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ruby_jane BSN, RN

ICU/community health/school nursing

"Living life on far too little sleep" - Jason Boland.<br /> "Not all who wander are lost" - JRR Tolkein. Except middle schoolers...sometimes they wander until they get lost.

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ruby_jane has 12 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

ruby_jane's Latest Activity

  1. ruby_jane

    COVID-caused conjunctivitis

    I learned yesterday that in (less than) 5% of our kiddos, goopy bloodshot eyes may actually be COVID-related. As in, this is a new symptom we've discovered. But that opened up the can o' worms: If I send a kid out for diagnosis and the doctor does not do a COVID test but just treats the viral or bacterial conjunctivitis and I let the kid back in....I don't want to think about what that looks like. Good thing that conjunctivitis must be ruled out before return in my district. But I already suspect a lot of the local clinics (not the pediatricians specifically but the doc-in-the-boxes) are merely swabbing kids' sore throats for strep and not doing a COVID test. Last year said clinics were not even testing kids for the flu but just swabbing for strep. Anyone have any lived experience with this?
  2. ruby_jane

    Second guessing myself

    Bless his heart. That's not how it happens (at least in my district). That's why we offer the parent-purchased indemnity insurance. Any reasonable nurse would have removed that boot. You assessed pedal pulses (something I do not do regularly but may add to my list of interventions. Was it OldDude who used to talk about xray vision and how we generally don't have it? Don't second guess. The kid made a choice. Dad is blustery. Make sure your documentation looks solid and go on. Also - if you have the chance to reassess the kid and the kid walks in with no gait impairment....yeah I'd do that, too.
  3. ruby_jane

    Got My Vaccine Yesterday

    Anecdotally from friends: The two people I know who had COVID less than 90 days ago had a strong immunological reaction (YAY- Moderna vaccine may be working) - fever of 100-101, body aches. One person who had COVID in June had a similar reaction to the first Moderna vaccine but only a mild reaction to vaccine #2. Again, yay, Moderna vaccine seems to be working. I know nobody who got Pfizer's vaccine so have no data on that. Remember - we are all part of phase 4 trial. We do not know the answer to the question you ask but we will likely have better recommendations in 6 months.
  4. ruby_jane

    Got My Vaccine Yesterday

    But you're an awesome nurse-nurse.
  5. ruby_jane

    Got My Vaccine Yesterday

    I am assuming no history of this for you, yes? Please also consider reporting it to the vaccine system they have set up (it's not the traditional VAERS). We are all essentially phase 4 trialling both vaccines. Hang in there.
  6. ruby_jane

    RULE #1: Never Say the "Q" Word

    The Q word is VERY REAL. We used to have a hospitalist who would stand in the middle of the freaking ICU and say "Well you're having an easy night." And then it would all go to h-e-doublehockeystics. Any form of the Q word, including easy, simple, uncomplicated.... Shussh. Shush your mouth.
  7. ruby_jane

    Nurses with Unusual Diets

    @SilverBells no judgment on my part. I drink 3-4 cups of coffee daily and might even sneak in a Coke Zero in between. This is not a "diet." You are reaching for stimulants and chewy, salty easy to grab snacks that soothe the neuroreceptors but do not provide nutrition. Problem is that when you cut back on the sweet or salty food your body will crave it for a while so things may feel worse. When I worked 12s (actually 14s) I would start off on the first shift with a nicely packed lunch that had more protein than carbs and a fruit and a vegetable. By the third shift I would eat almost anything out of a vending machine or the day old pizza. My suggestion is to find a way to incorporate 60-80 ounces of water every day. You're already filling with fluids but what you're giving yourself are mostly diuretics and chemicals (and I am a teeny bit worried about your kidneys). Once that happens - if you are able to get to a nutritionist that may be the easy button. Ruby Jane Junior is in college and I just paid for nutrition counseling that may save her life or at least move her from being a junk food carbaterian with a few menu suggestions/substitutions. If not, consider a meal delivery service or something that will allow you to at least have balanced nutrition on your days off. Worry about those days, first. Remember the body loves homeostasis and will compensate until it cannot. I wish you the best of luck! At least it's dark chocolate...for the heart benefits... :)
  8. ruby_jane

