toxic leadership

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    Profile photo of K Mac
    Mac RN

    Has anyone survived toxic leadership with out leaving? How does a nurse passionate about patient care survive politics and intimidation by leadership?
    I am close to leaving because I don’t want to change who I am in order to get along in an enviroment where toxic leadership is permitted. However the odds of remaining and not becoming a target for speaking up looks dim. Anyone with advice? I have support from the staff , but no one wants to “stand up’ and draw fire.

    nacy nurse

    Oh, Mac, I’m so sorry. Nursing should be a career where you can do what you went to school for, Patient care, not a mess of political intrigue.
    I’d do a pro/con list on what is GOOD about your job, and what is not, and weigh the balance.
    Unfortunately, you can rarely rely count on others to join your cause. They usually have THEIR own agenda.
    Is it one person, or all or most of Leadership? That matters. If it’s just one person, you may be able to wait them out. because if they are acting miserably, maybe they, too, are unhappy, and will leave on their own.
    I had one supervisor who disliked me for a silly reason. She told me how proud she was, in her practicum, going for her NP. that a man came in for erectile dysfunction, and she was able to do a complete history without feeling embarrassed.
    I asked her if she had done a finger stick blood glucose, because often, men can ignore diabetic symptoms. But when ED kicks in, that’s what brings them to seek medical care. She said “No” and abruptly walked away. She told someone that she thought I was showing her up, by asking that. And after that, she was rude to me, and gave me evaluations that were lower than I deserved. Fortunately, she moved on 2 years later.
    But if there is widespread bullying, it may not be easy to deal with, and you may do better to just cut your losses and go. BUT, you need to see how close you are to be vested in a pension, etc. Don’t ruin your future because of poor management.
    One thing I DID learn, from a very smart, and savvy Director of nursing in a major NYC Hospital. Before you apply to a hospital, check and see HOW the Hospital started, and WHY it was established.
    I worked in a WONDERFUL hospital, that had been founded by an order of Nursing Nuns. The Hospital was VERY supportive of the Nursing staff, and we were told the Supervisors were there to SUPPORT us. If there was a problem, say an angry Patient, we called the Nursing Supervisor, and THEY dealt with it, so we could get back to Patient care. Of course, if we were at fault, we’d certainly hear about it, but no Nursing care time was wasted. We once had a Surgeon with visiting OR privileges, who’s sterile technique was appalling. Called the Supervisor, she called the Surgical director, and his privileges were revoked. They handled most problems, small or large. I foolishly thought ALL hospitals were run that way.
    Then, I took a job because it paid better, and knew THAT Hospital was founded for the convenience of the Doctors teaching at a nearby Medical school for their private Patients. I never realized what a Difference that made. If an MD wanted something done THEIR way, there was little recourse, even if their way was not in the best interest of the Patient
    I once took away the blood drawing tray from an MD that refused to call pediatrics to get a child’s blood, after the child had been ‘stuck’ multiple times. The MD told me I was “Just an assistant” I retorted that MY main job was to be a Patient Advocate. The MD clearly could not see this as a Nursing role.
    Not all situations are cut and dry like this, but doing some research ahead of time may give you an idea how much nursing is respected, and if you want to work there.
    I hope this helps, at least a little.

    Profile photo of RNHiker


    My first question is this. Is the toxic leadership exhibited at work part of the ethos of your organization? In other words, is it the prevalent style of management used in your organization? If so, get as far away from there as possible.

    If not, then form a union, if one doesn’t already exist, and address the issue with the heads of your organization.

    Toxic management styles do more damage to great organizations that one can believe. Also, large organizations many or may not know what is occurring down below–then again, sometimes they know something, “But now is willing to speak up,” so it continues. I’m not a big Union guy, but I know sometimes they are needed.

    Bottom line: If you believe in your Healthcare organization and love you what you do, then do what you can (ethically and politically) to save what is good. But remember, if after a time, they still don’t get it—get away from them and find an organization that supports your views.

    Most importantly, when you become that leader/manager use this experience to shape your own style for the good of your unit and your nurses.

    God Speed.

    – Luis, ICU RN

    Profile photo of CristyGerald

    That’s a tough situation. Have you tried addressing the leaders involved directly? If you feel you can manage, sometimes having an open, honest conversation about how you feel can be surprising. It’s sometimes possible to address the issues without putting others on the defense and getting in trouble. And if you do get in trouble, and you feel it’s a worthy cause, then hey, what do you have to lose? It’s an awful feeling when you think you have no control over it – you may end up as I did in one job, just complaining endlessly at home. Some solution has to come around or you’ll drive yourself crazy. Speak up, or move on would be my advice. Good luck!

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