By Dillon Phillips
When Paula Denum first got her start in nursing, she wasn’t looking for a career – she just needed a job.
She was finishing her degree in biology and needed six months of nursing experience to qualify for the genetic counseling program she’d planned to enter. Her mother suggested she apply for a CNA position at a nearby long-term care facility.
“I never made it to my genetic counseling program,” Denum said. “I stayed as a nurse.”
Thirty years later, she’s gone from a CNA to an RN to a DON, serving in multiple roles on multiple floors at multiple facilities. But, Denum feels most at home right where she started: long-term care.
“I really get to know the people that I take care of,” she said. “So often in nursing, the new grads want to go to the ICUs and the emergency departments because they’re the most exciting, the most glamorous, and they pay the best. But today, I made a dining room full of people laugh because I was talking like a pirate. I wouldn’t get to do that if I was programming a pump every day.”
Denum believes patients in long-term care facilities are a gift. They connect us to the past and provide younger generations with a wealth of history, knowledge, and wisdom. Working with them is a privilege, one Denum is grateful and humbled to be entrusted with. She sees the work of long-term care facilities as so valuable that she’s even struggled at times to balance it with her personal and family lives.
The downside of her ceaseless dedication to her job really hit home when she was caring for her grandmother-in-law, who relocated from Florida to Denum’s facility in Missouri in the wake of a hip injury she suffered during the pandemic.
Out of the 36 days her grandmother-in-law was there, Denum worked all but four, including the day she passed away.
“I was going to work at like 6:00 in the morning and getting home at 11:00 at night, which was really awesome because I could still see her,” Denum said. “I told her as long as she was there, I would be the director of nursing. She told me if I continued to work like that, I would lose my family.”
Denum kept her promise and remained at the facility. One day, she left to join her oldest son on a college visit. On that same day, her grandmother-in-law passed away. Denum resigned shortly thereafter.
On top of coping with the loss of their grandmother, Denum and her family also faced the challenges of her relentless work schedule. During the pandemic, she typically worked 44 hours – on weekends alone. That didn’t include how much she was working each day during the week.
“People say, ‘Oh, that’s what directors of nursing get paid for. That’s what they signed on for,’” she said. “No. They sign on to make the building better and help the building remain compliant and to make sure that the building is staffed. That doesn’t mean that they’re also the person who staffs the building.”
Not long after resigning, she received a call from her recruiter asking if she’d be interested in traveling. Denum talked it over with her family and decided she’d give it a try – under one condition: when she was home, she was home.
Two-and-a-half years later, she’s still going strong as a travel DON. Thanks to smartphone apps like Snapchat and FaceTime, she’s able to stay connected with her family even when she’s on assignment. And then, when she is back home, she doesn’t have to worry about being called back into work.
“People are amazed that through travel I actually have a good work-life balance,” she said. “It’s so much harder when you’re a mile-and-a-half away from home and you don’t see your family. Now, when I’m home, I can be completely present. I can also take more time off, and the change of my salary allows me to do that more frequently.”
If Denum has her way, she’ll be directing long-term care facilities until she can’t anymore. She still loves the work, and with her youngest son approaching college age, her husband will soon be able to join her on the road. That’s enough to keep her going for years to come.
“I like working hard,” she said. “I like coming into chaotic buildings, planning corrections, and then really seeing the improvement from where we started. I think the biggest compliment is when I have a surveyor come in and say, ‘Oh, this building feels so different.’ Then I’m like, ‘OK, I did my job. We’ve made it better.’”