Toxic Team Turnarounds: Wise Employer Interventions When a Team is on the Brink of Failure

Teams on the Brink of Failure Require Wise Employer Interventions

From Paul’s bestselling book, “101 Tough Conversations to Have with Employees: A Manager’s Guide to Performance, Conduct, and Disciplinary Challenges” (HarperCollins Leadership and American Management Association Books)

Leading a dysfunctional or toxic team can be the ultimate career challenge. Stubborn resistance to change, overreactive corporate grapevines, us-versus-them logic, or even setting others up for failure are not beyond the realm of possible landmines awaiting even the most good natured and effective leaders. How do you turn around a toxic team and bring it back from the brink of failure? How do you reset expectations and manage performance in a unit or department with ill-willed employees? Most importantly, how do you create a “new normal” going forward where participants either get on board or self-select out of the unit or organization?

Senior executives and department heads sometimes find themselves in dire straits because of interpersonal conflict, misaligned talent, or organizational structures that lack efficiency and fail to align with their customers’ needs. When interpersonal conflict and character assassinations rise to the level of an urgent distress call, it’s time to take a candid look at resetting group performance and conduct expectations or replacing certain individuals within it.

As a leader possibly faced with a department that’s about to implode, you’ll want to conduct individual and small group meetings to learn firsthand what the specific problems are. You’ll need to tally the issues you learn of, share them with the team as a whole, and then redefine everyone’s commitments and priorities in eliminating those roadblocks. If this process sounds like a lot of work, that’s because it is. Still, there’s no better investment of your time than turning a flagging team into a functional, cohesive unit. It’s the stuff legends are made of. Make yourself known as a turnaround expert for even the most dysfunctional teams, and you’ll find yourself on the path to career growth and higher levels of strategic leadership.

A word of advice: Leadership is a team support. Before you make your way down this path of team turnarounds, make sure your ducks are aligned and in a row. Specifically, ensure that your (1) immediate superior and (2) HR business partner are aware of what you’re doing and there to support you. After all, leadership can get lonely at the top. And under all circumstances, you’ll want to ensure that you’re “acting within the course and scope of your managerial authority.” In other words, gain the appropriate signoff from your two most critical resources: your boss (above you) and your HR partner (to the side of you). Once you’re all in agreement, you can move forward with greater self-confidence and a pre-approved roadmap to intercede wisely.

Better yet: invite HR (if your company has an HR function) to conduct these intervention meetings with you. There’s power in numbers, and as long as you’re partnering with a third party that’s objective and non-involved in your day-to-day operations, you retain an air of objectivity that keeps your findings in line, in scope, and consistent with your company’s policies and past practices. That’s especially the case if this particular intervention eventually leads to terminations for cause, resignations (where “constructive discharge” legal claims may be made), or other claims of retaliation, discrimination, or harassment may later ensue. That’s especially the case if you believe that anyone on the team may be particularly litigious.

The Scenario: Your MBA Business Case and "Consultant Mindset"   

Let’s assume that you’re responsible for the surgical unit at your hospital, and the team is constantly at odds: RNs blame LVNs, LVNs blame CNAs, and CNAs blame everyone else. (For those of you unfamiliar with medical staff acronyms, we’re referring to Registered Nurses, Licensed Vocational Nurses, and Certified Nursing Assistants, where the Registered Nurses typically have the highest level of education and professional licensure.) All three groups complain that the management team doesn’t hold people equally accountable and there’s favoritism shown at every turn. These factions won’t cooperate (for example, by not responding to patients’ call lights when the primary nurse isn’t available). Worse, there are two shifts—AM and PM—where team members take sides to protect their peers and blame “the night shift” or “the day shift” for the ongoing problems in the unit. However you look at it, whether by role or by shift, patient care is compromised, documentation is missing or inconsistent, and no one wants to assume even partial responsibility for the core breakdown in team operations.

First things first: a “consultant mindset” can help you remain objective and dispassionate throughout the turnaround. Granted, you may have been part of this unit for years and carry your own “baggage” in terms of past resentment and frustration with certain team members. Or you may be new to the hospital and have inherited this problematic department. But once you step up to turn around the team, it’s important that your credibility and objectivity remain above reproach throughout the investigation that you’re about to conduct. You’ll want to constantly keep in mind the record that you’re creating at every stage of the intervention (so take good investigative notes!). Better yet: consider this your “workplace MBA” where you can get your “degree” by successfully completing a project where most humans fear to tread.

