#but also never forgot my PPE | Explore Tumblr posts and blogs

hangrypa · 4 years ago

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s/p first year as a PA

I was hired as a hospitalist primarily for the transplant service. However, in the setting of the pandemic and staffing shortages, I am all over the place now and work in almost everything non-pediatric and non-surgical.

In my first few months as a PA, I was incredibly overwhelmed. I went from being a learner who switches specialties every month to a fully-fledged provider making life-or-death decisions on an hourly basis. Oftentimes I’d find myself in the room of a patient actively crumping, surrounded by the patient’s family and multiple nurses awaiting instructions on what to do to save the patient. I thought that I faced a lot of pressure in school, but it was nothing compared to this.

And just when I started to get a hang of it all, the pandemic hit. What a nightmare. As mentioned above, I was hired to work with with transplant patients. Prior to the pandemic, my transplant colleagues and I were masking and gowning for almost every patient: 1 surgical mask and 1 gown per patient and per patient encounter. But once COVID hit, we were rationing PPE. 1 N95, 1 pair of goggles, and 1 face shield for the pandemic. 1 surgical mask per week, and 1 gown only if a patient had Cdiff or a history of MDRO bacteremia.

What did the pandemic mean for our transplant patients?

Our patients are on immunosuppressant medications to prevent transplant rejection. Unfortunately, this makes it difficult for them to fight infections.

Our department did what it could to prevent COVID. We'd test patients on admission for COVID, regardless of symptoms or exposure history. If they were positive, they went to the COVID team and quarantined on their unit for a period of time and had to test negative before returning to our unit and being transplanted. We took many other measures to reduce COVID risk to the best of our ability.

People still died. To see someone get transplanted successfully and then die of a virus is horrifying. Unfortunately, despite our admission tests, sometimes patients contracted COVID within the hospital. Patients would be happily FaceTiming their family one moment, telling them all of their plans for once they were discharged- then the next day they'd be intubated. We tried Remdesivir, Dexamethasone, prone positioning, etc. But the virus moved through them quickly, and these efforts often were too late. No amount of hoping and praying brought them back.

As a first year PA, I learned to go to an empty conference room, close the door, and remove my mask before calling to the family of the deceased. This way, as they gathered around the phone in their homes, the family could hear me unmuffled as I delivered the news. Also, this way my tears didn't ruin my mask for the rest of the week.

I learned a lot this year. It's been a mixture of crying and laughing. There are times that I question why I ever became a PA, and then there are times when this career feels like home. In addition to transplant, I’ve also been working in the ED, IMC, ICU, inpatient hospice, clinic, and infusion center these past 6 months. I’ve learned quite a lot along the way.

Lessons learned as a first year PA:

1. Check your pager hourly: This is in addition to checking it whenever you get paged. Sometimes I’ll get paged while I’m rounding, read it, and then forget about it. Now I go through my pager at every hour to ensure that I already responded to all my pages and then answer ones that I missed/forgot. On a semi-related note, a while back I wrote about good paging etiquette.

2. Let people know when you're out: I work a rotating schedule. As a result, it’s hard to predict when I’m in or out of the hospital. Sometimes I’ll come back on service and find urgent emails or texts that are a few days old. Now I leave an away message with my return date and my supervisor’s contact information on both email and hospital text. If someone really needs to get a hold of me, my supervisor has my personal cell phone number.

3. Be conscientious of what time you consult: I generally try to get all of my nonurgent consults done before 3pm. Many services have only 1 resident covering after 3pm, so I try not to page/call unless I have an emergency.

4. Call the nurse if something needs to be done urgently: Being a nurse means being the ultimate multitasker. Room 5 is due for his IV Amphotericin, Room 2's Foley is supposed to come out prior to void trial with Urology, Room 1's infusion completed and is beeping, and Room 4 is a bit altered and yanked out her PICC. Now I’m placing an order for Room 3 to get IV Lasix due to concern for pulmonary edema. However, the nurse may be preoccupied with Room 4 and not see the order in the computer for some time. If I really need to the patient to get the Lasix right way, I’ll place the order through EMR and then call the nurse and see what their situation is. If they’re crazy busy with Room 4 and likely to be unable to get to the Lasix within the next 15min, I ask whether they’re okay with me asking another nurse to give the Lasix now. Usually the answer is yes.

