Workplace toxicity is a frequent topic discussed among nurses—whether on social media, in blog posts, on podcast episodes, or in day-to-day conversations at work. Bullying, incivility, harassment, and aggressive behavior can be found in many American healthcare workplaces, and nursing can sadly be a profession overrun with toxic behaviors. We found that 76.4% of healthcare professionals said that morale in their hospital had gotten worse since this time last year.
Since so many nurses face these types of situations on a daily basis, nurses need to practice advocating for themselves and finding ways to feel empowered when faced with toxic workplaces, and managers. After all, it’s hard to have a satisfying nursing career if you don’t feel safe.
Pushing back against bullying
Self-advocacy means speaking up for yourself and making your needs, opinions, and feelings known. In your work as a nurse, your self-advocacy may look like going toe-to-toe with a nurse bully, communicating clearly with a toxic manager who seems hell-bent on making everyone’s life a living hell, or meeting with your hospital’s administration to discuss the latest evidence on safe staffing and how nurse-patient ratios on your unit are damaging patient outcomes.
If you’re being harassed, intimidated, or poorly treated by one or more colleagues, you’re not alone, and advocating for yourself is paramount. According to Our Own Worst Enemies: The Nurse Bullying Epidemic, a 2019 article published on the website of the National Library of Medicine, studies show that high numbers of both nursing students and working nurses experience bullying or other negative behavior, including up to 60% of nurse managers and executives, and 78% of students.
According to Dr. Renee Thompson, one of the country’s leading authorities on incivility in healthcare and nursing, there are specific actions a nurse can take in order to advocate for themselves in the presence of toxicity and bullying. First, negative behavior has to be documented in a formal way, and if someone can get witness statements in writing, even better. Second, if you can link a bully’s behavior to compromised patient safety, it is more likely to catch leadership’s attention.
A strong form of self-advocacy when confronted with bullying is having the courage and sense of personal power to call the bully out on their behavior. Bullies thrive on perceived weakness or vulnerability, so showing them the opposite can stop them in their tracks.
Stating what you see and how it doesn’t fit with the work environment can demonstrate your unwillingness to be a target. For example, you could say, “Rolling your eyes when I ask a question and making fun of my shoes and scrubs in front of colleagues and patients isn’t how we do things here, and I have no problem documenting what happened. I want you to know that I won’t accept being on the receiving end of such rude behavior, nor will anyone else.”
The toxic manager
A toxic boss is a human landmine that nurses may need to deal with in order to simply do their jobs. Gallup reports that, of more than 7,000 workers surveyed, 50% had left a job to get away from a bad manager.
If a toxic nurse manager or supervisor is the issue, they may show any number of behaviors, including, but not limited to:
- Taking credit for successes that they had nothing to do with
- Playing favorites, speaking negatively about certain staff members, and creating division and cliques through gossip and scapegoating
- Giving unhelpful, blaming criticism without constructive feedback
- Putting blame on others without taking personal responsibility
- Passive-aggressively ignoring or neglecting staff
When you have a toxic manager on your hands, there are options in how you can respond, keeping in mind that the power imbalance between you can often stand in the way. However, these strategies are worth a try:
- Talk openly with your manager and explain how their behavior is negatively impacting your work and morale; appeal to their humanity
- Don’t ignore the behavior; your silence can be seen as acceptance of their bad behavior
- Ask for positive, constructive feedback—and point out if the feedback is not actionable or helpful
- Find ways to be supportive and create a positive working relationship
- Just as with a bully, document incidents in a detailed manner, including witness statements, if possible
- Study and learn skills related to emotional intelligence (EI) and Non-Violent Communication (NVC)
- Have clear boundaries and maintain emotional distance by always being professional and courteous
- Bring your complaints (and documentation) to Human Resources
- Resign if necessary and seek a healthier work environment
- Most importantly, don’t blame yourself
Sticking up for yourself in the face of toxicity is necessary, but can be very difficult. But, the choice to avoid or ignore toxic behavior can often backfire, leaving you even more exposed to bullying and intimidation, not to mention burnout, compassion fatigue, and deep unhappiness and dissatisfaction.
If you focus on clear communication, strong personal boundaries, emotional intelligence, and protecting yourself, you can go far in helping your current workplace feel safer. You also might become very clear that you need to move on to a healthier environment in the interest of your mental health, your professional development, and the success of your nursing career.
Toxicity in the workplace will never be completely gone, but you can empower yourself to say no to toxic supervisors and environments. You’re a hard-working healthcare professional and you deserve better.