The Logistics of Your Intervention: Toxic Team Turnarounds by the Numbers 

When faced with a scenario where no one seems to want to listen to the other side, and apathy, anger, and distrust pepper the workplace, it’s time to step in by meeting with each team separately—RNs, LVNs, and CNAs. Remember, there are two shifts in play, but if the shift transitions occur at 7:00 a.m. and 7:00 p.m., those are the optimal time windows to hold meetings with team cohorts. Here’s what your opening discussion might sound like:

Fact-Finding Meeting 1: Registered Nurses (RNs)

RNs, I’m calling you together as a group to learn what’s going wrong with our team. No LVNs or CNAs are here because I want to hear your side of the story as openly and transparently as possible. This meeting is about you, and here’s where it will go next: I’ll hold a similar, separate meeting with the LVNs and then with the CNAs. My job now is to listen to all three groups and then call us all together afterward as a full team to discuss my findings.

Once we map out the key issues with each of the three groups, I’m going to ask for commitments to solutions that we can all agree on and support. Does that sound like a fair approach and reasonable set of expectations on my part? [Yes.] Good. Then let’s start with this: what are the top three issues that are bothering you and getting in our way as an RN team? And please tie your responses to how the problems affect patient care. After all, that’s why we’re all here and have jobs. Who wants to go first? [Jot all responses down on a white board or on butcher block paper at the front of the room.]

Next, let’s look at this on a scale of 1 to 10, with 10 indicating that we’re fully functional, working great together, and that we can do our very best work every day with peace of mind and with the full support of our peers. What score would you give our team of LVNs and CNAs across both the night and day shifts in terms of the support you receive, the encouragement you get, and the overall sense that we have one another’s backs and bring out the best in each other?

[Team average response: 4 out of 10]

Fair enough. Why are we a four out of 10? What does a four feel like?  (Jot down team members’ responses here as well.) 

Final question: What would make us a 10?

Write out the RNs’ responses to this question as well and ensure that everyone’s in agreement. Push for more ideas and suggestions until the team is literally silent. Then ask, “Would you all be willing to do your part to make these things happen? Will you agree to be the first domino to move our unit in a new direction? Can I count on your leadership as the RN team to move the needle forward and help our team reach a new milestone in terms of our identity and way of interacting with one another?  Is that a fair ask or expectation on my part?” (Yes) At that point, thank everyone for sharing so openly how they feel, what they’ve been experiencing, and for helping you at this fact-finding stage of your intervention. (Hint: You’re going to take all the items from this “What would make us a 10?” listing and use it later to set the team’s goals moving forward.)

Fact-Finding Meeting 2 (LVNs) and Meeting 3 (CNAs)

Repeat this intervention with the other two groups to gather commonalities, discrepancies, and frustrations. You can also ask them to engage in this same “Scale of 1 to 10” exercise, or you can ask them to conduct a “Start-Stop-Continue” exercise. Again, with marker in hand and while taking notes on the board, ask them what the team needs to start, stop, and continue doing to turn things around. Ask them if they’d be willing to do their part and make themselves part of the solution you’re hoping to reach. Ask if they’re willing to be the first domino. At that point, conclude the meeting and commit to coming together in the next 24 hours to share the newest findings and bring resolution to the matter.

At this point, you’ll have committed roughly three hours and three meetings to this turnaround intervention: one meeting with RNs, one with LVNs, and one with CNAs. You’ll be armed with the problems shared, solutions offered, and commitments willing to be made. With this information in hand, you’ll likely notice one element that stands out to you like a lightning rod: everyone is complaining about “the other guy” or “the other team” using the same verbiage: They don’t respect us. (No, they don’t respect us!) They leave their work area a mess at shift change and we can’t find anything. (No, they leave their area a mess and we’re forced to clean up after them.) They don’t even say hello when they see us at shift change during our huddle meetings to discuss patient care status. (No, they don’t say hello to us during shift change when we meet for the huddle to turn over shifts.) You get the idea. . . They’re all accusing the other side of doing what the other side is accusing them of.  Adult human beings. . . Go figure!

Meeting 4: The Team Meeting Resolution

Once you finish with the initial rounds of information-gathering meetings, call the entire team together to discuss matters openly and to gain commitment as follows:

Everyone, as I explained earlier, this is the large group follow-up meeting where I get to debrief you on what I’ve learned through my interviews with the three subgroups in our unit. Interestingly enough, you all seem to agree on what the three biggest problems are: (1) lack of holding others accountable consistently, (2) perceptions of favoritism and inconsistent treatment by certain managers toward certain medical staff members, and (3) a lack of respect, demonstrated by outbursts of anger, a condescending tone in daily communications, and an immediate inclination to blame others.

