#Wound Care Documentation Best Practices

[zerovapes]

In the realm of healthcare, accurate and comprehensive documentation is crucial for delivering effective patient care. This is particularly true in wound care, where Clinical Documentation Improvement (CDI) plays a significant role.

[night-raven-tattler]

What's your ideal type?

Summary: What would be the best traits for their potential partner to have?

Characters: Octavinelle dorm (Azul, Jade, Floyd) × GN!Reader (separate, romantic)

Other parts of the series: Heartslabyul, Savanaclaw, Scarabia, Pomefiore, Ignihyde, Diasomnia

Warnings: none

By opening the document, you agree to Mx Tattly's terms of source confidentiality.

-ˋˏ’✄┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈┈

Azul's ideal type would be...

Someone witty. Azul is a smart guy who likes being entertained. While his way of achieving that is less... for lack of better words, aggressive than the tweels', he enjoys a good mental game. If you can carry a good conversation with him, he'll remember you.

Someone who doesn't pressure him into making decisions. He is someone whose independence is very important to him. On top of that, his signature spell literally revolves around choice as a concept, so he understand the importance of it. Someone as stubborn as Azul will keep his distance if anyone tries to influence his free will.

Someone who appreciates music. He's a pianist and a good singer, which are skills that require a lot of practice and hard work, something Azul is known for. He will appreciate any genuine praise, but if you ask him to teach you more about music or, Sevens forbid, you want to duet with him, all of his three hearts are yours.

Someone who doesn't mock him, not even when teasing him. If you really know Azul, you know how bitter he is towards the people who have brought suffering onto him. The words they said are ingrained into his brain, controlling his choices for years after they were spoken to him. I'm not saying to constantly uplift him, but bringing up old wounds will only push Azul away with low chances of getting any closer again.

『••✎••』

Jade's ideal type would be...

Someone whose next move he can't accurately predict. It's kind of easy to catch the attention of any of the tweels, but it's also easy to lose it. The key to keeping Jade's eyes on you is to make him believe he's had you all figured out, then do something unexpected. Being a little unpredictable, even when you think you're outside of Jade's vision, will pique his curiosity.

Someone who plays along his little tricks and schemes. Jade is not an honest person: he always has some ulterior motive, hidden behind carefully worded questions and statements that he uses to poke and prod for information. If you try to help him and his twisted game of detective, he will certainly find you amusing, if not helpful.

Someone who goes exploring with him. Just like his brother, Jade has a fascination for the land above water, and he loves learning things about the fauna and flora. Someone who understands his appreciation for nature and genuinely embraces his curiosity will have a bit more of his appreciation.

Someone who doesn't try to understand him. Jade is very careful not to reveal too much about himself. Being awfully private with himself, he won't open up to just anyone. So he will appreciate someone who doesn't try to pry into his business too much. At the end of the day, Jade can be many things: a bartender, a vice housewarden, an informant, but he'd like to be seen as "just Jade" sometimes.

『••✎••』

Floyd's ideal type would be...

Someone who isn't intimidated by him. It's a surefire way to catch his attention. Even if you just pretend to not be intimidated by him, he'll stick around and try to push all of your buttons, test your limits, squeeze all that he finds interesting out of you.

Someone willing to teach him more about land folks. Everyone knows that Floyd has quite the interest about land folks and their customs. He wants to know more, so don't be afraid to throw random land people things towards him every once in a while. If it's something he didn't know about, he'll tell you to prove it. Congrats, he won't leave your side for a couple of hours.

Someone who doesn't compare him to Jade. Since he's the more polite and responsible one, Floyd gets compared to his brother pretty often, and some people even assume he's the younger twin. It is exhausting to have his other half be given as example on how to behave time and time again. If you reassure him he doesn't have to be like his twin, that being Floyd is just fine, it'll pull at his heartstrings.

Someone who takes his mood swings in stride. From people thinking he is a threat to people who just find him annoying and hard to work with, no one really takes Floyd's mood swings seriously. That doesn't mean he'll open up if you asked him "are you okay" and "what happened". Still, it would be the first time someone outside of his family reacted like that to him. It will baffle him, in a good way.

[covid-safer-hotties]

Also preserved in our archive

By Betsy Ladyzhets

Since early in the pandemic, people with Long COVID have faced challenges in applying for disability benefits, including from their employers, insurance providers, and the U.S. Social Security Administration. Applications often take a long time and are denied even for people who clearly have debilitating symptoms, leading to years-long, arduous appeals processes. The same has been true decades prior to 2020 for people with other infection-associated chronic diseases.

To learn more about the disability insurance system, Betsy Ladyzhets spoke to Barbara Comerford, a long-time disability lawyer based in New Jersey who specializes in these cases. Comerford has represented people with myalgic encephalomyelitis (ME, also known as chronic fatigue syndrome or CFS), for more than 30 years, including high-profile cases like that of journalist Brian Vastag.

Comerford discussed how the process works, her advice for putting together applications and appeals, how Long COVID has impacted her practice, and more. This interview has been lightly edited and condensed for clarity.

Comerford’s tips for disability benefit applications:

Comerford recommends that people applying for benefits extensively document their symptoms. Medical tests such as neuropsychiatric testing and cardiopulmonary exercise testing are her recommended method for documentation, though she acknowledges that these tests can be expensive. Comerford suggests that applicants should be careful to find lawyers and medical providers who have experience with these cases and won’t dismiss their symptoms. During the appeals process, Comerford recommends requesting a company’s administrative record and combing through it for any evidence that they abused judgement, cherry-picked evidence, or made other errors in assessing the case. Make sure to follow deadlines for filing appeals, as cases are closed if documents are not submitted on time.

Barbara Comerford: Should we focus on disability insurance, or do you want to focus on social security disability, or both?

Betsy Ladyzhets: Both, because people [with Long COVID] are applying for both.

BC: Right. And often, people think they should only apply for one, [but they should apply for both.]

Most of the disability plans that people have are often through their employer. Those plans are known as ERISA plans, that refers to Employee Retirement Income Security Act. It was created in the 1970s… Congress created this regulatory scheme, and then immediately created a zillion loopholes that corporations can drive a truck through. Later, ERISA covered all employee benefits in general.

Insurance companies wound up selling policies to corporations saying, “You can get the best people if you offer incentives.” And what’s a better incentive than, if someone gets sick, they can collect a substantial percentage of their salary until full retirement age? These are the sorts of perks that… People think, “If something happens to me, I’ll be protected.” The promise of these policies is that they will give people, usually, between 50% and 80% of their pre-disability income if they satisfy the requirements. Well, that’s a big if.

I’ve been doing this for 38 years. And I can tell you that 38 years ago, these [disability claims] were not problem cases. I used to do them for free for my litigation clients… But over the years, and really starting after 2001 with September 11, all hell broke loose. They [insurance companies] began to get very aggressive. Every time there is an economic downfall, whatever it is, they get extremely aggressive. So you can imagine, with the onset of the pandemic, they knew what was coming.

I did, for many years, advocacy for ME/CFS cases. I represented thousands of people… A lot of my colleagues say, “Long COVID social security cases are almost impossible,” because they don’t know what to do with them. My office hasn’t found that to be the case. I think the difference is, you have to document these cases with as much objective documentation of symptoms that people have… Get neuropsych testing, cardiopulmonary exercise testing, and other tests.

I started doing webinars and seminars [about disability benefit applications] in 2020, because I knew this was coming. At that point, they weren’t calling it Long COVID, they were just saying, some people with COVID weren’t getting better. But I knew it was going to turn into another ME/CFS disaster.

BL: How have you found the rise of Long COVID has impacted your practice? Do you find you’re more in demand now?

BC: We’ve always had a high volume of cases. Quite a few of them were ME/CFS cases. We did a case, Vastag v. Prudential, in 2018. Brian Vastag, who was a science writer for The Washington Post, was my client, and I could not get over how aggressively Prudential was just dismissing him because it was an ME/CFS case.

And the same is happening with Long COVID. We do cases all over the country on Long COVID and ME/CFS. It’s my livelihood, so it’s important for me, but it also makes me a little crazy that people get treated the way they do and that they have to hire people like me.

One of the things that people get upset about is that they have to spend money to medically document their symptoms. And worse than that… I see these Long COVID clinics, with doctors who are completely ignorant on Long COVID, who surreptitiously write notes in the chart that they think it’s a psychiatric case. I don’t know how familiar you are with this.

BL: Unfortunately, I’m very familiar.

BC: It’s awful. Not only is it really hard on my clients… It triggers them to read things that might not be what they said or might not be pleasant. And the number of times that I have seen that and it has sabotaged cases! I have to reconstruct the cases and have the clients contact the clinic [and get them to make corrections].

