Healthy Workforce

When the Boss is the Problem

Is your manager tough but fair, or just a bully? How you can deal with both types.

Illustration of manager pointing finger at a nurse standing next to him in scrubs and with stethoscope

Editor’s note: Renee Thompson’s “Healthy Workforce” columns usually draw on real case studies from Renee’s consulting work and seminars and usually involve conflicts between workplace peers. In this special feature, she examines a tougher issue: what to do about a boss who may be a bully.


True leaders possess a unique combination of skill and personality that makes others want to follow them. Unfortunately, even in healthcare, nurses may struggle to find effective, compassionate leadership. true leaders possess a unique combination of skill and personality that makes others want to follow them. Unfortunately, even in healthcare, nurses may struggle to find effective, compassionate leadership.

According to the Workplace Bullying Institute, 61 percent of all workplace bullying in the United States is perpetrated by higher-ranking employees, whether supervisors, managers or C-suite executives. That’s a significant number that should raise concerns for every organization.

Difficult or demanding leaders usually fall into two camps: those who are “tough but fair” and those who are bullies.  Let’s examine the characteristics of each type and consider a few strategies to help you cope.

The “Tough but Fair” Boss

Tough bosses are focused on goals and outcomes. These leaders strive for results and expect each team member to do their part. Tough bosses tend to be gruff and have little time for small talk. They seldom forgive easily if you make a mistake or appear to be slacking off.

Experts say that working for a tough boss, especially early in your career, can be a good thing. They may teach you to focus on results or help you achieve goals you would otherwise think unattainable.  A tough boss can also be an ideal leader in high-stakes settings like the ED, where careless mistakes can cost lives. However, these leaders’ high standards and “rough and tough” exteriors can be challenging for many employees.

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The Bully Boss

A boss who’s a bully is focused on power and personal control over others. Bully bosses often try to wear down their team members’ confidence with insults, threats or harassment. “Remember, I can make or break you” is a typical bully boss mantra. Bully bosses are driven by narcissism and may think they are above the rules because of their title. They also tend to take credit for things that their team members do rather than passing on the kudos.

If you are a high-performing, self-assured team member with a bully boss, you may be in for a rough road. Where a tough boss tends to value employees who prove their competence and dependability, bully bosses often feel threatened by these characteristics and may look for ways to downplay or undermine your accomplishments.

Bully bosses want to intimidate you by any means available and may even threaten disciplinary action or termination for trivial infractions. Working for a bully boss isn’t just challenging — it can be downright miserable.

Coping Strategies

You need practical ways to navigate the workplace when a tough boss or bully is in charge.

Set clear boundaries

It’s imperative that you stand up for yourself. For example, if your nurse manager criticizes you in front of patients or other RNs, don’t just take it. Ask to speak to the manager in private and then clearly state that while you are willing to listen to their feedback, you are not going to allow them to do it publicly. Try to remain calm and state your expectations plainly and thoroughly.

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Build a case

If your boss really is a bully, it may be time to fight back. This isn’t a step to take lightly; rushing into a confrontation could cost you your job and damage your career.  If you decide to go forward, you need to first evaluate your options and collect evidence to give you a fighting chance.

Here are four steps to take:
  1. Identify specific behaviors that adversely affect the workplace culture, especially ones that could harm patient experience or patient safety.
  2. Review your facility’s policies on bullying and workplace behavior. Get familiar with that language so that you can use it when creating your case.
  3. Document the behavior. For each incident, jot down the date, time, details about the situation and the names of any witnesses. Ideally, you’ll want to gather at least six weeks’ worth of evidence before you present your case.
  4. File a complaint with human resources. Schedule an appointment and make sure you follow any specific procedures your organization requires for filing a grievance. When the bully outranks you, you want to make sure you follow those requirements to the letter.

Find a new job

As a nurse, you have a responsibility to your patients and to your own health and safety. If a bad boss is affecting your practice or even making you sick, it’s time to leave.  One of the beauties of the nursing profession is that your skills are in demand and there are many different settings and specialties to choose from. It make take some searching to find a role you enjoy with a supervisor who offers encouragement and collaboration, but it can be done. Remember, you have options and ways to take action.

RENEE THOMPSON, RN, DNP, CMSRN, is the CEO and founder of the Healthy Workforce Institute. As a speaker, author and consultant, her goal is to eradicate nurse bullying and incivility.


JASMIN MORA is a Los Angeles-based illustrator. Reach her at


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