Urgent or Just Poor Process? How Strong Systems Keep DONs from Drowning in Daily Chaos

Hey boo hey — let’s talk about something every Director of Nursing knows too well:

Those so-called “urgent issues” that magically show up the moment you’re not in the building.

You know exactly what I’m talking about.

Yesterday, I wasn’t at work. Did that stop me from leading? Absolutely not.

I texted my managers with a few key reminders — the things that can NEVER fall through the cracks.

And like clockwork, the calls started coming in about what the day looked like, followed by a couple of “urgent” issues that apparently needed my attention.

But as I listened, I found myself asking the same question I wish more DONs would ask:

“Is this truly urgent… or is this a process problem that keeps resurfacing because something in the system is broken?”

Most DONs don’t pause long enough to ask that question — they just react.

But reacting is exactly what keeps you drowning.

Urgent Problems Are Usually Broken Processes in Disguise

In long-term care, everything feels urgent:

• A resident concern

• A documentation issue

• A missed intervention

• A wound that wasn’t updated

• A call bell out of reach

• A refrigerator item that’s out of date

• Tubing that isn’t labeled

• A family complaint

• A fall

  
  

But here’s the truth no one wants to say out loud:

If it keeps happening, it’s not urgent — it’s a broken process.

And if the process is broken, it will follow you everywhere:

➡️ On your day off➡️ On Saturdays➡️ On your vacation➡️ In morning clinical➡️ Right into survey

Urgency is a symptom. Process is the cure.

When State Walks In… Everything Becomes Urgent

Let me paint a picture, boo, because every DON has lived this:

State arrives. Suddenly the building turns into the Olympics.

You’re telling staff:

• “Make sure all tubing is dated!”

• “Check the refrigerator for anything expired!”

• “Put every call bell in reach!”

• “Fix the urinals!”

• “Check water temps!”

• “Get those rooms together!”

• “Fix the wandering alarms!”

  
  

Everybody is moving fast. Everybody is hyper-alert. Everybody is suddenly invested in “the details.”

But tell me this:

Why is it only urgent when state is watching? Why isn’t it your everyday routine?

Because when these things aren’t built into your daily standard of practice, they become emergencies. And DONs end up reacting instead of leading.

Aren’t You Tired of the Panic?

Let’s be real for a second.

Aren’t you tired of:

• Running around when state arrives?

• Finding out things weren’t being done?

• Stressing over things that should have been handled already?

• Fixing the SAME problems week after week?

• Feeling like you’re always one step behind?

• Being the only one who notices what’s slipping?

• Having staff treat urgency like a surprise?

  
  

Because I was.

And the truth is simple:

If your process is strong, nothing becomes urgent.

If tubing is dated every day, If refrigerators are checked every morning, if call bells are always in reach, If rooms are consistently safe and clean, If staff know EXACTLY what to look for…

Then state walking in changes nothing. You don’t scramble. You don’t panic. You don’t rush. You don’t “fix.”

You simply continue the same consistent practice you do EVERY day.

That is leadership.

The Goal Is Not to Respond Faster.

The Goal Is to Prevent Needing to Respond at All.

Anyone can react when things go wrong.

A true Director of Nursing leads by shaping systems that prevent problems from occurring in the first place.

When your processes are strong:

✔ You stop getting calls on your day off

✔ Staff stop needing you for every crisis

✔ Your team becomes more independent

✔ Your building runs with consistency

✔ Survey becomes predictable

✔ Your stress drops

✔ You’re no longer drowning in emergencies

✔ You gain control over your department

This is what “proactive leadership” really means.

Not doing more. Just structuring better.

If You Don’t Want to Live in Urgency, You Need Systems. Every Day.

Most DONs don’t have systems —they have coping mechanisms.

They survive the day. They put out fires. They go home exhausted. Then wake up and do it again.

But you can’t build consistency on reaction. You build it through:

• Clear routines

• Daily rounding

• Process checklists

• Accountability systems

• Standard practices

• Follow-through

• Team training

• Leadership presence

  
  

This is how you stop panic, stop chaos, and stop living in “urgent mode.”

Final Thought:

If urgency shows up every day, your process is broken. Fix the process, and you fix your peace.

And if you want tools that help you build consistency, eliminate chaos, and strengthen your processes so you’re not scrambling the next time state walks in…

Just remember:

Planning & Preparation Produces Positive Outcomes. And your processes tell the story.

Lead with love 💜

yourfavnurseleader

Bilquis Ali