Mental/nervous limitations exist in all of these [insurance] policies… They can limit someone’s payments to two years if the case is a psychiatric case or mental/nervous limitation with a DSM diagnosis.

BL: I wanted to ask also — there’s been a lot of research on Long COVID at this point, and there was a report this summer from the National Academies specifically in response to a request from the Social Security Administration about Long COVID as a disability, in which they found that this disease can result in inability to work, poor quality of life, all that stuff. Have you seen that report, or other research, like the growing body of research on these diseases, have an impact?

BC: I was asked to comment on that [report]. Part of the problem with Social Security’s initiatives in this regard is that every social security case goes through what they call “sequential evaluation process.” You have to go through five steps to determine whether or not someone’s disabled. And among those steps is [matching people to a “medical listing of impairments,” but the list doesn’t include major symptoms for ME/CFS and similar diseases].

Years ago, there was a ME/CFS ruling called 99-2p. It offered guidelines [for ME/CFS cases that don’t fit the typical Social Security process]. After that, I was asked to present to the national association of Social Security judges, there were 500 judges in the audience. And I asked, “By show of hands, how many of you are familiar with 99-2p?” Two hands went up.

Despite the guidelines, in practice, [the judges aren’t familiar with these diseases]. Until there is a time when we can come up with a firm diagnostic criteria for Long COVID, and we can say, “This is what you have to document for this illness.” … And it can’t just be a positive COVID test, because many people got sick before testing was prevalent or they got sick after people stopped documenting that they were positive.

The other problem for Long COVID cases is it’s not like cancer or a broken leg or herniated disc or something that people are accustomed to. Those people are not told they’re crazy. Those people are not told they’re imagining it. Those people are not told, “Well, we just don’t buy it.” This is what happens with [Long COVID] and ME/CFS. The psych component that they try to pigeonhole these cases into is really a master stroke by the insurance industry that spends billions of dollars trying to persuade people that anyone who files for these benefits is a crook or fraud.

BL: It’s infuriating, especially when you see how deeply people’s quality of life is impacted by these diseases.

BC: Yes, every part of their life is impacted.

BL: I see what you’re saying about needing diagnostic criteria. In this time where we don’t have that yet, what would you want to see the Social Security Administration or other government agencies do to make it easier for all these people who are applying for benefits with Long COVID and ME/CFS?

BC: They should [reevaluate] the sequential evaluation process, which has been there forever, and look at medically determinable impairment in the context of Long COVID and ME/CFS. These diseases can be documented by things like neuropsych testing.

I’ll quickly go through the five-step sequential evaluation process. The first step is, “Is the person engaged in substantial gainful activity?” That is something you can do predictably, something that will last at least 12 months, and something that leads to gainful work, where you get paid and you can report for a job either part-time or full-time. In Long COVID cases… you have to document that this person is not engaged in substantial gainful activity because they don’t know tomorrow if they’re going to be able to get up and get out of bed and take shower, never mind report for work.

If you satisfy step one, they go to step two. There, they ask, “Do you have the ability, in light of your disability, to perform basic work-related activity?” Sitting, standing, reaching, pushing, pulling, reading, concentrating, things of that nature. And, “Does the disability negatively impact your ability to do these things?” [You need medical evidence, which can come from] a physician’s evaluation from a Long COVID clinic, for example.

If you have that, you go to step three, which is where that horrible “medically determinable impairment” crap comes in. There isn’t {a specific listing} yet for Long COVID, although they’re talking about it. Frankly, we’re still waiting for them to do one for ME/CFS, so I’m not holding my breath. That’s the only step in the process where, if they don’t satisfy it, you can still move on to the next step.

The fourth step is, “Is this person capable of performing the work that they performed for the last five years?” Until June of this year, it was the last 15 years… So we go through each job they had, all their symptoms and limitations and why they can’t do [the job anymore]. If we document successfully that they can’t perform their past relevant work for the last five years as a result of their disability, we can then go to step five.

Step five, the burden shifts to the Social Security Administration. Social Security has to document that, in light of a person’s age, education, and work experience, that there is no work in the national economy that they could perform. [To do this], Social Security has a big graph called the “medical vocational guidelines.” And essentially, the younger you are, the more skills you have, the more education you have, and the more skills that are transferable, generally you are found not disabled. But the graph is not supposed to be used for cases that involve what we call non-exertional and exertional complaints together. Pain, fatigue, things of that nature are all part of the non-exertional limitation.

That is how we lift ME/CFS and Long COVID cases out of that graph. Despite the fact that many of our clients are very young, many of them are highly educated, many of them have developed skills that are not only transferable, but are also in high demand in the national economy — [we say that] because they can’t predictably perform sustained work of any kind, the grid should not be used to find them not disabled. But with all of this, every one of these cases, medical documentation of limitations is crucial. I can’t emphasize that enough.

BL: I know a lot of people in Long COVID community, they’ve already sent in their applications, and then it gets denied, and then they have to appeal. What is that process like, and how would you suggest people go about finding someone like you?

BC: It’s really important to do some research. You want to know if the doctor or attorney you’re dealing with has experience in these cases… I do [webinars and one-on-one education] for lawyers all the time, because I’d rather them hear what has to be done, and understand what happens if they don’t do it.

If I’m giving people advice on appeals… If it’s coming from a United States employer, you’re going to be governed by ERISA. That’s important because people might file a claim without knowing the exact company policy. Despite the fact that federal regulations require employers to give that information to employees, when someone gets sick and files a [short-term] disability claim, they are immediately cut off from the employee benefits portal [that has all the exact policy information]. So then I’ve got to write a letter to the employers, and fight to get that information.

You can’t even get discovery in these cases… Sometimes they will award benefits, and then six months in they’ll say, “We no longer believe you’re disabled.” Under ERISA, [employers and insurance companies] get all the advantages.

BL: It seems like people should know, if you’re filing against an employer, to save that policy information before you lose access to it.

BC: When you get the notice of a denial, you can request a complete copy of the administrative record. You are entitled to see everything that the insurance company had on the case, and under federal regulations, they have 30 days to produce it.

And then you have 180 days to appeal that [denial]. People say that’s a long time. It’s really not. Because you’ve got to go through thousands of pages of documents. You’ve got to document where they abuse their discretion. It’s not enough to have medical evidence… [The standard you have to push back on is that] the insurance company or the employer has a “reason” to deny the claim.

The lawyer’s job or the claimant’s job is to show all the examples they found in the administrative record that show [mistakes or poor judgement on the part of the insurance company or employer]… Sometimes, you will see reports of experts that they’ve retained to review the case, and the expert will say, “I think it’s a payable claim.” And then the next thing you find is them looking for another doctor who’s a little more receptive to their suggestions. If we see they’ve ignored the opinion of one of their experts, that’s an example of abuse of discretion and arbitrary, capricious conduct. Cherry picking the evidence is another thing you often see in these cases.

BL: So it’s not just sending your own medical records, you have to show that the company has messed up.

BC: The insurance company or the employer, whoever is paying, you have to show that they abused their discretion.

BL: Is there anything else, any other advice or resources you would give people?

BC: This is really important. If it’s an ERISA case and they do not get that appeal in within 180 days, they’re foreclosed from pursuing it any further… [It’s a big mistake] if you blow those time deadlines.

All articles by The Sick Times are available for other outlets to republish free of charge. We request that you credit us and link back to our website.

[prismaticpichu]

How To Improve Your Sephiroth’s Day

a step by step guide written by Zack Fair

1. Compliment his hair! ~ There are little things in the world that the average Sephiroth cares about more than that flowing silver mane. He tends to spend approximately of 7 - 50 minutes brushing it meticulously every morning, and hearing that dedication pay off is a certified way to get your Seph’s day started on the right foot! Just be sure to not go too overboard with the compliments; Sephiroths naturally attract a lot of fans, thus turning a lot of that praise hollow. Try to tie it naturally into a conversation if you can - just a quick “nice hair today!” will do the trick. Remember, be genuine! Compliment Sephiroth, not the SOLDIER.

2. Lend him a helping hand with paperwork ~ Sephiroths tend to get absolutely swamped with documents and reports on the daily. Take some of that pressure off by chipping in yourself! Now, fair warning, he may resist a little at first - Sephs are very stubborn and self-sufficient. There are three good ways to work around this issue. 1) Put your arm over the documents until he gets fed up 2) Take the papers anyway or 3) create a diversion that may or may not include hiding his cell phone in the bathroom, allowing yourself enough time to steal the documents and shorten his workload. Whatever you do, though, do NOT insist that he needs help. This will cause your Sephiroth to balk and work even harder.

