Stepping into a Director of Nursing (DON) job will push you to adapt, lead, and find ways to communicate up and down your organization. It isn’t easy, but if you’re looking to challenge yourself beyond your nursing career so far, it’s a role that can be a rewarding stretch.

A Nursing Director manages the day-to-day nursing operations within a healthcare facility. While specific responsibilities vary by facility size, type, and location, it’s an administrative role that typically includes:

  • Overseeing nursing staff, including scheduling, hiring, and professional development
  • Managing department budgets, inventory, and long-term goals
  • Setting and ensuring a standard of care that meets state and federal requirements
  • Being a point of contact in your organization for nurses and allied healthcare professionals, patients, families, outside agencies, and other consultants

Karla Williams, Clinical Specialist Manager at Medely, previously led the nursing department at a mid-sized Ambulatory Surgery Center that averaged 500 cases a month.

 “I felt very passionate about working there, the people who did the work, and the care that we were providing,” she said. “Moving into that role felt like a natural transition for me.”

Karla Williams, Clinical Specialist Manager at Medely

But the move wasn’t without its challenges. We recently asked Williams for her best tips for new Directors of Nursing or anyone considering that career move in the future. Here are five things she wishes she’d known ahead of time

1. Identify where your support network will come from

One thing Williams found invaluable was having a group of trusted peers she could turn to. So, one of her top tips for new nursing directors is to figure out where to turn for help and how to build your network. 

“I wish I’d known from the start where my support network was—other people in my position I could text or email to get insights and information,” she said.

One of the most effective ways she found to connect with other DONs was by joining industry and professional organizations and participating in online forums, going to conferences, and participating in workshops. 

It took time to create a network. But Williams said the shared expertise helped her navigate a lot of different situations: “If I didn’t have a resource person available, I could ask my network or post in the forums and people were always very responsive.” 

2. Learn how to delegate and walk away

Delegation and prioritization are essential at every stage of your nursing career. But when you’re a director of nursing, effective delegation is the only way you’ll be able to get things done. 

“You have to be able to delegate and walk away,” Williams said. 

First of all, it’s an excellent way to recognize strengths and leadership skills in other members of your nursing team. But, more importantly, if you’re completing day-to-day tasks, you won’t have the time or energy to do the higher-level planning and oversight that your position demands.

3. Remain up-to-speed on regulatory requirements

One of Williams’s most significant challenges was learning the appropriate federal and state regulations, ensuring compliance, and preparing for inspections. 

Requirements vary by location but can impact a wide swath of activities, including:

  • Staff-to-patient ratios
  • Patient care plans
  • Protocols around patient data
  • Food and nutrition

Navigating regulatory issues is one area where Williams said a local professional network could be beneficial.

4. Explore different staffing options

Budget considerations are top-of-mind for healthcare facilities, and Williams was no different. However, while her facility didn’t have the finances to hire travel nurses and allied pros regularly, she does wish she’d had a tool like Medely to explore her options.

“We had a small pool of professionals that we used,” she explained. “If they weren’t available, I either stepped in to fill that position, or we had to operate shorthanded.”

The extra support can make a difference, she said. “First, just having extra help available would have made a huge difference for the staff themselves. And when you have plenty of staffing, and people feel energized, it has a positive impact on patient care.”

To mitigate periods when the facility needed more resources, Williams would step back into bedside care—but that took away from her ability to do her duties as DON. It’s challenging to find the right balance between needs and budget.

Working with an on demand healthcare staffing platform like eases the stress of finding staff for DONs across the country. The ability to simply post a per diem job or longer local or travel assignment helps thousands of like-minded DONs meet the patient-staff ratios they require. 

5. Ask for help when you need it.

“Don’t be afraid to ask questions of anybody that you’re working with,” Williams said. “You can’t be expected to have all the answers, and—often—your nursing personnel or allied departments are going to have the answers.”

Asking for help can feel intimidating when you’re in a new healthcare facility or position, but don’t let that hold you back. When Williams first took on a leadership role as a registered nurse (RN), she was the youngest person in her group and felt like she had to prove herself. She learned that to gain someone’s respect, you need to be respectful of their position and knowledge.

Planning ahead? Take any leadership opportunities you can get.

Leadership is central to the role of nursing director, and while there are books you can read and courses you can take, those critical skills can come from anywhere. “Consider the role you’re in right now and look for opportunities, like being a team lead or spearheading a new initiative,” Williams suggested. These opportunities can be a great way to improve your communication skills and management skills.  

It can also be helpful to find ways to cross-train yourself and make connections with people in other nursing units and specializations, so you gain a better understanding of staff operations, operating procedures, and what different roles entail.

Ultimately, being a Director of Nursing is a demanding and rewarding way to impact patient care and the facility’s nursing program directly. And, our caring team of RNs at Medely are ready to help you find the on demand per diem, local, and traveling staff you need to run your facility smoothly. When you have a better sense of what to expect on day one, you can take steps to make sure you have the proper support in place when you need them.