Dear Helpdesk: Working in a Toxic Health Care Environment


Dear Helpdesk is your steadfast companion, offering life coaching and workplace advice from 2 seasoned IPs for some of your most challenging real-life situations. Let us help you navigate the intersection between work and life, guiding you to navigate the dynamic world of infection prevention with confidence and grace. This article is on handling a toxic health care environment.

Dear Helpdesk: Inoculating your work life with IP Wisdom from Infection Control Today

Dear Helpdesk: Inoculating your work life with IP Wisdom from Infection Control Today

Dear Helpdesk,

I have been working in a toxic environment, and it has been eating at me. I am angry with myself for allowing the work environment to affect me so much. How can I "get over it" so I can stay at a job where I like the work but hate my manager and the culture?

Dear Drained,

I sincerely appreciate your vulnerability and can hear your pain bleeding off the page. On one hand, you love your job. What you do brings you true joy and fulfillment. But on the other hand, the environment in which you are working feels toxic and unhealthy, and it’s starting to take a real toll on your mental and emotional health. First, I want you to know you’re not alone in this battle.

According to a recent study by the McKinsey Health Institute, 1 in 4 employees are working in a “toxic workplace.”1 The Institute defines toxic workplace behavior as “interpersonal behavior that leads to employees feeling unvalued, belittled, or unsafe, such as unfair or demeaning treatment, non-inclusive behavior, sabotaging, cutthroat competition, abusive management, and unethical behavior from leaders or coworkers.”1

I am deeply sorry if you are experiencing any of these behaviors. I am grateful for your bravery in bringing forward such an important issue. I have no doubt that others are struggling in similar ways.

Something in the way that you presented this issue gave me pause. You said, “How can I just “get over it.”” Can we sit with that statement for a moment? Before we move any further, I want to see whether you can remove the shame you’re holding onto for how you’re feeling. How would you speak to a dear friend struggling with the same situation? Would you tell them to “get over it?” No. You are trying to perform a job in a burning building. I don’t expect you to so easily “just get over it.” I expect that you’re going to be in pain and lost while trying to find your way through this predicament. Could you extend yourself some grace for the struggle that you’re enduring? How you feel is not the problem, but it is in how you respond to your feelings that you’ll find your solution. So please, be kind to yourself.

An IP Lifeline column from Infection Control Today

An IP Lifeline column from Infection Control Today

I often think of a toxic workplace as a building on fire. If the fire is small and contained, you may be able to extinguish it, given the appropriate training and resources. If you’re a firefighter, you’ll be trained to deal with larger fires and equipped with a fire-retardant suit that protects you from fire injuries. Finally, after a certain point, we must all recognize when the building is unsafe for everyone, including the firefighters, and it’s time to get out.

Extinguishing the Fire of a Toxic Workplace

Let’s begin by talking about when and how we might be able to extinguish the fire of a toxic workplace. Is it possible for us to confront the toxic individual or individuals responsible and discuss how their behavior is affecting you and/or others in the workplace? Before doing so, you’ll need to assess the situation and determine whether it’s mentally, emotionally, and physically safe to confront the individual. Is this a fire you may be able to extinguish using the appropriate resources?

Next, plan how and when you will address the toxic individual or individuals. Pick an appropriate time and location for the confrontation. Inform them that something is weighing on your mind that you were hoping to discuss with them. Begin the conversation with a nonthreatening statement such as “I really value our working relationship together, and I appreciate you taking the time to meet with me here.”

After you take your lead, you must choose your words carefully. People are more prone to becoming defensive when you directly attack their character or behavior. Do not, for example, say, “Everyone thinks you are a manipulative, self-absorbed narcissist, and we are tired of your behavior.” That approach will not get you anywhere. Instead, stick to using “I statements,” which are less accusatory and better received. “I statements” help a toxic individual see how their behavior affects those around them. Try saying, “I feel uncomfortable when you talk about our coworkers negatively.”

Your goal is to get a toxic individual to a place where they can be open to receiving feedback on how their behavior is affecting those around them. Sometimes, people don’t realize how their behavior impacts others, and with some well-delivered feedback, they may be open to change. If someone is open to hearing your “I statement,” they might just be open to delivering an apology and changing their behavior.

Put on Your Fire-Retardant Suit

It’s important to remember that we do not have power over another individual to change their behavior. We may be able to influence it, but real change is their responsibility. You are only responsible for what you can control--your own behaviors and responses to the external stimuli of the world. I’m talking about setting boundaries. You have control over the boundaries in your relationships. Your boundaries are the fire-retardant suit that allows you to continue working amidst the fires of this world. The truth is that we will always be living and working amongst individuals with unhealthy behaviors. And learning how to set boundaries in all our relationships, especially with unhealthy individuals, will leave us less stressed.

The “fire extinguishing” conversation is a great time to assert your boundaries. Your goal in this conversation is not to change someone. Only they can do this for themselves. The goal of the fire extinguishing conversation is to communicate how their behavior affects you and how you’ll respond to it in the future, hoping that this conversation influences behavior change. You may say, "I feel uncomfortable when you talk about our coworkers negatively. It’s been leaving me feeling more drained lately. I’ve decided that, as a result, I can no longer participate in those conversations with you.” You get to decide how and when you engage with a toxic individual. Set boundaries to protect yourself from toxicity. Another piece of fire-retardant clothing is your stress-coping skills.

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Research shows that we’re less capable of dealing with toxic individuals and stressors when we’re struggling to cope with challenges in our work and life.2 Our capacity for emotional resiliency decreases when we cannot manage or cope with stress. When we’re stressed or emotional, minor problems become big ones. Ensure you equally assess your stress-management skills, emotional resiliency, ability to set healthy boundaries and adaptability. Remember that YOU are in your control and only you.

Get out of the fire

Sometimes, despite your adaptability, resiliency, and stress-coping skills, you may still need to consider moving on from a workplace that is continually negatively impacting your mental and emotional health. Maybe you’ve already tried healthy confrontation, worked to build up your emotional resiliency, and set boundaries in relationships. However, you are still faced with toxic behaviors that are taking a significant toll on your health. In this situation, it’s time to recognize that it’s unsafe for you to continue in this environment.

Remember, it’s not you that is the problem, but the environment that you’re in. The job brings you joy and fulfillment, but if you’re continually faced with toxic behaviors from management or employees, you’ll eventually come to a place of burnout where nothing brings you joy or fulfillment, including the work you do. Do you feel stuck in this job? Do you think that you’ll be unlikely to find a place of employment elsewhere? Are you afraid to start again? Sit with why you’re reluctant to leave and assess whether that reluctance should truly outweigh the stress that you’re experiencing in your current position.

I know that starting over or stepping out into the unknown can be scary, but is it possible that doing so is a little less terrifying than staying in a job that you dread going to every day? If you have exhausted your resources and still find yourself in a daily state of mental and emotional pain, then it might just be time for you to consider getting out of the fire.


  1. Addressing employee burnout: Are you solving the right problem? McKinsey Health Institute. May 27, 2022. Accessed March 27, 2024.
  2. Toxic workplace behavior and employee burnout: Fix one, fix both. McKinsey Health Institute. September 30, 2022. Accessed March 27, 2024.
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