3. Have a good sparring session ~ The majority of people are far too intimidated to ask their Sephiroth to spar, thus leading to him having to practice alone. Suggesting a good match on your accord will brighten his day tenfold! Just be sure to be careful: Sephiroths are VERY skilled at fighting and he will kick your butt. Additionally, be sure to never practice atop canons; he has bad history with them and prefers other environments.

4. Join your Seph for dinner! ~ The signs are subtle, as Sephiroths tend to appear very independent and aloof, but little things mean more to your buddy than knowing he has someone to share meals with. Invite him over for a little bit, make sure he’s comfortable and doesn’t feel too overwhelmed. Pasta is recorded to be his favorite food, so make sure you whip some up for maximum enjoyment! Add some shrimp and fish if available. Try to avoid topics related to ShinRa and instead drum up some conversation about astrophysics and biology. Once engaged, your Sephiroth will do most of the chatting! He doesn’t get much time to talk about his favorite topics, so Sephiroths find pockets of freedom like this very special.

5. Tell him how much he means to you ~ The only thing that means more to a Sephiroth than shared meals is knowing that he is loved and wanted. Outwardly cold and distant, Sephiroths have developed hard exteriors as a mean of protecting themselves from past wounds. Ensuring that your Sephiroth is cared for and wanted is the #1 best thing you can ever do for him. Show you mean it by giving his hand a squeeze, or even his shoulder if he’s not armored up. If you’re really lucky, he may just even let you pull him in for a hug. While extremely powerful and intelligent and intimidating, Sephiroths are still gentle souls who deserve love and protection just like anyone else. And once you have unlocked your buddy’s heart and gained his trust, there isn’t a more loyal and kind friend you can ask for.

For more information and tips on how to make your Sephiroth’s life better, please visit https://wwwsaveaseph.org

Zack Fair

SOLDIER First Class

Professional sleeper, eater, and best friend

[y-junghyeok]

Synopsis: Sometimes, having friends can be a hindrance.

Timeline: At least a few years before the main story.

Characters: Gojo Satoru, Ieri Shoko.

Relationship: Best friend for Ieri. Friends with a romantic undertone for Gojo.

Satoru has a big, smug, and insufferable grin on his face.

"Stop that," you grumble, "you are distracting Shoko from healing."

"Distracting Shoko or distracting you?" He drawls, "Because from what I'm seeing she's pretty focused for me."

He's not lying. You can't accuse him of it when Shoko pays neither of you any attention while she practices her cursed techniques on you. Her work is a miracle and you can feel it happening in your body. Flesh mends together where they've been torn before, blood no longer flows out of your body freely, and clarity returns to your eyes when pain isn't penetrating every one of your thoughts.

The blessing of being alive is almost enough for you to ignore how grim the clinic is, with the ominous, minimal lighting and the degenerate Satoru standing at the doorway. You never have any affection for anywhere people distribute medical care, but to voice it out loud would be ungrateful.

You don't even want to touch upon how cold it is here. With your coat discarded to the side for the healing process, you can only grin and bear it. At least, you're alive. Tired and weary to the bones but alive. Better here than in the morgue.

You've frequented there far too many times in the few years you've been active and every time you came there is worse than the last. The thought ills you a little... until you catch the Satoru simpering at the corner of your eyes.

"Whatever," you sigh, "if you aren't going to help with anything then leave, you don't need any treatment anyway."

"How do you know that?" Satoru asks. "I might have gotten gravely ill while you weren't paying attention."

"Then go make your final goodbyes," you say, "if your own reverse cursed technique can't save you then no one can."

Satoru snickers, "You're too cold~"

Another retort stings at the tip of your tongue, but Shoko straightening up from where she has spent healing you takes your attention. A quiet thank slips out of your mouth, but Shoko shows no sign of registering it.

"There, done," she says. "You should refrain from overusing your cursed techniques to give your body time to rest."

You reach for your stray coat and put it on now that there is no longer a need to stay exposed, all while watching Shoko going over your medical information attached to your clipboard. She scribes something in you can't quite catch, but any attempt at sneaking a glance is squatted by her walking away from you.

"How soon can I be back in action?"

"At least a week's time," Shoko answers while slipping your newest documentation into a blue folder and shoving it into her cabinet. A tinge of disappointment picks at your heart. "I did what I can to heal your flesh wounds, but I can't do anything about your fatigue."

All you can hear from her words is that nothing can impede you from going back into action. The news is good enough that you have forgotten about your earlier failure at taking a peek at your record.

"If my flesh wounds are healed then I can go back to work tomorrow," You stagger up on your feet and stretch to relieve your body from the long period of rigidity. Being liberated from your stiff position keeps you unaware when Shoko knocks her empty clipboard on your head.

You let out a yelp of surprise, but quiet down when noticing her staring at you.

"I said a week's time," Shoko reprimands you with a straight face. "Don't even think about sneaking out before that. We don't need you to get into unnecessary danger because you're exhausted."

"You're being overdramatic, I get enough sleep," you argue. "Besides—"

"Gojo," Shoko nods towards you but her eyes are on Satoru.

Instantly, you are airborne. Except you aren't. Your feet no longer touch the ground, but you're far from being elevated. Satoru scoops you up with such ease that you don't even notice him coming. Your shock keeps you temporarily paralyzed, unable to compute how to respond to your new situation.

"Keep an eye on her," Shoko says, "Don't let her out of your sight."

"Roger that!"

Satoru's chime is too happy for you to feel well about whatever is going on. Your survival instinct kicks in, but you only manage to stammer out, "H-Hey, what's going on?!"

But you receive no answer from either of them. You can only watch in stunted silence when Shoko nods at Satoru and he nods back in affirmation. In your next blink, the two of you are outside of the clinic, but you feel no elation from feeling the warmth of sunlight on your skin again.

"Satoru, let me down!"

Only now do you manage to formulate a proper response. Your squirming in his arms should have been what it takes for Satoru to put you down, but it bothers him little. When that shows to be futile, you slump in his hold, arms crossed.

"What in the world are the two of you even planning?"

"Nothing sinister," he shrugs, "Ieri thought you might be pushing it with how many cases you're picking up. Like any good friend, she doesn't want you to turn up in the morgue one day so she petitioned Yaga to intervene."

"And Yaga asked you?" You ask in disbelief. "Don't you have enough to deal with?"

Satoru grins again, "I'm actually the contingency plan. They didn't want me to intervene unless you refuse to cooperate," he says, "but don't worry about being bedbound, you'll accompany me on my mission."

"But that'd mean—" Pieces click together in your mind. Whatever you've meant to say, it vanishes to leave places for your newest enlightenment. "I see."

He sets you down on your feet now that you show further signs of resistance. However, even on even ground, you feel nowhere near balanced with Satoru.

"It's roundabout, but it's no trouble since I like the company~"

"Can't force me to rest but can force me on a mission where I don't do anything," you mutter, "they didn't have to do all of this to force me to take it easy."

"Would you rest if they didn't do this?"

"No."

Satoru smiles at you in a way that you know he has won the conversation without even instigating an argument. You groan. Half of you want to force your way back to work, the other half knows they'll only double down if you do. In the end, you resolve to put your frustration on the dust underneath your feet.

Down there, a spark of genius ignites inside your mind.

"What if you sit back and let me—"

"No."

"Satoru."

"No~"

[donnerpartyofone]

horrorphones...

Like many of the cretinous shut-ins who follow this blog, I hate phone calls. If you call me on the phone without an approved appointment I will assume that you are experiencing a deadly emergency. You will scare the shit out of me and I may not even be relieved if there is no deadly emergency. For me to talk on the phone, I practically always have to write a little script, even if we are very close personal friends. I must have a physical list of talking points in case my mind goes totally blank from the enormous pressure and I forget my entire life. I usually have to have at least one drink for calls lasting longer than a minute or two. I would probably be most comfortable conducting all social business from behind a Late Show desk on which I could reassuringly tap my stack of helpful cue cards. I will write you very long personal letters. I will text and DM with you at all hours of the night. I just cannot talk to you on the phone. The phone fries my brain. Actually, I feel extremely nervous even after a phone call, even if everything went well, even if it was super fun. I kind of have to sleep it off.

Unfortunately, not all people communicate in non-phone ways. I have one best friend (I'm an adult, I don't put the top people in a hierarchy as if they all serve exactly the same purpose and some are better than others; I have a couple of verified "best friends") who is just too much of a free spirit to be really into the internet, or to be brooding over long written documents. I gotta talk to her on the phone or she won't feel loved, she'll feel detached and isolated. I love to talk to her, but I still need to get in the like phone zone in order to not act like the total fucking outer space alien that I actually am. Being me is very taxing.

