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ruby_jane BSN, RN

Registered User

"Living life on far too little sleep" - Jason Boland.

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Content by ruby_jane

  1. ruby_jane

    Something Good

    Bunny, my Grinchy heart grew three sizes reading this. Have a great summer!
  2. ruby_jane

    just a Thursday vent

    HAHHAHHAH!!! Body part. I avoid the bathroom issue by looking at the teacher/administrator and saying "You know someone just threw up in there, right?" (therapeutic silence x 20 seconds while it sinks in).
  3. ruby_jane

    Licensure

    You cannot practice as a nurse in a state where you don't have a license (or that compact agreement). So their argument is invalid. Are they willing to pay to license you in that state? Get on the state's BON and find out what needs to happen. It's also possible that there's some coverage for transitory times - I've read about this but never experienced it: school nurses on field trips may be covered for a limited time in another stated. The Board will have more info.
  4. ruby_jane

    Unsafe Environment for Graduate Nurse?

    While waiting for some ER nurses to weigh in- We never drill for this. So now's your chance to practice what you would do in your own head. Decline the assignment initially, seek advice from the manager (and given the situation you've described, there may not be much help forthcoming.) You're in a different situation. You have some familiarity with how processes and equipment work. That may give you a boost even though you're not currently an RN. It may also have been thusly: These seven may have been walking well and the preceptor may have felt that the nurse had skill enough to monitor seven uncomplicated and brains enough to realize if someone began to CTD. Or that nurse may have decided already that the grad nurse isn't fit for the ER and tried to make (a very unsafe) point.
  5. ruby_jane

    Last Day!

    WOOHOOO!!! You're all "KMAG YOYO." Have a great summer.
  6. ruby_jane

    Wise One Liners

    Not my circus, not my monkeys. Said nearly every day. A corollary for those of us in Texas (or farm country everywhere): Not my barn, not my cows.
  7. ruby_jane

    Feeling like I'm not making a difference

    My cynical heart grew three sizes right now, Korky.
  8. ruby_jane

    New Graduate, Only one interview, Should I Be Picky

    Unless you see something on the unit that makes you believe that it's an unsafe place, yes. Go with what is offered, get trained up, and be the best nurse that you can be.
  9. ruby_jane

    Transgender man has stillbirth

    So regardless of appearance.... What organs does the person have? Usually testosterone suppresses the estrogen in a female-to-male transgender person (which is how this likely got missed). If there's a uterus, there can be a pregnancy. It would be better for our patients if we focused on that and not the who/how/what and why.
  10. ruby_jane

    What are the "extras" that you do?

    Congratulations UrbanHealth!!! I want you to sit until that feeling passes. Kidding (sort of). I relish my bulletin board collaboration with the art teacher. I email her concepts and the kids illustrate things like hand washing, covering their coughs, and sun safety. Office of Women's Health has a list of the health-related weeks and months if you choose. I used to do that. I caution you on the blood drive....lots of people feel sick afterward (and yes, you get to recover them). Weigh the benefit with the amount of dizzy/nauseous/needs hydration in your clinic. And best of luck. Let me know what you end up doing. Maybe you'll motivate me.
  11. ruby_jane

    Wow

    I love that you value this. Thank you for the blast of cheerful fresh air!
  12. ruby_jane

    Primum non nocere

    I think that like anything, we'd all be able to provide more competent care if we had more time. We do not. Education empowering people to ask for pain medication when their pain is, say, a five as opposed to when it's a 10 is also critical but how often does that get done? One day we may have some kind of spit test to tell us which pain relievers are efficacious for our genetic profile and which aren't...but until then, I guess we keep doing our best.
  13. ruby_jane

    Joint Commission Citing & Employee Files

    OK so...in a non-acute care setting none of the diabetics I've ever seen wipe that first drop. What were you trained to do? I assume if you were trained to do it the way you did it, everyone gets retrained.
  14. ruby_jane

    Is it like this everywhere now?

    I learned a thing and I'm stealing and using it.
  15. ruby_jane

    Is it like this everywhere now?