5. Value your nurses: Nurses know the patient best. They’re the ones answering call bells, giving meds, doing dressing changes, etc. Unfortunately they oftentimes bear the brunt of everyone’s frustrations, from patients to patients’ families to attendings to managers. Not to mention, they’re the ones doing the dirty work. Bedside nurses are the heartbeat of healthcare, but they also are high risk for burnout. Always support your nurses, whether that’s volunteering to answer a patient’s family member’s 17th phone call of the day or responding to a patient’s call bell yourself.

6. Know how to get a hold of someone quickly: It’s less than ideal to page someone repeatedly. At my hospital, if I need to talk to an attending urgently, I call the operator and ask them to connect me directly to the attending’s cell phone. If a patient is crashing and we’re not in the ICU, I dial the emergency number and call a rapid response, which sends people running into my patient’s room.

7. Plan your discharge meds from Day 1: The goal of every admission is to treat the patient and then discharge them safely. Send medications early for prior auth and call the pharmacy to make sure that they have medications in stock. (One time a patient’s insurance didn’t cover Levofloxacin, of all things.)

8. Keep social work and care coordination aware of all needs from the start: Does your patient looks unsteady? Place a PT/OT consult and let social work and care coordination know that the patient might require home therapy services and/or DME so that they can start looking at services and companies that may be covered by insurance. Does your patient have a central line? They’ll likely need a home health service to teach them how to care for it daily at home. Do they seem to require frequent transfusions? They’ll probably need labs on discharge. Is the patient’s living situation safe (no heat/AC, possible abuse at home, financial difficulties, etc)? They may need alternative housing.

9. The attending is not always right: Generally speaking, the attending has the last say on how the team manages a patient. However, I’ve come across situations in which an attending’s decision put a patient in more danger. Sometimes asking them about their decision can help steer the care plan toward better patient care. Other times you just have to stand your ground and be okay with being on the receiving end of an attending’s misdirected rant. Report these instances to your manager and to other higher-ups.

10. Always have gloves in your pocket: You never know when you’ll find a mess. Or which part of the body someone asks you to examine. Or how hygienic a person is (or is not).

11. Verify weird vitals: I was very new when I walked into work, opened a patient’s chart, and promptly bolted down the hallway when I saw a patient’s O2 sats recorded as 15-20s. I found the patient sitting up in bed, eating breakfast, and bewildered by me bursting into the room. Turns out that overnight someone mistakenly recorded his respirations as the O2 sats.

12. Remove whatever tubes you can: Anything entering the body is an infection risk. Does your patient still need that Foley placed by the surgery team? No? Yank it (don’t actually yank because ouch). Is your patient A&O and able to eat without aspirating? Remove the NG tube. Does your patient have good veins and require infrequent transfusions/labwork? Pull their central line.

13. Take a buddy with you to emergencies: Two heads are better than one. Even if you’re a seasoned provider and well-equipped to manage an emergency, you might need another body to help with performing CPR, making urgent calls, grabbing supplies, etc.

14. Ask your patients about premeds for procedures: We all have different levels of pain tolerance. A procedure goes far more smoothly if your patient is comfortable. Note: if you’re going to premed with Ativan or an opiate in the outpatient setting, make sure they have a driver.

15. Be good to your charge nurse and unit secretary: I don’t know how they do it. If I had to manage the unit’s signout, patient complaints, calls from other floor, being yelled at by providers, verifying paper orders, and finding beds for incoming patients- all at the same time - I’d lose my mind.

16. If your patient is mad, just shut up and listen: There are many things that you can’t control: the time it takes for a patient to get a room, the temperature of hospital food, the dismissive attitude of your attending, etc. And oftentimes the patient knows this. My reflex is to want to apologize for things and overexplain why different things are happening. But sometimes the patient just needs to rant. Take a step back and just listen. That can make all the difference.

