Navigating Workplace Toxicity: Dr Karen Hoenig Rigamonti On Strategies for a Healthier Work Environment
An Interview With Vanessa Ogle
Cultivate Emotional Intelligence
Encourage self-awareness, self-acceptance, and self-care among employees. Experiential workshops can help staff learn to navigate challenging interactions with grace and empathy.
Example: A workshop I conducted with nurses and physicians focused on responding to “difficult” patients and “difficult” families. By practicing mindful communication, staff learned to de-escalate conflicts, leading to a calmer and more cohesive workplace.
Toxic work environments can have a significant impact on employees’ mental health, productivity, and overall job satisfaction. From poor communication and office politics to bullying and burnout, toxicity in the workplace can manifest in many forms. What are the most effective strategies to address and overcome these challenges? How can organizations and employees work together to create healthier, more supportive work environments? In this interview series, we are talking with with leaders, HR professionals, organizational psychologists, business leaders, and experts about “Navigating Workplace Toxicity: Strategies for a Healthier Work Environment.” As a part of this series I had the pleasure of interviewing Dr Karen Hoenig Rigamonti.
Dr. Karen Hoenig Rigamonti, with her dual training in internal medicine and anesthesia, and organizational leadership, transformed healthcare environments at Johns Hopkins Aramco Healthcare. Developing a person-centered culture and improving communication and compassion among staff are her tools to eliminate workplace toxicity. Her workshops and leadership coaching sessions have addressed the challenges of dealing with difficult individual or group interactions and fostering positive work environments.
Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit more. Can you tell us a bit about your “backstory”? What led you to this particular career path?
Over 30 years ago, I was a practicing physician and a parent, balancing both worlds with dedication and passion. My career took an unexpected and life-altering turn when my second child was born prematurely at just 25 weeks, due to a misdiagnosis. That experience was transformative — not just because it introduced me to the lifelong challenges of caregiving for a child with severe disabilities, but because it opened my eyes to the gaps in communication and compassion within the healthcare system.
As a physician and caregiver, I experienced firsthand the consequences of a system that sometimes lacks alignment between medical expertise and human-centered care. This dual perspective — both as a professional and a family member navigating the system — sparked a deep commitment in me to advocate for cultural change in healthcare organizations.
Over time, I realized that remedying workplace toxicity and fostering an environment where healthcare providers feel valued, engaged, and supported directly translates to safer, more effective, and more compassionate care for patients. My journey has been about building bridges between healthcare professionals, caregivers, and patients, creating systems that prioritize clear communication, collaboration, and empathy at every level.
Today, I consult with healthcare organizations globally, focusing on transforming their cultures to achieve better outcomes — for their staff, their patients, and their communities. This work is deeply personal to me, and it’s the legacy I’m most proud of.
Can you share the most interesting story that happened to you since you began your career?
One of the most interesting moments in my career occurred while consulting at a hospital system in the Middle East. The organization had significant cultural toxicity — staff across departments felt undervalued, disconnected, and frustrated. Even the IT and finance teams, who didn’t work directly with patients, insisted they shouldn’t have to engage in cultural training programs. Their reasoning was simple: “We don’t deal with patients; this doesn’t apply to us.”
I saw an opportunity to change their perspective. During a training workshop, I had them participate in role-playing exercises, putting themselves in the shoes of patients and frontline staff. They experienced, albeit in a simulated way, what it felt like to be a family caregiver waiting for answers or a nurse trying to access critical support from the IT team. For many, it was a transformative moment.
One IT professional told me afterward, “I never realized how much our work impacts the care patients receive. It’s humbling to see that our actions ripple through the system.”
This experience reinforced a profound lesson: every role in healthcare, no matter how far removed from direct patient interaction, contributes to the culture and outcomes. By bridging those gaps, the hospital saw not just improved collaboration, but also a measurable boost in patient satisfaction and staff engagement. It’s a testament to how human connection and understanding can truly reshape an organization.
Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?
When I was an intern, I was determined to make every patient feel cared for and supported. I vividly remember an elderly patient who had been admitted for malnutrition. I was prescribing meal supplements diligently — vanilla, strawberry, the works — but the patient wasn’t eating them. Frustrated, I decided to ask her directly, “Why aren’t you drinking the supplements? Is something wrong?”