Does this surprise you? Also, am I missing anything? Speak now or forever hold your peace, because I’m only planning on doing this group-level intervention once, so I want to make sure I’ve captured everything correctly. Do you all agree that these three problems are your biggest concerns? [Yes.] Are there any other matters that need to be shared in this meeting, as we launch our turnaround strategy? [Yes—patients complain that the CNAs aren’t paying enough attention to them or addressing their requests fast enough. Also, the CNAs and LVNs aren’t properly completing documentation, which puts pressure on the RNs.]

Fair enough. Let me jot that down up here on the board. Is there anything else I’m missing in what’s now our top five list of concerns? [Yes. We CNAs feel talked down to and disrespected just because we’re junior members of the team.] I’m glad you shared that—I’ll add it to the list now. Anything else? [Silence.]

Okay then, this meeting can now move in another direction: the resolution. During the small group meetings, I asked you all for suggestions on how to fix the problems, including what you’d be willing to do differently to remedy the problems and build a greater sense of teamwork. Here’s what I heard throughout the three fact-finding sessions:

·         I’m willing to answer other patients’ call lights, but only if the other nurses do the same for me.

·         I can commit to more accurate charting, but only if there are consequences for those who fail to chart accurately or thoroughly.

·         I won’t challenge anyone with a higher license or rank than me, as long as they don’t keep reminding me that they’re higher than me on the corporate totem pole and always disregarding the fact that we CNAs have been here in the unit the longest and have valuable suggestions to contribute.

·         You won’t participate in any gossiping or ‘stirring the pot’ if others don’t talk about you behind your back.

·         You’ll say hello and goodbye at shift change and make others feel welcome and well informed about patient care status, but you expect that behavior to be reciprocated.

Continue as follows:

I think those commitments are fair under the circumstances . I believe they’re doable for our team. Do you all agree? [Yes.] Would anyone like to add anything else? [Yes: There has to be greater respect all around. How we treat people shouldn’t be a function of our role in the ‘nursing caste.’ We all deserve to be respected equally, regardless of our title.] I think that’s also a fair request—Do we all agree? [Yes.] Then let’s map these commitments on the board and discuss what our unit might look like if they’re being adhered to. I also want to discuss what you all feel the consequences should be if someone doesn’t keep their end of the bargain.

[Conclusion] Okay, I’ve heard you all, both as individual groups and as a team. We’ve all agreed on the top problems plaguing our unit, as well as our go-forward individual and group commitments to turn this problem around. I appreciate your willingness to share this with me because I know you all want this situation to improve. There’s enough work around here to sink a battleship, and when you add the indignities, the disrespect, and the drama to the mix, it makes it impossible to do your best work every day with peace of mind. Don’t you agree? [Yes.]

Thank you. So, here’s my go-forward plan for all of you individually and for our team as a whole. I, as the department director, commit to demonstrating respect for all of you, regardless of your title or role within the unit. I pledge to be the first domino, the person to assume good intentions, to serve as a role model, and to ask you all to follow my lead in terms of my behavior and conduct. I’m welcoming you all back to the hospital as of now—June 6—by drawing a circle on the calendar on today's date and letting you all know it’s safe to come out of your foxholes and reestablish our unit as “normal”—fun, supportive, inclusive, a place where your ideas and suggestions are welcome and sought after, and eventually a place where we all have each other’s backs.

Understand, however, that if I’m holding myself accountable to these new standards that you’ve established for yourselves and for the rest of the team, I’m going to be holding you all equally accountable going forward. In other words, I can’t expect less of you than I expect of myself. Is that a fair assumption on my part? [Yes] Okay, then no more walking on eggshells, no more shouting matches in breakrooms, and no more internal sabotage. Those things existed prior to June 6, but after June 6, they have no place in this unit. Please don’t put me in a position to have to discipline (or Heaven forbid, terminate) anyone for failure to abide by these commitments that you’ve just established for yourselves. I’m assuming good intentions and placing my faith in all of you.

We are more than we’ve become, and we’ve allowed petty resentments to impede our path forward. Today you’re free of those indignities, and you’re now a key part to the turnaround solution. Is everyone on board, and do I have your commitment going forward to assume good intentions when dealing with one another? [Yes.] Then allow me to paint a picture of where we’ll be six months from now: our unit will be recognized as one of the highest-performing teams in the hospital. The physicians will be scratching their heads over how you’ve all been able to reinvent your relationships with one another and with them. The patients will be singing your praises because we’ll become known for outstanding patient care, customer service, and operational excellence (including documentation).

