Published
I started work at a psychiatric facility nearly 3 months ago, and I'm starting to miss my old nursing job (I worked in acute inpatient dialysis). Sure, I had bad days as well as good days, but you were largely left to your own devices, and as long as you got the job done, you went home, no drama. I'm not asking for constant accolades or relentless (even false) positivity, but nastygram emails about "You forgot to hit 'complete' on a progress note" come off as annoying. Eventually I'm sure it'll become demoralizing to the point where I'll think, "You know what? Take it or leave it! My work is what it is!" and apply elsewhere!
Private duty and home health.
That can be a good thing or a bad thing. When you need to ask an important question,expect to wait 2 days at most for a manager to answer. Most times,their answers do not even make sense. Like the manager that told me to give tylenol that was not ordered and document that the parents gave it instead.
Home Hospice (which from a point of view is very close to home health).
You drive solo with the only time management is around is for an annual survey of your skills/practice. When you get good at SBAR's, almost all providers accept your recommendation and often time tell you things like "good job" or "good thinking," or "well thought out" offering encouragement. The families and the patient are often very thankful. As long as you chart in the home, there's minimal work activity outside of work except for a few days before IDG.
I had several case mgmt jobs, some with incredible autonomy and some with worse micromanaging than you can imagine ( think a boss who changed my documentation over my signature and enraged the recipient because it was the exact opposite of what I told him to expect and he had already acted on because it was correct)(took me awhile to figure that one out and fix it).
I’ve had hospital jobs with autonomy and with micromanaging, education jobs with autonomy and micromanaging... are you sensing a pattern here?
Learn as much as you can for as long as you can stick it out (there’s always something to be learned), and then move the heck on.
Orca, ADN, ASN, RN
2,066 Posts
You can find micromanagement and lack of autonomy in just about any specialty area. It largely depends upon management.