I have a lot of autonomy in my job now on an ACT team. I am very well respected by the whole team and no one ever overrides my decisions. My boss, an NP, always has my back and trusts my judgment.
Previously I worked on an inpatient psych unit and the micromanagement was ridiculous. It was mostly the culture, but also built into some of the policies. I had to get a doctor's order for every little thing, stuff like letting a patient wear a hat. At first, I was like okay, I'll get the order when the doc comes around. Then the techs who worked under me would tell me no hat until that actually happens. Like, are you serious? I was the charge nurse. One time I had a tech tell me that I had to get a doctor's order before I put a patient's pill in pudding. I told the tech to go ahead and report me to management, I don't need a doctor's order to put the pill in pudding to swallow. I then was pulled aside by my manager and asked why I put the pill in the pudding. Was I sure this 7 year old patient could not swallow pills without pudding?
It was a total nightmare and I'm so glad I.left.
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