How to recognize a toxic EMS leader

There is a difference between a bad leader, and one that is blind to the negative impacts of his or her actions

By Matthew R. Streger, Esq.

Is it a Red Day or a Green Day?

No, these are not alternative rock bands. They are code words used by employees in a department to clue each other into the boss’s mood that day. If it was a Red Day, you wanted to avoid the boss’s office at all costs, but on Green Days, you were okay to take advantage of the “open door policy.”

Sound familiar?

Unfortunately, we find ourselves working for, with, and around leaders like this all too often: People who, for whatever reason, have failed at the most basic principles of leadership. Perhaps they were good leaders once who lost their way, or they were good at their previous job and were promoted to a place where their lack of confidence surfaces in unfortunate ways. Or maybe they are too self involved, and are driving their own agenda instead of the organization.

Look around and see if anyone you work with or for has certain personality traits that are toxic to your department. Keep in mind that there is a difference between not being an effective leader and reaching the point of toxicity. Ineffective or bad leaders may exhibit one or more of the toxicity traits, but they are usually trying to overcome those shortcomings. Toxic leaders are blind to the negative impacts of their actions. Ineffective leaders may need to chart a new course, while toxic leaders are killing their department, and their people, from within.

How good, bad and toxic leaders manage

The four basic precepts of leadership are honesty, competency, consistency, and vision. Think about these basic principles and see if any of your colleagues fit these descriptions:

1. Honesty

  • Good leaders tell the truth, and if they are withholding information it is usually for a good reason.
  • Bad leaders often tells lies, or try to spin the truth to their own ends.
  • Toxic leaders not only tell lies, but manipulate facts or circumstances to hurt other people.

2. Competency

  • Good leaders admit their mistakes openly. When good leaders have shortcomings they ask for (and receive) help.
  • Bad leaders have noticeable areas where they are unable to perform the basic job functions, and it negatively impacts the organization.
  • Toxic leaders refuse to acknowledge a lack of basic competence, and often blame others for their own failures.

3. Consistency

  • Good leaders tell you where they stand on a topic and do not waver. If they change their minds, it is for a good reason and they explain their shift in position.
  • Bad leaders will blow in the wind, changing direction when the prevailing opinion changes.
  • Toxic leaders not only change their position, but refuse to admit the change, and they often take their insecurity out on their subordinates and peers.

4. Vision

  • Good leaders have a clear, concise vision of where they want an organization to go, and they have communicated that at all levels.
  • Bad leaders don’t lead, and the organization just drifts along, still doing the basic job but not moving in a specific direction.
  • Toxic leaders focus on their personal vision, and put the goal of making themselves look better above the betterment of the department.

How to handle a toxic leader

So what do you do about this? A toxic leader may be a subordinate, supervisor, or peer.

When your toxic leader is a subordinate, the choices are much easier because you have control over the individual. You can mentor them and steer them to try to improve their performance. This usually works best with concrete examples of deficiencies combined with recommendations on how to improve in the future.

In the end, you always have the ultimate trump card of termination of employment.  Document repeated failings and use progressive discipline to remove a toxic leader from the team if they do not correct their errant ways.

A toxic leader as a superior is a different challenge. We’ve all heard of “managing the boss” – if your boss is toxic, you make the best of the situation, trying to protect yourself and the people around you. Perhaps the most important thing that you can do with a toxic boss is to set your own tone, so that your subordinates, peers, and colleagues all know that you have a different philosophy.

This is a difficult road to travel, as you cannot be seen as undermining your supervisors, but at the same time you don’t want to be painted with the same brush. You can use your influence to try to prevent some of the more flagrant fouls, and demonstrate by your actions that you have a different philosophy. You can try and make whatever independent decisions you are empowered to using your values, and you can demonstrate by your actions how you define your moral compass. Of course, you may draw fire for doing this, and you should be prepared for the potential fallout.

Working with a toxic peer may be the most difficult situation. With a subordinate, you have the authority to ultimately compel compliance. With a toxic boss, you are limited by your position and level of authority.

But with peers, you have to demonstrate your own leadership and values to steer their behavior. You should recognize and acknowledge their position and authority, and be reasoned and calm as you outline your issues, but effective interpersonal communication is the key to resolving peer issues. And, of course, putting aside your ego in the process. You are probably not 100 percent right either, and ceding some ground to find a common place will go a long way towards resolving issues.

When you see numerous managers leaving an organization, there are several possible reasons. Perhaps the organization is charting a new course, and some people do not subscribe to the new agenda. It might be that people are being held accountable for their actions for the first time, and they are not able to keep up with the new efforts. Or it might be that one or more of the leaders of the organization are toxic, and people are using the only final recourse that they can to escape the tyranny. It can often be extremely difficult to parse which of these is taking place, so you should look closely and critically at what is happening before you choose your own course of action.

In the end, make sure that you establish your personal set of values, or moral compass, and make sure that it guides you throughout your journey. Always be willing to learn and adjust, but do so within the framework of your fundamental values.

The good leader has a well-calibrated moral compass and lets it guide his or her actions but is always willing to learn. A bad leader perhaps needs their compass calibrated a bit but can often be steered back on course, especially with good examples around them. The toxic leader does not have an effective compass, and as a result leads the organization toward disaster.

About the Author

Matthew R. Streger, Esq., is a senior consultant at Fitch & Associates. He serves as the executive director of mobile health services at Robert Wood Johnson University Hospital in New Brunswick, New Jersey. Streger is also an attorney who focuses his practice on healthcare law, and has an extensive background in all facets of EMS. He can be reached at

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