17. Fact check your notes: The framework for your progress note often is the note from the day prior. It sounds obvious, but make sure that you go through the note and make updates and changes accordingly. If today is 01/15, there’s a good chance that the Fungitell from 12/31 is not still pending.

18. Try to learn some nursing skills: This is one of the areas in which I most envy my NP colleagues. If a patient’s IV pump is beeping or their central line need to be flushed, I oftentimes awkwardly step out of the room and look vacantly into the distance for a nurse. I’ve finally figured out how to spike a bag (albeit I do so very slowly, and it certainly makes the RNs giggle some). I talked to our unit’s nurse manager, and she’s willing for me to learn some nursing skills from the staff during a slow day- we’ll see when thing slow down!

19. Be kind: Generally speaking, being in a hospital is stressful. Patients are feeling out of sorts, and staff are working with constant dinging in the background. I rant plenty on this website, but I’m kind to everyone at work (with few exceptions) because it makes things more comfortable for everyone. Additionally, if you are always kind to your patients and colleagues, your reputation will speak for itself. One time I was walking down a hall with poor reception while on my ASCOM with a notoriously standoffish nurse from another unit. My phone cut out. She called my unit’s nurse manager to complain, and the nurse manager told her that I would never hang up on purpose. My interactions with the nurse going forward were always more pleasant in nature.

20. Support your team: The best colleagues are not the smartest colleagues; the best coworkers are the ones who have your back. Whether it’s a medical emergency or just a strange situation, it’s important to be supported and to give support.

I know that I’ve learned a lot more than this, so I’ll likely be adding to this throughout the year. Happy Snow Day, all!

#hangrypa #PAblr #physician assistant #PA-C #PA

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but-i-feel-fine · 3 years ago

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I BELIEVE UNIVERSAL MAKING IS A HORRIBLE IDEA

here is why

Math. I’m going to explain why universal masking is a horrible idea with math.

The problem of universal masking has been so clear to me that I haven’t engaged the debate with any presence. The arguments fly back and forth with equal parts passion and incredulity. ��How can you think that, you monster” is the conclusion of any “dialogue”. Let��s face it, there is not much dialogue happening on this planet right now in any arena.

So that’s it! I’m stepping it! I’m going to put this to rest once and for all and I am sure my massive following and millions of readers will usher in a new age of sound reason.

Math.

First a couple of points to clarify mask use before I astound you with the most obvious of equations.

Masks do work, at some things. But not all masks work equally at all things. Dr. Fauci the magnanimous just stated what matters is wearing a mask, any mask. This type of ridiculous logic is why I am spending time earmarked for Riverdale to write this post. This statement is, in a word, stupid. It is meant to give the panicked public a sense of control, but it also creates a religious cast of acolytes, and by nature of the apparent consequences, self appointed inquisitors. It’s garbage science to be sure, but it is even worse leadership. Even the once holy Michael Osterholm stated that cloth masks are ineffective (August 3, 2021). And they mostly are ineffective for anything positive besides a fashion statement. (I don’t take blind adherence to be positive). So let’s just take these ridiculous and useless items out of our discussion. They are not for the serious inquirer.

What about the surgical masks? Medical personal wear them! Surely, they do this for a very good reason. Why do they wear masks in the operating room?

This line of thought is again, so obvious to me I believed it would have been discussed ages ago. These masks are effective for droplets. Period. And why are droplets important in sterile environments? Well it’s the word sterile. Bacteria people. Nurses generally wear the masks to stop blood or puss or any manner of ungodly particulate flying in their nose and mouth. It is a thin veil of self protection and I have nothing but respect of those that put themselves in the presence of bacterial harm with just the simplest of PPE. In the operating room surgical staff wear those masks for the same purpose. Bacteria. First to stop a spurting vein or a pustule explosion from entering their orifices. Also to stop droplets from going from their mouths into an open wound. The human mouth has almost as much bacteria as a dog’s butt. Stopping a bit of spittle entering the human envelop is a rather important thing to do. These masks are quite effective at this. Droplets are of a size that surgical masks will stop them from travelling into the wound. Note that these are droplets not aerosolized particles.No serious medical person will say that the masks stop viruses. Not one. (Seems that there are many who are no longer serious. Or maybe they are so serious they have lost their minds.)

