How micro-managed are you?

carachel2 · Jan 20, 2011

OMG, I remember those days. I had to "round" on my patients in the ER with a cart of warm blankets, juices, etc. EVERY TWO HOURS. We had a script to follow too and then in our "down time" (???????) we were supposed to call previous ER patients and tell them something like "at X hospital we value customer service. You will be receiving a phone call in a few days assessing your feelings about your recent ER visist." BLAH BLAH BLAH. Never mind that we got your STEMI self to the cath lab in 22 minutes....did YOU HAVE A WARM BLANKET AND WAS EVERYONE NICE TO YOU???? I don't miss the Press-Gainey (sp?) survey stuff at all!

I am not micromanaged at all as an FNP. However, I work for a privately owned practice. I think your chances of micro management go up considerably when you join a practice or a hospital that is part of a large group or large hospital system.

The physician I work with DOES read all of our charts after we have signed off on them. It isn't a micro managing thing, he just likes to know what is going on with his patients.

rnsrgr8t · Jan 20, 2011

I work in a hospital (in the outpatient side) that does use press gainey and scripting (not to the extreme extent that I have heard here). A few years ago, we were told to do this script with all our new patients basically bragging about all of my accomplishments and the accomplishments of whatever attending they were seeing, etc. I flat out refused to do that and never heard about it again. My NP coworker has been in our division for almost 15 years... what patient is going to want to see me after they hear I have less experience. Same thing with out attendings, we have 2 with 20 years of experience and 2 a few years out of fellowship...that puts them at a disadvantage. I was not vocal about my refusal, I just did not do it. Never heard about it after a few months. We do hear a lot about our press gainey scores etc but most of the time the things the patients are complaining about we have no control over (scheduling, the phone system, some of the OR scheduling etc). I already work very hard at how I am with my familes, our division is very good about promptly returning phone calls, lab results etc. So if you are associated with a hospital you are going to hear about it but nothing to the extent you would as a floor nurse, at least not at my hospital.

allnurses Guide · Jan 21, 2011

Hey Joe,

I am not micromanaged in the the way I see or treat patients. However, my clinic's director likes to micromanage things like our schedule, how many appointments we have to book, the size of our patient panels, getting all notes done within 24 hours of the visit. Mostly administrative stuff and I ignore half of it.

Advanced Practice Columnist / Guide · Jan 21, 2011

Our hospital has introduced a script that nurses are supposed to repeat when we greet a patient at the beginning of the shift. Apparently they don't trust us to say the right thing.
Though I was working in a hospital, not a customer service center, but apparently I was wrong.
This got me wondering if it's any better at the APN level. My initial thought was that with greater authority would come greater autonomy. In general, it's what I've heard as an advantage over being an RN.

I'm fortunate that the only time I experienced the "micro-managing" you described above was when I was working as a bedside RN in a smaller privately run hospital in a suburban area. I have left that place and found employment in large teaching hospitals in urban settings since and while Press-Ganey scores are just as important, the management had enough sense to not come up with unimaginative tactics like that.

But I got thinking, couldn't you be just as micro-managed as an APN as an RN? Couldn't they be just as likely to give you a script when dealing with patients?

It probably would depend on who "they" are. I've only seen such practice propagated by managers within nursing departments who also believe in piling a lot of useless paperwork to already overworked nurses because they have forgotten what it's like to practice at the bedside. I've worked in acute care settings as an NP and have been under a department where the leadership belongs to a physician or a senior NP and I've never experienced the kind of "micro-managing" you described in your post.