NURS FPX 5007 Assessment 2 Managing the Toxic Leader

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Managing the Toxic Leader

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

I will design a performance improvement plan (PIP) for Jackie in this assessment. The performance improvement plan of Jackie will be used to address the human resources department of my organization. My objective is to evaluate leadership and management theories and practices in the context of professional nursing practice. Based on the employee’s behavior, I will determine how it impacts the mission, vision, and goals of the organization. 

Evaluation of a Leader’s Performance on the Base of Assessment of Performance

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

As a BSN-prepared psychiatric nurse who hopes to become a manager of an inpatient psychiatric unit, Kyle is enrolled in a part-time graduate program for the purpose of earning his MSN degree. In her role as a primary nurse on a 12-bed inner-city psychiatric unit, Kyle is responsible for the care of a patient named K.C. There is a primary care nursing model on the unit, and patient care conferences are held every Tuesday and Thursday afternoon. However, during one of these conferences, Jackie, the Nurse manager and chair of the conferences, cancels the meeting without informing all the necessary staff, leaving Kyle feeling unsupported and unsure of how to manage a patient who is becoming increasingly aggressive. Additionally, Jackie displays unprofessional behavior by showing up to work in a provocative outfit and engaging in flirtatious behavior with a younger, less senior nurse.

Evaluation of Jackie’s Performance as a Leader

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Based on the scenario, Jackie’s performance as a leader is lacking in several ways. She is not meeting professional performance standards and not providing effective leadership to her team. According to Spiva et al. (2021), nurse leaders must provide care and cooperation to patients. The main role of a nurse leader is to support and encourage the nurses by making sure that nurses must have enough knowledge and morals to care for the patients. 

Jackie has different issues with her performance. Jackie failed to communicate effectively with her team, specifically Kyle, about canceling the patient care conference. She also failed to respond to Kyle’s email promptly, which left him feeling unsupported and uncertain about how to manage a difficult patient. In a too-short sequined dress with large gold hoop earrings, a three-inch heel, and a too-short sequined dress, Jackie’s appearance and behavior were totally unprofessional. She also appeared to be engaged in inappropriate behavior with Martin, a younger and less senior nurse. A nurse should always dress appropriately and behave well to communicate with others. A study by Moore (2020) demonstrates that one of the major themes of effective leadership is communication. Nurse leaders should openly communicate with every nurse in the organization to avoid misunderstanding. Otherwise, it will lead to a crisis.

NURS FPX 5007 Assessment 2 Managing the Toxic Leader 

 When Kyle approached Jackie for guidance and support, she brushed him off and did not make time to address his concerns. She failed to provide the necessary resources and support to help him manage a challenging patient, which put other patients and staff at risk. In the study by Kelly et al. (2019), a large mix method study was conducted to examine compassion satisfaction and report burnout in nurse leaders. The professional quality of life scale was given to 29 nurses in a healthcare system. In qualitative interviews, sixteen leaders participated from two different hospitals. The result shows nurse leaders can gather compassion through support and peer-staff interaction. 

Violation of Two Standards of Professional Performance

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Jackie is not meeting the standard of effective communication with her team, which is critical to ensuring patient safety and providing quality care. Jackie violated the professional dress code of nurse leaders by wearing a casual dress to work. Professional dress codes are in place to ensure that employees present a professional and respectable image to patients and colleagues, and leaders need to set an example for others to follow. Also, Jackie is not meeting the standard of effective leadership and management. She is failing to provide her team with the necessary resources and support and is engaging in unprofessional behavior. According to Bryant et al. (2020), professional performance standards assess a nurse’s competency in a professional role. It involves all the activities related to communication, leadership, collaboration, education, and evidence-based practices. 