    Unsure About Position: Critical Care Float Pool RN (+ ED)

    YEP. That's ICU, although it may be worse now with COVID than it was when I was in the ICU preceptoring "training class." There is simply too much to know and outside of training on cardiac rhythm and interpretation and memorizing some oft-used drugs....you may be on your own. You didn't ask this but: Critical care (ICU/Telemetry/what have you) and ER seem to have a lot in common but they don't really. One is about juggling and managing the complex needs of a set of patients whom we know are sick, and the other is about juggling many more patients to find out who is sick and who can get out of here and go see someone else. Mr. Ruby Jane was an ER nurse the first decade of his career and while his skills are still excellent, he does not know how to prioritize care. While I was an ICU nurse for the first year and I can prioritize care but when I have an emergency I literally have to reach waaay back and it all comes down to circulation/breathing/airway anyway. SO - perhaps you are feeling that push - that you like the ED setting and rhythm more than you like "critical care?" Just a thought. A previous poster advised that you give the gig a little time and once we're out of the COVID swamps things may be better.
  9. ruby_jane

    So Much For Michigan Becoming Compact

    I no longer remember what I made, only that the computer shut off pretty early and I nearly choked. But - you are right on about credentialing. Given that there are no legitimate nursing shortages in North Texas (we just have a shortage of hospitals willing to adequately train new or newish nurses) and there are legitimate shortages in other states - the compact may be the difference between getting staffing and not getting staffing. Does MI turn out so many new nurses that they can afford not to be part of the compact?
  10. ruby_jane

    Got My Vaccine Yesterday

    YAY! I love how this network was pulling for you.
  11. ruby_jane

    Got My Vaccine Yesterday

    Remote hugs from Texas. I got teary, too. Didn't phase the MA who gave it to me but the office manager who was tasked with enforcing the waiting period got a lil something in her eye, too.
  12. ruby_jane

    Intubation Should Be A Nursing Skill, Especially Now

    We had all that. On manikins, on computer, or if we were lucky enough and our preceptors in clinicals let us, in a patient. I think you might mean that we need actual time doing these skills with patients, not in a skills lab.
  13. ruby_jane

    Pool Testing

    Holy sheets! Please keep us updated. I believe I understand the point of the Binax is that it's used on symptomatic kids and is fairly effective at saying "yes, they have it."
  14. ruby_jane

    COVID-19: Antibody testing vs Positive Test

    In my district we are not supposed to test out of quarantine. Ever. Even the nurses. Having said that....we are unsure if the titers for antibodies wane past 90 days (we just don't have enough experience). And there have been anecdotal reports about people who had COVID and titer negative for antibodies. I've had FOUR HBV vaccines (three in the 90s and a booster for nursing school) and I still titer negative. The CDC tells me that if I am for reals exposed to HBV I will produce an antibody reaction. Having said all that....I never go wrong when I follow policy even when it makes the parents angry. We probably need a second line study following people with COVID to see what happens to them when they're re-exposed and/or how long immunity seems to last.
  15. ruby_jane

    New Nurse COVID Vaccine Clinic IM Injection Advice

    I would not mix the vaccines. As a former vaccine nurse while I could tell you that mixing the meningococcal 4-strain vaccines from different companies *might* convey protection - we were told not to do it, and that doing so would be a medical error. If your work site has the Moderna vaccine at the time you need dose #2 I'd just ask for that. One of the things I fear is that some of us won't get dose #2 because the incoming administration apparently advocates getting more first doses out there and hoping that the private companies can make more in time. So I would tell you to be unusually persistent starting the day before the second vaccine is due and the week after. Maybe there are cancellations. Maybe they've got three doses left and an hour before these expire. Best of luck.
  16. ruby_jane

    New California Nurse to Patient Ratio

    Doesn't matter. You had a choice and you chose service over convenience!