1. Drake, Kirsten DNP, RN, OCN, NEA-BC

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Q I recently became the manager of a small unit and, over the past few months, I've noticed that there are cliques. What's the best way to address this situation?

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It's important to address issues such as cliques that are poisonous to the unit's culture. First, assess if the groups are cliques or merely close friends. The difference is that a clique can become exclusive, not allowing others to join them to the extent of excluding others, which may lead to incivility on the unit.


Cliques can go unnoticed if you aren't paying attention. Be present in the work area and assess for trends. Do the members of the clique consistently schedule themselves on the same work days? Are they manipulating assignments to work in the same area of the unit? Do they take their breaks and lunches together? This behavior isn't necessarily an issue unless it becomes consistent. As the leader, it's up to you to break these patterns.


Confronting unwanted behaviors works best; remember, doing nothing is an action that relays acceptance of behaviors. Start by having a conversation with the members of the clique. Don't be surprised if you witness defensiveness and denial. If this simple intervention doesn't initiate a change in the group, it will take the involvement of others. For instance, if a supervisor or committee completes the schedule, they'll need to be aware of the needed change. Ask if they've identified trends in staff members working together, but be cautious about asking directly about the members of the clique because this can cause rumors to start. The person making the assignments, usually the charge nurse, will also need some information. These can be touchy situations-you don't want to breach employee confidentiality or feed gossip on the unit.


Cliques within small units may surface in different ways. As the nurse leader of a small unit, I can share my personal experience. The unit had a few groups of staff members who appeared to be friends. Things seemed fine until there were reports of one of the groups speaking to each other in their native language in front of other staff and in patient care areas. Some people presumed the group was talking about them. I was certain there was a clique forming. I consulted with my human resources (HR) representative and we collaboratively investigated the situation. It was revealed that one member of the group was having personal issues that she didn't want other staff to know about because she was afraid of gossip. The result was that staff members were permitted to speak in their native language as long as they weren't in the presence of patients. After a few months went by, the clique began switching from English to their native language when certain staff members were in their presence. Having HR involved earlier was helpful when addressing the new issue.


The key steps for leaders to avoid workplace cliques are to be visible, identify behaviors as observed, and address the behaviors as soon as possible. Include your HR representative if you feel this is outside your comfort zone; he or she is there to protect you, your staff members, and the organization.