Deliberate Withholding and Narcissism: Part 1, The Case of Chinese Nurses and Toxic Workplace Behaviors By their Managers
Deliberate Withholding and Narcissism: Part 1, The Case of Chinese Nurses and Toxic Workplace Behaviors By their Managers Crossposting audience: This is a new subreddit at r/zeronarcissists, the first anti-narcissism subreddit based on scientific evidence as far as I can tell. Please give us a follow at the original sub! We are new and growing
Chinese nurses’ perceptions on toxic leadership behaviours of nurse managers: A qualitative study
https://onlinelibrary.wiley.com/doi/pdf/10.1111/jonm.13758
Toxic behaviors lead to poor psychological health, low job satisfaction, low nursing quality, and high turnover for a very needed job. Medical errors also ironically increase under abusive supervision because of the anxiety and depression they cause.
Research repeatedly reports the consequences of toxic behaviours in terms of poor psychological health (Zhang et al., 2021), low job satisfaction, low quality of nursing care (Sharif et al., 2021), counterproductive work behaviours (Low et al., 2021) and higher turnover intention (Lyu et al., 2019). As to patients, the incidence of nurse-reported adverse events increased, such as medical errors (Lyu et al., 2019) and the decline in care quality (Labrague, 2021)
Chinese hospitals speak a lot on transformational leadership but are negligent to identifying, observing and preparing for counterproductive and abusive management behaviors in order to mitigate them. Being realist about abusive management behaviors in order to help employees identify and mitigate them is critical.
Chinese hospitals mainly advocate positive leadership behaviour such as transformational leadership styles but pay less attention to negative leadership behaviour. Therefore, this qualitative research explores Chinese nurses’ perceptions of toxic leadership behaviours of nurse managers and identify the type, cause and response measures.
Toxic leadership causes psychological harm, potentially permanently with many victims of long term abusive supervision showing signs of PTSD later
Toxic leadership refers to the use of organized, systematic and persistent destructive behaviours by leaders that may cause psychological harm to their followers and harm to the organization, emphasizing undesirable outcomes (Webster et al., 2016). Unlike workplace bullying (Tuna & Kahraman, 2019), which is repeated hostile behaviour of one person or group towards another, toxic leadership behaviour specifically refers to behaviour from managers to subordinates and does not include bullying from colleagues.
Filipino nurses experienced less toxic leadership, showing Chinese nurse managers can learn from Filipino nurse culture
Filipino nurses rated their nurse managers’ toxic leadership behaviours to a lesser extent, suggesting that Filipino nurse managers have a lower tendency to exhibit toxic leadership behaviours (Labrague et al., 2021).
Turkish nurses had average amounts and Chinese nurses can read their research to resolve similar issues.
A survey of 224 nurses in Turkey showed that nurses were exposed to a moderate number of toxic leaders.
Toxic leadership includes deliberate withholding of needed information and the silent treatment, which is extremely destructive, ineffective, and interferes with the ability of nurses to do their jobs just to show status and power. This is not having the correct priorities.
Toxic leadership is characterized by chronic abuse of subordinates, including public ridicule, threats, deliberate withholding of needed information and silent treatment (Peltokorpi & Ramaswami, 2021). They always find ways to crush and reduce the confidence and interest of subordinates (Singh et al., 2018). They are destructive, abusive and ineffective, interfering with the ability of others to do their jobs. They are concerned with status and power, thus increasing the toxicity of the environment (Milosevic et al., 2020).
Chinese culture may play a large factor in the issue here due to the fact Chinese are expected to be harmonious, hard on themselves and lenient to others, while also being strict and goal oriented to get results. These two needs in Chinese culture often prove to be incompatible, resulting in more experiences of abusive supervision than harmony, although both may be present in different situations.
The Chinese work culture emphasizes harmony in collective relationships on the one hand. Managers need to be fair and selfless and care for subordinates. On the other hand, it requires managers to be strict in rewards and punishments and goal oriented. There is a large power distance and a clear organizational hierarchy in Chinese work (Sun et al., 2020; Yin et al., 2021). Chinese managers’ leadership behaviours are strongly influenced by traditional Chinese culture (Barney & Zhang, 2009; Ma & Tsui, 2015).
