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Ruby Vee BSN

CCU, SICU, CVSICU, Precepting & Teaching

Original Member of the Crusty Old Bat Society

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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

    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.
  2. 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!
  3. 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.
  4. Ruby Vee

    Ask Me If I'm Safe At Home

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

    Ask Me If I'm Safe At Home

    Good on you for going no contact! You're mighty!
  6. 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 Abuse If 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 Decision Two 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.
  7. 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."
  8. 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.
  9. 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.
  10. 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.
  11. 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.
  12. Ruby Vee

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

    At my first ICU job, all of the patients got Metamucil down the feeding tube. It was tricky to administer -- you had to mix it with cranberry juice and then give it quickly, before it had a chance to congeal. But very few of our patients had tube-feeding induced liquid stools. In those days, we put blue food coloring in all tube feedings, so the stools would come out looking like little round, rubber bouncy balls. Our unit was 8 beds, fairly close together and surrounded by privacy curtains that ended about a foot from the floor. I'm sure you can guess where this is going. My friend and I were cleaning up a patient, and set the used bedpan at the end of the bed, where the patient promptly (and most likely accidentally) kicked it off the bed. Those little blue turds went bouncing out of the bedpan and under the curtain, where they bounced across that patient's area, surprising a visitor whose shriek caught everyone's attention, then rolled two beds over. The worst part was going from bed to bed, looking for errant bouncing turds. And then there was the time Dr. Worldfamousinfectiousdiseasespecialist came walking into my patient's cubicle for a consult just as I was pushing liquid Tylenol -- that obnoxious red stuff -- into a feeding tube that turned out to be clogged. I sprayed myself, the patient and Dr. Worldfamousinfectiousdiseasespecialist with bright red, sticky liquid Tylenol. The patient was pretty forgiving, his wife thought it was hysterical but Dr. W was decidedly NOT amused.
  13. Ruby Vee

    The Worst Interview of My Life! Ever!

    I was interviewing for an assistant nurse manager position, and I woke up that morning to some absolutely horrible menstrual camps. I had endometriosis, and I'm sure many on AN know how bad those cramps can be. Nevertheless, I dosed myself with Ibuprofen (prescription strength, because my cramps were so bad I *had* a prescription) and went to the interview anyway, figuring if I didn't go I wouldn't get the job. While at the interview, I was sitting at a long conference table across from the nurse manager and three assistant nurse managers. The Ibuprofen was wearing off, and the cramps were seriously getting my attention. As the interview progressed, I was in so much pain my head was starting to get light, I was sweating profusely and felt as though I was going to pass out. The interview didn't go well -- go figure -- and when I got up, I felt that warm rush down my leg. Ruined my interview suit and didn't even get a second interview!
  14. It may not actually be illegal, but the OP should definitely ask about it — *ASK*, not accuse. Some hospitals pay their nursing staff on a salaried basis, so you have to stay over at least four hours before you get overtime. It’s a rip-off, but it’s not illegal. Some hospitals don’t pay overtime unless it’s more than an hour (or some pre-determined amount of time) but also don’t squawk if you’re done with report by 6:30 and skip out early. So maybe strictly “illegal” but not something to rock the boat over since presumably you, too, will benefit over the chance to leave early. Some hospitals don’t pay overtime to orienteers because you aren’t adding any value at this point. It would be wisest to ASK someone before getting riled up.
  15. Ruby Vee

    BSN but not a nurse

    You might not know anyone in real life who admits to it being a "calling" -- I don't, either -- but there is a huge debate on this site about whether nurses who don't have a "calling" should be allowed to BE nurses.
  16. Ruby Vee

    SHOES!!! with ankle support!!!

    People answer questions on this forum out of a desire to help. The fact that you are unhappy with the answer does not mean it was ill-considered or inappropriate. When you snark at people who are trying to help you, it makes others less willing to try to help you. The sports shop advice was good advice. Even if you didn't like it.

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