This study investigates the extending negative effects of impression management (IM) on organizational outcomes in the nursing context. Specifically, this study aims to understand the impact of IM on workplace exclusion through workplace deviance. The data came from 277 head nurses (nurses in leadership positions) in elderly care homes in Belgium. Structured paper-and-pencil questionnaires were administered on site in the respondents’ workplaces. In the findings of the current research, IM is positively related to workplace exclusion and the relationship is mediated by workplace deviance. Although, initially, IM is performed by the actors as a natural behavior to maintain their image, at some point, the actors can become fatigued with maintaining their image. Under ego depletion theory, the exhausted IM actors will be highly experienced in deviance or bad performance. Furthermore, consistent with social information processing theory and a correlation study between employees’ poor performance and workplace exclusion, the IM actors who fail to deliver good performance or behavior following their like-based rewards may be subject to social exclusion in their workplace.