Documentation of Performance Issues 

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

To address these performance issues, a performance improvement plan (PIP) should be developed for Jackie. According to Wei et al. (2019), training must be provided to nurses before assigning new patients to them. The purpose of a performance improvement plan is to improve and enhance the outcomes of care, decrease costs, and reduce the risk in the healthcare system.  Based on the case study, Jackie’s performance as a leader is inadequate. She consistently fails to attend important patient care conferences and provide guidance to her team members, even when they seek her out for help. She also displays inappropriate behavior, such as wearing unprofessional attire to work and engaging in flirtatious behavior with a subordinate. These actions violate professional standards of leadership, including accountability, communication, and professionalism. Jackie’s poor leadership negatively impacts patient care and staff morale and must be addressed through a performance improvement plan.

Implications of Jackie’s Behavior for the Organization’s Mission, Vision, and Goals

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

As a Chief Nurse officer of the Jackson Psychiatric Hospital, I am responsible for providing high-quality, compassionate care to individuals suffering from mental illness. Our vision is to be the leading psychiatric hospital in the region, providing comprehensive and innovative care to patients and their families. The goals include improving patient outcomes, enhancing patient and family satisfaction, and ensuring the safety and well-being of our staff (Jackson Hospital, n.d.).

Implications of Jackie’s Behavior

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Jackie’s behavior has significant implications for the mission, vision, and goals of Jackson Psychiatric Hospital. The hospital’s goals include providing patient-centered care, ensuring the safety and security of patients and staff, improving patient outcomes, and maintaining a positive work environment for employees.

Jackie’s behavior directly affects the hospital’s ability to achieve these goals. Her lack of leadership skills and poor communication style make it difficult for her to effectively manage her team, resulting in poor patient outcomes and employee dissatisfaction. Jackie’s inability to micromanage and the nature of criticizing her staff can lead to low morale and turnover, and it will be difficult to maintain a positive work environment. According to Pakizekho and Barkhordari-Sharifabad (2022), a cross-sectional descriptive study was conducted in which 180 nurses participated. Data was gathered using three questionnaires: “Ethical Leadership,” “Conscientiousness,” and “Moral Courage.” The result showed that according to the correlation between ethical leadership and conscientiousness, and moral bravery, nursing managers could boost nurses’ moral courage and conscientiousness by using this leadership style.

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Furthermore, Jackie’s behavior puts the safety and security of patients and staff at risk. Her failure to respond appropriately to a patient’s suicide attempt and her neglect of safety protocols for medication administration indicate a lack of attention to patient safety. This behavior violates the hospital’s values of patient-centered care and puts the hospital at risk of liability. Jackie’s behavior can have a ripple effect throughout the organization. If her team members feel unsupported or disrespected, they may become demotivated and less engaged, leading to decreased productivity and quality of care. According to Salvage and White (2019), collaboration in the healthcare setting is crucial to provide high-quality care to patients. The nurse leader should encourage the other nurses to share their opinion. It will help them form a shared care plan for the patient.

Consequences For the Organization of Jackie’s Documented Behavior

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Jackie’s behavior, as documented, has significant implications for the hospital’s ability to achieve its mission, vision, and goals. Her behavior must be addressed through the performance improvement plan to ensure that the hospital can continue to provide high-quality, compassionate care to its patients and their families while also supporting the safety and well-being of its staff.

Development of an Action Plan to Improve Jackie’s Performance

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

The action plan to improve Jackie’s performance involves the following factors.

  • Establish Clear Expectations: Jackie’s role as a leader must be clearly defined, and expectations for her performance should be established in writing. This should include specific performance objectives and metrics that Jackie is expected to meet.
  • Leadership Training: Jackie must receive leadership training to develop her management and communication skills. The training should focus on communication, conflict resolution, team building, and creating a positive work culture.
  • Regular Feedback and Coaching: Regular feedback and coaching sessions should be scheduled to evaluate Jackie’s progress toward meeting the established expectations. The feedback should be specific and focused on both strengths and areas for improvement.
  • TeamSTEPPS Implementation: TeamSTEPPS is a program developed by the Agency for Healthcare Research and Quality that provides tools and strategies for enhancing teamwork and communication in healthcare settings, leading to better patient outcomes (Agency for Healthcare Research and Quality, 2019). Implementing TeamSTEPPS can help Jackie work more effectively with her team, reducing communication errors, improving coordination, and enhancing patient safety.
  • Use of transformational leadership: Transformational leadership can be used in the action plan for Jackie by encouraging her to focus on inspiring and motivating her team members towards a shared vision and goal. Through this approach, Jackie can work to develop her team’s skills and abilities and create a positive work culture that empowers team members to take ownership of their work and feel invested in the success of the organization.

