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Ruby Vee BSN

CCU, SICU, CVSICU, Precepting & Teaching

Original Member of the Crusty Old Bat Society

Platinum Platinum Nurse
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Ruby Vee has 40 years experience as a BSN and specializes in CCU, SICU, CVSICU, Precepting & Teaching.

Ruby Vee has roughly four decades of nursing experience, primarily in ICU.  She has worked on the east coast, on the west coast and in the midwest.  

Original Member of the Crusty Old Bat Society,

Liked 65,000 times or so before the change

Ruby Vee's Latest Activity

  1. Ruby Vee

    Guns at the Bedside

    Years ago, a good friend of mine was nursing supervisor in a VA hospital out west. He was shot in the butt by a veteran who was unhappy with his VA benefits. My friend got an award of some kind for bravery, but he says it's bogus. He got shot while running away from the irate veteran and his .45! The bullet passed through the nurse's station desk before hitting my friend, and he got an *** full of splinters as well as the fired projectile. A colleague who gave a patient's son an update on his mother's (poor) prognosis was shot in the abdomen by the son. The colleague survived, the mother did not. A colleague in the mental health department was shot in the head by a patient -- no clue why. He then shot himself. They were both in surgery for upwards of 12 hours. The patient survived; the psychiatrist did not. My best friend and former boss was once shot at through the windows in the ICU while she was caring for a patient whose husband had attempted to beat her to death. He was outside in the parking lot with a rifle, trying to finish the job. I've been around guns my whole life, but the hospital is no place for them unless they're being toted by a trained security guard, a corrections officer accompanying a prisoner or a law enforcement officer who has signed in with security. Oh yeah. I was threatened by armed federal agents because my febrile and delirious patient called her brother and his partner and told them the NP was "trying to kill" her. They showed up, didn't ask questions, and started waving their guns around and demanding that the NP in question be produced so they could arrest her. When I wouldn't produce the NP -- I called my manager instead -- they called the police and demanded my arrest. The police arrived at the same time as hospital security. Risk management mediated the whole thing . . . turns out even law enforcement isn't supposed to be armed in the hospital unless they've registered with security first. The police didn't get arrested for having their guns on hospital property without alerting security as long as they made no attempt to arrest hospital employees, the federal agents were removed and the NP snuck out the back door and wouldn't come back to work until the patient was discharged.
  2. Ruby Vee

    allnurses Time Travel

    June 1978 I graduated from nursing school earlier this month, and today I took my State Boards -- the first half of them anyway. Tomorrow will be another 8 hour day of test taking, and the results will come in 6-8 weeks. Until then, I'll be practicing as a Graduate Nurse. I really hope I'll pass because if I don't, I'll get fired . . . . I got hired at Midwestern General Hospital, and my head nurse told me I'm the first BSN they've ever hired. Usually, they hire only the diploma nurses from their own program, but my head nurse told me that she wanted to hire me because I had always worked and she knew I'd be a hard worker if I worked 2-3 jobs all through school and still graduated magna cum laude. The nurses here are talking about going out on strike next month when their contract is up, and I'm scared. I haven't been here long enough to get paid by the union for striking, and I'm still on probation so I could get fired. I have a husband to support! I cannot afford to get fired. Those older nurses really know their stuff but I'm afraid I seem really, really stupid to them. I don't know half the stuff those diploma graduates know! Their last semester of school, they run charge of the whole unit! Yikes! The charge nurse told me to weigh all of the patients this morning, and I didn't even know how to get a patient out of bed safely. Fortunately the nurse's aides are nice and helpful. I'm learning a lot from them! And t he LPNs are awesome -- I really hope I know as much as they do by this time next year!
  3. Ruby Vee

    Personal Life Affecting Work Life

    I've had marital problems, but those were due to the fact that I was married to a cheating, abusive, personality-disordered anal sphincter and not because of my job. (Diagnosed -- he was diagnosed with Narcissistic Personality Disorder. That fact is important to some.) I might recommend the book "Leave a Cheater, Gain a Life" by Tracy Schorn. Even if you're not thinking he was a cheater (although he was texting other girls) or you don't want to leave him, that book has a hilariously snarky, common-sense approach to relationship issues that anyone can learn a lot from. I wish I'd found the book years ago! II don't think there's anything wrong with you. But you cannot rebuild a marriage single-handedly, and it doesn't sound as if your husband is helping. Give yourself a break. Read the book. You have to ask yourself, "Is it OK with me that he spends every evening out with friends or drinking with his sister? Is it OK with me that he's texting other girls?"
  4. Ruby Vee

    Is it normal to hate my job this much?

