Tip of the month: Confronting nurses over unacceptable behavior

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Kathleen Bartholomew, RC, RN, MN, is well known for her work related to nurse-to-nurse hostility. She also teaches us that many unacceptable behaviors result from managers who are unwilling to confront situations.

The following situations are ones where managers must hold a conversation in a timely manner:

  • A policy or procedure was not followed
  • Poor clinical judgment resulted in a bad patient outcome
  • Unsupportive work environment
  • A work environment built on cliques
  • Disrespectful or condescending language
  • Misuse of authority by a nurse in a senior position

Confronting situations isn’t easy, but it is essential. To get started, consider using the DESC model created by Sharon Cox, RN, MSN, CNAA:

D (Describe the facts): “I noticed you turned your back and walked away just as I approached you.”

E (Explain): “This makes me feel you are avoiding me.”

S (State): “As your manager, I need to know that you and I can communicate whenever necessary.”

C (Consequences): “If you continue to avoid me, we will address this at a formal disciplinary meeting in my office. We cannot provide safe patient care if I cannot communicate effectively and timely with the staff.”


Bartholomew, Kathleen. (2006). Ending Nurse-To-Nurse Hostility. Marblehead, MA: HCPro, Inc.


Shelley Cohen, RN, BS, CEN, Health Resources Unlimited, Adapted with permission.

Sharon Cox, MSN, RN, CNAA. Cox & Associates.