3 Steps Leaders Can Take to Promote a Healthier Work Culture

Workplace Bullying and Incivility

Every day, Renee Thompson, DNP, RN, FAAN, CSP, hears from someone facing incivility at work.

Thompson, the founder and CEO of the Healthy Workforce Institute, says that workplace bullying and incivility have become a “huge problem” that’s getting worse. A recent report from MIT shows that a toxic work culture is the leading cause of employee turnover, and Thompson says that when it exists in healthcare, there’s evidence to support that it affects patient outcomes.

“There was a study by the American Medical Association that showed that rude surgeons have higher infection rates with their patients. That shows that the way people treat each other is just as important as the care they provide,” she said. “The U.S. Surgeon General also says toxic workplaces are not only bad for mental health, but physical health as well.”

An October report from the U.S. Surgeon General concluded that stress could disrupt sleep and increase your vulnerability to infection and risk for other chronic health conditions.

Thompson says it’s up to nurse leaders to determine the culture in their department and deal with negative behaviors. “Organizations don’t often do a good job equipping their leaders with the tools they need to address bad behavior,” she said. “So, they often end up doing nothing.”

While nurse leaders might not always know how to deal with negative behavior, Thompson shared three tips on how they can start:

1. Heighten awareness of disruptive behaviors. “We need to be talking about bad behaviors, because we’ve normalized deviant behaviors,” Thompson said. “We say ‘that’s just the way he or she is,’ but before you can change a work culture, you must heighten awareness. You can’t expect someone to adapt their behavior if they don’t know it needs to be adapted. If no one has ever told someone that a way they’re acting is unacceptable, they will think it’s OK.”
2. Set noticeably clear behavioral expectations. Thompson said healthcare organizations have performance expectations and a Code of Conduct, but there needs to be more. “Each department must come together and talk about how they want to be treated. Everyone needs to have a voice in that discussion (surgeons, techs, anesthesiologists, and nurses), and create a document based on the themes they discuss,” Thompson said.
3. Confront disruptive behaviors. When dealing with disruptive or rude behavior, organizations need to equip leaders with what to say, how to say it, and when to say it, Thomson said. “In a situation where someone says something that’s unacceptable, you have to interrupt them immediately. If you don’t say anything at that time, you’re saying it’s OK to behave like that. It’s important to catch their attention, name the behavior, and ask them to stop,” Thompson said. “Many times, in the moment, leaders are ignoring it and then talking about it later with other colleagues.”

Ultimately, can a negative work culture change for the better? Thompson says absolutely.

“It works when leaders are equipped, and employees are empowered with tools and supports,” she said. “We’re seeing amazing transformations in some work cultures.”

If you want to learn more, Thompson leads a Leadership Summit session at AORN Global Surgical Conference & Expo 2023 aimed at helping leaders understand what bullying is and isn’t. She also plans to share strategies to confront negative behavior and tips to cultivate professionalism, respect and kindness at work.  

Thompson is the CEO and founder of the Healthy Workforce Institute. To learn more, read the organizations’ blog.

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