#I DON'T KNOW HOW TO TAKE COMPLIMENTS????

[zaacoy]

Tang in dresses I think he'd like :3c

[andhumanslovedstories]

Hey so your post about pain management as a bedside nurse is so important to my own nursing practice that I've considered printing it out so I can have it to hand all the time. So thanks for that. Also, how do you deal with assignments that are busy enough that pain management is harder than it should be? I'm coming up on two years as a nurse and I feel like I take it personally when I am too busy to adequately manage my patients pain. I'm also coming from a newly unionized hospital where the ratios are still horrendous (I do 1:10 on med surg) and I'm hoping once we can enforce our staffing grids it'll be better but idk I'm burning out and I love my job so much and I really respect your nursing philosophy? I guess. Sorry for the word vomit it's been a crazy shift.

I've been trying to think of how to answer this since I got it. It's just such a horrendous ratio. With ten patients a shift, that's like six minutes an hour for each in a fantasy world where there's no charting and everything is exactly where you need it to be. I feel like I don't have great insight into this because the most med surg patients I've had assigned is five. Ten patients to one nurse is just a raw deal for everyone. Like christ no wonder you feel like you're burning out! I'll give you what thoughts I have and hopefully other people can chime in if they have suggestions. But that's such a hard patient load.

When I've been super swamped, I've found that's when being really explicit about your thinking with the patient helps. Like if I have to dash into a room and then dash back out, I'll make sure the board is updated with the next medication time and that the patient knows when the medication is going to kick in. I'll also provide call light parameters. I have a lot of success telling people, "the med should be doing something by 5:30. If I haven't checked in with you by then, and the pain is unchanged or barely changed, hit your call light and we'll try the next step. Also hit your call light if you feel any sudden change, like now you're nauseated or you have a headache or the type of pain changes or something just feels very wrong. Is there anything you need before I step out of the room?"

I like to be explicit about when to call me because I think there's two directions call light usage can go wrong: someone calls all the time, or someone never calls. With someone who calls all the time, I find that telling them when I'll be back and that I want them to call me if I'm not takes away some of that anxiety that can causes some people to call frequently. Often those patients are afraid that if they aren't on the call light, they're gonna get ignored.

For the other type of patient, the one that doesn't call, I want to make explicit that it's GOOD AND NORMAL TO CALL YOUR NURSE WHEN YOU HAVE SYMPTOMS. We've all had that patient at the end of shift who goes, "btw the gnawing pain in my leg is now a 10/10" and you're like "what gnawing pain sir?? you've literally never mentioned it before now?? I don't have any meds for that lemme page super quick????" These patients can get into pain crises easily because they don't ask for help until something is unbearable. In addition to pain crisis bad, it takes a lot more time to deal with something unbearable than it does to deal with something uncomfortable.

On that note, are you spending your very limited time efficiently? To me, that actually means spend more time talking with patients, at least up front. Manage expectations, make sure people know what to expect. Having conversations with patients that are like, "You just had surgery, it's not gonna happen that we get you completely painless. We want to get you to a manageable pain level that allows you to do whatever it is you most want to do this shift." (For me on nights, that's usually sleeping at least a little, but sometimes the realistic goal you make together is that you will feel at some point better than you feel right now.) "You have this medication scheduled, and you have this one available every X hours when your pain is severe. Is there anything you know that helps you deal with pain?"

Also establish if patients want to be woken up for certain prn medications or if they're sleeping, to let them sleep. With some patients, I will advise them to get woken up for pain medication because I know that they're going to need consistent control to avoid a crisis. (Crises take so much time!)

When I'm crunched for time, I'm fond of bringing in an ice pack and being like "if it works, great, if it doesn't, just take it off, either way here it is." Sometimes I'll do the same with a warm blanket. If I know my patient needs to take pills, I'll bring a cup of water with me into the room. If there's a basic prn like melatonin or tylenol that I think they might want, I'll pull them in advance. If the patient doesn't want them, I return them next time I'm in the med room. (Obviously, don't do this with controlled substances. It's super easy to forget to return them, and not returning opioids is one of those whoopsies people get fired over.)

Decision making takes time. Walking to go get stuff takes time. I want to save the time it takes to assess if the patient needs those things and then walk off to fetch them by just having the things already. If your tightest resource is time, be liberal with resources you can spare. If you're stuck with a patient, do you have anyone you can delegate a prn med pass to? Do you know how to do the absolute minimum charting you need to? Do you have flushes and alcohol wipes and whatever other most common things you need? And since you can't hoard time, if you've got some to spare, ask yourself if there is anything you can do now that will save you time later. If you have five free minutes now and an incontinent patient, getting them up to the bathroom now can save you from taking the time for incontinence care and a bed change later on when they've also sundowned and decide they hate everything but most of all you.

So much of this answer I realize is investing as much time upfront as you can, which I realize is so hard when you are so busy. It sucks immensely that prepping takes much less time than not being prepared does when you don't always have time to prep. Plus when you invest that time to pain plan with patients and do small preventative interventions, I think it also provides some psychological comfort that helps with pain. You're letting them know you're invested and you care and you have a plan, even if you don't have all the time you'd like. That can mean better pain control, which can mean needing to spend less time in that room overall, meaning you can save six whole minutes at some point and maybe even, if we're feeling crazy, get a chance to indulge in that greatest of indulgences: just a real leisurely on-shift piss.

[navybrat817]

Just got out of a meeting and my manager found out I'm barely 5'3 (I think I'm 5'2.5?). She said I give off tall girl vibes and everyone else agreed. They also still think I'm lying about my age because I look younger.

