Healthy Workforce

Can a Bully Be “Too Good” to Lose?

Don’t let clinical skill become a free pass for bad behavior

By Renee Thompson, RN, DNP, CMSRN • Illustration by Jasmin MoraFebruary 20, 2024

5 min read

Tanya was an experienced nurse known for her exceptional clinical skills, and equally notorious for her toxic behavior. She often used a sharp, condescending tone with coworkers, openly criticizing them in front of others, and even sabotaged colleagues’ work by withholding critical information. Tanya’s coworkers were too afraid to confront her, and while some expressed their concerns to the unit director, Tanya was never held accountable because leadership felt she was “too good to fire.” Her unit became notorious for high turnover, low morale, and poor outcomes.

Good nurses are hard to find, and during nursing shortages, healthcare organizations need every nurse they can get. So, we may turn a blind eye to poor behavior if the perpetrator is good at her job. How many times have we heard something like, “Yes, so-and-so is toxic, but she’s such a great nurse”?

When I bring this up, people often insist that there’s no such thing as a great nurse who’s toxic or a bully. Unfortunately, turning a blind eye to nurses like that remains an all-too-common problem.

If you’re a manager with highly competent but unpleasant staff members who just won’t fix their behavior, you might tell yourself that you can’t afford to lose them. So, the bad behavior continues, year after year. Here’s what you can do about it.

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Count the Cost

A toxic nurse, even a “great” one, can do a lot of damage: lowering morale, increasing turnover, and creating a negative atmosphere that makes it harder for other staff to do their best work. Studies have also shown that bullying and abusive behavior increase the risk of errors and adverse events.

Think of it this way: Even if a toxic nurse really is clinically excellent, is it worth dragging down the rest of the unit for one “great nurse” with terrible behavior? Of course not!

Worse, the longer bad behavior is tolerated, the greater the cost. Think of how many experienced nurses and new grads a single toxic nurse might chase away over five or 10 years. A bully is no bargain, whatever their clinical skills.

Cut Through the Excuses

When other staff members complain about a toxic “great nurse” who’s somehow allowed to continue wreaking havoc on their unit, managers often respond in one of the following ways:

Deny (“I can’t believe she’d do that”)
Minimize (“It’s really not so bad”)
Rationalize (“His life hasn’t been easy”)
Deflect (“All the physicians love her”).

If you find yourself making excuses for nurses on your staff —

Stop ignoring or justifying bad behavior!
Stop protecting one toxic employee at the expense of everyone else.
Make it clear that if employees want to remain employed, they have to be clinically competent AND professional.

Document Bad Behavior

Have you been on the receiving end of a “great” nurse’s wrath? If so, documentation is your best weapon. Write down specifically what happened, the date and time, who was there, and report it to your manager.

If your manager is reluctant to do anything about your complaints, take your documentation to HR — especially if the nurse’s behavior affects patient care or creates a hostile work environment based on factors like race, gender, or sexual orientation.

What we ignore, we condone. What we tolerate, we become. Bullying and toxicity undermine a culture of collaboration, a healthy work environment, and patient safety.

Got a bully like Tanya who refuses to clean up her act? She needs to go, no matter how excellent she may be.

RENEE THOMPSON, RN, DNP, CMSRN, is the CEO and founder of the Healthy Workforce
Institute (healthyworkforceinstitute.com)

In this Article: Bullying and Incivility, Nursing Teams