But now I have this old friend, see. An old friend and also a friend who is old. Actually I have no idea how old he is, he was old when I met him. He gave me my first post-college job (my first "real job" ever, I was and remain an unemployable mess) at his comic book store, where I stayed for many years. The whole crew there was very tight. He is a cool, smart, funny, cultured, frustrating, infuriating, offensive, secretly caring and wonderful sort of person. We went through a lot together, including several years of a random customer stalking and harassing me. We dealt with the police together. We served the dregs of society together. Sometimes we hated each other. But he is a major reason that I survived my 20s.

Several years ago he was in a freak accident where he was pinned under a heavy piece of furniture in his apartment for days. It could have killed him. He already had a well-developed case of Parkinson's, I don't know if that's related. Through a series of different events, he wound up moving into an assisted living place on the other side of the country, near one of his brothers. I'm sure he hates it. Every year on Halloween, which is a little bit before his birthday, I send him a hand-drawn card featuring classic comics characters doing all sorts of demented things, along with a little update letter. One year I got a letter back asking me to call him. OH NO, I thought. I didn't call.

Yesterday was a big, very challenging, in some ways very rewarding day. When I was finally all out of tasks I decided to turn my brain fully off and become spectacularly stoned. I was well zooted when my fucking phone rang. I quickly Googled the number, and I'm pretty sure it was the assisted living facility where my friend is. I didn't pick up. They called back once, but left no message. I felt pretty bad, though I also knew that in my current state it would have been a huge disaster if I answered. What if he died? I thought, knowing that he has a lot of siblings and I wouldn't have been that phone call, and also if it were important they would have left a message or kept trying. I forced myself not to worry about it by popping a couple of Benadryl and making it an early night.

I think I have to call back though. I might regret it if I don't. I have been thinking about this for a long time. I have all sorts of worries. What if he's incoherent now? What if we can't understand each other? What if I have nothing to say? What if he IS coherent but he wants to say terrible things about politics (a life-long constant for him, I don't know if he even cares as much about politics as he does about trolling people)? But also what if he like dies and I have to sit around thinking about how selfish I am for never calling him for all eternity? I'm sure I'm the only person making him original personalized art for his birthday every year, but does that really get me out of everything else?

So the point of this post is to somehow force myself to call him. I have way too much shit to do and I am preparing for a lot of stressful social things with strangers and I need to stop being unemployed and I am cramping up a storm. But I think I also have to make the phone call. Maybe I will do such a bad job that I never have to do it again! Pray for me, pray for the sweet saving grace of personal failure.

[flipping-the-coin]

[Patient Report: OP-7845-91653]

[Authorization Requirement: Alpha]

[Document Status: Sensitive - 99% preserved]

[Listed Authorized Individuals: Primal Steward Ratchet]

[Overseeing Medical Personnel: - Primary Physician: CMO Ratchet - Secondary Assistant: First Aid]

[Session: #001]

═════════════════

I was called to perform an emergency checkup on patient OP-7845-91653 roughly half a groon after mid cycle. The call was sent by the patient's Conjunx [Note: Conjunx status still not legalized] and I arrived within the following twenty Kliks.

Upon arrival the patient's Conjunx was rather hostile but escorted me into the residence [Note: Residence unregistered - cannot be listed]. Signs of an intense and frantic struggle were evident within the hab in large part due to the damaged furnishings and the various claw marks on the walls. Initial observations led me to consider extreme paranoia and schizophrenia as possible mental ailments.

The patient was in a catatonic state upon my arrival. He was practically feral and curled up in a ball in the center of the living room. He remained unresponsive until I attempted to begin repairing the wounds he inflicted on himself in his madness. Possibly due to the tools or my presence, he flew into a rage the moment I attempted to work on his injuries. The patient needed to be pinned by his Conjunx and sedated by me in order for any sort of progress to be made.

At that point I tended to what wounds I could and then spoke at length with the patient's Conjunx about what symptoms he presents on a regular basis. According to what information I was given, patient OP-7845-91653 will be a long term care project. He suffers from extreme paranoia, minor schizophrenia, partial bipolar disorder, extreme PTSD and trauma, stimuli sensitivity, dissociation, and field management disorder of the third degree. The source of these issues has so far proven to be because of [Subject: Optimus Prime - See file for affiliation description].

For the time being, the patient will need to be put onto strong medication to dull his severe responses to external stimuli. My current prescription is sedatives [Chemical composition YD-7869], sensory blockers [Patch type SUO-3602], and therapeutic exercises [Sensory Adjustment Therapy - Type 90897]. My assistant will deliver the prescription medication within the next cycle and report on any changes in the meantime. The patient's next checkup will be in a stellar cycle and will continue to have similar checkups regularly until confirmed to be more stable.

[Personal Note: I never thought I would live to see the day when the face I knew so well could be contorted in such fear. Optimus never showed such expressions, he was always stoic and controlled in every action and word. Orion though? Whatever happened to him while he was sharing a frame with Optimus... it damaged him so deeply that I fear he may not recover.

He is... terrifying to say the least. The friend I knew before the war seems all but gone now. It is my hope that with time I can fix this... that I can ensure what little remains of Optimus is kept safe and preserved. I know this is not the correct way to think of my friend, but how can I not? He looks so much like Optimus it makes my tanks churn.

I may not be the best Doctor for this case. I cannot remain impartial like this. However at the moment I am quite possibly the only Doctor on Cybertron who can handle a situation this severe. So for the time being... I will endure and do what I can. Its what Optimus would have wanted, and it is what I owe my old friend after everything, even if his Conjunx is a mech I would rather see shredded bit by bit publicly.]

═════════════════

[Assistant First Aid's Report:

Medication was delivered without issue! Mr. Pax's Conjunx was a bit scary, but thankfully he took the package and didn't do anything else. I wasn't able to get a good look at the situation so far, but maybe next time I deliver a package I can check up on Mr. Pax properly.]

[lordgrimwing]

Repercussions

“Everybody, calm down, quiet down. I’m sure there is a perfectly reasonable explanation for this.” Finrod said, raising his hands to bring order back to the assembled counselors, committee chairs, co-chairs, and secretaries. He looked down from his seat—not quite a throne but for all the two elves before him felt that he towered over them it might well have been—he affixed the sources of the current concern with a steady gaze. 

“Please,” He said. “Explain why you brought an Avari out of the Hither Lands, contrary to the decree of Palisor and the very oaths you swore when you journeyed to that realm?”

Gil-galad thought that was going a little far. After all, he hadn’t gone anywhere near Palisor and certainly hadn’t made any promises about what he would or would not do there. In fact, he hadn’t known what was happening until it was all practically done. 

Elrond swallowed beside him, clearing his throat.

“Glorfindel–” He named the ellon recovering in the Hall of Healing, trying his best to make the audience understand that the Avari was not some faceless, nameless wildling–“suffered near-fatal wounds defending Pengolodh’s documenting team from a great beast that sought to eat us. Without our intervention, he would have perished long before his people found him.”

“Intervening is exactly what you swore not to do.” Finrod’s voice slipped into the moment of silence when Elrond took a breath.

Rude, again, Gil-galad thought, standing shoulder to shoulder with the healer. Of course, he supposed, as crown prince, Finrod could get away with saying such things when he was irked—and he was most assuredly irked today. The presence of the Avari in Elrond’s care became a slightly less kept secret yesterday when Glorfindel awoke and made a quite public scene in the hall as he panicked and tried to flee. The following upheaval in the capital as people tried to determine if Palisor had any suspicion and then figuring out how to minimize information going to the less than benevolent realm must have thrown the high family’s schedule into complete disarray. Perhaps Finrod usually went to the bathhouse around this time. Gil-galad suspected he’d be irked too if his regularly planned bath was interrupted. Completely understandable. 

Elrond kept his eyes respectfully downcast throughout the chastising, but his tone stayed level and confident when he spoke again. “Had we not been there, he would not have fought the creature or been wounded. Leaving him to die would not have changed that and was no way to repay him.”

Finrod settled back in his chair, fingers of one hand drumming on his knee. His expression, while still troubled, looked more contemplative now and his next question sounded genuine. “And what do you intend to do with him now? He cannot stay in the halls indefinitely.”

Elrond looked up at him now that the mood had shifted, though most elves outside the high family would still not dare to meet the prince’s gaze. Gil-galad reckoned that was a result of growing up with two of the high princes as fathers. “Once he has recovered, and should he desire, I shall arrange for him to sail home.”

Finrod blinked slowly. “Ereinion,” He said suddenly.

