nonlicensed personnel, such as nursing assistants, who provide direct patient care. They are not typically responsible for other staff members, such as physical therapists or those who draw blood. The director of nurses may have one or more assistant directors of nursing who may be in charge when she is off. Nurse managers and nurse supervisors also have varying levels of responsibility, all answering to the director of nurses.
Day to Day Activities
Strong leadership skills and the ability to hire and fire are required of a director of nurses. She must be able to communicate well with her bosses, physicians, patient families and the heads of other departments. She must be able to anticipate and solve problems, prepare for government inspection of her facility and assure proper care of the patients. It can be a stressful position. In the nursing home industry, almost 50 percent of DONs get fired or quit each year, according to Nurses.com.
A typical registered nurse earned over $64,000 in 2010, according to US News & World Report. As you might have guessed, a director of nursing should make considerably more than average, falling closer to the top 10 percent of nurses who make around $95,000. DONs working at smaller facilities generally make a lot less.
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