Volume 19 - Issue 2

Opinion Biomedical Science and Research Biomedical Science and Research CC by Creative Commons, CC-BY

Toxic Incumbents on Hospital Work Environment (What to Do)

*Corresponding author: Evangelia Michail Michailidou, ICU Director Anaesthesiologist, Intensivist, Greece.

Received: June 24, 2023; Published: July 05, 2023

DOI: 10.34297/AJBSR.2023.19.002580


For 17 years I have crossed the threshold of different conditions, culture and subject of the health industry that you can imagine. And of course, I constantly hear about difficult bosses who don’t understand, don’t inspire, know the job less than their subordinates, discriminate against them, don’t listen to them, withhold information from them, and the list goes on.

Also, lately I’ve been hearing or observing how catalyzing the involvement of a single person, a newly employed frontline health professional, in the project that a team is creating or trying to create can be catastrophic.

Example of ICU Operation: Shots with objectives are very important and translate into team and individual bonuses. Director has identified “the weak link”. Observational coaching has confirmed that it is not his obsessions or misconceptions as, e.g., during hours of visiting relatives or receiving cases, the person in question deals in public view, undisturbed, with the Facebook staff, and leaves the colleagues to serve and offer services. His manager has made use of what he knew, he has asked for help from the Head of Nursing, but the situation remains the same. The only thing he succeeds in doing is transferring the employee to another clinic, which soon begins to have the same problems. In essence, that is, Director moved the problem.

And this list could go on and on.

So “what can I do” is the appeal of people who are in charge of employees with behavior that cannot be improved and negatively affects both the psychology and the performance of the team. After all, they say, I consume so much energy that if I had invested it in those who are already “pulling” I would have multiplied results and certainly a better working atmosphere.

Is there anything else I can do? They wonder. You can. Don’t be afraid to open the issue. If you are afraid, you get carcinoma. You are not protecting anyone. You hide behavior that sabotages the effort of an entire team. Open it, first, to him (yes, many times I hear “but he doesn’t understand” and I answer “we don’t understand what’s bothering us. Continue”).

Share the effort with someone, don’t take it on yourself. You have enough in your head. You also have a supervisor but you can also seek the help of a consultant / coach. Look at it as an investment. You do it not just to control a problem but to find a way to increase your team’s performance.

If you’re the senior manager and you don’t want to or can’t remove that employee, don’t transfer them. He will transfer the problem to other clinics of your hospital. If you are the immediate supervisor, moving him is a relief but keep in mind that he may be “returned to you” and then the problem will be much worse. You can suggest ways for him to improve and inform him of the consequences. Open communication is not the easiest communication but, in the long run, it has the best results. For all. Include them in the evaluation process. It can be a simple process e.g., personal goal for improvement / result / action in case of deviation. But mean it. Adhere to deadlines and procedures. This is how you tell them that you, as the boss, have the say. Otherwise, whatever you say, they have him. Don’t give in to gossip. Be honest. Don’t be put off by the excuses they give you. They are not your naughty children - many times in the clinic and more generally in work settings we reproduce family models - they are people who have a contract. Natural but also essential.

The above will at worst open the way for you to make difficult decisions, and at best they will confirm that good accounts make good friends. You may even see drastic improvement where you didn’t expect it. I have seen both. Either way, you’ll also set a great example for the team you lead. Just take the first step and open the issue.

And as Wes Beavis says, “no matter what they do and drive you crazy, your reaction is still your choice. When you say “that they take your clothes off” it is not true. These people cultivate the conditions. You decide under these conditions to “get out of your clothes”. As long as you don’t act and react, you give them power and authority over your life (and over the clinic you run). It’s almost never easy, but if we don’t escape their influence, we’ll never overcome them. Consider what David Swartz said. “If you don’t get rid of them, you’ll soon start to look like them.”

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