Toxic Work Environment in the ICU due to a Problematic Director and Ways to Deal with it

Evangelia Michail Michailidou*

Intensive Medicine Department, University of Macedonia, Greece

Published Date: 29/10/2020

*Corresponding author: Evangelia Michail Michailidou, Intensive Medicine Department, Hippokration General Hospital, Senior Student in the Department of Business Administration, University of Macedonia, Masters Degrees, International Medicine-Health Crisis Management, Greece/Member of Health Response team to Crisis Situations of G.H.T. Hippokration, Greece

DOI: 10.51931/OAJCS.2020.01.000008


Every day we encounter in our work people who are toxic, negative and generally difficult to work with. Toxic people are all around us, things get worse when the toxicity comes from our manager. Toxicity in the workplace is something that exists in even the most modern ICUs. Even if you leave a job due to the toxic work environment in that particular ICU, no one can guarantee that you will not meet toxic people in the next one. The point is not to escape, but to overcome it. If you encounter toxic managers at work, there are three things you can do to improve your relationship with them and help change the culture in the ICU.

Understand their behavior

When someone reacts, speaks or behaves negatively, stop for a moment. Put yourself in his shoes before defending or reacting. Many times, we feel offended when someone misbehaves, but is that the whole story?

We all see things through the eyes of our own experiences. But this limits our ability to empathize with people in their good and bad times. Our ability to accurately interpret the actions of others is at the root of the many cultural differences that arise. To understand a colleague, we need humility, thoughtfulness, and a willingness to look beyond that, and to consider time and space. But how can this be applied to the ICU work environment? Sometimes the best way to deal with these challenges is to understand toxic behavior.

Try the following Exercise the Next Time you see a Toxic Behavior at Work

Remind yourself that most people think they are good. They do not imagine that they can be bad, especially in their own history. The next time you encounter a toxic person, ask yourself how he or she would tell his or her own story.When you can shape the narrative of his life, you will be able to understand this person. Compassion is a powerful force that allows you to build meaningful relationships.

Think about your Reactions

Successful leaders and managers know how to control their emotions. They do this by cultivating their emotional intelligence, which helps them stay calm in times of crisis and deal with conflicts. They are not attracted to selfish battles and escalating arguments. You may be thinking, "How can they do this?" The truth is that they need years of conscious work to improve themselves. However, you can do the following exercise: imagine yourself leading the way. A truck deviates from its course and you begin to feel anxiety, nervousness, terror and fear.

Imagine a sign that reads "ANXIETY OUT OF OPERATION"

This sign reminds you to be calm, careful and maybe use your humor to deal with the situation. You can smile when you see the sign, which is a reminder to calm down and deal with the situation later in peace. You may have encountered the following situation at work: your colleagues accuse you of mishandling, in their view, the management of an incident by senior ICU executives. Normally, the first reaction is to be upset, angry and ashamed. But you can calm down and see things clearly. You can ask for help to improve the people who slandered you without ever having to mention anything further.

Deal with Toxicity with Cooperation and Compassion

Believe it or not, most toxic people do not understand that their behavior affects others, and in fact we are all guilty of it. Their tendency to interrupt, shout or react negatively is not premeditated. This is true when people are unaware of the root cause of toxicity. The next time you witness a toxic behavior, use it as an indication and show a spirit of cooperation. Collaboration is a great way to help someone stop some unintentional stressful behaviors. You can also train other colleagues and more residents. In modern work environments culture is common and most people are willing to see mistakes in their behavior if you approach them with compassion, but unfortunately not always. Sometimes toxic behavior is simply intentional as a result of malice and competition.

Toxic Managers

Is your manager the source of your stress at work? This is not uncommon and he may be dealing with his own mental health issues. This does not make things easier but there are solutions you can try to improve the situation. Sometimes when we improve our knowledge of different personalities and deal with them it allows us to work with people very different from us. Here are some types of managers.


It can be overly emotional, irritable, intense, unpredictable, reactive or even intimidating.To approach him: Stay calm and resist the reaction. Often people who behave this way have high levels of stress and any unwanted or unexpected reaction can make the situation worse. When they are calm, try to clarify what they expect from you.


He rarely trusts others, he feels that his subordinates or other managers want to fire him or take his place.To reach out to him: Do not challenge him or ask him questions. Give him all the information about your job when he asks you to. Do not take risks or take initiatives without first obtaining permission.

Avoids risks

He is usually afraid of being judged or criticized or he is afraid of making justified changes. He may avoid change and want to explore everything in detail before doing anything. To reach out to him: Do not go ahead and stay committed to the procedures and responsibilities given to you. Do not take any risks and do not make changes.


It seems difficult to read and is not very sociable. It shows no compassion or emotion. Communicates only when necessary and even then is quite limited.To reach out to him: Sometimes these people prefer written communication to have time to think and articulate their answer. Try to give them space and limit random communication. Resist the controversy.


These people behave well in front of you but may speak badly behind your back. They find it difficult to support their point of view so they avoid disagreements, resist them or sabotage what they do not like or do not do what they say. To reach out to him: Do not disagree or argue with them. Ask exactly what they want and how they want it. Do not assume that they will agree with you or support you when needed.


These people believe that the universe revolves around them and that this is how things should be. They do not react well to criticism and will rarely admit that they are wrong. To approach him: Flattering comments usually work well and remember that you may regret any question or accusation you make in their face if something goes wrong. Just state the problem you have and ask for their wise advice on how to solve it.


They may enjoy being the center of attention or focusing on something that excites them or getting angry about something else. To approach him: Pay attention when he is in front and let them take the floor. Resist giving advice or getting attention from them.


These managers may have strange, unwarranted, or inapplicable ideas. Their vision is impossible to execute, or they may not communicate effectively.To reach out to him: Try to understand their ideas and look for ways to implement them. If your ideas include, ask what your requirements are and how success will be assessed so you know your share of responsibility.

Continuous supervision and intervention

This type of manager is obviously afraid of criticism or constantly judges himself, which is why he is obsessed with the details of the job that no one else does like him. His demands are irrational or he may not let you get involved in every step of the way.To approach him: Of course, you have to pay attention to detail with this boss but you can also find ways to make your work meet certain standards.

Ask for help

If the situation with your manager gets worse, talk to someone who can help you. You may want to express your concerns about your well-being instead of enduring their attitude. Of course, this is not the process if there are threats, violence, intimidation or harassment. In these cases, follow the procedure provided or think about what you are willing to endure and for what purpose.

See this situation as an opportunity

You cannot run away from toxic people. Obviously you cannot change them. Only your own behavior can be controlled, for this the best thing you can do is stand on your own two feet and be compassionate. Think about this: What does not kill you makes you stronger! For this be strong. Do not accept toxicity, learn to manage it and create an environment in which everyone will want to be a member.

Take care of your own well-being

It is unlikely that your manager intends to cause you anxiety and worry, but if that is the case, it may be causing biological changes in your body. These chemical changes that occur in our body as a result of chronic stress or anxiety are responsible for all health problems from cardiovascular to autoimmune diseases and mental health problems. 

If all else fails, get ideas from others

If all else fails, get ideas from others. While you may need your job if you no longer enjoy it because of this relationship and it negatively affects your well-being, you may need to make the decision to find another job at another ICU. Do not see it as a failure or giving up, it is an important decision for your own health.

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