When Nurse Leaders Fail their Subordinates

Have you experienced being bullied by your nurse leader or manager? Have you been humiliated by your superiors in the public? Congratulations, you met the protagonist of your nursing career, the toxic nurse leader/manager, or whatever you call them.

nurse leaders

But what is a toxic nurse leader?

A toxic nurse manager or leader is defined as a person who is a bully and threatening. Such people are preoccupied with their own status and power, leaving their subordinates in the dark regarding key strategic and tactical issues . Meanwhile, toxic leadership is referred to as disruptive behaviors in the healthcare industry which is a concern as healthcare continues to evolve .

What are the warning signs of a leader with disruptive behaviors?

According to Holloway & Kusy (2010) and Gilbert, Carr-Ruffino, Ivancevich, & Konopaske (2012) these are some traits you need to watch out for:

  1. Disrespectful
  2. Verbally and physically abusive
  3. Berating in front of peers and patients
  4. Demanding
  5. Condescending
  6. Selfish

What are the toxic effects to the workplace?

1. Decreased workplace productivity & motivation. Some nurses may lose their motivation to work because of unsettled conflicts and poor management within their unit or department. According to a literature by Mtimkulu, Naranjee & Karodia (2014) conflict due to interpersonal incompatibilities can lead to tension and hostile environment. Nurses lose hope, trust, and interest in their work due to leaders’ inability to resolve conflicts fairly.

2. Increased Absenteeism. Have you ever felt that you don’t like to go to duty anymore because you are disappointed by the poor management of your institution? Well, you are not alone. A findings from the study of Smith (2005) conveys that a collective of 66.6% respondents agreed that they absent themselves from work due to the poor leadership style of the manager. Failure by management to effectively resolve work related conflict frustrates some employees because they cannot cope. In a non-conducive work environment, some employees then choose to ‘stay away’ from work.

3. Rise of resignations. When you lose your reason to stay, why keep bothering yourself from going to work? This is the mindset of some nurses who are so fed-up with their job and the poor working environment in the hospital.

When employees resign for personal reasons such as seeking for professional growth or health-related reasons, then it’s quite understandable to see early resignations. However, when such decisions are based on work conditions and organizational culture, then probably there’s something wrong with the leaders or managers.

4. Job dissatisfaction. Studies have identified a significant relationship between effective leadership and job satisfaction (Laschinger, & Finnegan, 2005; Upenieks, 2003; Wilson, 2005). Spence Laschinger & Fida (2014) stated that both organizational and intrapersonal resources appear to play a protective role against early career burnout development over time. Authentic leadership and psychological capital appear to protect new nurses from negative early career work experiences.

How to address toxic behaviors?

One of the greatest challenges in addressing toxic leadership in an organization is simply that it is widely tolerated by employers. But let’s admit it! It is not only the employers who tolerate their attitude but also their subordinates, the nurses. So how can we stop the toxic behaviors? Stop toleration.

What are the qualities of a good leader?

Effective leaders are required to use problem-solving processes, maintain group effectiveness and develop group identification. They should also be dynamic, passionate, have a motivational influence on other people, be solution-focused and seek to inspire others.

In conclusion, a good nurse leaders and managers should not only know how to do their paper works but also know how to empower and encourage their staff. They must learn to value and appreciate their people’s effort. Most of all, they should be their advocate, because at the end of the day, nurses need a voice. Someone who will defend them. Someone who will protect their rights. Someone who will understand them…and they expect that from their nurse leaders and managers. 


  • Edmonson, C., (Sept 30, 2010) “Moral Courage and the Nurse Leader” OJIN: The Online Journal of Issues in Nursing Vol. 15, No. 3, Manuscript 5. DOI: 10.3912/OJIN.Vol15No03Man0. Retrieved from http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Courage-and-Distress/Moral-Courage-for-Nurse-Leaders.html
  • Frankel, A. (n.d). Leadership skills for Nurses. Nursing Times. Retrieved from https://www.nursingtimes.net/Journals/2011/08/24/j/n/i/Leadership-Skills-for-Nurses.pdf
  • Holloway, E. & Kusy, M. (2010). Disruptive and Toxic Behaviors in Healthcare: Zero Tolerance, the Bottom Line, and What to Do about it. Medical Practice Management. Retrieved from http://www.mitchellkusy.com/Disruptive%20behaviors%20in%20healthcare–Holloway%20&%20Kusy.pdf
  • Hymowitz, C. (2004). Bosses create problems if they’re too secretive or divulge too much. Wall Street Journal, 21, p. B1.
  • Gilbert, J., Carr-Ruffino, N., Ivancevich, J., & Konopaske, R. (2012). Toxic versus Cooperative Behaviors at Work: The Role of Organizational Culture and Leadership in Creating Community-centered organizations. International Journal of Leadership Studies. Vol. 7 Iss. 1, 29-47. Retrieved from http://www.regent.edu/acad/global/publications/ijls/new/vol7iss1/IJLS_Vol7Iss1_Gilbert_pp29-47.pdf
  • McHugh, M. D., Kutney-Lee, A., Cimiotti, J. P., Sloane, D. M., & Aiken, L. H. (2011). Nurses’ Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care. Health Affairs (Project Hope), 30(2), 202–210. http://doi.org/10.1377/hlthaff.2010.0100
  • Mtimkulu, D., Naranjee, N., & Karodia, A. (2014). An evaluation of the leadership styles of managers and their impact on human capital factors of motivation, performance and absenteeism of employees at selected hospitals in Eastern Free State, South Africa. Arabian Journal of Business and Management Review (Oman Chapter). Vol. 4, No. 2. Retrieved from http://www.arabianjbmr.com/pdfs/OM_VOL_4_(2)/5.pdf
  • Roter, A. & Spangenburg, J. (2013). A Phenomenological Study of Registered Nurses Exposed to Toxic Leadership Behaviors: What it Means to Health Care Organizations. ResearchGate. Retrieved from https://www.researchgate.net/publicati/276204651_A_Phenomenological_Study_of_Registered_Nurses_Exposed_to_Toxic_Leadership_Behaviors_What_it_Means_to_Health_Care_Organizations
  • Smith, L.E. (2005). Practical Research Planning and Design. 7th Edition. New Jersey: Merril Prentice Hall.
  • Tei-Tominaga, M. (2013). Factors related to the intention to leave and the decision to resign among newly graduated nurses: a complete survey in a selected prefecture in Japan. Environmental Health and Preventive Medicine, 18(4), 293–305. http://doi.org/10.1007/s12199-012-0320-8
  • Zangaro, G., Yager, K. & Proulx, J. (2016). Recognizing Toxic Leadership. RNJournal. Retrieved from http://rnjournal.com/journal-of-nursing/recognizing-and-overcoming-toxic-leadership

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  • Colin Baird

    Outstanding Article.. Thank you for writing it!