Subversion

klone, MSN, RN · Jul 1, 2015

What is subversion?

Just googled. "Responsible subversion" seems to be a term used in nursing school. Is this a homework assignment?

roser13, ASN, RN · Jul 1, 2015

Has anyone dealt with responsible subversion. This is something I am struggling with currently. Some of the subversion is against my ethics and moral code as to how some cut corners and cover for one another and management is blind or simply chooses not to see the reality. Im currently a CNA in a hospital. Im starting RN program next fall but if this really is common practice I may choose another major. Any advice?

Not a clue what you're talking about.

Pangea Reunited, ASN, RN · Jul 1, 2015

Yes, it's common ...because we are thinking, human beings and not mindless robots. I have no advice.

Oh'Ello, BSN, RN · Jul 1, 2015

Subversion exists in all professions, even tightly regulated ones. If you're basing your career choice on its existence in the field, I fear you may be unemployed forever.

roser13, ASN, RN · Jul 2, 2015

Still, not a clue.......subversion....moral code....ethics...robots.....??

WTH are you trying very hard to say? Spit it out.

Editorial Team / Admin · Jul 2, 2015

Are you talking about lying, cheating, intentionally placing patient lives in harm's way, along with a cover-up to prevent discovery?

... but if this really is common practice I may choose another major.

Do you really believe it is common practice in the Nursing profession?

klone, MSN, RN · Jul 2, 2015

When I googled the phrase "responsible subversion" (had NO idea what it is!) it suggested it means bending/breaking rules in order to help the patient. Can't really think of any concrete examples of that at the moment.

Maybe it's like when Izzie cut Denny Duchette's LVAD wire in order to put him in the #1 spot on UNIS's heart transplant list? (sorry, just started rewatching Grey's Anatomy)

crazin01 · Jul 2, 2015

I also had never heard of this term before, so I googled it and found a short article on it (examples & all):

Legally Speaking: The trouble with bending the rules | Modern medicine

Another example I know I've seen before, is putting 4 siderails up to prevent the 90 year old fragile hospice lady with significant dementia, from climbing out of bed (after you find her half out of bed three times in an hour). At that institution all 4 siderails is legally a restraint. However, if she would have fallen, she probably would have broke a hip, hit her head, etc. Heaven forbid you find her on the floor & have an event report to do, with pissed off family members etc. Because you don't have the staffing to have a 1:1 sitter, and one CNA and 4 nurses with 40 patients, quite a few with dementia. Just an example I know I've seen before, as I'm sure most have. Just wanted to throw that in there.

Edit: To OP, I don't think it's a matter of management covering up, or colleagues covering up for people deliberately cutting corners, like not completing a full admission history because it's time-consuming. Also, in the one example given in the article, the nurse turned the tele monitor off because the constant beeping. I know I've replaced batteries/monitors numerous times, but never actually turned off a monitor.

I know i'll probably get flamed, but I think it's a judgment call sometimes (ie, four siderails up) versus somebody just being lazy (documenting treatments or something that didn't actually happen, that's totally different and falsification of the medical record). You can only work with what you have (staff, med, equipment etc) so if there is no 24 hour pharmacy available maybe the doc needs to change an antibiotic order, versus the other articles example of 'borrowing' meds from other patients until the pharmacy comes in). I think that's a little different than doing all you can to prevent a fall.

I personally have added lab orders on patients, to save them a stick (especially when an extremely difficult stick with limited access), when I know the resident is going to call back & add something they overlooked before.

I also think once you are in the 'real world' of nursing, you use nursing judgment (or critical thinking) to use what you have in order to prevent an adverse event. So, flame away. Just my two cents.

:rolleyes:

healthcare2015 · Jul 5, 2015

Crazin01 understands what I mean. There is a judgement call balance constantly and unrealistic expectations set by upper management. Many break the rules and have to to get things done but then some of these nurses may turn in another for doing the exact same thing forcing disciplinary action or termination.

Legally Speaking: The trouble with bending the rules | Modern medicine

healthcare2015 · Jul 5, 2015

Thank you. You clearly understand. I can tell by your post that you are a quality nurse. I am switching my major to pursuing my Masters in Social Work.

caliotter3 · Jul 5, 2015

Subversion exists in all professions even tightly regulated ones. If you're basing your career choice on its existence in the field, I fear you may be unemployed forever.[/quote']
Agree with this statement. You learn to deal with it or you remain unemployed and unemployable once you develop a reputation for not playing the "game". Nursing is a very closed community and word gets around.