‘Toxic Nursing’: Managing two-faced coworkers

Two faced nurses
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 handling two-faced coworkers.

Two of the nurses on the MICU day shift are notorious for acting one way when management nurses are around, and another when they’re gone. Dana and Bonnie, longtimers on the unit, know when the nurse manager is likely to show up and make a point of acting superbusy and supercordial when that occurs. As soon as the nurse manager leaves the unit, they slack off and hide out in the breakroom, gossiping, while Nadine, a newer nurse, picks up the slack.

When Nadine asks Dana and Bonnie for help, they only comply if a nurse manager is nearby to see it. Nadine feels “trapped,” because Dana and Bonnie will support each other if confronted, and the manager only sees them when they’re on “good behavior.”

Expert Commentary

Nurse managers can do several things in this scenario. They can talk with others on the unit to get their perceptions of Dana and Bonnie’s behaviors. If several witnesses can confirm Nadine’s story, they can bring this to Dana and Bonnie’s attention and come up with a plan for changing their behavior. If Nadine is the only one who reports the behavior, management needs to show up on the unit at times when they are not expected and make their own observations. Management can instruct Nadine to stop picking up the slack for Dana and Bonnie, so they be- come responsible for their own work. If Nadine stops covering for Dana and Bonnie, then management can hold them accountable for work they are not doing.
–Susan Johnson

Nadine needs to privately meet with the nurse manager and share what’s happening, but not in a tattletale way. Avoiding accusations, Nadine can just say this is what she is feeling and seeing. She should share her perceptions but expect the nurse manager to validate them by observing Bonnie and Dana when they are not aware she is there.

The nurse manager needs to be ready to help find out what Nadine is feeling. Nadine can help the nurse manager by asking him or her to figure out a way to observe Dana and Bonnie’s behavior. Then, based on what the nurse manager finds, he or she knows how to intervene. The expectation is that the behavior would be corrected (assuming Nadine’s perceptions are accurate).

It takes a real level of maturity on Nadine’s part to handle this well. She may or may not be able to do this without appearing as though she is complaining. The key for nurses is to enlist their nurse manager’s help because they don’t want to feel frustrated with their work or feel like they aren’t part of a team. It takes maturity to spin it right. Anyone is a situation like this would feel it was just not fair, but there’s nothing a nurse manager can work with if it’s expressed as a complaint. “Help me understand if what I’m feeling is really happening,” is a statement that can work.
–Kathy Curci


Do you think that your nurses ever put on an act to try to impress you? If so, what can you do about it? Would visiting the floor of your unit at varying times help?

If you believed that a nurse was putting on a show for your benefit, what would you do about it? Would you say something to the nurse? What would you say? How would you say it?

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 five of nine; don’t miss parts one, two, threefour, sixseveneight and nine!

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