Rebuilding a Toxic Culture

By Rose O. Sherman, EdD, RN, NEA-BC, FAAN

Over the years, many new nurse leaders have talked with me about assuming leadership of a team with a very toxic culture. Their questions range from – How do I get started? to What is a realistic turnaround timeframe?  One thing they collectively agreed on is that cultural change is the hard stuff of leadership.

Last week, I talked with Norm Weller, a perioperative director with UAB Medicine. A longtime blog reader, he noted that I had never written a blog on this topic. He was gracious enough to share his experience rebuilding a toxic culture. His journey began with a new perioperative leadership role where he discovered a toxic team environment. Norm’s experience is not that unusual. Left unchecked over time, deviant behaviors such as bullying and incivility can be normalized in teams. New team members join and either embrace the toxic culture or they leave.

Norm began with a strong vision of what a healthy team culture should look like. This is an important starting point. Staff needs to envision it before they can be it. The vision includes the establishment of ground rules and expected behaviors. We know that on teams with healthy cultures, you see the following behaviors:

• The creation of psychological safety and trust for both new and seasoned staff members.
• Strong team relationships where members know one another on a personal level.
• A spirit of teamwork and team backup.
• An atmosphere of inclusivity and mattering – we are all part of something.
• A willingness to be vulnerable and ask for help when you need it.
• An engagement in rituals such as eating together and celebrating events.
• An assumption of good intentions when working with other team members.
• Respectful communication.
• A no-bully ground rule.
• The avoidance of cliques or teams within teams.

Norm met with each staff member to discuss the vision and reinforce these behaviors. Much of his focus was on new staff members to ensure they did not become part of a toxic culture. There were some seasoned staff that he knew would stay the same but eventually might leave as the culture shifted around them. That is what happened. So I asked Norm the million-dollar question – How long did it take? He noted it was between one and two years. The culture change accelerated when he saw that he had at least 50% of the staff on board with the new culture.

The lesson here is that it can be done. Like Norm, you can do this. But it won’t happen overnight. Culture change takes time, and leaders need to work at it.

© emergingrnleader.com 2023

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Other Programs/Books Your Leaders May Find Valuable

From Traditional Nurse Leader to Nurse Leader Coach – Click Here for the Flyer

For new leaders and emerging leaders, consider doing The Nuts and Bolts of Nursing Leadership Program – Click Here for the Nuts and Bolts Flyer Final

New Leader Development Option in 2023 – Team Coaching Designed to the Unique Needs of Your Organization  Leader Coaching Brochure

Read the Nurse Leader Coach – Available at Amazon and Other Book Sellers

Recommended Book by the Association of Critical Care Nurses – The Nuts and Bolts of Nursing Leadership: Your Toolkit for Success