How to Be a Director of Nursing in Long-Term Health Care

Develop Organizational Systems


Schedule a consistent daily meeting time for your nursing team. As the director of nursing, you will be responsible for making sure that care is proceeding properly and records are being accurately updated. Conduct each meeting in an established order to make your team comfortable with your expectations, facilitating their preparedness. Ask about problems with individual patients to be addressed or passed on to physicians. Review records for completeness while the issues or incidents are still fresh in the minds of your staff.


Track regulatory changes, technological changes and policy changes. According to the Bureau of Labor Statistics, medical managers work in "an increasingly complex regulatory environment." As the director of nursing, you will need to stay updated on many new regulations and the accompanying policy changes in order to ensure understanding and compliance by your staff. Use the daily staff meetings to discuss upcoming changes, answer questions about changes and plan additional training sessions.


Develop a system of communication with the members of the families of your long-term care patients. Patients in a long-term care facility have special needs to address, like treatment preferences for chronic illness and end-of-life planning. Encourage family input and involvement in this process. Explain options to your patients' family members. Coordinate treatment plan discussions with family members, the patient and your staff. Develop a practical system for updating decisions and making changes to the treatment plan. Prepare in advance needed medical releases and legal documents, as this improves the quality of life for the patient and greatly reduces stress for the family during difficult stages of the patient's illness.


Develop an organized reporting system for members of the medical staff and other caregivers. You will be responsible for passing essential patient information gathered by your nursing team to physicians and other staff members. Develop reports for hospital administrators regarding needed policy and procedural changes as issues arise. Include information about staffing and scheduling issues within your team. Keep a daily log of patient information, team information, and important events to use as references for your reports.


Track your nurses' training levels. Make sure all the members of the nursing team are properly trained on common procedures, facility policy, equipment usage and safety protocols. Schedule sensitivity training sessions for handling the end-of-life and chronic illness developments in long-term care patients. Plan regularly scheduled training sessions for your nursing team. These sessions can be used to learn new procedures, train on new pieces of equipment, implement policy changes and refresh training on existing practices.

As the director of nursing in any facility, you will face a very complicated job, and a long-term care facility will add its own layer of complications. As the director of nursing, you will be responsible for the work of the entire nursing team. Some of the responsibilities include creating work schedules for your team, assigning tasks and procedures to your nurses, tracking regulatory changes, and reporting important information to physicians, staff members and administrators. By developing a tightly organized system of reporting and communication, you can help your team maintain highly effective care.