16 Signs You’re in a Toxic Work Environment as a Nurse

6 Min Read Published May 24, 2022
16 Signs You’re in a Toxic Work Environment as a Nurse

As nursing professionals, it is our responsibility to care for patients but it is also the duty of our employers to ensure we are working in safe, supportive, empowering environments that are free from toxicity and lateral violence. 

The World Health Organization (WHO) defines a healthy environment as a place of “physical, mental, and social well-being,” supporting optimal health and safety. Does your work environment reflect that? 

My own burnout stemmed from a solidly toxic workplace but at the time I had no idea. I had no frame of reference and I thought it was “just the way it was.” The environment plus my people-pleasing tendencies and lack of boundaries was a recipe for disaster and I slowly become more and more resentful and burned out. My colleagues and I used our voices but nothing ever changed. There was an illusion of “we want to make things better,” but in my world actions speak louder than words. Eventually, I decided to save myself and moved on.  

This experience, as horrific and disappointing as it was, helped me hone in on what truly wasn’t working, what aspects of the environment were truly problematic, and what I had control over when it came to my mindset and my actions. Through that reflection, I was able to identify what kind of job and environment would be more supportive of my goal of living a healthy life both as a human being and in my role as a nurse. Ultimately once I had that clarity, I took the leap. 

So, I’m sure you have a few questions, the first and probably most important, how do you know if you are in a toxic work environment? Sometimes it is insanely obvious. Other times we are either in denial or we really haven’t figured out why we aren’t happy. Or honestly, maybe we are scared out of our minds and not sure what to do to make it better…so in an effort not to rock the boat, we do nothing. But here is some guidance.

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Signs you are in a toxic work environment

  1. Are you happy? Be honest with yourself. If the answer is no, ask yourself what is contributing to your discontent. Ok now look around you, are people smiling? Are other people happy? How is morale? If the people around you seem unhappy and the environment is one of poor morale and dissatisfaction you may be dealing with toxic workplace culture.
  2. Lack of positive feedback for a job well done but readily available negative feedback even for the slightest misstep can be a sign something is off. Are there instances where the punishment doesn’t fit the crime? Is there favoritism from leadership? 
  3. Dishonesty, inconsistency, and lack of transparency. Does leadership tell the truth? Do they follow through on their word? 
  4. Bullying, microaggressions, or lateral violence between coworkers. This is unfortunately quite common and can lead to decreased self-confidence, anxiety, burnout, and depression. Just remember bullies thrive on control and enjoy seeing others squirm. Try to maintain the moral high ground and choose mature professional communication. This may help disarm them or keep the incident from escalating while you involve leadership.
  5. Is there adequate value placed on work-life balance and personal needs? This is huge. Staff needs to be able to “unplug” and remove themselves from the workplace when at home. Do you feel taken advantage of? Are the work commitment expectations reasonable?
  6. Failure of leadership to manage unmotivated staff who aren’t pulling their weight. This fosters a culture where high performance isn’t valued and fuels resentment among staff members. This makes the people working hard to excel and contribute feel disillusioned. If you see this it may be a sign of poor leadership and toxicity. 
  7. Is there reactivity and defensiveness when having conversations versus listening and providing constructive feedback? Is there a willingness to take action or create change and how willing are others to hear other people’s opinions? 
  8. Leaders who play favorites (or discriminates in general), are never happy with a project, micromanage, or are a poor communicator who is upset you couldn’t “read their mind,” or a leader with narcissistic tendencies who may have a “do as I say, not as I do” approach.
  9. Staff members throwing others under the bus without a blink of an eye, a lack of community, and poor support among colleagues. Colleagues are “out to get” other colleagues. 
  10. High turnover and absenteeism: This is indication morale is low and people are unhappy. Again…BIG red flag. 
  11. People who complaining ALL the time. This is an indication people aren’t happy and morale is low. It is not uncommon to see people complaining here and there but if it is a daily thing this is an indication of deeper toxicity. Keep in mind it may not be overt with people talking at the water cooler. It may be through social media, chat features online, texting, etc. Regardless…Yuck. Try not to engage and set up healthy boundaries.   
  12. A workplace culture of humiliation, intimidation, or harassment.
  13. Little to no feedback about your performance and solely negative feedback when you do get reviewed. 
  14. Other people taking credit for work you have done, especially if it’s your boss. Yikes. 
  15. Infighting, gossip mills, paranoia about other staff members, and the formation of cliques. If the workplace feels like high school… it’s probably dysfunctional.
  16. Sexual harassment, discrimination, and workplace violence - keep in mind that this treatment is 100% NOT OK AND ILLEGAL. 

Physical effects of toxicity in the workplace

Not only can a toxic workplace lead to dissatisfaction when it comes to your job and career choice but it can also contribute to physical symptoms. Many of these are triggered by the stress associated with the environment but any of these can be a sign you are in a toxic situation. Oftentimes these are felt on the way to work or on the night before your workweek starts:

  1. GI upset, nausea, lack of appetite, or emotional eating
  2. High anxiety, heart palpitations
  3. Depression
  4. Insomnia or nightmares 
  5. Feeling on edge or panic-stricken
  6. Lack of appetite or weight loss
  7. Headaches and muscle tension
  8. Agitation, irritability, restlessness

At the end of the day sometimes these types of environments are able to be navigated through self-advocacy, leveraging effective leadership, and systems change.  But other times it may be beyond repair and it's okay to save yourself. You are number one. You are never stuck and your mental health matters. Being healthy in all aspects of your life matters. 

Recall that a healthy nurse as defined by the ANA: 

 “One who actively focuses on creating and maintaining a balance and synergy of physical, intellectual, emotional, social, spiritual, financial, personal, and professional wellbeing”. 

If you’re thinking about becoming a nurse, are a nursing student, or are a current nurse who is ready to transition careers - this guide will help guide you to make the best professional decisions.

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For a list of some ways to overcome a toxic workplace head to THIS nurse.org blog post by Wali Kahn and as always visit www.selfcarecatalyst.com for more support, free resources, or head to Instagram @catalystforselfcare for more burnout repellent tips! 

You aren’t meant to do life or nursing alone.

Diana Page
Diana Page
Nurse.org Contributor

Diana Page, ACNP-BC, is an outpatient neurology nurse practitioner, burnout expert, and mentor helping exhausted nursing professionals have optimal work life balance through mentorship, education, empowerment, and community. She founded Selfcare Catalyst LLC in 2020 and has helped dozens of nurses find fulfillment outside of work and clarity on their place in nursing, and has connected with and supported 1000s though her social media platforms. She is a leader on topics related to Nurse/APP wellbeing and burnout and is a believer that we are more than a nurse and that we deserve care too. Diana is a self-proclaimed boundaries queen, self-care strategist and loves a good PTO day! Learn more about Diana and check out her free resources for clinician wellbeing at www.selfcarecatalyst.com or check out her Instagram @catalystforselfcare where she posts daily tips to help you feel empowered to put yourself first and more fulfilled while working in healthcare.

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