1. Hader, Richard RN, CNA, CHE, CPHQ, PhD, FAAN, Editor-in-Chief

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She's such a great nurse, but her poor attitude brings down the rest of the staff." Sound familiar? Many of us have managed extremely competent and compassionate clinicians who are also, unfortunately, a source of malcontent. We don't want them on our team because they spew poison into our departments, contaminating organizational effectiveness. Repeated staff exposure to a virulent demeanor requires swift leadership intervention. The employee's high level of clinical competence doesn't neutralize her negativity.

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Peers often shy away from confronting disruptive colleagues for fear of retaliation, resulting in an even more challenging work environment. Staff members most likely approach you with their complaints, expecting anonymity. By informing you of the conflict, concerned employees believe that you'll take action without involving them. If their concerns aren't appropriately resolved, the issue may escalate, as your own credibility and leadership effectiveness get called into question.


"Righting" a poor attitude is, most certainly, a management dilemma. On the surface, the offender's reliability and work ethic are incontestably exemplary. His patient care is precise; he consistently makes expert clinical judgments and implements effective interventions. Given the lack of quantifiable proof of poor performance, you must rely on subjective evidence, making it difficult to pinpoint a specific incident. The troubled employee will frequently use inappropriate communication camouflaged by negative nonverbal or insidious actions that are difficult to define but profoundly impact others.


An overwhelming majority of individuals believe that they're outstanding performers. Very rarely will a person arrive to work with the intent to cause disruption. Given this, it's incumbent upon you to meet with the employee and describe examples of behavior that needs to change. Be prepared for the person to vehemently disagree that a problem even exists. She'll probably further defend herself by citing examples of her astute clinical performance. Rarely will these offenders take any responsibility for the negative interpretation of their actions.


Stay the course, though: Emphasize that even though her clinical performance is outstanding, she must work to improve her attitude if she wishes to continue to work at your organization. Explore with the employee her willingness to seek guidance from an unbiased coach like an employee assistance counselor or a professional mentor.


Every work setting should have a code of conduct that clearly articulates performance expectations. Facilitate dialogue with team members to determine principles to which each member must subscribe. Then, have everyone sign an agreement to adhere to these behavioral guidelines. Inclusive in these standards should be that each member of the team is accountable to consistently meet these performance standards or be subject to disciplinary action. To minimize the chance of hiring someone who doesn't value these standards, consider implementing peer interviewing.


Attitude is difficult to manage. But leadership persistence and a strong team commitment to established values will force "drains" to deselect themselves from your organization.


Richard Hader