Viruses are too small to be stopped by these materials. You may argue that the viral particlescan be diverted by the pressure of the mask to escape to the sides of the face and therefore lessen the potential viral load hitting the open wound before the surgeon. But that would be silly. Any aerosolized virus would hang in the air and settle on everything in the room. These masks don’t stop viruses. Says it right on the box just in case the surgeon forgot their first year of medical school. The only solution to stop a surgeon from giving his virus to a patient is that the surgeon call in sick when feeling unwell. If these masks don’t stop viruses in a controlled sterile environment, they won’t do anything in the wider world either. But what about N95 masks? Let’s talk about them and then explain the real reason universal masks are a terrible idea.

There is a case for N95 masks. They appear to be effective in stopping viral particles to a degree. That amount has not been well tested, but I am going to give the mask brigade the benefit of the doubt on this one. An N95 mask that is properly fitted to the face and left alone during its wear may have an effect. (For the purposes of this post I will say it will have an effect because the reason universal masking is a bad idea has nothing to do with effectiveness). Now please note that the mask must be properly fitted. Buying them in bulk from your local shop won’t do. You need a proper PPE fitting and once you put that sucker on you cannot touch it. No drinks. Sorry. No smokes outside on your break. No food. None of that unless you are willing to discard the mask and get a new one. Remember we are wearing these things to protect everyone else from us as the wearer. So, the protocols for use are far more stringent. You must never break the seal of the mask when in use. Ever.

I will grant for the purposes of this exercise that N95 masks are effective if properly fitted and worn properly without tampering. And that leads me to the absolutely obvious reason they are a terrible idea.

Math.

We don’t discriminate right? Everyone should be treated equally, right? Every man woman and child have the right to health, right? And more importantly, according to our health overlords every man woman and child is a breeding ground for viral death. Therefore, every last one of us on the planet MUST wear a N95 mask. Every one of us. No exceptions. And every one of us must wear these masks properly. And these masks must be changed whenever contaminated. Period. That’s the science folks. So we need 7.6 billion masks a day to fully cover the planet. But let’s assume that some of the people need more than one because they have active jobs. It is only logical. 10 billion masks a day sounds like a nice round number. That’s what we need. 10 billion. The cost will be rather large. Even if we get the crappiest Chinese knock off company to make them for 50 cents a mask (quality I’m sure), that is still 5 billion dollars a day spent on masks. That will cost One trillion eight hundred and twenty-five billion dollars a year. A small price to pay to save a couple of lives right! I mean we can’t feed the hundreds of millions of people starving to death right now but let’s get them all a mask. Worth it! Logistically this may be a challenge. We will have to fully occupy the global supply chain to deliver masks every day to spec so let’s wave goodbye to all other imports. That probably includes food but if we all have masks at least we won’t die of a virus. And don’t worry about the environmental impact. We banned plastic straws, so I’m certain the massive increase in biohazardous materials made of…. Drum roll… petroleum won’t be an issue. Oh ya, didn’t you know that these masks are made with a large amount of petroleum products? Don’t worry the planet understands. The dinosaurs died and decomposed so we can discover the glory of… universal masking.

Folks, it’s not a bad idea. It is a ludicrous laughable idea that is blocking the path to real solutions. Do the math. Mask people in high impact places where the protocols can be followed. And move on.

Math.

A.F.

#masks dont work #covid masks #tyranny #logic

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oboevallis · 4 years ago

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Hey! Wondering if u could write something related to this season with Amelink, the baby, Maggie, the kids, idk or maybe link goes to work and all the kids give Amelia hell and drive her crazy and the baby cries a lot

week 1

thank you so much for the prompt! im considering maybe doing a mini series on this, because im really living for domestic amelin, and i also didn’t do everything in the prompt also part 2 to baby blues will be out soon

"Auntie Amelia when is mommy going to be home?" Bailey asked as his aunt tucked him in.

"We talked about this the other day remember? Your mom has to help people at the hospital, but she can't come home because she may get us sick. So she's going to stay at a hotel. I promise first thing tomorrow you can FaceTime her."