    BEAUTIFUL. We won't do more with less. We'll only do less with less. Unfortunately the supervisor is responding to a complaint from a family member. No amount of logic is going to help here.
  16. ruby_jane

    Fun times

    So the sky was really falling in high school.
  17. ruby_jane

    It’s a Lice Celebration

    YAY! So, when you meet with the teachers, start by saying "I'm going to ask for grace on this." Because 90% will hear you better. Meet with your principal prior to the all-staff meeting in the summer. Prep yourself by having the written policy in hand and enough copies for everyone to have three! Send a reminder mid-year. Grit your teeth and silently bless their hearts this next year as they get used to it.
  18. ruby_jane

    just a Thursday vent

    See...for the high schoolers, I had no Vaseline. I hate Vaseline. Here in PK-7 I find that the littles just.can.not if their lips are chapped. Unfortunately parents cannot manage to slip a chapstick in the backpack and/or the kids lose it immediately. It's a harmless intervention (even though I hate petroleum on lips).
  19. ruby_jane

    Are we allowed to notify parents of pregnancy?

    Google Guttmacher Report and that should provide a list of what services teens can consent to at what age...
  20. ruby_jane

    Current Situation: Symptomatic Asthmatic

    It bothered me the first time. It no longer does. And PRAISE and THANKSGIVING I am in a different district where the guys on the rig listened to me both times that I called EMS and had no issues transporting. I want that walkie!! That's like the gauntlet with the Infinity Stones - snap your fingers and an ambulance is at your door!!
  21. ruby_jane

    Are we allowed to notify parents of pregnancy?

    The answer is...it depends. What is your district policy? Consent age for treatment for STDs and pregnancy varies by state. Also be careful....we cannot diagnose a pregnancy. I have declined the offer of pregnancy test kits because 1) they expire, 2) may or may not be accurate and 3) a decision to test is a decision to treat and I have nothing backing me up. So if a student came to me with a doctor's report indicating a positive blood serum pregnancy test I'd get the counselor involved immediately. If a kid came in and said she took a pee test....I'd be looking up my referrals. And encouraging her to tell parents.
  22. ruby_jane

    Poll: do you have professional liability insurance?

    If you're working as a good Samaritan (check your state law) then you are not held liable (unless you really show poor nursing judgment). I always respond the the neighbor visit with "What does your doctor say" or "Yes, that needs to be seen." Most of the time my neighbors are assessing severity - like, does this need to be seen in the clinic now or can it wait? Re: church- EXCELLENT question. I would ask if the church has liability insurance for lay leadership. Many pastoral care nurses go above and beyond for their congregations. One year I helped out taking BPs and realized that because I had no MD to refer these folks to that I didn't feel comfortable formally screening with no mechanism to ensure further assessment and treatment.
  23. ruby_jane

    And The Reason Nurses Don't Get Fired

    Nurse manager not fired for working his PRN job while on duty at the job he was paid to work. His justification - he was available by phone remotely to staff. Same nurse manager did not fire the "travelling" nurse who did the same thing three years prior - travelling nurse was an NP and was doing intakes for his side gig while being a travelling nurse.
  24. ruby_jane

    Current Situation: Symptomatic Asthmatic

    I've thought a lot about what you wrote. In our current situation, in the absence of orders or a supervising doctor...just because we CAN doesn't mean we SHOULD. Three times a fire captain rolled his eyes at me in my last district because I chose to call him because I was out of options. All three times I was right (mental health crisis in a student, chest pain in a woman that he completely disregarded until I said "Do you at least want to put some leads on her before you tell her she's not having a heart attack," and what turned out to be a new-onset anaphyactic reaction to a bee sting in an adult). It doesn't matter. We are the front line and the backup and there is zero shame in realizing we need more equipment, some orders, or transport. Essentially I have my super-tuned assessment skills, an AED, orders for an EpiPen for anyone with a new onset anaphylactic reaction, and ice. I have a handful of doctors' orders for emergency meds, and all those come with an EMS call. Every time something like this happens we learn from it. I'm glad you asked the question.
  25. ruby_jane

    Current Situation: Symptomatic Asthmatic

    Hang in there, darlin. It's the right call. You have nothing else (no emergency albuterol and Flovent is a preventive, not an emergency treatment as OD said). Never trust a pulse ox over your ears and eyes. My favorite pulmonologist says that he's seen kids tank satting 95%.
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