Leading an organization from a culture of bullying or blaming to a culture of safety is a daunting undertaking. Unhealthy alignment is deeply rooted in toxic cultures, and informal power dynamics can influence people’s behavior. Instead of respectful communication where the giving and receiving of constructive feedback continues, common behaviors include:
They all perpetuate a cycle of broken trust and bad behavior.
While patients, the workforce, and key outcomes are much better off in a culture of safety, the process from a toxic to a healthy culture requires a challenging shift from a relationship rooted in mistrust to one of trust. To ensure long-term meaningful change, leaders must firmly establish a foundation of trust.
An apology that acknowledges that there was bad behavior, that it was hurtful and will not be tolerated, will help build trust and open hearts and minds to new ways of being. It will also model ownership and create rich listening opportunities. All of these are an integral part of healthy cultures. Such an apology might look like this:
Dear ABC Hospital Staff,
As your CEO, I am writing to announce our organizational initiative to create a culture of safety. This initiative includes a zero-tolerance policy for abuse, effective immediately, and a long-term training and enforcement plan. This letter is the first of many important steps.
As you know, bullying and blaming behavior is insidious and widespread in many healthcare organizations. Unfortunately, I am aware of some such behavior here at ABC Hospital, and I recognize that there may be incidents that I am not aware of. There may be people in all departments, at all levels and in all specialties who have experienced disrespect in the past.
I want to clearly and publicly apologize for any inappropriate behavior that occurred in this workplace.
No one deserves to be treated disrespectfully! I am truly sorry for any behavior that was perceived as disrespectful. I can’t erase the past, but I can acknowledge it and offer resources to help build a better future.
If you have been the subject of or witnessed disruptive behavior at ABC Hospital or another facility and would like to share your experience openly, please contact Human Resources. If you prefer to remain anonymous, please contact the Employee Help Desk we have created to help change our culture. I will also be available if you would like to make an appointment to speak with me in person, please do so.
Also, please sign up to attend these two mandatory training sessions: Identifying and Addressing Inappropriate Behavior and Giving and Receiving Constructive Feedback.
Finally, thank you in advance for joining me in creating a culture where we can work safely and respectfully together and offer the highest quality care.
At your disposal,
Leaders may feel reluctant due to staff shortages, staffing challenges, or liability concerns. Clear expectations, staff resources, training, forgiveness, good listening, PRN disciplinary action, and trust-building interventions such as medical enhancements will contribute to long-term meaningful change.
Beth Boynton is a nurse and improv practitioner.
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