The vital role of director of nursing services (DNS) in skilled nursing facilities (SNFs) comes with so many demands. DNSs are often—or always—on call for questions regarding changes in resident conditions; they often fill in for staff who called off; and they put out fires when emergencies arise. Just when they get a moment to relax, something comes up. Because of the responsibility the job requires, work-life balance often seems unattainable. However, every leader deserves a break to recharge and reenergize, so they can be their best selves and lead their teams most effectively. This article will provide tips on how to increase the balance that every DNS needs.
Take it one day at a time
It can be easy to feel overwhelmed when looking at all the DNS’s tasks—and crucial to remember that work-related responsibilities are separate from all that has to be done when the DNS gets home. DNSs are people first, with complex lives outside the facility. That’s why it’s important to take each day one at a time; becoming overwhelmed in one area of life can negatively affect other areas.
To begin to organize all of the tasks, make a daily schedule. Consider writing it out the day before so there’s a plan for the next day. Even if that plan changes, try to follow the original schedule as closely as possible. Split up each day with what should be tackled hour by hour. Importantly, pencil in meals and breaks so that those aren’t overshadowed by other to-dos. It also may be helpful to schedule “focus time” to ensure important tasks get the attention they need. Avoid scheduling meetings during this time, and if possible, ask staff to limit interruptions.
Note: The Organizational Toolkit for the Director of Nursing Services in AAPACN’s Nurse Leader Fundamentals course is a great tool to help with time management. Included are tools to assist the DNS to set priorities, tables with DNS responsibilities and how to schedule them, and a daily and weekly planner template.
Delegate and set boundaries while away
Although they sometimes try to, the DNS cannot be everywhere all the time or personally do everything. Therefore, it’s important to decide which tasks can be delegated to other team members, especially when the DNS is off and out of the facility. Establishing a strong relationship with the administrator can dramatically improve the DNS’s work-life balance. The DNS should work with the administrator to see how they can best cover for each other to achieve balance.
“The administrator could take on tasks such as staffing, daily time slip reviews for overtime or not punching out, and review of supplies to make sure there are enough,” says Denise Winzeler, BSN, RN, LNHA, DNS-MT, QCP-MT, curriculum development specialist for the American Association of Post-Acute Care Nursing (AAPACN). Identifying what tasks others can perform can help the DNS to carve time out of a packed schedule.
It’s also important that DNSs set boundaries for their teams and establish what truly constitutes an emergency. Remind staff what deserves a text or a call and what can wait until the next day. When the team understands these communication expectations, the DNS is less likely to be interrupted during important personal time.
Take that much-deserved vacation
The DNS needs a backup not only for when a personal emergency may take him or her away from work, but they also need someone to help out while the DNS takes a real vacation. It’s not advisable to never take a vacation—people need time away to reinvigorate themselves, refresh, and recharge. In addition to the administrator, a good candidate for the backup person could also be the assistant director of nursing (ADON) or another nurse with leadership skills. Identify and work with a nurse who is looking to grow and take on more responsibilities.
According to a 2021 Forbes article, research suggests that taking a vacation increases mindfulness, improves heart health, minimizes stress and anxiety, boosts creativity, and enhances sleep. The work is always important, but health is too. Therefore, establish a plan with the administrator or other backup, and then plan that trip that’s on the “one day” list. It’s time.
Balance with family and friends
Several studies confirm what has been evident from the COVID-19 pandemic: isolation causes negative impacts, but strong social connections can improve mental and physical health. When the day has been stressful, enjoy quality time with family or friends. These connections are a centering and supportive force in life. Nurture these close relationships—call those who are near and far, have dinner together after work (or breakfast if working the night shift), and be fully present when coming together.
Being able to vent, talk about struggles, and problem-solve with a trusted person can also have healing benefits that could help with processing and alleviating the stresses of both work and home life. So, take time with someone close to decompress and acknowledge any negative emotions.
Finish strong with kids
Having a consistent bedtime routine and finishing the day strong with kids is beneficial to family dynamics and kids’ emotional health. When there’s not a lot of time available to have a perfect day together because mom or dad has been working long hours as the DNS, it’s even more important.
Do something positive with kids right before bed. Read a book or play a game, and talk to them about their day. Always try to end the day on a good note. This routine will help both parent and child sleep better, knowing they did their best to end the day well with love.
Because the hours spent with children are precious, making sure time spent is quality time is important too. Winzeler says, “I think it is really vital to let your kids know that they are important and to show this in your actions as well. Be present when spending time with them. Don’t keep looking at your phone or emails when you are with them. If you give them your full attention, they can even energize you.”
A recent study from the Greater Good Science Center at the University of California, Berkeley, suggests that taking even a small amount of time to appreciate and give thanks for the little and big things in life may boost mental health. By starting a gratitude journal, the DNS can bring positive aspects of their work and home life into focus.
Start with something as simple as five lines of gratitude. Here are a few questions to answer as examples:
- What do I appreciate about my team today?
- What challenge am I grateful I experienced today?
- What is one thing that went well today?
- Who is one person who always supports me?
- What is a recent accomplishment I am proud of?
This exercise may also have the positive impact for the DNS of revealing what’s important in his or her life, which helps with prioritizing.
Make sure to fit in “me time”
“Just like on an airplane, if the oxygen masks come out—you can’t take care of others if you don’t take care of yourself first. You have to take care of yourself,” says Winzeler.
Balance means finding time for both others and one’s self. DNSs who give their all for everyone else but don’t leave any time for themselves will feel dissatisfaction, possibly resentment, and eventually burnout. Therefore, they should take time each day to fit in something that makes them happy just for them. Consider what is personally meaningful or what gives peace. Some suggestions include:
- Go for a run/walk, or work out
- Read a book
- Drink a cup of coffee or tea
- Breathe and practice mindfulness
- Do yoga
- Listen to a podcast
- Relax outside
If it’s a struggle to find time for this “me time” activity, try maximizing while multitasking. For example, listen to an audiobook while doing the dishes or some other chore. Or if short on time, start with just a few minutes a day. Ask “What can I do in 10 minutes that’s just for me?” and be sure to incorporate that 10 minutes into each day.
Do a values assessment
To get the most out of personal time, it’s important to acknowledge and understand what’s valuable. Write down how time is being spent each day. See if there’s something that should be removed or reduced and something else that can take its place. Spending too much time on the internet? Reduce time attributed to that activity and fill it with something more meaningful and valuable.
Write a list of values and order them by importance. Add anything to the list, big or small.
- Caring for the elderly
- Creating a strong team
- Time in nature
- Good food
- Quiet time
Post this list in the office and somewhere at home to be a reminder of what matters most.
Many people start a career in long-term and post-acute care because they value quality care for the elderly, especially as they know they will be old one day too. It’s important to remember that value on the hard days. When the job feels like too much, coming back to values and the “why” will help the DNS lead in such an important role.
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