Stop Tolerating Bad Managers

Rebecca Hendren, October 11, 2011

Healthcare organizations historically have made excuses for bad behavior from nursing managers:

  • She has stuff going on at home
  • He worked a double shift last night
  • It was a difficult case
  • That’s just the way she is, and has been like that for 20 years

“Hospital leaders are overwhelmed just trying to stay financially viable, so they are myopically focused on the bottom line on which their very survival depends,” says Bartholomew. “If they could only see the impact that these disruptive behaviors have on that bottom line, they would act with the urgency of a code.”

Poor nurse managers don’t simply produce turnover, which is easy to quantify. They have a deeper effect on softer measures, such as teamwork, engagement, and accountability. A manager who exhibits toxic behavior begets the same from his or her employees. This damages efforts to improve patient care and poses a hazard to patient safety. Bartholomew says managers are the culture carriers of an organization. If they demonstrate hostility, then what you see is what you get.

To transform hostile nursing managers, the culture of healthcare needs to change, Bartholomew says. And for that to occur, executive leadership must focus on specific behaviors and better language.

“These two things have historically been considered soft stuff or human resources or personality problems not worthy of attention,” she says. “It is a longstanding bias that must be changed in order to keep our patients safe.”

Rebecca Hendren Rebecca Hendren is a senior managing editor at HCPro, Inc. in Danvers, MA. She edits and manages The Leaders' Lounge blog for nurse managers. Email her at
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