"Okay, but why can't she come home to see us. I won't get sick."

"There's something called a pandemic going on right now, and basically that's a sickness that spreads really really quickly. And since your moms at the hospital all the time working with people who have the sickness it isn't safe for her to see us." Amelia wanted to cry when she saw the tears welling up in her nephews eyes.

"You don't do anything right though. You don't tuck me in right, and you don't make sandwiches right, and you don't play cars right either. Actually you don't play with me at all like you used to." Bailey ranted before he took his covers and pulled them over his head. Amelia tried to reach out to him only for him to turn away from her. She wasn't sure how she was going to handle this, it had barely been a week since lockdown begun.

"Good night Bailey, I love you." Amelia reassured as she closed the door behind her. She walked down the attic stairs to find Link putting the covers over Ellis while she laid on Merediths bed, for the past couple of nights she's refused to sleep unless it was in her mothers bed. She was pulled out of her moment of serenity from her baby's cries, she sighed and made her way to Maggie's room. They put his crib in there for the time being as it was the closest to their room.

"What's the matter my sweet boy?" Amelia picked up the crying baby from his crib. She sat down on Maggie's bed and cradled her son, resulting in her sons cries to subside. "Someone just wanted their mommy huh?"

"Auntie Amelia?" Zola's voice startled her aunt causing her to gasp. "Sorry I didn't mean to scare you."

"It's okay ZoZo, everything okay?" The girl just nodded and crawled into the bed next to her aunt.

"Is Scout okay?"

"Yeah, he's just fine. I think he just wanted some attention."

"Can I sleep with you tonight?" The question took Amelia aback, she expected it from her younger niece and nephew but not from Zola. She sometimes forgot she was still a kid and not a teenager. She'd always acted mature for her age.

"Sure ZoZo. Are you okay?"

"Yeah, I just miss my mom. When I'm scared I always sleep with her."

"Why are you scared ZoZo?" Amelia knew it was a dumb question, she was scared herself. But it broke her heart her niece was as well.

"This sickness must be really bad if we can't go to school, or see friends, or see auntie Maggie and mommy."

"We're taking precautions, we wear out masks if we were to go out, we're quarantining. At the hospital your mom and aunt Maggie wear something called PPE, and they social distance and they constantly are washing their hands."

"So they won't get it?" Zola worriedly asked. Amelia didn't want to lie but she also didn't want her niece to be constantly worried.

"They're taking precautions ZoZo."

"Will you and Link be going to the hospital?"

"Well, not right now we're on something called maternity leave. That's when you have time off of work after you have a baby. So we'll be home for awhile and then we'll see what we should do. Don't be worried about this though, ZoZo. How about you go change into your pjs and brush your teeth, then you can go into my room and get to sleep that sound good?"

"That sounds good." Zola softly smiled as she jumped off the bed. Amelia sighed once her niece left the room, and turned her attrition to her baby.

"You are very adorable, but you need to sleep. You don't seem to like sleep very much though." She whispered as she placed the drowsy baby into his crib.

______________________________________

"Auntie Amelia your phones ringing." Zola yelled from the living room the next morning.

"Who is it?" Amelia asked, she was in the side room trying to help Bailey log onto a zoom meeting.

"Someone named Addison."

"Can you try to help Bailey log on? And bring my phone in here please." Zola skipped into the room and handed her aunt her phone, and took her seat at the computer. Amelia ran up the stairs and shut the bathroom door behind her, before Ellis realized she was up here. She sat in the bathtub and swiped the call on.

"Oh wow you look terrible." Addison commented, as her screen popped up with the face of her exhausted friend.

"Why thank you."

"Sorry, how are you holding up?"

"I'm alright, how are you doing?"

"I'm okay, I just have never lost this many patients before."

"I can't even imagine, I hear it's really bad."

"Yeah it really is. So have you decided if your going back to work after your maternity leave?"

"I have no idea, I mean they desperately need doctors. But what happens to Scout and the kids. We can't leave them with a babysitter, because of quarantine. I don't know, I'm just kind of taking it a day at a time."