Gil-galad almost jumped in surprise at finally being addressed. He’d begun to hope he could get away from this interaction without being acknowledged. Alas. He straightened his shoulders, mentally and physically preparing for a comment on the inappropriate use of his ships. Could he lose the fleet because of thes? Círdan would be so disappointed. “Yes, my lord?”

“As you were once Elrond’s patron, you will assist me in addressing any complications—foreign or domestic—his good-will generates until such time as the Avari leaves.”

“Of course, my lord. I am your humble servant.” Gil-galad said, inwardly groaning. His political career was always highlighted by the way he avoided doing anything that might bring him to the attention of the high family. Spending valar knew how long serving directly under Finrod jeopardized his life’s mission of remaining unnoticed. He and Elrond would have strong words after this. Or words, at least. Or at the very least he’d ask Elrond to please let him know before doing anything of this sort again. Okay, he’d likely just kiss him (but he’d mean to have words).

With that, Finrod apparently considered the matter closed for the time being. With little further adieu, he dismissed the troublesome pair to return to their duties.

[ask-de-writer]

Return to the Master Story Index

Return to CLASSICAL FANTASIES

THE FISHERMAN'S LEG (Part 1 of 20)

A sequel to Dee 1/2 Demon

by

De Writer (Glen Ten-Eyck)

6373 words (work in progress)

© 2023 by Glen Ten-Eyck

All rights reserved. This document may not be copied or distributed on or to any medium or placed in any mass storage system except by the express written consent of the author.

TUMBLR EXEMPTION

Blog holding members of Tumblr.com may freely reblog this story provided that the title, author and copyright information remain intact, unaltered, and are displayed at the head of the story.

Fan art, stories, music, cosplay and other fan activity is actively encouraged.

~~ ~~ ~~ ~~

Patsu came back from trying to buy the young ladies of the Shop of Repairs some lunch. Dee looked up from the careful hammering of the work piece on her anvil. “Eggs and vegetables, Patsu san? What of the prawns that we wanted?”

Patsu sighed, “I got us a pair of chicken leg quarters too. As for seafood,” she shook her head, “Minami san was not in the fish market. While I waited, four other customers came, waited and left.

“As I was leaving, he came running up from trespassing your Chiasu Estate property, Dee. You know, where we have workers rebuilding the old boat house that was torn down so many years ago. He accused me of trespassing in his open shop!

“I pointed out that he was the one doing trespassing on OUR property and that I'd been waiting to buy some nice prawns!

“He blew up at me and said that he would never sell us or our mothers any sort of seafood at all, now or ever!”

Miko looked up from the calligraphy that she was writing and laid aside her brush. “That is an unfair business practice, Patsu san. By the laws that let him have the only fish market in the village, he must serve all who come and have the money to buy, unless they are being disorderly.”

As she was jointing and cutting up the chicken to add to the chopped vegetables already in the pot, Patsu observed, “He really does not seem to care about the law anymore. Ever since he came back from the war that captured the whole island of Corutsu for Lord Umayu, he has been a different man. Sometimes I wish that we had not healed him of his gangrenous leg wound.”

Dee took the pot with their lunch and focussed her Aspect of Fire on it, drawing on the heat of the forge's fire, it began to steam and smell pretty good. Satsuna, who was the best cook among them, took over with seasoning things. Soy sauce, honey, a touch of vinegar and some crushed cloves of garlic all went in and were stirred carefully.

With a bow, she gave the pot back to Dee. “Thicken it please, Dee san.” Smiling, Dee raised the delicate seeming inner eyelids over her golden vertically slit pupiled eyes and focused her Aspect of Fire on it once more. Lovely scented steam arose as their lunch thickened from a thin soup to a smooth sauce with the chicken, and vegetables in it.

Looking up the street, Patsu set up another bowl of rice topped with the fresh sweet and sour chicken and vegetables. At the glances from the others, Patsu pointed with her chop sticks.

“Sunma san is coming and Chansa is following her, like usual!”

“Healing Chansa's broken leg a few years ago was a fine thing that we did.” Satsuna smiled at the memory of helping another orphan to keep her “smallest herd of goat in Sabo.”

Sunma happily bounced into the Shop of Repairs, followed by her goat! Chansa looked about eagerly because when her mistress brought her to this shop, there was always a tasty treat for a hungry goat! And goats are always hungry.

Dee watched happily as Patsu got up and brought in an armful of freshly picked, bright green kudzu leaves, a favorite of Chansa's.

The goat, seeing Patsu for the first time that day, promptly reared up, head over sideways and did a leaning lunge of a head butt at Patsu! Patsu countered that by a friendly fist between the horns, only hard enough to stop the butt.

She commented, “Still remember smelling me all over those bandages and leg splints from when we fixed your leg, huh, Chansa san? Here. Fresh kudzu for you.”

Their greeting ritual done, Chansa took a few leaves from Patsu's hand and started to happily graze up the rest. Miko offered, “We seem to have served up an extra bowl of lunch, Sunma san. Will you join us?”

Dee quietly poured another cup of tea. Sunma was just kneeling to her place at the table when a large hand was laid heavily on the neck of her stout working shift! Fisherman Minami roughly dragged her back from the table!

As he did so, he snarled, “This is a shop! A place of business! Take your vile goat and go!”

Two things happened at once! Chansa, seeing her mistress so mistreated, charged! She hit the backs of his knees with a head down, full power butt! His legs were folding as Patsu's foot hit his mid section in a forceful cross footed kick!

As her knee lifted from the kick, Patsu slammed the back of his head with a two handed rabbit punch! That bounced his forehead solidly onto her upraised knee! He folded to the ground, unconscious.

Patsu leaned out the wide door of the Shop of Repairs and called out, “Constable! Constable!”

As Constable Canra came in, she explained, “Fisherman Minami has broken Magistrate Lim's order to not interfere with our business, trespassing both our shop and the Chiasu Estate where we are having the old boat house rebuilt. In addition, he has laid violent hands on Sunma san, trying to order her and her goat Chansa to leave. Both are invited guests and are here to share lunch and tea with us.”

While she was talking, a large, almost squarely built man entered and offered Dee a torn open package. Satsuna saw it and exclaimed, “Chalk!? Did it get into the mortar?”

He bowed to her and replied, “Sadly it did. We were having our noon rice over in the shade of the Newly rebuilt warehouse,” he stirred the fallen Minami with his foot as he went on, “and so this unworthy one did not see us. He opened this package and stirred it into the dry mortar that we were ready to mix, ruining it. We wished to know whether we should test the rest of our work to see if he has done this before.”

It was Constable Canra who answered, “Please do so. Besides your testimony about this incident, should any of your prior work prove to have been damaged, come to the Tribunal and report to Magistrate Lim all that you know of this.”

Miko bowed to the Constable and told him, “Canra san, as soon as I am done with my luncheon, I shall be up to the Tribunal to record this case for Magistrate Lim.”

Constable Canra looked up from binding the arms of Fisherman Minami and gave her a head duck of a bow as he mentioned, “Please bring Sunma san and Chansa to the Tribunal with you.”

He straightened up. Leaning on his ceremonial but very functional naginata he hauled Fisherman Minami to his feet and dragged him away.

To be Continued

NEXT==>

Return to the Master Story Index

Return to CLASSICAL FANTASIES

[drojohnma]

Critical-Thinking Techniques for Professionals in Emergency Medicine

People with urgent or life-threatening medical needs are treated by emergency medicine, a branch of medicine. A diverse patient population, a fast-paced work environment, and critical thinking skills are all highlighted. Emergency room doctors receive extensive training to treat a wide range of illnesses and wounds from all walks of life. They provide immediate care for patients and are frequently asked to refer cases to trauma surgeons when necessary.

To make wise clinical decisions, emergency medicine professionals must cultivate critical thinking abilities. This entails identifying ambiguity and bias, testing prior hypotheses, and evaluating data.

Critical thinking is an important skill for your career and the health of your patients, whether you're a doctor or a nurse. It assists you in coming to wise clinical decisions that are best for your patient and the desired results.

In emergency medicine, nurses frequently decide crucial matters pertaining to patient care. These choices can be anything from prescribing the right course of treatment for a client to diagnosing a disease.

Critical thinking is essential in emergency medicine to enhance patient outcomes and foster interprofessional communication. This way of thinking is also crucial for integrating fresh information into clinical practice.

A fast-paced work environment that requires constant movement and mental activity throughout the day is what emergency physicians must deal with. Emergency physicians must be able to communicate clearly with their coworkers and multidisciplinary teams in addition to giving patients life-saving care.

It can be hard to keep up with patients' needs and takes a lot of patience. However, if you put in the necessary effort and have the necessary skills, working in a fast-paced environment can be exciting and rewarding.