And we’ll become compliance wizards, ready for any surprise regulatory inspection that the Department of Health or the Joint Commission can throw our way. Are we all in agreement? [Yes.] Great! Then let this be your success story and tell it proudly in the future. I’ve got your back here, everyone. I only ask that you have each other’s backs as well. Let the turnaround begin!

The strategy of listening openly by separating the sub teams is critical, so they understand that you’re on their side. They need a safe space to vent their frustrations when one team pits itself against another. The strategy of gaining their commitment to go forward with the action steps that they’ve identified is the glue that binds: if they violate their own commitments, progressive discipline is a logical next step, and you now have a solid record in place to justify any sort of corrective action.

Also, don’t be surprised if there’s some fallout or turnover over the next three to six months. Some people thrive on chaos and drama; if you remove those elements from the mix, they’ll resign or transfer in order to find a new opportunity where they can pursue that dynamic. That’s healthy turnover, not regrettable turnover. Just understand that large group interventions like this usually result in casualties, so don’t be overly concerned about terminating rulebreakers or watching others resign because the “new normal” doesn’t fit their style.

The “Letter of Clarification” Solution: When Team Failure is Not an Option

Toxic team turnarounds start with listening. How you group the teams matters. How you record their grievances is important. What’s critical, however, is how you track the commitments and solutions they’re willing to make going forward. In fact, a letter of clarification to the entire team at that point ensures clarity of expectations going forward. Your one-page summary might sound like this:

Team,

Thank you for participating in the RN, LVN, and CNA meetings over the last two days. I appreciate your candor about your experiences working with our team. I heard you all closely and commit to serving as a role model in the leadership, communication, and teambuilding space. I’ll ask you all to do the same.

The most significant part of the exercises we conducted lies in the solutions you’ve suggested and the commitments you’re willing to make as the first domino in turning around the behaviors that up to now have impeded our team’s productivity. Following is the list of commitments you’ve agreed to and that I fully support:

1.    We will assume good intentions when dealing with other members of the team or staff members on other shifts.

2.    We will address one another respectfully and make every effort to support one another and help one another do our best work every day with peace of mind.

3.    Workspaces will be left clean for oncoming shifts, huddles will clarify current status updates, patient call lights will be answered collectively, and rumors, gossip, and talking behind people’s backs will cease immediately.

4.    If matters need to be escalated, you will inform me as soon as possible. You understand that now that we’ve set June 6, 2026, as the dividing line in terms of old, unacceptable behaviors versus new, role-model behaviors, any infractions of the agreements you’ve made may be met with disciplinary action, up to and including dismissal of employment.

5.    By signing this letter of confirmation, you agree to follow the commitments above as well as the items outlined at the conclusion of the internal investigation meetings that I conducted and shared with you.

Please see me privately if you have any questions moving forward. Likewise, please sign below to acknowledge receipt of the letter of clarification. Your signature denotes your assuming responsibility for turning around the problems at hand and raising the level of our unit’s performance and conduct moving forward. Thank you. – Paul Falcone, Director, Med Surge Unit

There you have it: you’ve extended an olive branch. You’ve welcomed everyone back to the table to do their best work every day with peace of mind. You’ve reestablished your expectations moving forward and included the possible consequences for failure to improve. In short, you have a record in place to protect yourself and the organization should any adverse action be taken in the form of progressive disciplinary interventions or termination. You’ll have treated the unit uniformly and consistently. And you’ll have turned around a flailing unit that might otherwise appear to be on the brink of failure.

Congratulations on a job well done. Your invitation to bring everyone back to the proverbial table and your well honed “leadership defense” skills will insulate your organization from legal liability and mitigate if not eliminate any future legal challenges that may come your way. Not a bad outcome for a total of four meetings and four hours over two days. And remember that the letter of clarification creates a new, healthy line in the sand. That’s “turnaround leadership” at its finest. And it’s this new tool in your toolkit that lets you turn around future challenges like this whenever failing teams come into play. Done once and done correctly, you can apply this at any time in the future when your team, department, or unit is plagued by ill intentions or mean-spirited attacks that might leave your employees floundering. In short, you’ll have demonstrated an “iron hand with velvet glove”—high expectations, a caring ear, and concrete consequences. That combination will take you far in your management career and leave the teams you lead far better off and grateful for your leadership.  

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