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Confronting micromanaging bosses and nurse substance abuse

Campbell, Gladys MSN, RN

doi: 10.1097/01.NUMA.0000387097.10811.dd
Department: Leadership Q&A

Northwest Organization of Nurse Executives, Seattle, Wash.

Q My boss is a major micromanager, and it's driving me crazy! How can I tell him in a professional way to back off and let me do my job?

Micromanagement is probably the most common complaint about a boss. There are several reasons why a boss becomes a micromanager, including trouble trusting others, being more professionally confident, focusing on your job rather than doing his own, and nervousness about either the overall practice level on the unit or with your specific practice.

My first step in an attempt to resolve this would be to talk with your boss. I don't suggest accusing him of micromanagement. Instead, you could open the conversation by focusing on your own performance. Tell your boss that you really want to do a good job on the unit and make your optimal contribution. Communicate that you want him to have confidence in you and to be proud of your performance. Ask for feedback and areas where you might improve.

If there are areas where your boss suggests that improvement is needed, see whether those practice areas correspond with where he seems to be micromanaging. If this is the case, then you'll know your boss's concern with your performance is driving the behavior that's disturbing to you, and you can work on improvement in these areas.



If your boss doesn't communicate performance concerns, you can then gently describe how the oversight that he's providing is impacting you. Consider the following: "I know you're responsible for all of the performance on our unit and that you take the responsibility very seriously, but when you supervise me very closely it actually makes it harder for me to perform to the best of my ability. The strong oversight makes me nervous and unsure of myself. Can we work together in a way that would allow you to give me more freedom to practice independently?"

Continue to focus on what you can do to allow your boss to feel more confident and trusting of your practice, letting him know that your ultimate desire is to do your best work. Tell your boss what he can do to help you instead of challenging or criticizing his behavior. If your boss is new in the role, there's a good chance that as he gets more comfortable and confident as a manager, he'll feel less of a need to micromanage the clinical work of the staff on the unit.

Q It's clear to me that a nurse on my unit has a substance abuse problem. How should I confront the situation before it results in her termination?

If you're a staff nurse peer of this individual, you must notify the manager of your unit immediately. If you're the unit manager, you can first call the nurse monitoring program for your state (usually associated with your state board of nursing). The professionals in this program can walk you through the correct steps to take to confront a nurse who appears to have a substance abuse problem, and to formally offer that nurse professional assistance while working to protect the nurse's employment and license. Those who declare a substance abuse problem have job protections if they agree to go into a treatment and monitoring program.

Nurse monitoring programs generally offer individual treatment and drug use monitoring while in treatment, providing formal communication with the employer while the nurse is under their care. After formal treatment is completed, the monitoring program will communicate the conditions under which the nurse can return to work and will continue to provide drug use monitoring during the reentry time period. Continued employment for any healthcare professional who has developed a drug or alcohol problem is contingent upon the individual's willingness to enter and complete both a treatment and monitoring program. As the nurse manager, when you confirm that a substance abuse situation exists, you must report this individual and the situation to the state board of nursing.

Although many nurses believe that a peer who has a substance abuse problem should be terminated and not allowed to practice as a nurse, substance abuse is an illness that can be successfully treated and resolved. As caring professionals, we have an obligation to report any nurse who's impaired and to offer that individual support for recovery.

© 2010 by Lippincott Williams & Wilkins, Inc.