Workplace dilemma: Can't get along with narcissistic incompetent boss. What would you do?

2 very different personality types. As long as you work for this company, it's your job to do whatever you can to make it better. I suggest you learn to adapt your approach to her by holding your tongue sometimes (if it's not going to make things better, why put yourself in the cross fires?). Another way of saying that is "pick your battles." She was hired for this position for a reason; perhaps the focus was on bringing in more sales while you're focused on the quality of care. I'm not saying she's great, just trying to point out a different perspective. If she's increasing sales, the higher ups might like her performance. Do you ever have an opportunity to speak with her boss? A book on work personalities I like is "The Platinum Rule"; it's helped me deal with others in the work place.