1. Raso, Rosanne RN, NEA-BC, MS

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Hiring the right people who both fit with the team and function in the team per expected competencies is a critical responsibility of nurse managers. It isn't unusual to be anxious to fill vacancies and not apply rigor and well-documented strategies to selection and early retention processes. In reality, staff members often say they would rather work short than work with the wrong people. Hiring right puts you in a position to improve the work environment for your staff, decrease turnover and related costs, and ultimately improve patient care. But how do you move from evaluating a potential employee on paper to evaluating the actual person?


How to do it

It does "take a village" to hire right. The process usually starts with the recruitment department, where marketing, screening, and vetting of applicants occurs before they reach the hiring manager. Basic required skills and certifications are evaluated at this step. You shouldn't see an applicant who doesn't pass recruitment screening. After you've met with the applicants and decided on a candidate, staff involvement is next during the peer interview process. Finally, early transition begins with the nursing education department for orientation, followed by unit staff for preceptorship and mentorship. Your close eye and assessment during the probationary period is essential. Each of these stages involves multiple people and all are vital to well-chosen staff. Let's break it down.


One of the most proven interview strategies is behavioral interviewing.1,2 The idea is to tailor the interview to target the desired qualities and have the candidate talk about how she performed in the past relative to those qualities. All the behavioral-based interview literature confirms that past behavior and functioning is the best predictor of future performance. However, before establishing behavioral-based interview questions, you must decide which competencies are required. The recruiter will most likely focus on meeting posted job requirements, as well as overall competencies such as communication, service, and teamwork. Bilingual skills may be required for some positions in organizations focused on cultural competency. Recruiters are very skilled at screening and identifying the right applicants for fit and function in the organization, so if they're cautious about anyone, beware!! You may focus on competencies specific to the unit, such as discharge planning, pain management, healthcare provider collaboration, or even handling schedule changes. Each defined competency should have a behavioral interview question; don't waste time asking questions that don't relate to the job. You may also be looking at personality fit for the unit, such as outgoing, intellectual, team-oriented, or calming qualities.


The behavioral-based interview is one of story-telling, not hypothetical, yes-no questions and answers. For example, if building patient-family caring relationships is important, you may ask questions such as:


[diamond operator] "Tell me how you've developed caring relationships with patients."


[diamond operator] "Give me an example of a patient with whom you developed a caring relationship. How did you develop it?"


[diamond operator] "Describe how you involve the family in patient care and give me an example."



As you can see, some questions aren't really questions at all, but open-ended statements designed to allow the candidate to tell her story. Take notes during interviews so you can recall answers, and then rate and compare the candidates. When the candidate enthusiastically answers questions and describes one or more relevant situations, you'll feel the connection to your organization's values.


New graduate interviews will be different in that the candidate won't be able to describe previous behaviors as a nurse; however, you can tailor the interview to touch on expected competencies. For example, these are questions from the tool used in my organization for new graduates:


[diamond operator] "Describe the clinical rotation you enjoyed the most and why."


[diamond operator] "Were you part of a team project and what contributions did you make?"


[diamond operator] "Tell me when you've made a patient or family feel you care."


[diamond operator] "What three words would your teachers use to describe you and why?"



Peer interviewing is the next step. Involving staff in the selection process is helpful for several reasons, including promotion of staff engagement and input into the candidate's fit at the unit level. It also promotes staff investment in the success of the new employee during orientation.3 Staff members should have their questions ready in advance. You may arrange for a 1:1 peer interview or a group interview, although more than two or three staff members at a time may be intimidating for the candidate. Staff members may also give the candidate a unit tour and use the time to ask some questions while they're walking. Reactions and questions from the candidate may be meaningful to the selection process.


There are a few other components of the process that should be considered. For example, reference checks from previous employers can be extraordinarily helpful if you can ascertain more than dates of employment. Also, some organizations use prescreening tools, tests, or surveys. If a valid and reliable instrument is used, the results can be valuable. Lastly, a part of the interview that really isn't optional is explanation of job expectations. There should be no surprises for a new hire during her transition to the workplace and if there are, the chance of a successful hire is diminished.


Posthiring tips

Early evaluation and retention processes are the next important stages in hiring right. It's during this time that you find out if the selection steps led you to the right person for the job. Classroom and clinical orientation, usually coordinated by the nursing education department, not only prepare the new hire, but also give her lasting first impressions and give you time for early evaluation. Managers should meet regularly (at least monthly for the first 3 months) with the new employee to obtain bidirectional feedback.3 During these meetings, determine whether expectations are being met for both yourself and the employee. If not, determine what can be done to correct the situation. You must also use the probationary period wisely. If the new hire isn't fitting in or meeting expectations despite tailored plans and support, cut your losses and move on. This should be happening less than 10% of the time if the selection process is working.


Fit and function

Interviewing and hiring are learned skills. The time spent on recruitment and early retention is well worth it in terms of right staffing to promote a healthy practice environment for employees and patients. Practice, preparation, and sound techniques improve the likelihood of finding staff members who both fit with the team and function in the team.




1. Studer Group. Behavioral-based interview questions.[Context Link]


2. Hunt ST. Hiring Success: The Art and Science of Staffing Assessment and Employee Selection. Hoboken, NJ: John Wiley and Sons; 2007:52-55,72-75. [Context Link]


3. Studer Q. Must Haves Video Series: Volume 3: Selection and the First 90 Days. Studer Group; 2003. [Context Link]