"That's okay, that's all we can really do. Take it a day at a time. How's the baby doing?"

"Oh he's really good." Amelia lit up at the mention of her baby. "I'm basically with him all the time, so Link is stuck with the other kids so I can't really complain."

"Link must be having the time of his life." Addison sarcastically laughed.

"Yea, he's never really dealt with kids before. At least not to this extent, the most he'd interact with a child before is if he had to do surgery on one." Knocking on the bathroom door took her out of her moment of serenity talk to her friend.

"Auntie Amelia, we still can't get Bailey into his zoom." Zola's voice came from the outside of the door.

"Crap, I've got to go Addie. Stay safe."

"You too." Amelia set her phone down on the edge of the tub, and hoisted herself up.

"You still can't get in?" Amelia asked once she opened the door.

"Nope, I tried everything."

"Alright I'll try and take a look at it." Amelia sighed, and went down the stairs to the room they've now dedicated to school. "Still can't get it?"

"No, so does that mean I don't have to do it?" Bailey hopefully asked.

"No your still going to have to do it. You know what I'll email your teacher, and tell her what's going on."

"Alright, I'm gonna go play." Bailey said quickly while running my out of the room.

"No, Bailey get back here." She called after her nephew, only for him to ignore her. She sighed and held her head in her hands. "Okay, ZoZo did you finish your school work yet?"

"Yep!"

"Okay, go play with Bailey then." She opened up Meredith's email, so she could contact Baileys teacher about the issue with the video call. Once she composed the email and sent it, she scrolled through the other emails. She noticed one from Zola's teacher and opened. Zola had 8 missing assignments, Amelia felt like crying and screaming. She already knew they were going to be up all night trying to catch her up, she wanted to be mad but she couldn't. This was nothing like her niece, she was obviously struggling with the quarantine.

"Hey the kids are done with school already?" Link asked as he came into the room.

"No, Bailey can't log on. And Zola's been lying to my face about completing her homework. I also have no idea what Ellis is supposed to be doing." Amelia choked out before she started crying.

"Oh, don't cry." Link walked further into the room and spun Amelia around in the spiny chair before wrapping his arms around her. “It's going to be okay. We'll figure it out. How about we sit everyone down, and come up with a game plan. We haven't sat down and organized how this is going to be."

"Okay." Amelia smiled slightly wiping away her tears. She spun around in the chair to face back towards the computer. She was going to write down all the children's assignments and figure the times that the teachers held their video calls.

______________________________________

"Okay do your Aunt Amelia and I wanted to talk to you guys." Link said as he placed down the kids plates in front of them.

"About what?" Zola asked curiously.

"Well we know that right now, everything's all messed up and kind of scary. But we still have to have a routine and make sure our school works getting done." Amelia said as she adjusted her shirt so her son could eat.

"So what does that mean." Zola asked before she messily slurped up her spaghetti.

"Well for starters we're gonna go to bed on time, and we'll wake up around 7 so we can get ready for the day before we start school." Link stated once he sat down at the kitchen table with everyone.

"So Bailey and Ellis you have two zoom calls everyday. At 8 and at 10, so Bailey you'll be in the side room and Ellis we'll set you up in the living room. Zola you have four calls so you'll be in the kitchen-"Zola interrupted before Amelia could finish her statement.

"Wait why do I have more calls then them, thats not really fair."

"Since your older you have more classes than they do. Back to what I was saying, we'll all have lunch together and then we can play for a little bit but then back to school. After everyone's done you can play or watch a movie then we'll have dinner and go to sleep. How does that sound?" Amelia asked, the couple realistically knew that this plan would probably never happen but they wanted to try to let the kids have a predictable routine everyday.

"Sounds fair." Bailey said and the two girls nodded in agreement. "Soooooo, can we watch a movie tonight?"

"Not tonight bud." Link said, causing sighs from all three children. After everyone was done with dinner Zola helped Link clear the table while Amelia put the baby to bed. "So you've got some missing assignments."

"Oh." Zola felt embarrassed. "I didn't know you knew about that."

"I do. Tonight me and your Aunt Amelia are going to help you with it, so you don't get further behind. Is that alright?"

