When the Charge Nurse is the Bully

Mean NurseMalaya is the charge nurse on an inpatient oncology unit. She is loved by the patients but hated by her colleagues. She takes 4-5 smoke breaks during her 12-hour shift; each 20 minutes long. Because she is the most experienced nurse on the unit, the newer nurses feel unsafe during her absence since they are dealing with blood transfusions and chemotherapy. If she doesn’t like you, watch out because she will make your life miserable by giving you the worst assignments, won’t relay accurate information obtained from physician rounds (the charge nurse rounds with physicians), and will somehow find a reason to get you in trouble. No one dares to bring this up because if she finds out, she’ll retaliate (she’s done it before). Everyone’s afraid to speak up for fear of what she’ll do.

I hear stories like this one over and over again.

The Reality

We put people into a charge position typically because they are really competent at their job. But being competent doesn’t make you a good charge nurse. In fact, the charge role can allow a competent unprofessional nurse the opportunity to wreak havoc on your department.

The reality is…

  • Charge nurses are NOT formal leaders but are expected to act as leaders
  • It’s rare that organization’s offer ongoing professional development for the charge role beyond the initial class
  • The charge nurse can destroy the team because they hover under the radar

Be warned…

The charge position is a power position. If given to the wrong person AND if they are not developed and watched, they can become the queen or king bullies on the unit.

Yet another example…

A colleague recommended me to one of her clients who was dealing with Brenda, a toxic charge nurse, in her ICU.

Brenda was extremely competent, had been there for over a decade, and was LOVED by the physicians.  Brenda made assignments based on whether or not she liked you, would befriend new nurses and then set them up for failure, would undermine everything Kim, the manager, did, and would basically change her schedule if she didn’t like it, etc.

The staff described her as beastly on a good day. During a focus group meeting, Brenda actually stood and arrogantly said, “Kim thinks she’s in charge. I’M THE ONE WHO’S IN CHARGE HERE!”

Any attempt Kim made to discipline Brenda was met with harsh criticism by the physician team. So Kim did nothing until her turnover rate reached 50% in her department. Then she asked for help.

And yet another…

I recently discovered the depth of bullying by some of the charge nurses. On one unit, if the charge nurse liked you, she gave you the easier patients. If she didn’t, you got the most complicated, worst patients. Some nurses figured this out. If they knew she was working, they would call when they knew she was making assignments; play dumb, “Oh. I didn’t know you were working today…” and then offer to “stop by Starbucks” to bring her favorite coffee. They resorted to bribing her just to get an easier assignment.

The manager had no idea this was going on.

5 Strategies Leaders Can Adopt When the Charge Nurse is the Bully

If you’re the leader in a department and suspect or know that your charge nurse is a part of the problem, follow these strategies:

1. Observe

So often we make assumptions that if we put someone in the charge role that they’re “good to go” and that we don’t need to worry about them. How wrong that is!!!

Pay attention.  Check the assignments after the charge nurse makes them. Are they fair?

Watch for any negative body language – not just from your charge nurse; pay attention to how others react towards her. Do your new employees appear afraid when around her? Are they trying to “butter her up” so that they don’t become her next target?

The key is to start paying attention.

2. Engage in honest conversations

Chances are, nobody has actually told this nurse that she’s toxic!! Don’t assume she knows. She may have received so many accolades for her performance that she doesn’t even realize there’s a problem.

You can’t fix something if you don’t know it’s broken. Tell her.

Schedule a meeting with her. Tell her that you want to talk to her about something that is uncomfortable for you to say and may be uncomfortable for her to hear. Tell her that you need to be honest with her about her behavior. That although she is clinically competent, the way she treats people is not okay.

In your conversations, use key statements such as:

– It’s not okay the way you’ve been treating your coworkers.
– You are incredibly competent, and I also need you to step up and act in a professional manner.
– This is a professional environment yet you have not been treating your coworkers professionally.

To read more about toxic nurses, click here.

3. Provide leadership training

Although education and training don’t solve problems, by providing ongoing leadership development for your charge nurses, you are better able to influence their behavior and teach them the essential skills needed to step up as leaders, even though they’re informal leaders.  Providing an initial charge nurse class isn’t enough!

4. Start a documentation trail

Start documenting as soon as you sense a problem. To be in charge, most organizations have an additional job description or at least written expectations for their charge role.

For example:

Demonstrates collaborative and respectful behaviors

Attends 80% of staff meetings

Gives honest feedback to staff, keeps the individual’s confidences

Make sure you’re documenting how your charge nurse is violating the expectations. Be sure to include dates, times, locations, any witnesses; describe any incidents and the impact. Also include any verbatim comments, “She’s [the manager] not in charge. I am!” Because the charge nurses are usually so competent, you will need to build a compelling case if you choose to therapeutically extract them.

Document, document, document.

5. Remove his/her power

During a coaching call with one of the leaders in my online academy, she wanted to talk about how to handle a charge nurse who never attends staff meetings (it’s a requirement), doesn’t do her mandatory audits, undermines her authority, and is a toxic force in her department. My advice?  I recommended that she remove her power – take her out of the role immediately.