Supervisors who “make it” show more narcissistic tendencies and power consciousness; they are more focused on “outing the weak” instead of being excellent carers. Given this is nursing and the medical field, “outing the weak” is deeply out of place and fascist in its nature.
Supervisor traits include narcissistic tendencies, power consciousness, outcome orientation, stereotypes and biases. Subordinate factors include self-perception, behavioural style, job performance and political skills
China is a high power distance society, and also Chinese nurses showed almost complete learned helplessness saying they didn’t believe anything would change coming forward. This shows a maladaptation to negative feedback in Chinese hospitals that usually results in silencing, punishment, the silent treatment, or worse, and no actual change when the nurses come forward about their suffering and the fact the behavior is making it hard to work.
Organizational contextual factors include power distance, Chaxu Climate, promotion channels and grievance mechanisms. Among them, the Chaxu climate emphasizes interpersonal relationships. ‘Cha’ represents the inequitable distribution of resources in the organization. ‘Xu’ represents the status gap between superiors and subordinates, emphasizing the order of respect and inferiority in the organization (Ma & Su, 2020).
“When asked about responding to the toxic leadership behaviors, they majority of nurses said they were overwhelmed with silence and would not respond. A nurse uttered…’I have no idea what to do…’” (learned helplessness, grief and pain that this abusive behavior won’t change)
When asked about responding to the toxic leadership behaviours, the majority of nurses said they were overwhelmed with silence and would not respond. A nurse uttered, ‘I have no idea what to do … Even if you report it, it will not change anything, and it will just make the leader dislike you more’ (N1). Another nurse mentioned that ‘when encountering such an incident, our department would rather work on the night shift than the day shift in order to work without the head nurse. I will do my best to forget the bad experience and avoid interacting with the chief nurse in the workplace’ (N5)
Toxic leadership behaviors included intemperateness (quick to anger), narcissism, self-promotion and humiliation of the nurses. Failure to support staff was a common and unacceptable (toxic) leadership behavior, seen as being passive aggressive and on purpose to harm the nurse covertly.
’ toxic behaviours are multifaceted. Labrague, Lorica et al. (2020) categorized the toxic leadership behaviours of nurse leaders into four types of behaviours: intemperateness, narcissism, self-promotion and humiliation. In addition to these apparent behaviours, toxic behaviours of leaders sometimes involve covert and passive behaviours, such as the failure to support staff and the constant use of insulting and offensive nonverbal gestures (Milosevic et al., 2020).
Leaders who are poorly managed (no strong administration keeping them from being abusive), chronically depressed (without purpose, meaning, or the correct social support and/or therapy) and sleep deprived (not the right support) were more likely to practice toxic leadership. Addressing these factors is key.
leaders who are poorly managed (Gunawan et al., 2018), chronically psychologically depressed (Tepper et al., 2006) and sleep deprived (Barnes et al., 2014) are more likely to practice toxic leadership.
Organizations with high toxic leadership ratings tend to not provide avenues for grievances at all, or these avenues are ineffective, not enforced, and/or not taken seriously. This is the key issue. These avenues need to be taken seriously.
Organizations do not provide avenues for grievances and do not have good responses to toxic nurse leaders
Compared to other countries, toxic leadership was more passive aggressive but still very hostile. This may make it hard for Chinese to relate to overt narcissistic behaviors research, but when it includes passive aggression, Chinese will find it more relevant.
First, compared with other countries, the severity of toxic leadership behaviours of nurse managers among Chinese nurses was not reflected in the apparent hostile act with an uncompromising attitude but in some unfriendly, concealed and disguised behaviours.
The organization should care for nurses, value them, pay attention to and promptly discover negative leadership behaviors, open up channels for feedback, find out the facts, and take them seriously.
“The organization should strengthen its care for nurse leaders, pay attention to and promptly discover negative leadership behaviours of nurse leaders, open up channels, clarify attitudes, find out the facts and deal with them seriously.”