The Wrong Way Leaders Respond to Toxic Employees

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Amani has been working as an ICU nurse for decades and has a reputation for eating students, new nurses, and new physicians for breakfast! When employees are hired, they are often warned about Amani. When nurses get pulled to the ICU, they are warned about Amani. When there is a change in leadership in the ICU, they are warned about Amani.

Toxic Employees

Amani is a toxic employee and everyone knows it. New nurses drop like flies and experienced nurses somehow find ways to transfer to other units. Turnover is high and staff morale is low.

Why is Amani allowed to continue working if she is so toxic?

Amani remains employed for 1 primary reason: Amani is an excellent clinician.

She is the one you want to work with when a patient codes and the one you want caring for your mother. Amani has saved numerous lives and prevented numerous errors (by both physicians and nurses). Amani never seems to get tired or burned out and therefore works as much overtime as needed.

Everyone, even the leadership team, tolerates Amani.

Nurses share their horror stories about the meanest, nastiest nurse (like Amani) who is somehow allowed to continue wreaking havoc on their unit without fear of discipline from the manager. Although at times, complaints may be filed against this person, the leadership team typically responds in one of 4 ways:

  • Deny (I can’t believe she would really do that…)
  •  Minimize (how bad could she really be?)
  • Rationalize (you know, her life really hasn’t been easy…)
  • Intellectualize (but she’s such an excellent nurses. The physicians love her!)

Amani was so hypercritical, unapproachable, and evil to her coworkers (oh, but her patients LOVED her!). When a complaint was filed against her by a group of her peers, the solution “brilliantly” thought up by management was to send the entire unit, all 75 of them, to a 4-hour workshop on how to deal with negative co-workers. Seriously? Imagine the cost to the unit in terms of dollars AND morale. Basically what management was saying was that the staff was helpless to do anything about it. No wonder the nurses were leaving in droves.

Instead of justifying toxic behavior, leaders need to FTB – which stands for FIRE THE BULLY!

I don’t care if the nurse is the second coming of Albert Einstein and can hold her bladder for 24 hours. If she is a bully and you’ve told her to stop, she needs to be fired!

Bullying undermines a culture of collaboration, a healthy work environment and patient safety – period. Got a bully? She needs to go no matter how “great” she is.

Instead of denying, minimizing, rationalizing, or intellectualizing, leaders need to follow these 3 steps when dealing with toxic employees:

  • Set expectations for behavior – Meet with your toxic employee and tell her what behaviors you expect. Be specific and be direct.
  • Identify consequences – Tell her what will happen if she doesn’t comply.
  • Follow-through on consequences – Then tap into your moral courage muscles and do it! Even if it means you will lose your best clinician, be short staffed, or the physician will be mad.

In the book, The No Asshole Rule by Robert Sutton, he shares that many organizations wait too long to get rid of their toxic employees. Once they do, the reaction is usually, “Why did we wait so long?”

What we ignore, we condone. What we tolerate, we become. Bullying has no place in a profession that is supposed to be caring and compassionate. Stop tolerating bullying no matter how “brilliant” the person is. FTB instead!

ReneeThompson_013_HRThanks so much for reading. Take care and stay connected.

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Dr. Renee Thompson works with healthcare organizations who want to overcome the leadership and clinical challenges their people face every day. If you’d like to find out more about her programs, please visit her website

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2 thoughts on “The Wrong Way Leaders Respond to Toxic Employees”

  1. I believe it comes down to the culture of the organization. If the organization has but does not enforce a no bullying environment across the organization and apply to all, the message gets sent that no bullying only applies to a certain few.

    1. Renee Thompson

      Thanks for commenting Cynthia. Culture eats strategy for breakfast. You are so right! You can’t hold SOME people accountable but not others. When you say “no tolerance” it should include everyone!
      Kind regards

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The Healthy Workforce Institute is the global leader in addressing disruptive behavior in healthcare. Through our cadre of services, we provide the strategies, skills, and solutions to address any incidences of disruptive behaviors that show up in healthcare.

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