Jeremiah 29:11: For I know the plans I have for you,” declares the LORD, "plans to prosper you and not to harm you, plans to give you a hope and a future."

Saturday, July 11, 2015

What about when the "right thing" is not so clear?

I hear so much talk about doing the right thing.

Sometimes I find that the right thing is not crystal clear.

My current series of dilemmas in this arena revolve around my work. I have been a nursing home administrator for this facility almost a year. Since I came there have been things that our director of nursing services (DON) does that I do not think are right. These areas of concern involve documentation, interpersonal dealings and honesty.  To my knowledge she is basically good and decent with regard to patient care.  The owner of this building is wholly dedicated to the DON and over the top favors her.

So far I've just tried to deal with her and the situations created to the best of my ability. I've basically sucked up any feelings that I have, and made life work.  I'm constantly working to be strategic and put systems in place that will result in a lack of need for the DON to do things I'm uncomfortable with in regard to documentation. She fights me regarding these systems.  It appears that she has a need to be a savior when things are wrong. I know this sounds crazy, but it's like she does not want things to run smooth and correct, because then she won't be needed to swoop in and save the day through questionable means.  She apparently wants all to know how much she is needed and how much she does for the facility and owner.

I've been praying and praying about the situation.  I've sought to stay grateful for my job and be positive. I do love the business, the leaders with whom I work, many of the staff I've gotten to know, and the fact that we can make a positive difference in people's lives every day.

But I have a lot of questions.  I'm the administrator, it's my license on the wall, this is the building that I'm running for the owner. If this facility is not run right it is to my shame.  I am accountable.  So daily I pray and ask for God to make me smarter than I am. For God to give me wisdom and favor and the ability to set things right and run a good operation.  One where patients and staff alike are treated good and where we are righteous in our actions.

Yesterday things came to a head for me.

There is an evaluative tool used in nursing homes called MDS. The MDS is the hub of patient treatment. Starting in October 2015, in addition to the annual and nursing 3.2 annual surveys from the department of public health, there will be an annual MDS survey.  Auditors will be coming in and making sure that we are following the Medicare guidelines correctly.  In view of the upcoming MDS surveys, my company is holding a 2-day training for MDS staff.  I set up for our 3 MDS staff to attend this training.  My DON left on a vacation this past Thursday.  Before she left she told me that she thought only 1 MDS staff should attend the training and then come back and train the other staff.  I explained that my boss had directed that all 3 attend and that I was in agreement.

Yesterday one of these MDS staff came to me.  She explained to me that the DON had told her that she is her direct supervisor and that she is, under no circumstances, to go to that training.  She directed this MDS person to call in sick those days and then say she got to feeling better, so then go ahead and come in to work at the facility.  She came to me because she said she feels in a quandary; she doesn't want to lie to me but she doesn't want to get in trouble with the DON. She said that we both how this DON is, and that she'll make her life miserable if she doesn't obey her. As I listened the MDS woman began opening up and talking more and more.  It was one of those situations where once she opened up and started talking, she just kept going; it was as if the flood gates were open.

What came out were how afraid she feels of losing her job.  She feels like the DON has made her create inaccurate documentation to make the facility look better.  She knows that as a licensed nurse she is responsible for her actions, yet she needs this job.  She started here around 15 months ago.  Within the first month of employment the DON came to her and asked to borrow $1,500.  She said that she couldn't afford to give her the money but really needed the job so she went ahead and did it.  She had her husband come to the facility when she loaned the DON the money and she's written up a contract that the three of them signed that stated re-payment terms.  She related that the DON was much slower than the re-payment terms but she did finally repay her.

As I listened to this MDS person, I remembered something recently told to me by my supervisor. My supervisor's sister works for me. Not long ago this sister told my supervisor that the DON had borrowed $1,000 and never paid it back.  My employee would not allow her sister (my supervisor) to take action against the DON.  Recently the DON borrowed $1,000 again from the sister. My supervisor told her sister to stop giving the DON money.  The sister said she feels that she must to keep her job. The sister and the DON come from a developing nation where things such as this are allowed.

There's another money situation in regard to this DON.  It involves me.  Within 2 weeks after I started  I was with my supervisor and the owner in the DON's office one day.  The DON told a very sad story regarding another staff person in the building.  The DON said that this person's husband was abusive and she needed to get away from him.  She said that this person needed $4,000 to move out and get started in a new location away from the husband. She asked the owner to front the staff person that money.  The DON explained that the staff person would pay back $500 each payday so that the money would be repaid in 4 months. The owner explained that, as a business owner, he could not do this.  He said it would set a precedent and if he did it for this person, he would have to do it for another. Somehow the three of them all ended up looking at me.  I kind of laughed and asked if they expected me to front the money.  The room was quiet.  So I went and got the $4,000 out of my personal bank account.  The person who allegedly received the loan paid me back $2,000 over the next 5 months and then stopped.  She said that I needed to talk to the DON about the other $2,000.  I got the feeling that the DON had only given this staff person $2,000 and that the DON had kept the other $2,000.  I talked to the owner about it in January 2015 and he said he'd pay me back the $2,000.  I talked with my supervisor about it in February, and she said she'd get the money for me.  I talked with the owner about it again in May 2015. In June the check for the $2,000 was sent to the DON instead of me.  It arrived on a day when I had the day off.  She went and cashed the check.  When I asked my supervisor about it she asked the owner who said the money went to the DON in error.  I asked why the owner didn't just get the money back from the DON and my supervisor said that he thought it would cause problems.  I told her that is his issue but I still need my money back.  My supervisor promised me she'd get it for me.  On July 9, 2015  the owner and my supervisor came to the facility.  After they left my supervisor came back and gave me $1,000 that she said was from the owner and she promised that the other $1,000 is coming.

This means there are three money situations that I know about. How many are there that I don't know about?

Yesterday my feelings of guilt and responsibility overwhelmed me as I listed to this MDS person.  What am I doing here?!  I have a responsibility toward my staff and the patients to run a righteous business.  So I called my boss.  I told her the whole story.  I've mentioned things to her about this DON previously but this time I gave details. I explained how grateful I am for this job.  I told her that with my license comes a responsibility.

My boss was distressed by what I said.

She, like me, has been uncomfortable about this DON. Yet we both struggle due to the owner's total favor and commitment toward her.  I told my supervisor that I've told my husband before that I've known that if it comes down to being between my DON and me, it's me that will be gone.  I recognize how the owner feels.  I'm the 7th or 8th administrator at this facility in 3 years.  I've been here 11 months at this point and have outlasted them all,...but still....I can be gone in a heartbeat.  Yet, when everything is all said and done, I'm obligated to do the right thing.  I can't let my staff suffer and not do something about it.  I choose to do what I think is right and trust God.  My supervisor said she'd get me a meeting with the owner and herself.  She also mentioned something about the company attorney being there to help problem solve how to handle the DON situation.

My prayer is that this meeting will actually take place.

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