Introduction: The Cost of Getting the DON Hire Wrong
In most healthcare facilities, the Director of Nursing (DON) is the heartbeat of clinical operations. When this role turns over, everyone feels it—patients, staff, families, surveyors, and your bottom line.
Yet many facilities rush the search, hire the “least bad” option, or focus on the wrong things… and then wonder why their new DON leaves in 6–12 months.
In this article, we’ll walk through how to hire a Director of Nursing who not only performs, but stays—and how a specialized healthcare recruiter can make that Director of Nursing recruitment process faster, safer, and less stressful.
1. Get Clear on What Your Director of Nursing Role Really Needs
Not every DON role is the same.
Before you post a job or call a recruiter, be brutally honest about your situation:
- Are you stabilizing a troubled building, or fine-tuning an already strong one?
- Is your current pain point survey issues, staff turnover, clinical systems, or family complaints?
- Do you need a DON who is more of a hands-on fixer, a strategic leader, or both?
Create a short internal profile that includes:
- Top 3–5 must-have competencies (e.g., survey recovery, mentoring new nurses, building a positive culture)
- Realistic expectations for census, acuity, and corporate support
- An honest description of what the new DON is walking into—good, bad, and ugly
The clearer you are up front, the more likely you’ll attract the right Director of Nursing instead of just any Director of Nursing.
2. Stop Treating the Job Posting Like a Generic Template
Most Director of Nursing job ads sound identical: “fast-paced environment,” “team player,” “must be able to multitask.”
Top-level DONs scroll past that.
To stand out:
Lead with the “why”
- Why would a strong Director of Nursing choose your building?
- What are you proud of—clinical programs, survey turnaround, stable leadership, strong Administrator?
Be honest about the challenge
High-caliber DONs aren’t afraid of complexity. They are afraid of surprises.
A line like:
“We’re stabilizing after a difficult survey and looking for a Director of Nursing who can rebuild trust and systems”
is far more compelling—and credible—than vague fluff.
Show your support structure
Mention if you have:
- Strong unit managers
- MDS support
- A reliable Administrator
- Corporate clinical resources
Great DONs want to know they won’t be alone.
3. How to Screen Director of Nursing Candidates for Leadership, Not Just Licenses
Yes, your DON must have the appropriate RN license and regulatory knowledge. But the biggest predictors of success are usually soft skills.
Look for:
- Calm under pressure – How do they respond when surveyors walk in unannounced?
- Staff engagement – Can they win the trust of CNAs, nurses, and ancillary staff?
- Accountability without blame – Do they own problems, or point fingers?
- Communication with families – Can they de-escalate tense situations and build confidence?
Great interview questions for the DON hiring process:
- “Tell me about a time you walked into a building with serious clinical or survey issues. What did you do in the first 30 days?”
- “What’s your approach when a family member is upset and demanding to speak to ‘someone in charge’?”
- “How do you handle a strong nurse who is clinically excellent but toxic to the team?”
The goal is to hear specific examples, not general philosophy.
4. Involve the Right People in the Interview Process
A Director of Nursing doesn’t work in a vacuum. The wrong cultural fit can drive good staff away—fast.
Consider thoughtfully involving:
- The Administrator (non-negotiable)
- A trusted Charge Nurse or Unit Manager
- Sometimes a long-tenured CNA or informal staff leader
You don’t need a panel of ten people, but you do want honest input from those who will work with the DON every day. Pay attention to:
- How the candidate speaks about frontline staff
- Whether they show respect and curiosity in both directions
- Whether they ask good questions about workflows, staffing patterns, and communication
If your team leaves the interview saying, “I could follow that person,” that’s a very good sign.
5. Be Transparent About Schedule, Support, and Expectations
One of the fastest ways to lose a new Director of Nursing is to over-promise and under-deliver.
Before making an offer, be crystal clear about:
- On-call expectations – Is the DON expected to come in for every call-off, or do you have a staffing plan?
- Weekend and holiday coverage – How often, and in what capacity?
- Administrative support – Do you have a scheduler, staffing coordinator, and MDS nurse, or is the DON doing everything?
- Authority – What decisions can the Director of Nursing make without three layers of approval?
Top DONs can work hard. What they don’t tolerate is feeling misled. Transparency upfront significantly increases retention.
6. Offer a Package That Matches the Responsibility
Compensation isn’t just about salary; it’s about signaling respect for the scope of the role.
Consider:
- Competitive base salary for your market and acuity level
- A reasonable bonus structure tied to realistic, measurable goals (e.g., survey outcomes, turnover reduction, quality metrics)
- Relocation support, if you’re in a challenging market
- Professional development: conferences, certifications, leadership training
You don’t have to be the highest payer in the state—but you do need to send a clear message that the Director of Nursing role is valued and supported.
7. Onboarding: Don’t “Throw Them the Keys and Run”
Even the best Director of Nursing will struggle without a structured onboarding process.
In the first 30–90 days, make sure they have:
- A defined orientation schedule (not “follow whoever is free”)
- Introductions to key contacts: medical director, preferred hospitals, pharmacy, therapy providers, corporate clinical leaders
- Time blocked for chart review, rounding, and staff meetings (not just putting out fires)
- Clarity on top three priorities – for example:
- Stabilize staffing and morale
- Prepare for an upcoming survey
- Fix specific clinical metrics (falls, pressure injuries, readmissions)
Schedule regular check-ins with the Administrator to remove obstacles and show visible support.
8. How a Specialized Director of Nursing Recruiter Can Help
Finding a Director of Nursing who truly fits your building—and stays—is difficult when you’re also running day-to-day operations.
A specialized healthcare search firm like Premier Search, Inc. can help you:
- Access passive DON candidates who are not replying to job boards
- Pre-screen for leadership style, culture fit, and track record
- Protect your time by only presenting shortlisted, qualified Directors of Nursing
- Advise on compensation, market realities, and offer strategy
- Maintain confidentiality when you’re replacing a current leader
Instead of starting from scratch every time, you can leverage a recruiting partner who lives in this world every day.
Frequently Asked Questions About Hiring a Director of Nursing
How long does it usually take to hire a Director of Nursing?
It varies by market, but many facilities see a realistic timeline of 4–8 weeks for a strong DON hire, especially if you’re targeting passive candidates rather than relying only on job boards.
What is the most important quality in a Director of Nursing?
Clinical knowledge is essential, but the most important quality is often leadership under pressure—the ability to keep staff engaged, accountable, and supported in a demanding environment.
What interview questions should I ask a DON candidate?
Ask for specific examples, such as: turning around a poor survey, reducing staff turnover, or handling a difficult family situation. You want detailed stories, not general statements.
Should I use a recruiter to hire a Director of Nursing?
If your building is complex, your market is competitive, or you’ve had repeated DON turnover, partnering with a specialized healthcare recruiter can save time, protect confidentiality, and improve your chances of a long-term hire.
Conclusion: Hire a Director of Nursing Who Performs and Stays
A strong Director of Nursing can turn around clinical outcomes, stabilize staff, and restore your facility’s reputation. A bad fit can do the opposite—quickly.
By clarifying what you really need, elevating your screening process, being transparent, and investing in proper onboarding, you dramatically increase your chances of hiring a Director of Nursing who performs and stays.
Call to Action
Need help hiring your next Director of Nursing?
At Premier Search, Inc., we specialize in connecting healthcare facilities with high-caliber clinical leaders, including Directors of Nursing and Nursing Home Administrators.
Ready to talk?
Call us at 310.247.8900 or email us at bernie@premiersearch.com, and we’ll follow up promptly to discuss your hiring needs.