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rubyagnes

rubyagnes

background in Art Therapy
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rubyagnes has 1 years experience and specializes in background in Art Therapy.

I love animals, health, wellness, exercise, nature, music, and many other things.

rubyagnes's Latest Activity

  1. rubyagnes

    psychiatrically unstable crohn's patient

    She has been one of my patients on and off for about a year now and she was born and raised in Maryland. She has been schizophrenic her whole life. It’s a very complicated and sad situation.
  2. Hello, I have been a nurse for about 4 years now. I initially worked in an extremely busy ER in the city that consisted of a cardiac interventional center, pediatric unit, and primary stroke center. Since then, I have been in Psychiatry that focuses on degenerative neurological disorders. In the ER we dealt with many intense traumas and invasive procedures. I am trained in phlebotomy, IV and ultrasound guided IV insertion, and have BLS, ACLS, and PALS certification. Due to my broad experience, when applying for agency jobs, do you think I would qualify for applying to any positions beyond the ER and Psychiatry? What other types of nursing do you think I would be eligible for. I don't want to sell myself short, but I also want too be sure I apply for positions where I would be competent and confident, especially since I may not receive much of an orientation (if at all) Thanks in advance!
  3. rubyagnes

    How to pick a job to apply for

    Hello, I have been a nurse for about 4 years now. I initially worked in an extremely busy ER in the city that consisted of a cardiac interventional center, pediatric unit, and primary stroke center. Since then, I have been in Psychiatry that focuses on degenerative neurological disorders. In the ER we dealt with many intense traumas and invasive procedures. I am trained in phlebotomy, IV and ultrasound guided IV insertion, and have BLS, ACLS, and PALS certification. Due to my broad experience, when applying for agency jobs, do you think I would qualify for applying to any positions beyond the ER and Psychiatry? What other types of nursing do you think I would be eligible for. I don't want to sell myself short, but I also want too be sure I apply for positions where I would be competent and confident, especially since I may not receive much of an orientation (if at all) Thanks in advance!
  4. Any experience/insight/advice for the treatment of Crohn's in someone who is very psychiatrically unstable? Someone who has about 10+ stools a day, causing a lot of abdominal pain, but also is psychiatrically unwell and denies that they have crohn's but rather says they are cursed with snakes in their stomach? I know this is a strange question but I work with a woman who has been diagnosed with Crohn's in the past (though it is unclear as to how she was diagnosed, she is a very poor historian in regards to medical history) She has had a resection, but there is no clear notation about the details that preceded the surgery. Lab work shows elevated CRP. Due to the frequency of stools we are awaiting a stool sample to test for c-diff but I am almost positive it will be negative. Any other easy tests that might bring clarity to her diagnosis? Due to her resistance to care, denial of crohn's, and guarded nature related to psych issues, the doctors working with her are reluctant to force her into testing she is refusing bc she is currently "stable" however the frequent stools and chronic abd pain are chronic and distressing to her. She does not have any family or outside support to help with medical info or to help with supporting further testing. Any ideas would be greatly appreciated. Thank you!
  5. rubyagnes

    2019 Nurse Corps Loan Repayment Program

    anyone else still "under review"??
  6. I'm currently an RN at Johns Hopkins Hospital and wanted to share some new job opportunities for anyone looking. We're now able to link people to jobs that were previously only visible through out internal career page. Hopkins is trying to improve staffing ratios and expand their programs, and this new option to share job postings will hopefully help to facilitate that. If anyone is interested in more details, please feel free to message me! I honestly really enjoy my position here, there are a lot of resources and opportunities to grow and advance in your field! - Tiffany
  7. rubyagnes

    Johns Hopkins Hospital - Baltimore, MD

    I'm currently an RN at Johns Hopkins Hospital and wanted to share some new job opportunities for anyone looking. We're now able to link people to jobs that were previously only visible through out internal career page. Hopkins is trying to improve staffing ratios and expand their programs, and this new option to share job postings will hopefully help to facilitate that. If anyone is interested in more details, please feel free to message me! I honestly really enjoy my position here, there are a lot of resources and opportunities to grow and advance in your field! - Tiffany
  8. I'm currently an RN at Johns Hopkins Hospital and wanted to share some new job opportunities for anyone looking. We're now able to link people to jobs that were previously only visible through out internal career page. Hopkins is trying to improve staffing ratios and expand their programs, and this new option to share job postings will hopefully help to facilitate that. If anyone is interested in more details, please feel free to message me! I honestly really enjoy my position here, there are a lot of resources and opportunities to grow and advance in your field! - Tiffany
  9. rubyagnes

    Cath Lab Code Blue

    Thanks @offlabel. I was really taken off guard about it when I found out
  10. rubyagnes

