The short answer
The director of nursing (DON) is the registered nurse responsible for all nursing care in the facility. The DON oversees the nurses and nursing assistants, nursing policies, staffing schedules, training and the quality of resident care. Federal rules require every nursing home to have a full-time RN as director of nursing.
Responsibilities
- Supervising RNs, LPNs and CNAs, usually through unit managers and supervisors
- Nursing policies and procedures, such as fall prevention, skin care, incontinence care and medication administration
- Nurse staffing schedules and assignments
- Staff training and competency
- Reviewing incidents, falls, pressure injuries, infections and complaints about nursing care
- Working with the administrator and medical director on quality improvement
When to contact the DON
Start with the charge nurse or unit manager for day-to-day issues. Go to the DON when a problem repeats, when the unit does not fix it, or when something serious happens: a fall with injury, a new pressure injury, an unexplained bruise or fracture, a medication error, or signs of abuse. Put your concern in writing (an email is fine) and ask for a written response.
Related roles
- Assistant director of nursing (ADON) supports the DON.
- Unit managers run individual floors.
- Nursing supervisors are in charge of the building on evenings, nights and weekends, when the DON is usually not there.
The rules behind this
- 42 C.F.R. § 483.35(b) (registered nurse and director of nursing)
Related questions
This guide provides general information, not medical or legal advice. Rules change; confirm current requirements with the facility, the New York State Department of Health or a professional. Attorney Advertising.