    The first year of nursing is rough for everyone. I think we all hated our jobs for the first year . . . or two. I know I certainly did! I stuck with it because I had a husband to support. After I found my niche in the ICU, it got better and now I love my job and cannot imagine doing anything else.
  5. This is pretty much what I was going to say. It's somewhat demoralizing as a preceptor when every new grad who takes a job in our CTICU announces at the start that they're just there for their resume and then they plan to go on to bigger and better things. It seems that very few are actually interested in the unit or our patients -- it's just a box they're checking off. It's also irritating to listen to a new grad go on and on about how much money they're going to make when they're an NP, a CRNA or MD. I've actually had new grads tell me there must be something wrong with me because I'm still at the bedside. Not saying the OP would be anything like that, but hoping they wouldn't be!
  6. Ruby Vee

    New RN, how to pick a specialty?

    What matters most is the support you'll get from your manager, your peers and your preceptor. The type of patient doesn't really matter as much. Really. As you learn and grow as a nurse, you'll discover things you like about your job and things you don't like. You may have your heart set on L&D, but find that ortho is your special place. You may be the only nurse in the ICU who is willing to take on that GI bleeder, or that AML patient who tranferred from hematology/oncology. You may be the only ER nurse who really hates getting children as patients. Pick a job where the manager, peers and preceptor are supportive and nurturing. Learn all you can, and you'll be in a much better position to know what you like and dislike about nursing when you pick your second job in a couple of years.
  7. Ruby Vee

    New Nurse Graduate - GMS vs. ICU

    I'm with your brain, but I suspect I'll be in the minority here. Back when I started, you had to have two years on Med/Surg (or something similar) before the ICU would even consider your application. So that's my dirty lens. Working on Med/Surg gives you the opportunity to learn basic nursing skills -- you'll need to be able to throw in an IV, an NG and a Foley while doing an assessment and taking a history when you're in the ICU. It's easier to multi-task when you already know how to do each of those tasks. You'll learn to talk to patients, family members, ancillary services, physicians and pharmacists -- so calling a doctor won't be as much of a big deal when you go to ICU. You'll learn how to communicate clearly and concisely with other health care professionals -- you'll learn what is important and what is not. Nurses who start out in Med/Surg seem to last longer in ICU without burning out. But that's what I've noticed in my career. The most important consideration is the support you'll have as you learn to be a nurse and not a nursing student. You want a manager who is fair and who is willing to work with you, supportive co-workers who will have your back and a preceptor is able and willing to teach. Really, the patients don't matter nearly as much as the support you'll have. Good luck!
  8. Choose the husband and the dogs -- especially since you're so close to the Twin Cities. Keep looking for the ICU job in the Cities.
  9. Ruby Vee

