Nurses eat their young.

Nurses demean each other in disrespectful ways.

Nurses bully and treat each other in uncivil ways.

Nurse leaders act in unprofessional ways.

Nurse leaders fail to recognize and address toxic workplace behaviors.

If you are a nurse, this is hard to read. If you are a nurse, you understand a message that resonates strongly. You have likely been part of a toxic work environment at some point in your nursing career as a student or while in the workforce. There is an epidemic of bullying and incivility in healthcare that must be confronted.

• 71% of physicians and nurses have linked incivility to medical error.

• 27% of physicians and professional nurses said disrespect compromise patient safety and could led to a patient’s death.

• 81% of nurses who leave an organization cite peer and nurse/manager relations as a cause for leaving.

It’s unimaginable that a profession whose core values are caring-centric can be filled with toxic and harmful behaviors. A recent study pointed to toxic work cultures as the critical determinant for employee turnover, which continues to fuel the Great Resignation in healthcare.

When left unchecked these lead to breakdowns in communication, destroy a unit's well-being, and can cause a trickle-down effect that infiltrates an entire organization in harmful ways that are ultimately detrimental to the care we provide our patients. The way we treat each other in our workspaces is just as important as the health care we provide.

In a recent study conducted by The Healthy Workforce Institute, 295 frontline leaders were surveyed. The greatest challenge was organizational culture. Leaders stated disruptive behaviors between team members and the interprofessional team, a lack of teamwork and collaboration, and a lack of support from upper leadership to hold employees accountable were the major obstacles in creating a healthy working environment.

The second greatest challenge was communication, and primarily related to a lack of knowledge on how to have crucial conversations. Also cited was a lack of confidence in addressing individuals with disruptive behaviors.

Many of the leaders surveyed acknowledged that they were in newly appointed leadership roles and felt they did not have the knowledge, skills, or abilities to engaged nurses and establish a healthy work environment within their units.

Many were seeking the necessary tools and resources to cultivate a positive organizational culture, but unfortunately, they did not have these resources available.

According to the American Association of Critical-Care Nurses (AANC), the following six standards make up a healthy work environment:

• Skilled Communication – Be as proficient in communication skills as you are in clinical skills.

• True Collaboration – Be relentless in pursuing and fostering true collaboration.

• Effective Decision Making – Be committed partners in making policy, directing and evaluating clinical care, and leading organizational operations.

• Appropriate Staffing – Staffing must ensure the effective match between patient needs and nurse competencies.

• Meaningful Recognition – Be recognized and recognize others for the value each brings to the work of the organization.

• Authentic Leadership – Fully embrace the imperative of a healthy work environment, authentically live it and engage others in its achievement.

 Nursing leaders and top-level executives of healthcare organizations must set  professional standards for healthy work environments and lead by example. Follow-through for these standards needs to be consistent and ongoing education for all those in leadership positions must be a significant priority.

Nurses and healthcare professionals must work together collectively and remain vested in creating and maintaining healthy work environments that impact the well-being of their staff and patient care.