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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Toxic Co-Workers — A Threat to Patient Safety?

Toxic Getty Images 948416916

By Gary Evans, Medical Writer

We have met him or her. And we would prefer not to meet them again. But there they are when you arrive for duty: The toxic co-worker.

The Association of Occupational Health Professionals in Healthcare (AOHP) recently held a podcast on this topic, featuring speakers Steven Wiesner, MD, and Mitch Kusy, PhD. The latter is an organizational psychologist at Antioch University and a consultant with the Healthy Workforce Institute. Recently retired, Wiesner has experience in human resources and three decades of clinical work in occupational health, physical medicine, and rehabilitation.

First of all, there are generally two types of disruptive behavior at the workplace — the covert and the overt, Kusy said.

“In general, we are seeing more of the overt — yelling and slamming doors,” he said. “But we’re also of seeing more the covert types of incivility and disruptive, toxic behaviors. My guess as a psychologist is that we’re seeing more [covert] because of the pandemic, when we were all behind screens and people say things in the chat function.”

As with so many issues, the problem of toxic employees predates the pandemic, and has been brought in stark relief by it.

“So it’s not a different negative outcome, it’s just been highlighted to a degree that we had not experienced,” Wiesner said.

Not only do toxic employees drive their co-workers from the job, those workers who remain may have a disillusioned affect that is a kind of “presenteeism,” he adds.

“Presenteeism can also have a very significant impact on the productivity and the ability of that team to work effectively,” Wiesner said. “These are people who are still at work, but they are going to have less of a committed job effort. They may show a decline in their own professional performance. So it’s not just the people leaving the workforce, it’s how do we support those people that are still there if they are working in an environment that is really not respectful and civil?”

There are three general benchmarks to determine if toxic behavior is being directed at you or your colleagues, regardless whether it is overt or covert, Kusy says.

“It’s targeted, it’s harmful, and it’s repeated,” he says. “So when you look at something that’s targeted, either one-on-one or to a group, it’s harmful. When it’s harmful, intention doesn’t matter. ‘I didn’t mean to hurt you’ is not an appropriate response. The repetition of the behavior rules out that it is just someone having a “bad day.”

Whatever course the target of the behavior takes, Kusy recommends asking one bottom-line question.

“If this behavior continued, could it be a patient safety issue?” he said. “If there’s any possibility that it is, then you need to do something about it.”