    Ask Me If I'm Safe At Home

    Two sides to domestic abuse? That's rich!
  10. Ruby Vee

    Ask Me If I'm Safe At Home

    Good on you for going no contact! You're mighty!
  11. October is national Breast Cancer Awareness month. It’s also Domestic Violence Awareness month. I wish I wasn’t, but I am very aware of both. Running Away...Two years ago today, I was driving northwest and crying most of the way. I’d want to take the exit ramp -- nearly every exit ramp I passed -- and turn around and go back to my home, back to my husband. But I didn’t. That was unexpectedly strong of me, because going back would have made things far worse for me. It would have signaled to him that I had no boundaries; was willing to put up with whatever he dished out. That wasn’t the sort of message I wanted to send. Running To...If I could have known then how much better my life without him would be, perhaps I wouldn’t have had such difficulty running from him. I could have been running to something instead. I *was* running to something; I just didn’t see it that way at the time. I was running to a more peaceful life without an abuser always nitpicking, criticizing, blame-shifting, gaslighting and having tantrums. Without an abuser who constantly threatened my safety, my very life. Maybe it’s OK that I didn’t know; life requires taking some risks. You don’t always know what will happen when you step off that curb; but you have to step off it anyway or you’ll be frozen in place. Probably as apt an analogy as any. Why?It was difficult to identify what was happening to me. We were happy in the early years of our marriage. I thought so, and he said so. Things changed when I was diagnosed with breast cancer, and not in the way that I would have predicted. My husband -- let’s call him “Mac” -- reacted by going to the Medical Library and looking up “breast cancer,” reading everything he could about diagnosis, treatment, prognosis -- medical stuff. He’s a nurse. I reacted by reading about all the “soft skills” surrounding living with cancer and its treatment -- having your support group, how to secure the drains inside your surgical bra and what questions to ask your doctor. Mac insisted that my treatment be at the large teaching hospital where we both worked as opposed to the smaller community hospital I preferred. (I had a strict policy against being naked where I work.) I went along with him because things would be tougher on him, as the caregiver, then they would be on me. After all, I would be unconscious during the surgery and already had my prescription for Ativan. Mac accompanied me to every appointment -- every lab draw, every MRI or CT, every pre-op visit, post-op visit and of course, the main event. He invited two women who were friends of his to wait with us in pre-op holding for me to go to the OR. I went along with that because this would be tougher on him, with the waiting, than it would be on me. I would be unconscious during the surgery, and I already had a dose of Ativan. It took me a long time to notice that all of this “support” I was getting from him was really his chance to show off to the people we knew at our hospital about what a good husband he was being, a chance for him to get attention and support from his friends and colleagues in radiology, in the outpatient center, in the department of surgery (where he was a nursing supervisor) and all over the house. In fact, he wasn’t so much supporting me as controlling which questions I got a chance to ask -- in fact whether I got to ask questions or whether he took up all of the appointment time showing off and talking a mile a minute. While I was in a room with three-foot thick walls with radiation bombarding my left chest, he was chatting up and flirting with the women in the waiting room, at the reception desk, passing through. I’m slow that way -- I was still operating under the assumption that we had a good marriage. He had always said so; I had always believed so. Narcissistic AbuseIf you’ve ever read about narcissism or narcissistic abuse, you’ve read that the cycle consists of love bombing, devaluation and discard. I’d had a really long run of love bombing, where the narcissist convinces you that you are the only person for them, that you’re wonderful, everything about you is perfect and that they are truly, deeply, madly in love with you. The mask dropped the day my oncologist pronounced me a “breast cancer survivor” rather than a “breast cancer patient.” I wanted to go out to dinner to celebrate my good news. He said maybe lunch instead, and then spent the entire meal criticizing my lack of energy for housework and cooking, calling me “lazy” and “useless.” Narcissists will treat you like gold in public; in private things are different. If I expressed concerns about any of his behavior, I was “jealous” or “a shrew” or “crazy.” Overnight, he became cold and uncaring, nitpicking and criticizing me constantly while refusing to be accountable for anything and making wild excuses for horrible behavior. I rationalized all of this by telling myself that caregiving was very stressful, and that he had had it much worse than I had. After all, I slept 20 hours a day. I was in survival mode, and let some of the worst behavior go. One day I was scrolling through my Facebook feed and got announcements that my friend Mac had just friended “Fawn” and “Lola” and “Windy,” with accompanying profile pictures of three women wearing not all that much and posing in very suggestive ways. (Mac said he didn’t know how they got there, and made a big show of unfriending them.) After the breast cancer, there was my mother’s descent into dementia to deal with, and then I had knee surgery and then Mac retired. I was still working, trying to make up for all of the time I had lost to medical leave, all the deposits that hadn’t made it into my 401k. Things got worse at home. Mac had long since moved out of our bedroom, and criticized me constantly. He presented my strengths as weakness and constantly compared me unfavorably to other women. My chest “used to be spectacular,” and he liked me better with long, straight blonde hair -- not the short hair that grew back curly and brown. He spent thousands and thousands of dollars, draining money from his 401k, and I knew nothing about it until the letter from the IRS arrived. “We” had underpaid our taxes by thousands, underreported our income. I had no idea where the money went, and asking Mac triggered the scariest tantrum I have ever seen. When I got the letter from our mortgage lender telling me to find another lender; homeowner’s insurance was a condition of our mortgage, Mac told me he had deliberately let the insurance lapse because he was angry with me. “I asked you for more money,” he said, “But you didn’t give me any.” (What I remember saying is that I didn’t have any money to give him until payday next Friday). He had sabotaged me at work, smeared me to his “friends” and acquaintances at the hospital, convinced everyone that I was crazy, jealous and controlling. I was constantly walking on eggshells at home, trying not to set off another temper tantrum and trying futilely to please a man who refused to be pleased Looking back, Mac’s behavior seems clearly abusive, but I couldn’t see it as such. At least not until he deliberately put me in a life-threatening situation and then sat back smirking when I got injured. And even then, it wasn’t until the SECOND time that the pieces slowly shifted into place and I realized that I had been suffering verbal and emotional abuse for years, and that he had escalated into physical abuse. Making the Right DecisionTwo years ago today, I left my home, my husband, my marriage with what I could carry, and my dog. I had no job, no home, no family, no car, no church, no community. What I did have was determination, an Enterprise (car rental) account, and a friend living a thousand miles away. My life is much better now. I have an interesting, challenging job in my new city. I’m happy again. I paid off the bills, saved my money, bought a car and filed for divorce. I don’t have much -- the collection of Revereware, the leather sofa, the beautiful home that all seemed so important to me once upon a time are now things of the past. But what I do have is mine, and mine alone. Starting over again in my 60s is so much more difficult than it was thirty years ago when I left the first abuser. I’m older now, but I’m wiser. And I finally have some peace; home is a refuge rather than a battleground. Breast cancer is not the worst thing that ever happened to me. Domestic abuse was.
  12. Ruby Vee

