Improving Collaboration with the Registered Dietitian

To meet residents’ individualized needs, the director of nursing services (DNS) requires the expertise of many healthcare professionals working collaboratively. For expertise on nutrition, the DNS should collaborate with the registered dietician (RD), who is an invaluable addition to the team for both the residents and the facility. This article …

Part of the Essential DNS Toolbox: Effective Daily Clinical Rounds

The director of nursing services (DNS) has many issues to prioritize each day, such as resident falls, staffing, and grievances. Unfortunately, the DNS may be tempted to relegate clinical rounds to “later,” considering them a low priority due to time constraints, which can prove to be a costly mistake. Daily …

Tips for a Comprehensive Post-Admission Medical Record Review

Admissions are vital to a facility. They may occur daily, or even multiple times a day, and should be a part of routine operations. However, the admission process can be cumbersome, and it is easy for staff to miss things, especially if the facility receives multiple admissions in a shift. …

Effective Business Case Development for Budget Wins and Better Care Outcomes

The phrase “budget development time” often elicits moans and groans from facility leadership. During this process, leadership usually asks the director of nursing services (DNS) if he or she has any requests of items to include in the budget. Often, the DNS makes a list of nursing department wants and …

Psychotropic Medications in the Skilled Nursing Facility: How to Manage the Process

The use of psychotropic medications in the skilled nursing facility (SNF) is a controversial issue with implications for resident, regulatory, and financial outcomes. The many requirements can be confusing, especially for a relatively new director of nursing services (DNS). This article reviews psychotropic medication requirements and offers tips to manage …

How to Make the Survey Process Smoother: Tips for the New Director of Nursing Services (DNS)

The director of nursing services (DNS) position is multi-faceted, and a new DNS must learn a lot quickly. Areas such as providing residents quality care and staffing take top priority, and rightfully so. However, another chief priority is on the DNS’s mind daily: survey. Poor survey outcomes can have negative …

How the DNS Can Ensure Staff Preparation for Code Situations

A certified nursing assistant (CNA) conducting afternoon rounds finds Mr. Smith slumped over in his chair. The CNA notices that he does not appear to be breathing and calls the nurse for help. The nurse enters Mr. Smith’s room and checks for a pulse and respirations. Finding neither, the nurse …

Turnover Solutions Series – Part 2: Understanding Why Employees Leave and Strategies to Reduce Turnover

The staffing crisis is an ongoing dilemma for long-term care. To combat the effects of this crisis, directors of nursing services (DNS) may be tasked with finding creative solutions. Often, DNSs focus on the lack of potential candidates and difficulties related to hiring. However, staff turnover is a large part …

Strategies for Overcoming the Struggles of Dementia Care

Dementia is a difficult diagnosis to manage in long-term care. The disease robs individuals of precious memories and their ability to communicate. This loss can cause residents and their loved ones fear, sadness, and sometimes anger. Often, the resident’s inability to communicate increases behaviors such as aggression toward staff or …