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In the nursing profession, effective leadership plays a crucial role in shaping healthcare delivery, influencing subordinate nurses, and impacting patient outcomes (Daly et al., 2020). Negative leadership, characterized by toxicity, has the potential to foster an unfavorable work environment, diminish employee morale, and ultimately hinder organizational productivity. When not addressed, toxic leaders pose a substantial risk to both subordinates and the overall organization. Consequently, it is essential to establish a well-thought-out strategy for managing toxic leaders to mitigate potential harm. 

Evaluation of Leader’s Performance

In the present situation, Kyle, a BSN nurse, encounters challenges in handling a critically psychiatric patient, primarily attributable to the inadequate performance of his unit manager, Jackie. It is imperative for Jackie to fulfill her leadership responsibilities and provide guidance to Kyle in addressing the issues at hand. The presence of toxic leadership poses a notable threat to both the organization and its workforce, as highlighted by (Pat, 2021). The subsequent assessment delves into the evaluation of Jackie’s performance.

Examples of Jackie’s Performance

  • Failure to provide guidance to Kyle in managing a critical psychiatric patient, demonstrating neglectful behavior.
  • Non-attendance at staff meetings and neglecting emails can impede effective communication and decision-making within the team, as highlighted by (Lissack, 2021).

. • Insufficient attention to leadership duties, with potential adverse effects on patient care and Kyle’s morale.

Standards of Professionalism that Jackie is Violating

  • Communication: Jackie should enhance her communication with the team, as demonstrated by her lack of response to emails and non-attendance at staff meetings. Meeting this standard is crucial, as effective communication significantly contributes to organizational process efficiency (Margaret et al., 2023).
  • Effective leadership: Jackie must fulfill her leadership responsibilities, encompassing the provision of guidance and support to her team. The attainment of organizational goals relies heavily on effective leadership, as emphasized by (Bhugra et al., 2023).

Performance Issues for Plan:

  • The absence of guidance and support for subordinates adversely affects patient care.
  • Ineffective communication with the team, posing a hindrance to decision-making and fostering a negative work environment. 
  • Neglect in fulfilling leadership duties, contributing to a decline in employee morale.

Implications of Jackie’s Attitude

Action Plan for Effective Leadership

The current mission of the healthcare organization is centered around delivering high-quality, patient-focused care to individuals with psychiatric illnesses. Its vision aims to establish leadership in providing innovative, evidence-based treatments to enhance the psychological well-being of patients. The organization’s objectives include enhancing patient outcomes, ensuring safety, and fostering employee engagement and satisfaction.

In her role as a leader within the psychiatric unit of this healthcare organization, Jackie is entrusted with guiding and supporting her team, facilitating effective communication and coordination, and cultivating a positive work environment (Geerts et al., 2021). Her performance expectations align directly with the organization’s overarching goals of improving patient outcomes, ensuring safety, and promoting employee engagement and satisfaction.

However, Jackie’s neglectful behavior towards Kyle and failure to provide guidance in managing a critical psychiatric patient can detrimentally affect the organization’s ability to realize its objectives. The absence of proper guidance and support may impede Kyle’s effectiveness in patient management, impacting both patient outcomes and safety. Additionally, Jackie’s non-attendance at staff meetings and lack of response to emails may hinder effective communication and collaborative efforts, further influencing patient care and the organization’s reputation.

Crafting an action plan that is both realistic and specific is essential for achieving goals, as emphasized by AHRQ (2020). The following is an action plan designed to enhance Jackie’s performance as a leader:

Step 1: Identify Professional Performance Expectations

 Define the professional performance expectations for Jackie in her role as a leader within the psychiatric unit, ensuring alignment with the organization’s mission, vision, and goals. This includes:

  • Offering guidance and support to her team, particularly in the effective management of psychiatric patients (Smith et al., 2020).
  • Regular attendance at staff meetings and timely responsiveness to emails.
  • Facilitating effective communication and coordination within the team.
  • Cultivating a positive work environment and actively promoting employee engagement and satisfaction.

Step 2: Provide Feedback and Coaching

Offer constructive feedback to Jackie regarding her performance and provide coaching for improvement. This may involve:

  • Engaging in discussions about specific instances where her actions have had adverse effects on both the team and patient care.
  • Offering guidance on effective team management and communication strategies.
  • Encouraging senior leaders to furnish resources or training to enhance Jackie’s leadership skills and foster a positive work environment, as recommended by (Sarik et al., 2019).

Step 3: Monitor Progress and Provide Support

  • Establishing routine meetings to review progress and address any issues or concerns regarding Jackie’s performance.
  • Offering additional resources or training as necessary

. • Acknowledging and rewarding positive advancements in both behavior and leadership skills.

Step 4: Evaluate and Adjust as Needed

Assess the efficiency of the action plan and modify it as necessary based on requirements. This may involve:

  • Gathering input from the team on Jackie’s performance and leadership approach, as leaders operating in feedback-rich environments tend to yield better outcomes than those without feedback (Elliott et al., 2022).
  • Adapting performance expectations if required to more closely align with organizational goals.
  • Offering additional coaching or resources if progress is not evident.

