7 DON Onboarding Mistakes You're Making (and How to Fix Them)

You just hired a new Director of Nursing. She has fifteen years of clinical experience, a stack of certifications, and references that made your decision easy. You handed her the keys, showed her the office, and wished her luck.

Now you're wondering why she's already talking about leaving.

Here's the hard truth: the first 90 days of a DON's tenure are the most dangerous. Not because of surveys or state visits. Because of everything that happens before anyone from corporate even shows up.

The industry has perfected the art of auditing buildings. But we're terrible at onboarding the humans who run them. And that gap is costing you more than you realize: in turnover, in culture collapse, and in survey outcomes that could have been avoided.

Let's talk about the seven mistakes you're probably making. And more importantly, how to fix them.

Mistake #1: Assuming Clinical Expertise Equals Leadership Skill

Your new DON was an incredible nurse. Maybe she was a Unit Manager or an ADON who knocked it out of the park. So you promoted her or recruited her, expecting that same magic to transfer.

But here's what nobody tells you: clinical skill and leadership skill are two completely different muscles.

A great nurse knows how to manage a patient crisis. A great DON knows how to manage a staff crisis, a family crisis, a survey crisis, and a corporate crisis: all before lunch. That requires executive function, boundary-setting, and the ability to hold people accountable without burning the building down.

The Fix: Stop hiring for clinical credentials alone. Start assessing for leadership readiness. And if they're not there yet? Build it. That's what we call Leadership Architecture: the foundational systems, boundaries, and executive skills that turn a good nurse into a confident leader.

Mistake #2: The "Sink or Swim" Hand-Off

You know this one. The outgoing DON left two weeks ago. The new one shows up on Monday. Someone hands her a ring of keys, points at a desk covered in binders, and says, "Good luck. Call if you need anything."

This is the "Sink or Swim" approach. And it's drowning your leaders before they even get started.

A DON walking into a new building needs context. She needs to know where the landmines are: the staff dynamics, the unresolved grievances, the survey history, and the unwritten rules that nobody put in a manual.

The Fix: Create a structured hand-off process that lasts at least two weeks. If the outgoing DON isn't available, assign someone who knows the building's history. Document everything. And for the love of all things compliant, don't leave her alone on day one.

Mistake #3: Ignoring the Culture and Team Dynamics

Every building has a culture. Some are healthy. Some are toxic. Most are somewhere in between.

When a new DON walks in, she's not just inheriting a census and a survey schedule. She's inheriting relationships, resentments, and unspoken alliances that have been forming for years.

If you don't brief her on the team dynamics, she'll spend her first 60 days stepping on landmines she didn't know existed. And by the time she figures it out, she's already lost credibility with half the staff.

The Fix: Before her first day, sit down with her and map out the team. Who are the informal leaders? Who has history with whom? Where are the friction points? This isn't gossip. This is intelligence. And it's the difference between walking into a room with confidence and walking into a trap.

Mistake #4: Overwhelming Them with Audits Before They Have "The Room"

Here's a scenario I see constantly: New DON starts on Monday. By Wednesday, corporate has scheduled a chart audit, a wound audit, and a "check-in" that's really just a compliance interrogation.

The intention is good. You want to support her. You want to know where the building stands.

But what you're actually doing is putting her under a microscope before she's had a chance to breathe. She doesn't have "the room" yet: the staff doesn't trust her, the systems aren't hers, and she's still figuring out where the supply closet is.

The Fix: Give her 30 days before the heavy audits begin. Let her observe, listen, and build relationships first. The audit results will be more accurate, and she won't feel like she's already failing before she's started.

Mistake #5: No Dedicated Mentor (External from Corporate)

Your regional team is great. They know regulations. They can tell your DON exactly what CMS expects and where the building is falling short.

But here's what they can't do: they can't be her safe space.

A DON needs someone she can call at 9 PM when she's spiraling about a staffing crisis. Someone who won't judge her, won't report her, and won't add to her to-do list. Someone who's been in the chair and understands the weight of those keys.

Corporate support is valuable. But it's not mentorship. It's oversight dressed up as help.

The Fix: Invest in external mentorship. Someone outside the corporate chain who can provide peer-to-peer guidance, accountability, and: let's be honest: a place to vent without consequences. This is exactly what our 90-Day Remote Roadmap provides. It's Leadership Architecture delivered by someone who's carried the keys, not just audited them.

Mistake #6: Expecting Immediate Survey Readiness Without Stabilization

You hired her because the last survey was rough. Maybe there was an IJ. Maybe the building is on a correction plan. And now you're expecting her to walk in and fix it all in 30 days.

That's not leadership development. That's crisis triage with unrealistic expectations.

A new DON can't be survey-ready if she's not stable. And stability takes time: time to learn the systems, time to earn trust, and time to implement changes that actually stick.

The Fix: Set a realistic 90-day stabilization plan. The first 30 days are about observation and relationship-building. Days 31-60 are about identifying priorities and building systems. Days 61-90 are about execution and survey prep. Rushing this timeline doesn't make her faster. It makes her gone.

Mistake #7: Not Protecting Their "Off-Clock" Time

This is the silent killer.

Your new DON is eager to prove herself. So she answers every call, responds to every text, and shows up on her days off "just to check on things." Within 60 days, she's exhausted. Within 90, she's burned out. Within 120, she's updating her resume.

You might think this is her problem to manage. But it's not. It's yours.

If you don't model and enforce boundaries, she won't set them herself. And a burned-out DON doesn't just leave. She makes mistakes. She snaps at staff. She misses things. And eventually, the building pays the price.

The Fix: From day one, make it clear that off-clock time is sacred. Don't text her on weekends unless it's an emergency. Don't expect her to answer emails at midnight. And if she's doing those things anyway, have a conversation. Her boundaries are your retention strategy.

The Bottom Line

Hiring a DON is expensive. Losing one is more expensive. And most of the time, the loss could have been prevented with a better first 90 days.

The mistakes on this list aren't about bad intentions. They're about a system that's designed to audit buildings, not support leaders. And until we change that system, we'll keep losing good people to burnout, frustration, and quiet resignations.

At Don 2 Don Development, we built the 90-Day Remote Roadmap specifically for this high-risk window. It's not another audit. It's Leadership Architecture: the systems, boundaries, and executive skills that turn a new hire into a confident, stable leader.

Because the industry doesn't need more compliance checklists. It needs DONs who can actually survive long enough to use them.

If you're an Administrator or Executive watching your DON investment walk out the door, it might be time to rethink the first 90 days. The building can't stabilize until the leader does.