Entrenched toxic culture in academic nursing: A concept analysis

Entrenched toxic cultures (ETCs) are pervasive in academic nursing, yet they are underexplored and have not been previously defined. The concept differs from unhealthy workplaces in that a profoundly destructive and deeply malignant problem exists that is highly recalcitrant to change and consumes the organization from within.

Defining this concept is crucial for creating a safe workplace and addressing the toxic behaviors that undermine the well-being of faculty.

We aim to define this concept using Walker and Avant's eight-step method of concept analysis.

ETCs have five defining attributes characterizing maltreatment as (a) high intensity, (b) chronically repeated, (c) attributed to power imbalances, (d) normalized, and (e) resistant to change. The antecedents and consequences are multifactorial occurring at various levels of the academic hierarchy.

By analyzing ETCs, we can better understand the impact on academic nursing and propose tools and strategies to address it.