Toxic hospitals: when workplace culture has a bad attitude

I have been asked on a few occasions why I chose to do cardiac surgery. Aside from the subject matter, the technical challenge, the real difference you can make to someone, it was the team work. At the hospital where I started my training, I was lucky enough to work with a wonderful team. It made me appreciate how each of us, as cogs in the larger machine, came together for a common end. I hope my colleagues felt the same, but to me, it was collaborative, collegiate, sometimes fun but above all, healthy. We didn't always get along, nor did we always agree. But it was a kind of functional chaos that I have not really seen replicated. With the release of the Royal Australasian College of Surgeon's EAG report on bullying and harassment in surgery, the focus on what is a good workplace is at the forefront of our minds. Even just in day to day life, there seems to be a shift in how people perceive others' behaviours in the hospital work environment. Could it be that we are becoming emotionally intelligent about what makes a workplace healthy and what makes a workplace toxic.

A toxic workplace is a workplace that negatively impacts on the welfare, productivity and wellbeing of employees. In the healthcare sector, there is an added and vitally important group at risk - the patient. If we are too busy bullying, bitching and being obstructive to one another, aside form our own health, we are risking that of the very person we are there to save.

Toxic hospitals are horrific places to work in. Every day is a constant battle to get what you want or what you need from your workplace. What you want or need might be to be treated fairly. Or it might be appropriate instruments. It might even be teaching or support or holidays or rostering support. People go home every day exhausted, emotionally and physically. And they leave to greener pastures. But a toxic workplace or coworker doesn't see this as a loss. They prefer maintenance of the status quo - people who don't challenge the culture.

Toxic workplaces are often deeply engrained with practices of bullying and harassment, fuelled by toxic co-workers. These individuals and consequently organisations don't always see their practices or behaviours as problematic. You probably recognise these workplaces by their battle cry - 'we've always done it like this' or 'nobody else has had a problem before'. As a consequence, enforcing change is so difficult. Look at surgeons for example. It took a very public exposure of these practices in surgery to begin a paradigm shift.

I want to make one thing very clear. Surgeons have as I said, been exposed and held to account for its past practices. And they should. The rest of the health care system needs to follow suit. Toxic coworkers should not be tolerated. The sooner hospitals who have toxic work environments admit they have a problem and take steps to rectify them, the better. And the more people who stand up to toxic coworkers and toxic workplaces, the better for us, the employees and of course our patients.

As a final note, if you are interested in reading more about toxic work environments, I would highly recommend reading 'Toxic Coworkers' by Alan Cavaiola or 'No Asshole Rule' - all excellent places to start with to build a healthier workplace.