‘Toxic Nursing’: Dealing with an energy vampire


iStockphoto | ThinkStock + Scrubs

iStockphoto | ThinkStock + Scrubs

In the Spring 2014 issue of Scrubs (get your copy here!), we gave you an in-depth look at incivility in the hospital with “Toxic Nursing.”

Now we’re sharing more on this subject with in-depth look at “energy vampires.”

Hilary is a part-time float nurse on the pediatric unit, where critically ill children come and go quickly. Since she first began work 2 years ago, Hilary has been “high maintenance” for the other nurses—she expects them to treat her differently. “I’m just a part-timer,” she frequently points out. “I can’t keep up with all these policies and procedures.”

One morning Hilary calls her nurse manager, Becca, after working the previous evening shift. “Everyone on evenings is so mean,” she sobs. “They just kept criticizing me all evening.”

When Becca checks with evening-shift nurses, she finds out that Hilary demanded a great deal of attention and created drama when she didn’t get her way. Two days later, the scenario repeats itself when Hilary is assigned to help out in the pediatric ICU. “Never send her again,” Carol, a PICU nurse, tells Becca. “I’d rather be shot than deal with her. She takes more energy than it’s worth.”

Expert Commentary

In this scenario, the manager needs to create a performance plan for Hilary. One of the expectations is that Hilary will keep abreast of unit standards, policies, and procedures. The manager could also set expectations that Hilary will comport herself in a professional manner—which means no dramatic outbursts at the nurses’ station. Staff members need to be encouraged to help Hilary if appropriate, but they should also document incidences when she is not meeting performance standards. Instead of criticizing Hillary or her performance publicly, invite staff to bring concerns to the attention of management, which will then address the issues. Management should have periodic meetings with Hilary and the charge nurse on the evening shift to determine whether Hilary’s behavior is changing.

Managers can never assume that they are hearing the whole story from one party. The person reporting the behavior may be incorrectly assessing the situation or purposely trying to get someone else in trouble. Whenever managers take action against inappropriate behaviors in the workplace, follow-up with the target of the behavior, the perpetrator of the behavior, and coworkers is needed. Managers can’t assume that behavior has changed just because staff does not continue to report it. Staff may wrongly assume that if behaviors do not change, it is because management cannot or will not do anything about them.
–Susan Johnson

The expectation is that when you’re a float nurse, you’re assigned to places where they are short staffed. A float nurse needs to be able to step in and do the job. If the float nurse can’t keep up with the policies and procedures, he or she needs to learn them. It’s not the coworkers’ responsibility to hold his or her hand. In terms of patient care, the expectations of a float nurse are the same as for anyone else.

Becca can tell Hilary that people aren’t “being mean” to her; they’re just frustrated. They’re short staffed and end up having to help her instead of vice versa. Hilary may realize she needs to become more informed about policies or step up to the plate in some other way. If she can’t, she needs to go back to Becca and ask for more orientation and time.

From that point on, Becca is responsible for providing what Hilary needs, but if Hilary doesn’t tell her, Becca won’t know. Everything will continue—Hilary will feel picked on, and everyone else will feel frustrated. But Hilary has to be mature enough to admit to her limitations and take measures to address them. Becca must take responsibility as a nurse manager who supports her nurses and wants to see them satisfied and fulfilled by their work.
–Kathy Curci


Your hospital may have part-time, temporary, or float nurses. Does your staff find it harder to work with nurses who are not a permanent part of their unit? Why or why not? How do you greet new nurses who come to work on your unit on a short-term basis?

Do you think it’s harder to be a float nurse? Why might a nurse choose to float? What do you think are the strengths and limitations—in general—of a nurse who chooses to be a float nurse? How can you work around those pros and cons?

Adapted with permission from Toxic Nursing by Cheryl Dellasega, PhD, RN, CRNP, and Rebecca L. Volpe, PhD. Published 2013 by The Honor Society of Nursing: Sigma Theta Tau International.

This is part four of nine; don’t miss parts one, twothree, five, sixseveneight and nine!

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