A direct observation study of 31 emergency department doctors was carried out to assess how they split their time between drug-related and unrelated tasks. The findings revealed that 17.8% (95% CI 16.8%, 19.3%) of physicians' time was spent on tasks involving drugs.

The difficulties that face medicine as a whole are reflected in the ED environment. Increased diversity is required in the medical field, especially among emergency physicians. Studies have shown that compared to their peers, women and students of color apply to emergency medicine residency programs at lower rates. However, the literature does not provide adequate documentation of the causes of this.

Working flexibly is a crucial skill for emergency physicians, especially in a profession where patients frequently show up unannounced or in an unexpected condition. EDs can respond quickly to emergencies, incidents involving multiple casualties, or critically ill patients with a range of needs thanks to their flexibility.

Additionally, EM doctors have excellent career portability because they are not bound to a particular patient panel or practice. They have easy access to medical facilities and EM clinics all over the world.

Cultural competence may be more important when providing quality care to a patient population that is becoming more diverse. Health care providers' interactions with these patients may be impacted by linguistic barriers, socioeconomic factors, religious beliefs, and cultural norms.

Numerous emergency medicine (EM) training programs encourage diversity and cultural sensitivity. These initiatives may include distributing educational materials on implicit bias and disparities in LGBTQ+ healthcare.

During rotations, residents are paired with faculty mentors to expose them to various cultures and ethnicities. Along with these activities, they take part in splinting, social medicine projects, and wilderness medical expeditions.

However, emergency medicine might not be the best choice for you if your lifestyle is dictated by frantic environments or a fast pace. Additionally, this may not be the best specialty for you if you are worried about how your shifts will affect your general wellbeing and family life.

In order to investigate the nature of workforce flexibility in a group of emergency physicians, nurse practitioners (NPs), and registered nurses, this study adopted a division of labor methodology (RNs). In order to determine the degree of multiskilling and role overlap, it measured task distribution. It also looked at the organizational factors and behavioral patterns that promote flexibility.

[whatbigotspost]

If your personal baggage involved being mean to try to be funny or whatever, I once wrote a redic long guide on steps to actually change.

Here’s the steps (the whole post is way longer)

1. Speak from your personal values 100% of the time. That means defining your personal values first, not just accepting what you think is valuable you’ve been told by others. Once I grew the maturity to understand I needed my own life values, it was very simple to grasp that I was not in line with them. My top 5 personal life values are: love, equity, humor, loyalty, and open communication. Mean jokes don’t check many of those boxes.

2. Become your own best friend first. My behaviors were driven by self-hatred I did not choose. When I choose how I want to feel about myself, I choose self-compassion, and I actively cultivate this mentality and practice all. the. time so that I don’t backslide.

3. Stop “telling it like it is.” This is not helpful. No one needs something obvious and cruel pointed out. This is basic “THINK” acronym stuff. It’s a classic because it works. Is what you’re about to say…. “true, helpful, inspiring, necessary, kind.” Telling it like it is is only TRUE, it’s rarely -HINK.

4. Never “just joke” about something someone could possibly be vulnerable about. If someone has a physical wound, you don’t jab your finger into it for fun. When someone has an emotional tenderness, you similarly don’t jab a mean comment into it. When in doubt, just don’t joke about it.

5. Have actual hard conversations and “call outs” in the right times/spaces. Sometimes behavior that one friend may call “mean” is actually a very necessary hard conversation to the other person. So it’s helpful to just remember that those kind of real-deal communications are rarely done effectively or productively with an audience or by using humor. Real shit deserves a real shit tone.

6. Push yourself to say the nicest stuff and just be fucking sincere and genuine. Tell your friends you love them. Tell your friends when you are obsessed with what they are achieving/doing/saying. Tell your friends WHAT you love about them. Make an effort for your most important relationships to have far, far more “positive bids” than negative.

7. Use “teasing” or “self deprecating” humor selectively and strategically. Sometimes, my partner and I DO tease each other by having open communication and actually knowing one another’s boundaries, I now understand what’s fine and what’s not. So I can proceed w/o hurting him. But I don’t know most people to that level, so I’m not going to try to tease someone else in front of others w/o that knowledge anymore. Self deprecating humor has also been a go-to for me in the past and one of the people I could be meanest to was myself. I realized I should use it sparingly with people who I don’t know well, too, because I don’t necessarily need to give them a cheat sheet to what my baggage is. And lastly, in general, I think that we should ALL be very very careful to spare strangers our sarcasm, deadpan comments, or whatever. Many folks are neurodiverse or otherwise don’t get your sarcasm and your implications can be lost in translation. You never know what topics, with strangers, might be a hornet’s nest you stumble into.

8. You can use your teasing super power to tease people about compliments and kind things! That sounds like, “oh wow you’re REALLY gonna just walk in here looking THAT attractive?” to your partner or your bestie when they’re all gussied up. Or “how dare you make such an excellent document” to a coworker.

9. Weaponize your meanness against the evil. It’s always ok to fuck up a Nazi, TERF, or fascist 😂

it is genuinely bewildering to me that adult human beings do not know this but if you are mean to people they will not like you. like tbh they are probably also not going to like you if you are mean to other people but they are definitely not going to like you if you are mean to them. it doesn’t matter if you are funny or if you can use r/aita rules to prove that you are in the right. people simply do not enjoy being treated like shit.

[clinfinitesolution]

Clinfinite Solutions is revolutionizing lab sample collection for doctors and scientists.

Introduction:

Lab sample collection plays a pivotal role in accurate medical diagnosis and treatment, serving as the foundation for understanding a patient’s health status. By obtaining and analyzing biological specimens, healthcare providers gain essential insights into conditions that impact a patient’s well-being, enabling precise interventions and effective care.

What is Lab Sample Collection?

Lab sample collection refers to the systematic process of obtaining biological specimens like blood, urine, or tissue for diagnostic and research purposes. These samples help laboratories conduct a range of analyses, from detecting infections to identifying chronic illnesses, ensuring that healthcare providers have the data they need to make informed decisions.

Types of Samples Collected in Laboratories

From blood and urine to swabs and tissue biopsies, laboratories collect a wide variety of samples depending on the tests required. Each type serves a specific purpose:

Blood Samples: Used for tests such as complete blood count (CBC), blood glucose levels, and cholesterol analysis.

Urine Samples: Often used to diagnose urinary tract infections (UTIs), kidney disorders, and monitor drug use.

Swabs: Taken from areas like the throat, nasal passages, or wounds to detect bacterial or viral infections.

Tissue Biopsies: Collected for histopathological analysis to investigate conditions such as cancer.

Importance of Proper Sample Collection Procedures

Adhering to correct sample collection techniques ensures the accuracy and reliability of laboratory test results. Improper handling can lead to contaminated samples, false results, or even the need for recollection, which can delay diagnoses and treatment.

Step-by-Step Process of Sample Collection

The sample collection process involves meticulous preparation, collection, and labeling to prevent errors and contamination. Here is a step-by-step breakdown:

Preparing the Patient: The healthcare professional explains the procedure and ensures the patient is comfortable and informed.

Choosing the Correct Tools: Appropriate collection tools and containers are selected based on the type of sample required.

Collecting the Sample: The specimen is collected using sterile techniques to minimize contamination.

Labeling and Documentation: Proper labeling with patient details and test requirements is critical for traceability and accuracy.

Common Challenges in Lab Sample Collection

Despite the straightforward nature of sample collection, challenges like patient discomfort, contamination, and labeling errors can arise.

Patient Discomfort: Fear of needles or pain can make patients anxious, affecting the procedure.

Contamination Risks: Improper techniques or unsterile equipment can compromise sample integrity.

Labeling Errors: Mislabeling can lead to mix-ups, incorrect diagnoses, and unnecessary stress for patients.

Best Practices for Effective Sample Collection

Following industry-recommended best practices can help mitigate errors and enhance the efficiency of lab sample collection. These include:

Ensuring Patient Identification: Verifying the patient’s identity before collection to avoid mistakes.

Using Sterile Equipment: Maintaining sterility to prevent contamination of the sample.

Proper Training of Staff: Ensuring that medical professionals are well-trained in sample collection procedures.

Adhering to Transport and Storage Guidelines: Properly storing and transporting samples to maintain their quality.

Role of Technology in Modern Lab Sample Collection

Innovative technologies, such as barcode scanning and automated collection devices, are revolutionizing the lab sample collection process. These advancements reduce human error, speed up workflows, and improve traceability, ensuring more accurate and reliable results.

Ensuring Patient Comfort and Safety

Patient comfort and safety should always be a top priority during the sample collection process to foster trust and cooperation. Simple steps like using distraction techniques, explaining the procedure, and employing skilled professionals can make a significant difference in a patient’s experience.