She looked at me with a perfectly serious expression and said, “Have you ever tasted this stuff? It’s disgusting!” I was taken aback but admitted I hadn’t tried it myself. She continued, “I’d drink it if it were chocolate. Chocolate is the only good one.”
It was such a simple oversight on my part — I had assumed she was just being difficult. I immediately changed her order to chocolate supplements, and sure enough, she began drinking them and even started gaining weight.
What I learned that day was invaluable: assumptions can lead you astray, and the best solutions often come from asking the right questions. Listening to patients, understanding their needs, and involving them in their care can make all the difference — even if it’s as simple as switching to chocolate. It was a funny, humbling moment that stayed with me throughout my career.
Is there a particular book that made a significant impact on you? Can you share a story or explain why it resonated with you so much?
Absolutely. A book that profoundly impacted me was Death Be Not Proud by John Gunther. I read it when I was just nine years old, and it left an indelible mark on me. The book chronicles the life of a young boy, Johnny, who battled a brain tumor with extraordinary courage and grace. His parents’ relentless love and advocacy for him, coupled with their ability to create a semblance of normalcy amidst unimaginable challenges, deeply moved me.
What struck me most was how their compassion and determination not only uplifted Johnny but inspired those around him. There was a moment in the book when Johnny received a standing ovation at his graduation — an acknowledgment of his resilience and the deep respect people had for him. That moment stayed with me, illustrating how the human spirit can triumph even in the face of profound adversity.
As a child, I didn’t fully understand why this book resonated so much. Looking back, I realize it foreshadowed my own journey. Decades later, I found myself advocating for my own son, born prematurely and living with lifelong disabilities. The lessons from that book — about courage, compassion, and the power of a supportive community — became the guiding principles of my life and work. It reinforced my belief in the importance of human connection, which continues to drive everything I do today.
Do you have a favorite “Life Lesson Quote”? Do you have a story about how that was relevant in your life or your work?
One of my favorite life lesson quotes is from Eleanor Roosevelt: “No one can make you feel inferior without your consent.” This powerful statement has guided me through many challenging moments in my life and career.
A particularly relevant instance was when I accompanied my husband, a highly respected neurosurgeon, to a prestigious healthcare organization in the Middle East. While he was welcomed with open arms and given a prominent leadership position, I initially felt overlooked. Despite my qualifications and experience, I wasn’t included in key discussions or given the professional respect I’d earned.
At first, it was easy to feel diminished by the situation. But then I reflected on this quote and realized I didn’t need anyone else’s permission to contribute meaningfully. I began creating my own opportunities — mentoring staff, implementing compassionate communication workshops, creating one of the first centers for young adults with disability, and fostering cultural shifts in the organization. By focusing on my purpose rather than seeking validation, I ultimately gained recognition for my work.
This quote is a reminder that our worth isn’t dictated by others. It’s about what we bring to the table and how we own our contributions. It’s a principle I try to instill in everyone I mentor: you have the power to define your value and make an impact, regardless of external perceptions.
Ok, thank you for that. Let’s now jump to the primary focus of our interview. Let’s start with a simple definition so that all of us are on the same page. What does workplace toxicity mean?
Workplace toxicity refers to an environment where employees feel unvalued, unsupported, or actively undermined. It’s characterized by poor communication and lack of trust where individuals in that culture experience conflict, burnout, or disengagement. In such settings, negativity thrives, collaboration suffers, and the organization struggles to fulfill its mission effectively.
When employees feel unappreciated or unsafe — emotionally, psychologically, or professionally — they often respond with quiet quitting, reduced productivity, or outright turnover. This creates a vicious cycle that can be incredibly costly, not just for the individuals involved but also for the organization and its clients or stakeholders.
At its core, workplace toxicity stems from a lack of connection, communication, and compassionate leadership — elements that are essential for fostering a happy, thriving, productive work environment where employees feel fulfilled.
Can you describe a time when you personally encountered or helped resolve workplace toxicity?
