Bringing Shadow Behavior Into The Light Of Day – Understanding and Effectively Managing Bullying & Incivility In Healthcareby Phyllis S. Quinlan, PhD, RN-BC
This book is a brief, insightful, and practical guide for leaders who are committed to creating a culture of safety. With less than 100 pages, you can read it in one sitting and it is rich with resources and reasoning you will refer back to for the duration of your culture change efforts. This book provides a foundation for long-term meaningful change that will serve healthcare consumers, staff, and systems well.
Some key takeaways!
- A compassionate acknowledgement about the need for nursing to have ownership into the causes of disruptive behavior and difficulty involved in changing contributory behaviors.
Asking these nurses to change this habitual allowing behavior is like asking them to relearn how to breath. It is not easy to stand in the realization that your well-meant interventions and actions were enabling individuals to embrace dysfunction rather than growth. –Phyllis Quinlan (page 12)
- An explanation of the difference between bullying and chronic incivility with distinct solutions for managing.
This accurate assessment [between bullying and chronically uncivil behavior] is vital if management is going to successfully collaborate with administration and human resources in the crafting of a plan that is going to address, manage, and remediate the employee’s behavior. —Phyllis Quinlan (page 28).
- A bottom line description of why civility matters along with it’s interconnectedness with patient safety and workforce health!
Our consumers are savvy enough to have safety concerns should they suspect that the team is not acting civilly toward one another. They question why they should expect the caregivers to be responsive to a frail family member’s needs when they cannot even be polite to each other. –Phyllis Quinlan (page 29)
- A compelling case for developing emotional intelligence as a longterm solution. Particularly exciting for the work of medical improv as an intervention for developing ‘soft’ skills involved in communication, emotional intelligence, teamwork, and leadership!

We have come to a time in our profession and industry when skills and knowledge are not enough to ensure sound clinical outcomes, a high level of patient satisfaction, and excellent staff engagement scores.
—Phyllis Quinlan (page 51)
- PLUS lots of resources and models useful for developing emotional intelligence and managing of disruptive behavior.
I highly recommend this book to nurse and healthcare leaders who are seeking guidance in their role for leading longterm meaningful change.