PurposeThe purpose of this article is to report on case study research conducted in a German hospital and describe the implications that the “Management by walking about” approach had on healthcare employees. “Management by walking about” is widely seen as one of the favoured procedures for increasing employee commitment and shared understanding as well as supporting high trust work relations.Design/methodology/approachThis case study set out to examine the actual labour processes and the concrete experiences of healthcare employees behind the “Management by walking about” approach in a German hospital. This was achieved by means of a six month field study of day‐to‐day life in the hospital's nursing division.FindingsIn this case study, the popular initiative of “Management by walking about” was used as a means of managerial control and, as such, the internal promotion of soaring values and path‐finding visions was met with both scepticism and cynicism.Practical implicationsPre‐commitment and motivation levels were high among healthcare employees, they were passionate about their healthcare work and they actively engaged in open communication and organisational development. But all this had little to do with “Management by walking about”, and its implications raise questions about its influence on high trust work relations more generally.Originality/valueThe paper concludes that a more critical analysis is necessary to challenge the way in which “Management by walking about” is examined by healthcare management academics and practitioners.