One vivid example that stands out is from my time consulting with the aforementioned healthcare organization in the Middle East. When I arrived, the environment was palpably toxic — staff felt undervalued, communication was fragmented, and departments operated in silos. Contractors (janitors, kitchen aids, gardeners, laundry room workers, and security) as well as Information Technology and Finance teams, didn’t participate in organizational training. Subsequently, they felt disconnected and resistant to change, arguing that they had no role in patient care and thus didn’t need to participate in such training.
In order to address this, I implemented organization-wide interactive workshops on compassionate communication and collaboration, emphasizing that every role — clinical or not — contributes to the patient experience. One breakthrough moment came during a session when team members experienced what it felt like to be a patient or a frontline worker relying on their services, through role-playing exercises. Suddenly, they understood the ripple effects of their work on the larger system.
The transformation was remarkable. Staff who initially resisted the program began to see their impact and value. Over time, engagement levels soared, silos began to dissolve, and patient satisfaction rates improved significantly.
This experience reinforced for me that workplace toxicity isn’t just about individual behavior — it’s too often a systemic issue. When you address it with empathy, fostering accountability and collaboration, even the most resistant environments can change.
What were the key signs that the environment was toxic?
The key signs of toxicity in that environment were unmistakable:
- Low Patient Satisfaction Scores: Feedback revealed patients felt neglected or dissatisfied with their care.
- Disengaged Staff: Many employees felt frustrated or burned out. There was low morale and motivation across various departments.
- Silos and Blame Culture: Departments operated in isolation, and when issues arose, staff were quick to blame others instead of collaborating on solutions. This “not my job” mentality deepened divisions.
- Safety and Quality Concerns: Errors were frequent, and rather than being seen as opportunities to learn and improve, they were met with scapegoating. This eroded trust and compounded the problem.
- Resistance to Change: There was significant pushback against initiatives aimed at fostering communication and collaboration, with staff feeling that change was unnecessary or irrelevant to their roles.
These signs painted a picture of an organization struggling under the weight of poor communication, lack of trust, and a disconnected culture. Addressing these underlying issues required a systemic approach, focusing on empathy, collaboration, and transparency.
What are some of the most common causes of toxic work environments, and how can leaders recognize these issues before they become pervasive?
As mentioned, toxic work environments often stem from systemic issues rather than isolated behaviors. Here are a few key factors:
- Siloed Departments: Teamwork is not given priority. When teams operate in isolation, collaboration suffers, inefficiencies abound, and conflict arises from misunderstandings or competing priorities.
- Poor Communication: Miscommunication creates confusion, inefficiencies, and lack of physical and psychological safety. Lack of transparency creates mistrust exacerbating tensions among teams.
- Blame Culture: A punitive approach to mistakes discourages learning and collaboration, fostering fear and defensiveness instead. This produces lack of appreciation. Employees who feel undervalued or unrecognized for their efforts often become disengaged or develop a “quiet quitting” mindset or burnout.
- Staff Overwhelm: When staff feel overburdened without adequate support or recognition, it leads to frustration, resentment, and eventual disengagement.
How Leaders Can Recognize These Issues:
- Active Listening: Leaders should engage with staff regularly, asking meaningful questions like, “What challenges are you facing today?” rather than general inquiries that yield superficial responses.
- Monitor Key Metrics: Declining employee engagement scores, higher turnover rates, and poor customer/patient satisfaction are red flags that need immediate attention.
- Observe Interactions: Leaders should spend time on the ground, observing how teams communicate and collaborate. Toxic environments often reveal themselves in everyday interactions — disrespect, lack of trust, or reluctance to engage.
- Encourage Feedback: Create both open and anonymous channels for employees to voice concerns. A culture that encourages honest feedback can uncover issues before issues escalate.
What steps can employees take to address workplace toxicity if they feel uncomfortable or unsupported by leadership?
Employees in toxic work environments often feel powerless, but there are actionable steps they can take to address the situation:
- Reflect on Your Role: Start by objectively assessing the situation. Ask yourself, “Am I contributing to the problem in any way?” Understanding your impact can help you approach the issue constructively.
- Document Concerns: Keep a record of incidents, including dates, details, and outcomes. This documentation is critical if you need to escalate concerns later.
- Seek Allies: Connect with colleagues who share your concerns. A unified voice often has more impact when bringing issues to leadership’s attention.