"I guess so." Zola sighed. "It's just confusing, I like it better when it's on paper not the computer."

"Okay, so we'll sit down and figure it out. It's going to be okay."

"Thanks Link." Zola smiled kindly. "Sorry I lied, to Auntie Amelia about completing my work."

"Just don't do it again, next time just ask for help. Nothing gets better if you don't ask fo help." Link smiled.

#amelia shepherd #amelink #atticus lincoln #baby amelink #greys anatomy #greys fanfic #greys anatomy fanfic #scout lincoln #zola shepherd #bailey shepherd #ellis shepherd #meredith grey #maggie pierce

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multifandomhoodies · 4 years ago

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. Here’s a. bit of a write up on corps life.

my big number one? I wanna go back lmao. I’ve been home for a few days and I’m already to go back out there.

Anyways. I spent two months camping and working in the pacific northwest and. honestly it was the most incredible experience of my life. I was on a five person crew (four members and a lead) and of that group there were only two people that hadn’t already done a session of conservation corps either at this corps or a different one. This was my first time doing a corps! I was like. deadass shitting a brick before I left. I was so nervous to fly across the country (I’d never even flown before!) and go do something I’d never done for two months. I’ve been camping. I’ve been hiking. I’d worked outside for the last nine months and had two seasons of outdoor work in park maintenance. but this was living out of tent for TWO months. I was super excited but I was. so fucking nervous too. And god to fly? Airports seemed scary and busy and I was scared I was gonna miss a flight or not be able to find where to go. So the weeks leading up to my trip I was so goddamn nervous. But I did it lmao.

And then. corps life. We spent the first day doing orientation where I met my crew!! and then left to head to our campsite where we’d do saw training the next three days. We left the parking lot of headquarters to Colter Wall’s “The Devil Wears a Suit and Tie” and headed to an area in the Willamette National Forest. The drive there was incredible. I’d flown into Oregon the night before and really hadn’t seen much because it was 9:30 when I landed and had only taken a short lyft ride to headquarters p early in the morning so. This was kind of my first time getting to see more than the freeway of Oregon. It was so beautiful. The big ass trees and the river and the mountains were just. incredible. And then that night two of my crewmates made entirely too much spaghetti which we had for two nights. We then had to use the leftover sauce for another meal. Fun fact! We only had spaghetti once more after that. In two months. Spaghetti is usually a staple on corps. Not on Red Crew. We were scared. Also the crewmember who doled out the pasta portions for that very first dinner of too much spaghetti was banned by our crew contract from doling out grain portions. After that, we went into saw training. Three straight days of saw training and evaluations on the last day. We were starting at seven I think? Like, meeting a five minute walk away in full ppe with saws ready to go at 7am. I think I wrote that I woke up at 4:45 the one morning but honestly that may have been the jet lag. Saw training was exhausting but it was so much fun too. There was a lot of information to take in and I’d at least run a chainsaw before. There were people that hadn’t run saws before at all. On the third day of saw training, we loaded up into our rig (by the way! 2021 ford f250. super duty cab. extended bed with a truck cap. gigantic. massive. imposing. it also had no labelling. it was not marked with anything corps related. it did not even have license plates. it was probably a little intimidating when we were bass boosting driving around in that thing. but whiplash inducing bass boosting because like. notorious big to mumford and sons back to back. can you believe that we never got pulled over in driving almost 5,000 miles). anyways. we did saw evals in a burned zone. I got my bar pinched. I know what I’d do differently now but I have a lot more saw time. But I passed! My whole crew passed and are now USDA National Sawyer Certification A Class Sawyers. Or Feller 3s depending on how you wanna say it. I’m super happy because I got my first professional certification at 19. Although my card says I got it after my birthday but I did my eval before I turned 20 so I’m gonna take it.

