What to do when your culture is becoming toxic: The basic Do’s and Don’ts

toxic culture in workplace

You are a high performing leader, slightly overwhelmed and completely committed to your role, your team, and your organization.

You have seen and felt the signs of a toxic culture.

  • The team doesn’t smile, laugh and joke like they used to
  • Cliques are forming and it is becoming obvious who is in and who is isolated
  • There is a divide between leadership and clinical staff
  • Meetings are spent spinning on problems rather than creating solutions

When you seek ideas from others, comments like “what’s the point, nothing is done about it anyway” or “my opinion doesn’t matter so why bother” are whispered. 

Your engagement scores are declining, and you might be losing some new, talented physicians to the competition. Nurse turnover isn’t much better. Dollars spent on recruitment and onboarding are increasing year over year.

There is no sense of community.

The consequences are real:

  • Financial burdens associated with the increasingly toxic culture are beginning to get the attention of the board
  • Quality issues might not have been flagged yet, but the rate of innovation has significantly declined as the organization wastes its “idea capital” (the collective knowledge of all the stakeholders) due to fear of speaking out.
  • A significant amount of time, energy, and resource is wasted on negative interpersonal interactions and managing the impact of toxicity.

If this sounds familiar, here are some Do’s and Don’ts of impacting cultural change:


First, consider the approach.

Do take a systematic approach instead of attempting to solve the problem with one-off solutions

It is important that we gain the input of all stakeholders and consider opposing perspectives to get to the root cause of the cultural angst. Band-Aid approaches lead to more overwhelm and frustration for staff. One-off solutions can even cause unintended consequences like more competing priorities. 


Don’t wait for the right time to start

There will never be a time when your calendar magically clears, and your to-do list shrinks. Cultural work must occur alongside your greatest priorities.

If you see the signs of a toxic culture. Act now.


Second, consider your role as a leader.

Do raise your self-awareness

Identify your blind spots. Find a coach or trusted colleague to hold up a “safe mirror” so that you can uncover your thoughts, feelings, and behaviors that might be inadvertently contributing to the problem. 


Do hold individuals with toxic behavior accountable. 

It doesn’t matter their position or contribution to the strategy or bottom line, regardless it’s important to hold firm behavioral boundaries that enhance the integrity of the organization. 


Do master the skill of engaging in difficult conversations. 

We must stop dreading the hard conversations, disagreements and even conflict if we want to impact cultural change. Click here for a free guide to walk you through a new approach to conflict that will set your mind at ease.


Do share your belief in your team and let them know of their capability to create a new culture. 

We are all driven by emotion, whether we like to admit it or not. We will do the absolute minimum for someone out of fear but we will excel when someone believes in us and our abilities individually and collectively.


Don’t insist that your current strategies are working when they aren’t

This might seem obvious, but all too often when I give feedback that physicians or staff don’t feel heard or understood, the response is to reiterate all of the current strategies in place to listen to each stakeholder. We may not need a complete overhaul, but usually, some tweaking to our approach can make a world of difference.  Accordingly, be willing to take risks. Be open to trying new things. Be open to ideas that are outside of your current way of thinking.


Third, consider those you serve.

Do identify cultural champions

There is a theory that it only takes the square root of N to change a culture. Identify individuals who believe in a new future and are willing to lead the necessary change. Then invest in these individuals, arm them with the skillset and mindset to create an impact on culture. 


Don’t ignore those individuals who seem most disengaged. 

As humans, we require connection and belonging. It might only take one conversation or one small connection that will encourage the disengaged to share their concerns openly. The feedback can be hard to hear, but we need to know our true baseline to adequately develop strategies for a new future. 

Every stakeholder can be part of the solution. 


Be brave, be courageous, listen to understand and communicate with transparency and vulnerability. And when you do, you will start a bold movement of possibility thinking for a better future.


What if you had an easy-to-follow checklist to help you overcome the three most common leadership challenges? Simply put in your name and email below and I will deliver the free checklist to your inbox! (p.s. I will never share your email, no one likes spam including me.)

Carrie Koh is a healthcare executive, speaker, Interpersonal Efficiency Leadership coach and consultant with a passion for enhancing the way we communicate with one another to ensure efficient and innovative results with greater fulfillment along the way. She would love to connect at www.carriekoh.com