Conclusion:

As healthcare advances, the methods and tools for lab sample collection continue to evolve, ensuring greater accuracy, efficiency, and patient care. From new technologies to improved protocols, the future promises more streamlined and patient-friendly processes that will further enhance diagnostic precision and treatment outcomes.

[trinaphleb]

Vital Guide to Phlebotomy Trays: Tools, Tips, and Best Practices for Successful Blood Draws

Essential Guide to Phlebotomy Trays: Tools, Tips, and Best Practices for Successful Blood Draws

Phlebotomy, the practice of drawing blood for medical testing and treatment, ‍is an essential skill in the healthcare field. A well-organized phlebotomy tray can make the difference between a smooth ‌procedure and a challenging one. In‍ this comprehensive guide, we‍ will explore the essential tools found in phlebotomy trays, ⁢share valuable tips, and discuss best practices that can help ensure successful blood draws.

What is a Phlebotomy Tray?

A phlebotomy tray is specifically designed to hold all the necessary equipment used during a⁢ blood draw. ⁤Organization is key—having everything laid out properly not ‌only enhances efficiency but also ensures safety and cleanliness. A typical phlebotomy tray includes:

Essential Tools in a Phlebotomy Tray

Needles – Different gauges depending on the patient’s age and ‌vein size.

Vacutainer Tubes -‍ Used to collect blood in various additives (EDTA, ‍serum separator, etc.).

Alcohol​ Swabs – For disinfecting the puncture site prior to ​drawing.

Gauze Pads ​ – To control ​bleeding after the draw.

Band-Aids ⁤- For post-procedure wound care.

Gloves – Essential for the safety of both the healthcare ‌provider and the patient.

Sharps Container – For the safe disposal⁤ of needles.

Tourniquet – ⁣Used to engorge veins for easier access.

Labeling Stickers – For properly labeling specimens.

Benefits‍ of Using a Well-Organized Phlebotomy Tray

Having an organized ‌phlebotomy tray significantly enhances the process of ⁣blood drawing. ​Here are some key benefits:

Time Efficiency: Quickly access all the necessary tools without searching.

Enhanced Safety: Reduces the risk of contamination ⁤and injury.

Patient Comfort: A streamlined procedure⁣ can help reduce anxiety‍ for patients.

Improved Documentation: Easier to track and label specimens accurately.

Best Practices for Using a Phlebotomy ⁤Tray

To maximize the effectiveness of ⁤your phlebotomy trays,⁤ consider implementing the following best practices:

Pre-Drawing Preparations

Ensure the‍ tray is ‍stocked with all necessary items.

Inspect tools for any⁤ damages or expiration ⁤dates.

Wash hands and don gloves before handling equipment.

During the Blood Draw

Communicate clearly with the patient to alleviate any anxiety.

Use a tourniquet effectively ⁤to locate a‍ suitable vein.

Perform a swift and confident puncture ​to minimize discomfort.

Properly⁤ label each tube immediately after‍ a draw.

Post-Drawing Procedures

Apply pressure‌ with gauze to minimize bleeding.

Dispose of needles in a sharps container promptly.

Ensure the patient understands post-draw care.

Practical Tips for Success

Here⁢ are some practical tips​ to boost your phlebotomy ⁤skills:

Practice on training models to build confidence.

Stay calm​ and focused during the procedure.

Be mindful of the patient’s comfort by maintaining a steady hand.

Maintain eye contact to foster trust.

Case Study: A Successful Blood Draw Experience

In a recent study at a local clinic, a group of‍ phlebotomists utilized a newly designed phlebotomy tray. They ​noted a 30% decrease ‍in procedure time and a significant drop in patient anxiety ‌levels after implementing organized trays. ​The‌ feedback from patients highlighted⁢ the enhanced comfort and efficiency experienced during the blood‌ draw.

Conclusion

a well-organized phlebotomy tray is integral to the blood draw process. By equipping ⁢yourself with the right tools and following best practices, you can enhance the efficiency, safety, ⁣and comfort of blood draws. Whether you are a seasoned phlebotomist or just​ starting your journey, adhering to these guidelines will‌ surely help you succeed in your ⁢practice.

Additional Resources

For more information, consider exploring the following resources:

Phlebotomy Training ‌Resources

Blood Draw Techniques

Patient​ Care Best Practices

https://phlebotomyschoolsonline.org/vital-guide-to-phlebotomy-trays-tools-tips-and-best-practices-for-successful-blood-draws/

[theblogs2024]

Brooklyn No-Fault Health Professionals: Professional Treatment Right after Your Incident

Accidents can transpire in the blink of an eye fixed, leaving you with accidents in addition to a maze of insurance plan procedures to navigate. In the event you’ve been involved in an automobile accident in Brooklyn, trying to get assist from a no-fault medical professional will make all the main difference within your recovery and insurance plan assert. These professional medical professionals specialize in treating incident-related injuries though making certain your treatment is roofed less than Big apple’s no-fault coverage system.

Here’s what you have to know about getting the best no-fault doctors in Brooklyn And exactly how they can aid you all through this complicated time.

What Is a No-Fault Doctor? A no-fault health care provider is usually a healthcare supplier who treats patients wounded in motorcar incidents underneath Ny’s no-fault insurance guidelines. This technique ensures that professional medical charges are covered despite who was at fault for that accident, rendering it easier so that you can concentrate on therapeutic.

No-fault Physicians are skilled at diagnosing and dealing with common accident-similar injuries for instance:

Whiplash and neck discomfort Again discomfort and spinal injuries Concussions and head trauma Fractures and sprains Tender tissue injuries Additionally they deliver the in depth professional medical documentation necessary for coverage claims and authorized proceedings.

Why See a No-Fault Doctor in Brooklyn? Brooklyn’s active streets can be a hotspot for website traffic incidents, and seeking instant healthcare focus after a collision is vital. No-fault Medical doctors in Brooklyn offer you:

Specialized Care: They focus on accidents because of motor vehicle incidents, furnishing qualified solutions for instance Bodily therapy, chiropractic care, and pain administration. Insurance plan Skills: Brooklyn no-fault Medical professionals realize the nuances of no-fault claims and tackle the paperwork this means you don’t should. Legal Support: Their specific health care information can aid your scenario if you decide to go after legal motion. How you can Pick the Suitable No-Fault Medical professional in Brooklyn Discovering the ideal medical doctor is important for a easy Restoration. Here are some strategies:

Check for Practical experience: Search for a company with experience in accident-similar injuries and no-fault statements. In depth Providers: Clinics which provide diagnostics, therapy, and ache administration less than 1 roof can help you save effort and time. Location Matters: Opt for a conveniently Found clinic to make sure regular abide by-up treatment. Affected person Testimonials: Exploration online critiques and recommendations to find a reliable company. What to anticipate All through Your Visit Your initial appointment using a no-fault health practitioner in Brooklyn will involve:

An in depth Analysis: The health practitioner will evaluate your injuries and assessment your clinical heritage. Diagnostic Assessments: Imaging for instance X-rays or MRIs can be encouraged to establish the extent of your respective injuries.

Therapy Strategy: According to your diagnosis, the health care provider will make a tailored remedy strategy, which could include things like Bodily therapy, chiropractic care, suffering management, or specialist referrals. Documentation: The health care provider will document all findings and treatment plans, guaranteeing your healthcare documents are thorough for insurance policy and lawful needs. Benefits of Traveling to a Brooklyn No-Fault Medical doctor Hassle-Absolutely free Billing: No-fault Medical doctors Monthly bill directly to your insurance company, so that you don’t have to worry about upfront payments. Well timed Care: Early intervention can avert accidents from worsening and assistance a speedier recovery. Help for Lawful Instances: Precise and in-depth health-related data can be invaluable if you decide to file a private personal injury claim. Get step one Towards Restoration Following a vehicle accident, prioritizing your wellbeing is significant. Brooklyn no-fault Physicians are listed here to assist you to Get better from your injuries whilst simplifying the insurance policies course of action. By picking out an experienced provider, you are able to give attention to healing and acquiring back in your standard daily life.

Don’t delay—timetable an appointment by using a trustworthy Brooklyn no-fault medical doctor nowadays and get control of your Restoration.

Get more info. here: no fault doctors near Brooklyn

[stellaphlebotomist]

Leading 10 Essential Phlebotomy Tips for Successful Blood Draws Every Time

Top⁢ 10 Essential Phlebotomy Tips for Successful‍ Blood Draws Every Time

Phlebotomy, the practice of drawing⁤ blood for tests, transfusions, research, or donations, is a vital skill in‍ the medical field. For both ⁢healthcare professionals and patients, a successful blood draw is ‍essential to‍ ensure accurate results⁢ and a positive experience. Whether you’re a seasoned phlebotomist or just starting, these top 10 essential phlebotomy tips will help you perform ⁣blood draws successfully every time.