    Your most bonehead moment in nursing. Or 2. Or 3.

    At least it wasn't TPN, which is so sticky there was still a sticky patch on the floor months later, and I overheard a colleague telling the medical student, "Yeah, that's where Ruby had a little accident with TPN . . . and over there, that brown stain -- that's where Ruby started the blood without plugging it into the patient."
  13. Ruby Vee

    To Travel or Not?

    Traveling is good for finding the place you want to settle permanently, but I didn't care for the actual traveling. I was always the newbie, and the permanent staff assumed that I didn't know anything. I came from a huge, prestigious teaching hospital in the CTICU, and I was used to far more acuity than what I saw in the smaller community hospital where I took an ICU contract, but I had to watch bad things happen because the charge nurses and the physicians didn't know that I knew what I was doing, what I was saying. That's the thing that made me stop traveling . . . watching poor patient outcomes and there was nothing I could do. It also got old, having to find a new grocery store, dry cleaner, etc. and when I had a toothache, my dentist was three thousand miles away.
  14. Ruby Vee

    Back Injury for 3 months

    Your employer is looking after THEIR interest, not yours. Go see a doctor. Numbness and tingling in your legs is a serious issue.
  15. Ruby Vee

    New RN, how to save face

    If you work in CCU, you'll run into this one day. A patient with a balloon pump will have a pulsitile pressure of 42/0, as long as the IABP is triggering. A patient with a pacemaker will trigger the balloon pump, and a patient on a ventilator with a set rate will breathe. Interns, residents -- and even a few attendings do not necessarily recognize when a patient has expired as long as the ventilator keeps pumping in air, the pacemaker keeps spiking and the balloon pump keeps triggering. If they can't tell when a patient has died, don't kick yourself for not knowing when the patient is dead. You DID know -- you just opened your mouth and the wrong thing came out.
  16. Ruby Vee

    New RN, how to save face

    There are numerous threads on here about bone-headed moves. We've all pulled them. We've all had those distinctly stupid moments that make us want to cringe every time we remember them. We've all made completely idiotic statements and pulled absolutely moronic moves. There's an active thread about that right now. I am not, nor have I ever been, a *complete* idiot. But I have done some truly moronic things. I used to work in a telemetry unit (my first job) where the house staff was divided up into the Red Team and the Blue Team. I had a patient going bad, and the new resident walked into the nurse's station. I wanted to know which team he was on -- could I ask him for orders or would I have to page someone. What I SAID was, "What color are you?" The guy looked affronted, and then said, stiffly, "I'm Black." OMG! I kinda hadn't really noticed -- I was looking at the white coat. In my efforts to backpedal, the smartest thing I could come up with to say was, "I can see that. But are you red or blue?" Fortunately, he saw the humor in my embarrassment, but he never let me forget it.