[tullecake]

please for the love of god if I get one more weird or suspicious drawing request I will cry and scream- -- anyways here's some lazy doodles of the twins of my sonadow fankids being angry and confused because me too :|

girlie on the left is pertinax, dude on the right is ferox here's my post of their siblings too because why not

(rambling in tags probably don't mind me)

[thegreatyin]

yeah it's such a fascinating look into curator society. it can't just ask you for help, it thinks it has to trick you into it. even during its recruitment it's very specifically framing joining you as an Exchange. it's not joining ur crew, see, it's simply... trading the pleasure of its company for a free ride. yeah. yeah totally

[furbyobsessedpup]

normalize posting absolute ass art because not all art is stereotypical pinterest worthy well colored fully rendered art

[raayllum]

working on the transcription for the latest hot brown morning potion podcast interview for mostly meta motivated reasons (which you should listen to bc it dropped lots of tasty tidbits regarding S5 and some small but fun spoilers for S6) and it turns out Aaron Ehasz knows who you are

re: a question with Viren's consumption/sacrifice of butterflies throughout the show, leading to him refusing to sacrifice Sir Sparklepuff, a very butterfly-esque creature Tamika: I can’t take total credit for those questions, like um, Raayllum with two As—Dragons, one of my best friends, always has like really deep questions— Aaron: Oh! I literally was going to bring them up.  Tamika: Oh really? Aaron: Wordswithdragons, I see their posts, and their observations and like, very often I’m like “Wow, that’s a really good observation!” Like, I hope we came up with that intentionally, but it’s sort of like you know, I think sometimes you do have feelings and you recognize that something feels right and there are aspects of it that sort of emotionally are there, and if you trust that emotional feeling, sometimes there are kind of subconscious currents of symbolism and things like that that work their way into those emotional decisions, even if you aren’t — you couldn’t write the book report on what you did. But yeah, it’s really cool when, obviously, super smart people like Wordswithdragons [chuckles] notice cool things and you wanna go “Yeah, we totally meant to do that.” 

[syrenki]

i fucking give up men have less humanity and dignity to me than dogs

[shokujin-art]

You are genuinely an amazing artist, it blows me away.

[misscammiedawn]

hi i wanted to say thank you for sharing your thoughts and experiences with did. i have trouble thoughts to words. comics like hulk help point and show this is what feels like same with mr robot. you point and show connect explain very well thank you

Appreciated, anon. Deeply

I don't know if what we type and share is helpful to anyone but it helps us get our thoughts out of our own head. If it's doing good for you then I'm grateful and it makes me smile.

End of the day, I just want there to be good representation for people to latch onto and positive things to share with those who don't fully understand. Heaven knows I benefited from showing Mr. Robot's depiction of dissociation, lost time, blending and switch headaches.

Good representation communicates well because it needs to communicate to people without lived experience.

Of course, not all representation is good, sadly.

It's why we try to avoid talking about Murder Alters in the media, myself and I tag and even still pretty much everything skates that line if not crosses it. Joe Fixit and Devil both kill in Hulk, Jack Lockley murders in the Moon Knight show, the less said about Metal Gear or Umineko on that regard the better -- weirdly enough Mr. Robot, despite the titular alter trying to act tough in Season 2 and participating in a plot to kill thousands, never kills anyone. I don't think the Alderson system is capable of killing because no matter how Mr. Robot acts, as said in the finale of Season 3, there's a little bit of the system in each of them.

Anyway all that ramble aside.

I want to do my best by people who are looking to see a little of themselves reflected in art. Peter David and Al Ewing's runs on Hulk should not be held up as the highest standard of these tropes but they're the only place I've seen the ethics of dating a system discussed.

I think in time I'd like to start reading more indie stuff and seeing what people who live with the condition put out rather than focusing on pop culture.

On that note...

I think I should do my next Media, Myself and I entry on The Third Person by Emma Grove.

[luminlunii]

Literally just discovered this blog like 5 minutes ago, and I'm already in live with your stuff! Your art style is soothing, and I love the little stims that Rocky is doing in some of your drawings!

E

[scketchorinopop]

Reads paper

It says here ur cool

Reads my own paper

Oh well it says here that-

Squints

You're delicious and extremely consumable!

[artofloof]

Hey have you ever used Ritsu's eve voicebank? It's cvvc which scares off some people but it has such a beautiful tone to it, I'm biased towards any Ritsu bank but it's probably one of my favorites hehe...also I'm a big fan of how you use something is kire (idk what the proper translation of it is but iirc Canon herself calls it that in english), your tuning and mixing is nice :)

I've actually been considering trying Ritsu eve!!!!! Like you said, the fact that its cvvc is very scary so thats the main reason I haven't lmao (I've quite literally never used a cvvc bank before)

but who knows... maybe someday... would love some song recommendations for the future if anyone has them :0

[green-alien-turdz]

Man, you’re so fucking cool, it’s unreal. You capture that small town teen experience that most people don’t get. It’s gross, it’s toxic, it’s shitty, but it’s life. Love you dude.

Sorry this is such a late reply! But thank you so much!!! I love just capturing life for how dogshit it is, so hearing shit like this always makes my day. Seriously, thank you for sending this in. I'm not great at expressing my thoughts, but it puts a lot of good feelings on me towards my art <3

[kavzz]

ok excusing my boops i just realizeed you go by kavya??? that is genuinely gorgeous oh my god????? i need you to know that is seriously one of the prettiest names ive ever heard of

THANK YOU ???? It's not the most common out of the names I go by but tysm☹/pos/gen

[phosphorus-noodles]

me: hm yeah i'll rb a post asking for anon opinions of me haha

me when the anons are nice to me??: