If you want to create a high-performing, respectful team, one of the most important things you can do is learn how to break the “us vs. them” mentality. In an environment where teamwork literally saves lives, division among staff destroys trust, drains morale, and ultimately harms patients.
From day shift versus night shift, nurses versus physicians, newcomers versus. veterans, and even staff versus. leadership — the “us vs. them” mentality is everywhere. While it may seem harmless or even playful at first, it can quickly develop into toxic subcultures that push people apart and hinder their ability to work together effectively.
Why it matters
Learning how to break the “us versus them” mentality isn’t just about being nice. It’s about creating a culture where everyone feels valued and connected, which has a direct impact on patient outcomes. Research shows that managers spend up to 20% of their time managing conflict. More than 79 million employees experience workplace bullying, and 65% say it came from a leader. Not only is this a morale problem, but most importantly, it’s a patient safety issue.
If we want to create a culture of safety, trust, and respect, we have to dismantle these invisible walls.
Where it shows up
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Generations
From Gen Z to Baby Boomers, age-based stereotypes and judgments flourish. Ageism remains one of the last socially accepted prejudices, and it divides teams that could otherwise learn from one another. Younger employees may be dismissed as entitled, while older colleagues are seen as outdated.
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Shifts and units
Whether it’s day shift vs. night shift, or this hallway vs. that hallway in an ambulatory care setting, physical and temporal silos are common. These divisions become battlegrounds of comparison and resentment, even though everyone is technically on the same team.
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Staff versus leadership
When frontline staff refer to leaders as “management” with a tone of skepticism or disdain, the message is clear: there’s a perceived disconnect. Comments like “Wonder how long she spent at the bedside” imply a lack of credibility and fuel a sense of alienation.
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Newcomers versus veterans
Both nurses and physicians often fall into the trap of “eating their young.” Hazing is rationalized with phrases like, “That’s just the way it is here.” This unwritten code discourages innovation and drives away promising professionals.
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Agency versus home staff
During the pandemic, agency and travel nurses filled critical staffing holes but were often met with hostility. These nurses—who stepped in to help—were labeled outsiders. A typical response: “She’s a floater. She doesn’t belong here.” Leaders frequently reached out asking for help to resolve this very issue.
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Role hierarchies
Internal hierarchies between departments or roles – like ICU vs. Med-Surg, nurses vs. assistants, inpatient vs. outpatient, physician vs nurse – create false superiority complexes and cause conflict.
One of my favorite examples is from Good Will Hunting: a janitor solved a complex math problem that stumped the “geniuses.” It’s a powerful reminder that brilliance and worth aren’t defined by titles.
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Healthcare team versus patients
Disdain towards patients is another “us versus them” dynamic. When we criticize their choices or call them “non-compliant” (sometimes even within earshot at the nurses’ station) we erode trust and lose sight of our empathy — the heart of what we do.
The cost of division
When we don’t learn how to break the “us vs. them” mentality in healthcare, it erodes morale, reduces collaboration, compromises patient safety, and stifles innovation. It drives good people away.
How to break the “us vs. them” mentality in healthcare
- Model inclusive leadership
Leaders set the tone. Use inclusive language, publicly appreciate all roles, and avoid creating or reinforcing silos. - Open up communication
Create shared spaces — huddles, town halls, cross-department meetings — where everyone can share and feel heard. Facilitate conversations around shared goals and open communication. - Normalize healthy conflict
Acknowledge common values and differences equally. Use activities like: “How are we the same? How are we different?” Encourage your team to focus on ideas, not personal attacks. Disagreement can be healthy if handled with respect. - Build vulnerability-based trust
Celebrate honesty and openness. Encourage phrases like “I need help,” or “I screwed up,” or “Your idea was better than mine.” These build a foundation of trust. Group activities like sharing childhood stories or discussing personal challenges can build this kind of vulnerability-based connection. - Build a team-first philosophy
Shift from “I” to “we.” Recognize team successes, highlight unsung heroes (housekeepers, support staff, etc.), and avoid individual credit hoarding. Ask, “Do you want to be a star or a champion?” Remind your people that there is a difference. Being a “star” is a single accomplishment while being a “champion” reflects the team. - Encourage social connection
When people connect outside of work, they see each other as human first. Social gatherings or shared service projects can help break walls. - Use practical activities to reinforce unity
• Appreciation rounds: Instead of focusing on what’s wrong, encourage your team to identify what is right. Start meetings by recognizing someone’s help or contribution. This helps move past the negativity bias while also removing the us vs. them mentality.
• Reflection exercises: Ask team members to write down on sticky notes one thing someone does that improves the team and one thing that someone does that harms the team. No names – just behaviors. Put them all up on easel paper and review together.
• Conflict as a puzzle: Remind teams that different approaches can still lead to the same outcome — like completing a puzzle together. For example, my best friend Kimmy and I both started with the border. But after, I pick an image to work on while she organizes pieces by color. We both end up with a completed puzzle, but with a different approach.
Final thought
In healthcare, every person — from frontline caregivers to executive leaders — has a role to play in erasing the invisible walls that divide us. Learning how to break the “us vs. them” mentality in healthcare is crucial if we want to build a culture where people feel respected, safe, and motivated. When we unite as one team, we create an environment where both staff and patients thrive.
Ready to take real action and break the “us vs. them” mentality once and for all? Book our keynote, Breaking the Cycle: Empowering Leaders to Address Bullying and Incivility. Let’s finally break the cycle — together.
