Cliques have a risk of growing "anywhere". I work at a pediatric facility. I remember seeing people gravitate toward people that they felt in common with, but the general consensus was we generally work with each other. Then there was a evolution that "clicked"...we discuss issues that arise, management knows about it. When it affects pt safety, they do act on it. The RN of the group was fired. The LPN and two assistants. that were (since they have been "neutralized") a part of the clique are all pregnant...when the issue raised about staffing and even taking on care, management did hold on everyone being equal in care assignments. Either way, management has no qualms about writing up, suspending, pushing out, and firing people when it comes to violating policy...but it has kicked it up a notch once the RN of the clique was fired. It just happened that a NEW supervisor that was hired, cleaned house. She has since resigned, but so far, people are taking a more active stance if clique like behaviors and issues that are not going to benefit staff as a whole, as well as management being actively aware, so I'll see what happens...I think management can set the tone with these behaviors only when it affects pt care, as well as staff morale. I just happen to at a place where it is a small non profit, and we work with kids, so it has an acute way of affecting the pts, because they are children.