- Communicate Clearly: If it feels safe, approach your supervisor or a trusted leader. Frame your concerns constructively, focusing on solutions rather than blame. For example, instead of saying, “This is unfair,” try, “Here’s how we can improve this process.”
- Leverage Resources: Many organizations offer employee assistance programs (EAPs) or have HR representatives trained to address workplace issues. Use these resources to navigate the situation.
- Consider a Third Party: If leadership is unresponsive or if direct communication feels unsafe, consider involving a neutral third-party mediator to facilitate dialogue and resolve conflicts.
- Focus on Mental Wellness: Engage in self-care strategies like mindfulness, journaling, or seeking support from a coach or counselor. These practices can help you manage stress and maintain clarity while addressing toxicity.
If none of these steps yield change and the environment remains harmful, it may be necessary to consider alternative employment options. However, by taking these proactive measures, employees can often create positive momentum and initiate meaningful changes.
What role does mental health play in navigating workplace toxicity, and how can both employees and organizations prioritize mental wellness?
Mental health is central to navigating workplace toxicity because a toxic environment directly impacts an employee’s emotional and psychological well-being. When individuals feel unsupported, undervalued, or overwhelmed, it can lead to stress, anxiety, burnout, and even long-term mental health challenges. Conversely, employees with strong mental wellness are better equipped to manage conflicts, adapt to change, and contribute positively to their teams.
How Employees Can Prioritize Mental Wellness:
- Set Boundaries: Protect your time and energy by setting limits on work hours and tasks. Advocate for realistic workloads.
- Practice Self-Care: Engage in activities that replenish your mental and emotional reserves, such as mindfulness, exercise, or journaling.
- Seek Support: Lean on trusted colleagues, mentors, coaches, or mental health professionals to share your concerns and gain perspective.
- Focus on Growth: Use challenges as opportunities to develop resilience and problem-solving skills.
How Organizations Can Support Mental Wellness:
- Normalize Conversations About Mental Health: Foster an open culture where discussing stress and mental health concerns is encouraged and supported.
- Offer Resources: Provide access to mental health programs, Employee Assistance Programs (EAPs), and counseling services.
- Create Safe Spaces: Hold regular team huddles or one-on-one check-ins where employees can share challenges and celebrate successes.
- Invest in Training: Teach leaders and managers how to recognize signs of burnout or distress and equip them to respond with empathy and support.
- Celebrate Wins and Acknowledge Effort: Recognition and rewards, even for small successes, go a long way in boosting morale and mental well-being.
When both individuals and organizations prioritize mental wellness, the result is a healthier, more productive, and more compassionate workplace. By embedding mental health practices into daily routines and organizational culture, teams can break the cycle of toxicity and thrive together.
Can you share some strategies or practices that individuals and teams can implement to create a healthier and more productive work environment? Please share your “5 Strategies For A Healthier Work Environment”?
Creating a healthier and more productive work environment requires deliberate strategies that prioritize communication, collaboration, and leadership. Here are my five strategies:
1. Foster Committed Leadership
Leadership must model transparency, integrity, empathy, trust, and collaboration. Leaders who actively engage with their teams, ask meaningful questions, and follow up on concerns inspire and motivate.
Example: A head nurse I worked with transformed her approach by asking staff specific, solution-oriented questions like, “What challenges did you face today?” This small shift improved morale and allowed her to address problems in real time.
2. Cultivate Emotional Intelligence
Encourage self-awareness, self-acceptance, and self-care among employees. Experiential workshops can help staff learn to navigate challenging interactions with grace and empathy.
Example: A workshop I conducted with nurses and physicians focused on responding to “difficult” patients and “difficult” families. By practicing mindful communication, staff learned to de-escalate conflicts, leading to a calmer and more cohesive workplace.
3. Create a Culture of Compassionate Communication
In order to foster a supportive environment, people need to learn how to communicate with empathy and clarity. Organizations can provide interactive workshops on compassionate communication, conflict resolution, and understanding disability across all disciplines.
Example: At a hospital where I worked, silos between departments created tension and inefficiencies. By facilitating role-playing workshops, staff began to see how their actions impacted others. This shift improved collaboration and patient care.
4. Promote Connection and Collaboration
Develop psychological safety through team huddles, feedback sessions, and peer support programs. These practices help team members share success stories, address challenges, and celebrate wins together.
