Nurses also described an atmosphere that was intimidating and punitive. They painted a discouraging picture of attempts to change the way the unit was run, describing a ‘disconnect’ between nurses and leadership. They mentioned negative consequences for those who criticized: ‘I keep my head low. Anybody that has complained or gone up and spoke their mind ... They put their money where their mouth was. Well, they got burnt.’ Nurses also described the detrimental effect this intimidation had on their ability to function: ‘People, especially that have direct experience being punished for negativity, feel very guarded. And they are just going through the motions of doing their job. They’re not sharing themselves with the patients or their coworkers because they feel so guarded.’