When small acts of incivility or disruptive behaviors go unchallenged or ignored, these people gain a sense of power. This power leads to more and more acts of aggression to the point where they feel untouchable.

If your charge nurse is the problem, it doesn’t matter how clinically competent he or she is. Take him/her out of the role. Period.

Never, never, never allow someone who isn’t a professional role model to stay in a power position.  People with power are more likely to abuse those without it.

Make no mistake about it. The charge role is a power role. Make sure you have the right people in that role because if you don’t, you’re putting everyone else at risk.

If you need help to address disruptive behaviors in your department, stop trying to figure it out on your own. Call us instead!!

The team at the Healthy Workforce Institute is ready to help you cultivate and sustain a healthy and professional workforce culture. Check out ways other organizations get the help they need by clicking here.

Be kind. Take care. Stay connected.

Renee Thompson

About Renee Thompson

Dr. Renee Thompson is a keynote speaker, author and professional development/anti-bullying thought leader. Renee spends the majority of her time helping healthcare and academic organizations address and eliminate bullying behavior. To find out how you can bring Renee to YOUR organization or nursing event, visit www.healthyworkforceinstitute.com

There are 9 comments on this post
  • Renee Thompson
    Jan Lee
    Dec 11, 2018 Reply

    Very good. Facility has to be willing to remove a bully who is in position of power.

    • Renee Thompson
      Renee Thompson
      Dec 11, 2018 Reply

      Exactly. Thanks Jan for taking the time to comment!!

  • Renee Thompson
    Jacque
    Nov 15, 2018 Reply

    This is right on target with what goes on behind management's back. And they do allow it and look the other way to get the job done. I believe anytime you have hierarchy systems, you have abuse of power. Especially when people such as charge nurses really don't have true credentials to manage people. Yes, the problem is overall shortage, but I believe the whole issue of bullying/domination/ favoritism should be addressed in nursing school just like when they address how nurses are legally obligated to be ethical in practice. Set up the model before they get their degree. It will not totally stop it, but it will put it on notice--others are looking at you. I was managed, bullied and overlooked in this profession. You couldn't get me back into this dysfunction in a million years now. Older and wiser.

    • Renee Thompson
      Renee Thompson
      Nov 15, 2018 Reply

      Great points Jacque. We do need to start early - when we are in nursing school. However, we also have a broken (at times) academic environment with a lot of disruptive behaviors being overlooked in academia too. Hoping to change that! I'm so sorry we lost a good nurse - my goal is to make sure we stop the hemorrhaging of really great nurses out of our profession. Kindest regards and thank you for your thoughtful comments.

  • Renee Thompson
    Jo
    Nov 15, 2018 Reply

    This is right on target with what goes on behind management's back. And they do allow it and look the other way to get the job done. I believe anytime you have hierarchy systems, you have abuse of power. Especially when people such as charge nurses really don't have true credentials to manage people. Yes, the problem is overall shortage, but I believe the whole issue of bullying/domination/ favoritism should be addressed in nursing school just like when they address how nurses are legally obligated to be ethical in practice. Set up the model before they get their degree. It will not totally stop it, but it will put it on notice--others are looking at you. I was managed, bullied and overlooked in this profession. You couldn't get me back into this dysfunction in a million years now. Older and wiser.

  • Renee Thompson
    Sarah Patrone
    Nov 15, 2018 Reply

    Great article on this topic as I have been in a position of charge nurses being toxic and documented; however there’s still no resolution and chose to resign due to unfair working environment.

    • Renee Thompson
      Renee Thompson
      Nov 15, 2018 Reply

      It's so sad that we are losing really great nurses to bullying and incivility. So often, the charge nurse gets overlooked as a source of toxicity. This article was one attempt to heighten awareness of this issue. Thank you for your thoughtful comments Sarah!

  • Renee Thompson
    Faith Brown-Schultz
    Nov 15, 2018 Reply

    One issue that I see that keeps bullies in roles of power is that we are short staffed on the best days, and management doesn't want to risk losing one of their most clinically competent, most experienced nurses, especially over something "intangible" like bullying. Also, the way bullies work, is that they have a "posse" of other mean girls who will back them up, and cause management not to believe reports of bullying. Additionally, these charge nurse bullies tend to have been at their jobs for a while, and are usually pals with the managers. The managers therefore have a level of doubt that the bully can really be "that bad", especially when combined with the first issue (understaffing).

    • Renee Thompson
      Renee Thompson
      Nov 15, 2018 Reply

      You are spot on!! I was a manager during one of the worst nursing shortages. If I didn't have staff...I had to staff + do all of my work. It was an impossible task. So, admittedly, I often overlooked the bad behavior of my nurses because I needed them. It's not right but it's the truth. I know better now and can totally empathize with the leaders who ignore bad behavior. Luckily, I know how to tackle this problem now!!!

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