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

ruby_jane's Latest Activity

  1. ruby_jane

    Too strong of a personality?

    May I ask: Are you a person of color? And are the people who consider you "strong" not people of color? It may not be that simple. In school nursing there's a lot of discussion right now on how students of color (specifically Black students, more specifically young Black women) are perceived as "unladylike," "disrespectful," and "they talk back." I've also heard Asian women being told "You're sure not like other (insert nationality her) women. They're so quiet." If they can't give you specific examples...I'd still document conversations. I have an 8 1/2 by 11 legal pad where I jot down stuff that I can't chart anywhere else. I write it out as a nurse's note, dated and signed. It's my memory aid so that I can come back and say "on or about July 11..." and indicate that I got a statement (You are too strong) without a valid example. Good luck!
  2. ruby_jane

    Strange New World

    Welcome back! Much like screening the whole campus for lice....we're trying to stay away from thermometer duty on the grounds that parents will have given a borderline ill-feeling student something anyway; that the students have already been on the bus (if we were serious about this that would need to happen), and the obvious fact that kids are much more likely to be asymptomatic. Texas DSHS has already said we're still responsible for getting shot records in by the day of virtual school starting, and that we will still be doing hearing and vision screening so we're working on that.
  3. ruby_jane

    Isolation room set up?

    GOOD JOB. Necessity is a mother, isn't it?
  4. ruby_jane

    Vault mail in testing?

    Check the sensitivity/specificity on these. It's interesting and I want to research more.
  5. ruby_jane

    Sending Home Any Covid Sx?

    We are discussing this right now. It will likely be more than a cough but less than four or more. We are leaning heavily on the local health jurisdiction for an algorithm. Here's the problem: We want one size fits all (fever - you have it or you don't). This is likely not one size.
  6. ruby_jane

    Pregnant New Grad Nurse

    I do wish you the best! You will potentially hamper any other nursing option if you do ambulatory care first. Couple that with a distinct lack of real PPE - I am nervous for you. Good luck!
  7. ruby_jane

    Isolation Room

    So....in our district the initial plan is to have the nurse be detailed to the isolation room (in full PPE) IF the kiddo needs that much observation. The clinic assistant gets the rest of the kids. If there's no clinic assistant...the secretary or designee, who are taught to give meds, are the back up. I don't like it and predict that will change. We are now having the teachers call when they send in a coughing student (to allow the nurse to properly garb, adding the N95 to whatever s/he is wearing. You are right. We've prepared the principals that this year their staff is absolutely, positively going to have to keep the non-ill, FF, math-itis, "I have a headache" kids out of the clinic. Flexibility. That's going to be key. I am worried about nebulizers and suctioning. We just don't have places to do those in enclosed rooms that may be shut for three hours to let particles settle.
  8. ruby_jane

    What is it like to be a school nurse?

    Most of us are already off contract and gone! I suggest you put your question in the search bar as this has been well-addressed. We'd welcome your skill set, especially at the high school level. OB/GYN nurses are just about as good as ER nurses in an emergency because y'all train for that stuff in OB. The biggest transitions are 1) not having much in the way of orders; 2) feeling comfortable about your nursing judgment without much in the way of orders and 3) knowing it's OK to call EMS because literally, you have a penlight and tongue depressors, gauze, a bp cuff and some dental floss. Also - the first year is spent learning how the district wants you to do things. You aren't relearning nursing. Best of luck!
  9. ruby_jane

    I'm so ashamed of myself

    Why are you ashamed? It's a good point.
  10. ruby_jane

    Ethical Issues

    Yep. THat's what they tell us. And the held to a higher standard part is definitely true. Why are you worried about "someone?" Unless the someone is you....
  11. ruby_jane

    Immunization Audit—-fail?

    1. There is a history of poor compliance - not her fault. 2. All parents must obtain an exemption for conscience from TDH. No exceptions except - 3. Medical exemptions are a thing with a note from the doctor. Usually these are given because the student has a condition like RA and they are on Humira or similar and cannot have the MMR or Varicella booster. There is usually no reason someone cannot have a non-live vaccine. If the parent feels strongly that in addition to the varicella booster, sweet baby can't have that TDaP and MCV vaccine - see #2. 4. This is an administrative issue. She needs to tell the principal that effective beginning of school, in compliance with TDH rules and state law, all students must be current with an updated immunization record or a current exemption. ALSO - the principal may NOT want to enforce this because s/he wants the kids in school and kicking a kid out is not acceptable to him/her for a variety of reasons. She needs to stand tough!!
  12. ruby_jane

    Used to love my job, pandemic changed everything

    Deep breath. Sorry - this sounds like a plate of poop for you. Don't be nice to the people and don't talk so long?? Really, is that what you're being told? SO....when you're done having the baby, perhaps consider school nursing? I don't know what school nursing will look like in 20/21 but any frustration I feel absolutely pales in comparison to what's happening here.
  13. ruby_jane

    Nurse Practitioners in the school setting

    That makes my heart happy for you. The ambulatory care NP situation in Texas is pretty bad right now....
  14. ruby_jane

    Summer camp called it

    I am so glad RJ Junior is 19 and driving. Although she's been doing essentially that since March as well. She signed up for Physics 1 and 2 (EEESH) because 1) she only needs it for med school and 2) on-line physics lab. It's not the same as being a counselor but it will keep her away from her version of Roblox!
  15. ruby_jane

    Temps at the door?

    Fact (from the large children's hospital n the NTX): Most children are asymptomatic. The majority of the tiny amount of pediatric cases were incidental finds when an adult actually had COVID-19 and the kiddos (even the asthmatic ones) were remarkably well, or had allergy-like symptoms that I would find easy to discount. This is borne out in the terrible information about secondary infection coming out of NY State. Opinion: I trust the contactless thermometers less than I trust the back of my hand because; Fact: We did this with Ebola and got limited, if any, results. And Fact based on long time observations: A lot of parents send kids to school during cold and flu season with a little dose of Tylenol because they've "done something" for sweet baby or they need to be called away from work as opposed to calling in - and there is absolutely ZERO judgement on my part about that. It is what it is. What will this net you? Now grownups - that might be worth it for me to take 65 temps instead of 650.... These are the days when I miss Old Dude. Check what your state education agency is saying about this.
  16. https://www1.nyc.gov/assets/doh/downloads/pdf/han/alert/2020/covid-19-pediatric-multi-system-inflammatory-syndrome.pdf The cytokine cascade caused by SARS-CoV2 is well-described in adults. And now it looks like it's happening in children who were likely asymptomatic when they had the virus. But somehow their immune and circulatory systems when haywire.

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