Example: I introduced daily team huddles at a hospital where staff felt isolated. These brief meetings encouraged open communication, shared successes, and created a sense of community, which boosted both morale and productivity.
5. Build a Just Culture
Create an environment where human errors are distinguished from intentional harm. Mistakes should be viewed as opportunities for learning and improvement, not blame.
Example: At one organization, shifting to a just culture revealed that many errors stemmed from systemic issues rather than individual fault. This approach reduced fear among staff and fostered a sense of shared accountability for solutions.
You are a person of great influence. If you could inspire a movement that would bring the most amount of good for the greatest number of people, what would that be? You never know what your idea can trigger.
If I could inspire a movement, it would be one committed to compassionate communication in healthcare and beyond. The idea is simple yet transformative. Teach people — patients, caregivers, healthcare professionals, and leaders — how to listen with empathy, communicate with clarity, and approach every interaction with mutual respect.
This movement would break down the silos that often isolate individuals and create barriers to trust. By fostering a culture where every voice feels heard, valued, and understood, we could not only improve workplace dynamics but also create ripple effects that elevate the quality of care, safety, and satisfaction for everyone involved.
Imagine a world where “difficult people” are no longer seen as obstacles, but as individuals who simply need to be understood. Where errors are learning opportunities rather than points of blame. Where collaboration replaces conflict. That’s the kind of movement I dream of leading — a movement rooted in connection, compassion, and the belief that when we truly see each other, anything is possible.
We are very blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them.
If I could have a private breakfast or lunch with anyone, it would be Oprah Winfrey or Richard J. Pollack, the President and CEO of the American Hospital Association (AHA).
Oprah has a unique ability to amplify powerful stories and bring critical issues into the mainstream conversation. Her influence could help shine a much-needed spotlight on the importance of compassionate communication and cultural transformation in healthcare. I believe she would deeply understand the human side of these challenges and could inspire change on a global scale.
On the other hand, Richard J. Pollack leads one of the most influential organizations in healthcare. A conversation with him could open doors to embedding compassionate leadership and just culture principles across hospitals nationwide. His insight into the complexities of healthcare systems and his position of influence could help drive systemic change that improves outcomes for patients, families, and healthcare providers alike.
Both of these individuals inspire me in different ways, and I would treasure the opportunity to discuss ideas and collaborate toward creating a healthier, more connected world.
How can our readers further follow your work online?
Readers can follow my work and stay connected through several platforms:
Website: Visit DrKaren.org for insights, resources, and updates on my initiatives.
LinkedIn: Follow me on LinkedIn for thought leadership articles and discussions on compassionate communication and workplace transformation.
I’m passionate about creating healthier, more connected workplaces, and I’d love for readers to join the conversation and help make this vision a reality!
Thank you for these fantastic insights. We greatly appreciate the time you spent on this.
About The Interviewer: Vanessa Ogle is a mom, entrepreneur, inventor, writer, and singer/songwriter. Vanessa’s talent in building world-class leadership teams focused on diversity, a culture of service, and innovation through inclusion allowed her to be one of the most acclaimed Latina CEO’s in the last 30 years. She collaborated with the world’s leading technology and content companies such as Netflix, Amazon, HBO, and Broadcom to bring innovative solutions to travelers and hotels around the world. Vanessa is the lead inventor on 120+ U.S. Patents. Accolades include: FAST 100, Entrepreneur 360 Best Companies, Inc. 500 and then another six times on the Inc. 5000. Vanessa was personally honored with Inc. 100 Female Founder’s Award, Ernst and Young’s Entrepreneur of the Year Award, and Enterprising Women of the Year among others. Vanessa now spends her time sharing stories to inspire and give hope through articles, speaking engagements and music. In her spare time she writes and plays music in the Amazon best selling new band HigherHill, teaches surfing clinics, trains dogs, and cheers on her children.
Please connect with Vanessa here on linkedin and subscribe to her newsletter Unplugged as well as follow her on Substack, Instagram, Facebook, and X and of course on her website VanessaOgle.
Navigating Workplace Toxicity: Dr Karen Hoenig Rigamonti On Strategies for a Healthier Work… was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.