Professional Performance Expectations

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Professional performance expectations for Jackie should include developing effective communication skills, building a positive and collaborative team culture, and demonstrating leadership qualities that prioritize patient safety and quality care. She should be expected to communicate clearly and effectively with all team members, including physicians, nurses, and support staff, to ensure everyone is on the same page and understands their roles and responsibilities. It is expected that Jackie will wear a professional dress while working in the organization. It will help her to be focused on providing more patient-centered care. Jackie should also be expected to build a positive and supportive team culture that encourages collaboration, respect, and open communication among all team members.

Improvements In Jackie’s Performance

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Improvements in Jackie’s performance can lead to several benefits for healthcare delivery and patient outcomes. By improving her communication skills, Jackie can ensure that important information is relayed accurately and promptly, which can prevent errors, delays, and other adverse events that can harm patients. Building a positive and collaborative team culture can improve staff morale, job satisfaction, and retention rates, which can lead to better patient care and outcomes. Additionally, by prioritizing patient safety and quality care, Jackie can help reduce the risk of medical errors, improve patient satisfaction, and promote better health outcomes.


NURS FPX 5007 Assessment 2 Managing the Toxic Leader

The assumption related to planning is that Jackie is willing to participate in leadership training and is open to receiving regular feedback and coaching. Resources are available to implement the proposed training and TeamSTEPPS program. The rest of the team is committed to working together to improve communication and teamwork.


NURS FPX 5007 Assessment 2 Managing the Toxic Leader

In this assessment, I discussed a case study of Jackie who is a nurse leader in an inpatient psychiatric unit. Based on the scenario of the case study, I developed an action plan for Jackie. Her attitude and behavior need to be changed for a better reputation of the organization and to provide better safety and care to the patients.

NURS FPX 5007 Assessment 2 Managing the Toxic Leader 


Agency For Healthcare Research and Quality. (2019). About TeamSTEPPS | Agency for healthcare research & quality.

Bryant, K., Aebersold, M. L., Jeffries, P. R., & Kardong-Edgren, S. (2020). Innovations in simulation: Nursing leaders’ exchange of best practices. Clinical Simulation in Nursing, 41, 33-40.e1.

Jackson Hospital. (n.d.). Our Mission | Jackson Hospital | Montgomery, Alabama. Retrieved February 2, 2022, from

Kelly, L. A., Lefton, C., & Fischer, S. A. (2019). Nurse leader burnout, satisfaction, and work-life balance. JONA: The Journal of Nursing Administration, 49(9), 404–410.

NURS FPX 5007 Assessment 2 Managing the Toxic Leader

Moore, C. (2020, November 16). Nurse leadership during a crisis: Ideas to support you and your team. Nursing Times.

Pakizekho, S., & Barkhordari-Sharifabad, M. (2022). The relationship between ethical leadership, conscientiousness, and moral courage from nurses’ perspective. BMC Nursing, 21(1).

Salvage, J., & White, J. (2019). Nursing leadership and health policy: Everybody’s business. International Nursing Review, 66(2), 147–150.

Spiva, L., Hedenstrom, L., Ballard, N., Buitrago, P., Davis, S., Hogue, V., Box, M., Taasoobshirazi, G., & Case-Wirth, J. (2021). Nurse leader training and strength-based coaching. Nursing Management, 52(10), 42–50.

Wei, H., Roberts, P., Strickler, J., & Corbett, R. W. (2019). Nurse leaders’ strategies to foster nurse resilience. Journal of Nursing Management, 27(4), 681–687.