    Cath Lab Code Blue

    Hello all, I am a new ED nurse. It's my first nursing job since school. We had an 80 year old patient come through the ED the other day. He was sent in by his doctor after seeing some EKG changes and had been experiencing "burning in his chest for months but didn't think it was a big deal". He was on our unit for less than an hour. I got his vitals, charted basic notes, and sent him on to the cath lab. Hours after sending him to the cath lab, he coded during the procedure and died. Obviously it was really upsetting to me. Though he wasn't my patient very long, I'm left wondering what happened? Many of my colleagues speculate he had a clot that was dislodged, but what other possibilities are there? I keep thinking what could I have done? I don't know, maybe I'm not cut out for the ED... anyway, I don't really know what I'm looking for, maybe insight? Words of wisdom? Thanks in advance and thanks for reading...
  11. rubyagnes

    ED Nursing Notes

    @wuzzie Yes, I definitely agree and understand the meaning behind the phrasing, that was just an example that came to mind. I'm slowly getting used to writing in this way, but it's a bit of a learning curve and doesn't feel fluid or comfortable just yet. I really wish my school had a documentation class or at least a documentation unit. I'm sure I'll get familiar and more confident with it over time, but at this point it's definitely slowing me down. Thanks for your response!
  12. rubyagnes

    Tips for a new grad ER nurse

    @medicalpartisan, rn Wow, so things have been busy! So busy that I just saw this post :) I'm really enjoying the ED Definitely learning a lot. Sometimes I feel like "yeah, I've got this" and then a moment later it's like "whoa, what just happened..." So the ups and downs have been a little exhausting. I just worked three 12's in a row (which ended up being 13's) I've found documenting is the hardest for me. I definitely update all of my interventions in a timely fashion, but I'm not so good about writing notes and using the "correct lingo" I'm worried that I might write something in a note that conveys something negative somehow... I also still have some hiccups in giving meds because I overthink the meds and get worried about things like adverse reactions or unknown allergies. I'm definitely paranoid :/ My preceptor says being worried is a good thing because it can keep me in line, but I definitely want to try to gain more confidence while being careful and concerned. I know these things come in time but my worries have been the hardest part. The best part is just working with patients. Even the more challenging patients, I feel good about walking in, giving them a smile, and asking them how they feel/what I can do for them. I'm sure my documenting and technical skills will improve. I can't wait for the day where I just care for my patients independently and can leave a shift without worrying that I did something wrong. Anyway, I've heard these feeling are all normal so I guess things are going well! :) Thanks for asking and I hope you're doing well :)
  13. rubyagnes

    ED Nursing Notes

    Hi, I just graduated back in January, and started my first nursing job in a busy ED about two months ago. Things have been going really well, but I've noticed I don't feel very confident in my notes. My school experience didn't really emphasize notes, and the notes we did learn were elaborate "med surg" notes. Many coworkers have said that in the ED they do focused assessments and focused notes, not longer med surg notes. I've gotten a lot of varying feedback from fellow co-workers in regards to note style - some write many one to two sentence notes throughout the patient's care, others write a cumulative note about the patient. I'm trying to find "my style" but I definitely want to do it the right way. We have many interventions through the meditech program we use, so a lot of what I would write in a note has also been documented within an intervention. I'm hoping to get some more advice as to what I should be including in a note, how often you write notes for a patient in your ED, and the wording/lingo that is used. I definitely feel that I get hung up on "phrasing" - for instance instead of saying "patient walked to their bed" my preceptor tells me I should say "pt is ambulatory" I definitely don't want to write anything in a note that is compromising to my license, but also want to convey the patients current disposition... Maybe I'm overthinking (I tend to do that) but I feel like note writing varies so much from nurse to nurse that I don't know the "right way" of writing a note, especially in the active ED. Thanks in advice for any advice you might have. -T
  14. rubyagnes

    Salary increase

    @llg Thank you so much for your cohesive and clear response. I really appreciate it. I'm definitely new to this and I'm sure I'll learn the ropes over time. My boyfriend is a high school teacher and went from starting at 50,000 to earning 70,000 within 9 years by getting his masters, taking continuing education courses, etc... So I was hopeful Nursing had similar methods of increasing salary. One thing at a time for me, though... My focus now is becoming a great nurse! Thanks again!!
  15. rubyagnes

    How much do nurses make?

    @djaemac please be my life coach! lol
  16. rubyagnes

    Salary increase

    Hi everyone, I'm a new grad just starting out in the ED. I'm trying to plan ahead... I only have my associates in nursing and definitely plan to go back for my bachelors and eventually masters. What are the ways you can get a salary increase? Raises? Do they happen? Advanced degrees/continuing education? Will that increase salary? PRN work? Temp work? Travel nursing? Are these realistic on top of a full time schedule? How much extra can you really make/is it worth it? My modest goal is to make ~70,000 to match my partner in income, and rn I'm starting at like 50, so I'm trying to plan ahead and figure out what steps I need to take to continue my career path in a proactive way. This is all very new to me. My #1 priority is to be an amazing nurse and I likely won't even attempt to take classes or anything until I feel confident as a nurse... I'm just daydreaming at this point and *curious* how nurses can increase their pay rate. Thanks for any info!
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