Assumptions about Plan

Enhancements in Jackie’s performance have the potential to enhance healthcare delivery and patient outcomes through the facilitation of effective communication, coordination, and leadership within the psychiatric unit. This improvement can result in elevated standards of patient care, better patient outcomes, and heightened levels of employee engagement and satisfaction. The cultivation of a positive work environment is instrumental in optimizing patient care delivery and enhancing patient outcomes, as highlighted by (Parr et al., 2020). Ultimately, by elevating Jackie’s leadership performance, the organization is better positioned to realize its mission, vision, and goals of delivering high-quality, patient-centered care to individuals with psychiatric illnesses.

Conclusion NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Destructive consequences can arise in healthcare when leaders exhibit toxic behavior, adversely affecting nurses, the organization, and patient outcomes. In a healthcare setting, a leader nurse is anticipated to demonstrate effective communication, exemplary leadership, and guiding behavior. If the leader fails to fulfill these responsibilities, the implementation of a carefully devised action plan can substantially enhance their performance.


AHRQ. (2020, September). My action plan. Www.ahrq.gov. https://www.ahrq.gov/health-literacy/improve/precautions/tool15a.html#:~:text=The%20Action%20Plan%20is%20a 

Bhugra, D., Smith, A., Ventriglio, A., Hermans, M. H. M., Ng, R., Javed, A., Chumakov, E., Kar, A., Ruiz, R., Oquendo, M., Chisolm, M. S., Werneke, U., Suryadevara, U., Jibson, M., Hobbs, J., Castaldelli-Maia, J., Nair, M., Seshadri, S., Subramanyam, A., & Patil, N. (2023). World Psychiatric Association-Asian Journal of Psychiatry Commission on Psychiatric Education in the 21st century. Asian Journal of Psychiatry88(6), 103739. https://doi.org/10.1016/j.ajp.2023.103739 

Daly, J., Jackson, D., Anders, R., & Davidson, P. M. (2020). Who speaks for nursing? COVID‐19 highlighting gaps in leadership. Journal of Clinical Nursing29(15-16), 2751–2752. https://doi.org/10.1111/jocn.15305 

Elliott, R., Beaubien, L., Coe, G., Müller, A., Predaina, C. M., Stiles, S., Toth, L. P., & Cline, K. (2022). Knowledge Sharing and Mentorship as a Systems Engineering Process: Stories and Methods from Industry Experts. Women in Engineering and Science23(5), 145–167. https://doi.org/10.1007/978-3-031-08950-3_5 

Geerts, J. M., Kinnair, D., Taheri, P., Abraham, A., Ahn, J., Atun, R., Barberia, L., Best, N. J., Dandona, R., Dhahri, A. A., Emilsson, L., Free, J. R., Gardam, M., Geerts, W. H., Ihekweazu, C., Johnson, S., Kooijman, A., Lafontaine, A. T., Leshem, E., & Lidstone-Jones, C. (2021). Guidance for Health Care Leaders During the Recovery Stage of the COVID-19 Pandemic. JAMA Network Open4(7), e2120295.  https://doi.org/10.1001/jamanetworkopen.2021.20295 

Lissack, K. (2021). School attendance difficulties: An exploration of perceived barriers to attendance and the support offered for non-attendance from the perspectives of parents and school staff. Ore.exeter.ac.uk19(2). https://ore.exeter.ac.uk/repository/handle/10871/126272 

Margaret, Kickett, M., Francis‐Coad, J., Hill, K., Umbella, J., Coombes, J., Ivers, R., Bowser, N., Palacios, V., & Hill, A. (2023). “Nih Waangkiny Kaadatjiny”: “Listening, learning and knowing”: Stakeholders’ perspectives about barriers and enablers to delivering a successful physical activity program for older Aboriginal people. Health Promotion Journal of Australia43(4). https://doi.org/10.1002/hpja.774 

Parr, J. M., Teo, S., & Koziol‐McLain, J. (2020). A quest for quality care: Exploration of a model of leadership relationships, work engagement, and patient outcomes. Journal of Advanced Nursing77(1), 207–220. https://doi.org/10.1111/jan.14583 

Pat, B. (2021). Generative Leadership Development in an Agricultural Leadership Program. The Journal of Leadership Education34https://doi.org/10.12806/v20/i4/r2 

Sarik, D. A., Thompson, R., Cordo, J., Nieves Roldan, I., & Gonzalez, J. L. (2019). Good for Nurses, Good for Patients: Nurse Leader19(8). https://doi.org/10.1016/j.mnl.2019.11.005 

Smith, K., Ostinelli, E., Macdonald, O., & Cipriani, A. (2020). COVID-19 and Telepsychiatry: Development of Evidence-Based Guidance for Clinicians. JMIR Mental Health7(8). https://doi.org/10.2196/21108 

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