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Writer's pictureBilquis Ali

How to Handle Difficult Conversations as a Director of Nursing:



As a Director of Nursing (DON), I've had my fair share of difficult conversations. In fact, just thinking about them makes me chuckle now, but trust me, it wasn’t always that way.


One of the most challenging aspects of my role was conducting evaluations. If you’re anything like me, the idea of hurting someone’s feelings doesn’t sit well with you.


But the hard truth is, if you want to grow your team and achieve positive outcomes, you need to master the art of tough conversations.


The Evaluation Dilemma: When Honesty Feels Like "Negative Nancy"

I’ll admit it—I used to dread evaluations.


I mean, who wants to be the person that rains on everyone’s parade?


Most of my employees were used to receiving sky-high scores, and then there I was, coming in with a dose of reality.


I felt like "Negative Nancy," the one who had to ruin their day with constructive criticism.


But here’s what I learned: You’re not there to be everyone’s best friend. You’re there to lead.


You’re a Leader, Not a Friend


Wouldn’t it be nice if you could be friends with everyone on your team? Sure, but that’s not your primary role.


Your job is to lead, to produce outcomes, and to ensure that your team is performing at its best.


This often means having conversations that might be uncomfortable but are essential for growth.


In my early days, I struggled with this concept.


I wanted to be liked, and I avoided difficult conversations, hoping things would magically improve.


Spoiler alert: they didn’t. Avoiding the tough talks only led to bigger issues down the road.


I realized that being a true leader meant embracing those uncomfortable moments and using them as opportunities for growth—for both my team and myself.


How to Navigate Difficult Conversations


Here are some strategies that helped me turn those dreaded conversations into productive, even empowering, experiences:


  1. Prepare, Prepare, Prepare


    • Know what you need to address and have specific examples ready. Vague feedback won’t help anyone improve. Be clear about what the issue is and what changes need to happen.


  2. Approach with Empathy


    • Yes, you’re delivering tough feedback, but you can do it with compassion. Acknowledge the person’s strengths before diving into areas of improvement. This helps balance the conversation and makes the feedback easier to digest. I once had an employee stop speaking to me because of an evaluation they received. (ouch)


  3. Stick to the Facts


    • It’s easy to let emotions take over, especially if the conversation is about something that’s been building up for a while. However, sticking to the facts and avoiding personal judgments will make the discussion more constructive.


  4. Encourage Dialogue


    • Make it a two-way conversation. Allow your employee to express their thoughts and feelings. Sometimes, you might find out there’s more to the story, and it gives you both a chance to come to a mutual understanding.


  5. Follow Up


    • After the conversation, set a time to follow up on the progress. This shows that you’re invested in their growth and that you take their development seriously.


The Outcome: Growth for Everyone


Over time, I realized that these difficult conversations weren’t about tearing people down—they were about building them up in the right way.


When approached thoughtfully, these talks can lead to significant improvements in performance and overall team dynamics.


So, the next time you find yourself dreading an evaluation or another tough conversation, remember this: You’re not "Negative Nancy." You’re a leader with the responsibility to guide your team to success. 


Embrace it and watch both your team and your leadership skills grow.


In the end, leading isn’t about making everyone happy all the time.


It’s about creating a space where growth happens, even if it’s uncomfortable at first.


And trust me, when you start seeing the positive outcomes of those tough conversations, you’ll be chuckling too.

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