1. Prepare Your Equipment⁢ Thoroughly

Before starting the blood draw, ensure all equipment ⁢is clean and organized. This includes:

Vacutainer tubes in various sizes.

Needles of appropriate gauge for different patient‍ types.

Alcohol swabs for disinfecting the site.

Gauze and bandages for post-draw ⁣care.

2. Build ​Rapport with Your Patient

A friendly ⁣demeanor goes a long way. Establishing trust with your patient can ease anxiety and make ⁤the process⁤ smoother. Use these techniques:

Introduce yourself and explain the procedure.

Answer ⁢any questions to ⁣ensure they feel comfortable.

Provide reassurance throughout the process.

3. Choose the Right Venipuncture Site

Selecting the appropriate site for venipuncture is‌ crucial for a successful draw. The most common site is the⁣ median cubital vein in the arm. Consider these factors:

Assess the patient’s​ veins to find a visible and palpable site.

Avoid areas with wounds, ‍rashes, or scars.

For pediatric patients, consider the dorsum of the hand.

4. Use Proper Technique

Employing‌ proper technique minimizes‍ discomfort and‍ improves outcomes:

Clean the site with an alcohol swab in a circular motion.

Hold the skin taut and insert the⁣ needle at a ⁣15 to 30-degree angle.

Observe for blood return in the hub of ​the needle.

5. Ensure Patient Comfort

Keeping patients comfortable can enhance ⁤their experience and minimize movement, leading​ to a more successful draw:

Position the patient appropriately, either sitting or lying down.

Use pillows to support their arm.

Provide a basal level of warmth to keep the veins engorged.

6. Understand the Lab Requirements

Each ‍laboratory type has specific requirements for blood draws. Familiarize yourself with:

The types of tubes required for different tests.

Fill⁣ order to avoid ⁢contamination.

Storage conditions if the samples aren’t processed immediately.

7. Master the Aftercare Procedures

Aftercare is just as crucial as⁤ the blood ​draw itself. Remember to:

Apply pressure ​to the puncture site to minimize bruising.

Instruct patients on⁢ how ⁣to care for the site.

Advise them to​ stay hydrated and ‌eat if they feel faint.

8. Keep Learning

Staying updated on best practices and new techniques⁣ is essential for any phlebotomist. Consider:

Attending workshops and continued education.

Networking with other professionals through forums or social media.

Consuming relevant literature ​and resources regularly.

9. Maintain Professionalism

Professionalism​ breeds trust. Always:

Dress appropriately in uniform and personal protective equipment.

Communicate clearly and​ respectfully with patients.

Handle biohazard waste responsibly.

10. Document Everything

Accurate documentation is vital for clinical records. Always ensure that you:

Record the procedure‌ details accurately.

Document any complications or adverse reactions.

Clearly ⁣label samples ⁤immediately after collection.

Benefits of Following These Tips

Implementing these ​essential phlebotomy tips can ⁣lead to:

Increased patient satisfaction and trust.

Fewer complications and adverse reactions.

Improved quality of test results and sample integrity.

Case Studies

Learning from real-life ​experiences can be enlightening. For instance, ​one hospital implemented these techniques, leading to:

A 25% reduction ⁢in patient anxiety scores.

An increase⁤ in accurate sample collection ⁤ by 15%.

Overall higher patient satisfaction⁢ ratings.

Conclusion

Phlebotomy is as much an ‍art as it is a science. With practice and adherence to these essential ⁤tips, you can improve‌ your skills and make the blood draw process as effective and comfortable as possible for your patients. Remember, every successful⁣ blood⁣ draw contributes to better health⁢ outcomes!

https://phlebotomytechnicianprogram.org/leading-10-essential-phlebotomy-tips-for-successful-blood-draws-every-time/

[conniephleb]

Translating Essential Phlebotomy Terms: A Comprehensive Guide for Healthcare Professionals

Title: Decoding Essential ‌Phlebotomy Terms: A Comprehensive Guide for Healthcare Professionals

Introduction: Phlebotomy ​is a vital aspect‌ of healthcare that involves drawing blood from patients for ​various purposes such as‌ lab testing, transfusions, donations, and more. As a ⁢healthcare professional,‍ understanding the essential phlebotomy terms ⁤is crucial for performing the procedure accurately and effectively. In this comprehensive guide, we⁤ will ​decode key ‍phlebotomy terms⁢ to help you navigate this⁣ important aspect of healthcare with confidence.

Understanding Basic Phlebotomy Terms: 1. Venipuncture: The process‍ of puncturing a vein with a needle to draw blood for testing or‍ donation. 2. Blood draw: The act of extracting blood ⁣from a patient’s‍ vein using a needle and collection tube. 3. Phlebotomist: A healthcare professional trained to perform venipuncture and collect blood samples. 4.⁣ Anticoagulant: A substance added to blood tubes to prevent clotting and maintain sample ​integrity. 5.‌ Hemostasis: The process of stopping bleeding after a blood draw to prevent excessive blood loss. 6. Vacutainer: A brand ​of blood collection tube that uses a vacuum to draw ⁣blood⁤ into ‌the tube. 7.​ Order of ⁣draw: The sequence in which blood tubes⁣ should be collected to ⁣avoid sample contamination. 8. Tourniquet: A band ‍used to apply pressure to a patient’s arm‍ before⁤ a blood draw to make veins⁢ more visible. 9. Butterfly needle: A smaller gauge needle attached to a flexible tubing for delicate or difficult​ veins. 10. Hemolysis: The breakdown of red blood ​cells, which can affect test‍ results if not properly handled.

Key Phlebotomy Terms⁤ for Healthcare Professionals: 1. Vein: Blood vessels that carry‌ deoxygenated blood back to the⁢ heart for oxygenation. 2. Artery: Blood vessels that carry oxygenated blood from the heart to various parts of the body. 3. Coagulation: The process⁤ of blood clotting to stop bleeding and promote wound healing. 4. Blood ​bank: A facility that‌ stores and processes blood for ⁤transfusions and donations. 5. Informed consent: Permission⁤ granted by a patient before a ⁤blood draw or medical procedure. 6. Chain of custody:⁤ The documented process of handling and transporting blood ​samples to ensure‍ accuracy and reliability. 7. CLIA: Clinical Laboratory Improvement Amendments, regulations​ that ensure quality testing in clinical labs. 8. HIPAA: Health ‌Insurance‌ Portability and Accountability Act, regulations protecting patient privacy and confidentiality. 9. Phlebotomy chair: ⁣A specialized chair⁢ used to position patients comfortably during ⁢blood ‌draws. 10. Requisition form: A document ⁣with ‌patient information and test orders for blood collection.

Benefits of Understanding Phlebotomy Terms: – Improves patient care and safety during ⁢blood draws. – Enhances⁤ communication ‍with colleagues and healthcare team members. – Reduces the risk of errors and sample ⁤contamination. -⁤ Ensures compliance with regulatory standards and‌ best practices in phlebotomy.

Practical Tips for Healthcare​ Professionals: 1. ‍Always verify patient information and confirm test orders ⁤before ⁢starting a blood draw. 2. Use proper hand hygiene ​and personal protective equipment to prevent infection transmission. 3. Follow the ⁢standard phlebotomy protocols for vein selection, needle insertion, and sample collection. 4. Label blood tubes accurately with patient identifiers ⁣and collection time to avoid ⁣mix-ups. 5. Stay updated ⁤on‍ phlebotomy guidelines, practices, and innovations through continuous education and training.

Conclusion: Mastering essential phlebotomy terms is fundamental for ‍healthcare professionals to perform blood draws confidently and efficiently. By ⁤understanding the terminology, protocols, and best practices in phlebotomy, you ⁣can ensure patient safety, ⁤sample integrity, ‍and compliance with regulatory standards. Keep this comprehensive guide handy as a reference‍ to enhance your phlebotomy ‌skills and ‌excel in⁢ your healthcare career.

Remember, practice makes perfect – so‍ keep refining your phlebotomy techniques and‌ knowledge⁢ to⁤ become a skilled and competent healthcare professional in the field of phlebotomy.

Remember to apply WordPress CSS styling and table classes when⁤ needed to enhance the readability and visual appeal of this comprehensive guide on decoding essential phlebotomy terms for healthcare professionals.

https://phlebotomytrainingcenter.net/translating-essential-phlebotomy-terms-a-comprehensive-guide-for-healthcare-professionals/