After saw training, we went up to a suburb of Portland to. sigh. move sticks for Karens. The area we were in SCREAMED homeowners association. in the name of “fuels reduction” they had us pick up sticks and hike them down to the road. The sticks were down because the trees were dying from this shitty little park. The first week was cold and rainy and we moved sticks. We cleared out an area close to the road the first day and then the rest of the week we had to swamp (move/clear) sticks up a hill onto this narrow trail. Everyone had blisters because no one was used to walking up and down a hill all day. Carrying wet and occasionally rotting sticks. We’d hike it up the hill to the trail and then load sticks into shitty wheelbarrows and then take those down this narrow path on a steep hill when it was fully loaded with sticks. By the end of the week we were walking a good quarter/half mile to the the road with heavy wheelbarrows. It was miserable. NO one wanted to complain because it was our first project but. eventually we all came to the conclusion that it was bullshit. It had nice views tho. Still my least favorite project. Even thought it was miserable I still like. had fun??

After that we went into Washington and planted trees. We actually did this for two weeks but with another site in between. This site uh. did not have bathrooms. Learned how to use a cathole. It hailed the first time I used a cathole. That was exceptionally miserable. But we planted trees! I wasn’t a huge fan of the site our first time there but I warmed up to it. We planted over 3,000 trees in our two weeks. One of our project partners stayed out with us, which mad respect. He was so sweet. We all joked that we were a little in love with him. He wound up hanging out with us during a few of our campfires. He told us about this trip he’d taken back in college to Peru. At this site we coined the phrase “meat plate” which would stay with us until the end of session. Meat plate is dinner that is just, assorted meats that need to be gotten out of the coolers. Also on this site a crewmember got his hand in stinging nettle while taking a shit. The first week was cold. It was rainy and shitty, mostly on the weekend. We did check out the ocean though!! I’d never been to see the ocean and we took the 101 north from near the Willamette to where we were and stopped actually at Fort Stevens State Park and that’s where I got to see the ocean for the first time. In march! It was sunny but actually super nice. We all waded in and one of my crewmates jumped in. It was march. IT was cold. This is the Pacific Ocean. Anyways he’s built different. The second time at the site was a week later, and it was super pretty. It was much better weather. We planted more trees.

Third week was further in Washington like an hour drive from Olympia. This was my first time seeing snow covered mountains that were massive in the distance. We cleaned up 195 trashbags of plastic plant protectors. Also kind of a shitty project but hey. Wasn’t hiking stuff up hills so. Our partner for this had people come talk to us for educational stuff which was okay, bad, and fantastic in order lol. The partner sent people from their org to be with the speakers (who weren’t part of the org) and we told the one lady what we’d been doing and she started LAUGHING and she was like “I’m sorry they gave you that project it’s because no one else wanted to do it” thanks. it was a shitty task but our partners were so nice that it made up for it. they even got a portapotty on site for us. no but they were all super nice. oh god they’d told us not to yell/slam doors/make loud noises because there was an owl in the barn on the property. we all were loud people and kind of forgot but it was okay we didn’t scare the bird. the bird scared us. one of my crewmates got up to go pee in the middle of the night and it swooped at him. this place was great for birds. We had a very angery killdeer beep at us!! we pulled out scotchbroom from the corner of the property and every time we walked near where it must have had its nest it would very angrily beep at us. It was so cute. We all loved it. My crewlead would always yell back at it. “What!! What do you want!!” I love that lil bird. Pulling out scotchbroom was a trip. To pull out scotchbroom you should in theory be ale to use a weedwrench to pry it out. Right? No. This was old growth scotch broom. This stuff was two inches in diameter as the smallest. It wouldn’t always fit in the weedwrenches. At one point it took me, my crewlead, and a crewmate to pull a scotchbroom with as much force/bodyweight as we could put on it. A couple times my crewlead put his entire bodyweight on to it and wound up falling into blackberry lmao. There was so much blackberry there too my god. It was so painful. We all kept joking about letting our crewlead just burn the area in a prescribed burn to get rid of the invasives. In the parking lot of a different preserve from the same partner org I found a red dinosaur who became one of our crew mascots.

After our second week back planting trees, we headed back down to Oregon to work on a fuels reduction project. We were all so excited for this one. We’d gotten certed for saws at the beginning of the session and had been told that we were gonna be a saw crew doing mostly fuels reduction which our lead had specifically asked to do because he had experience with it. But this was our first real saw project with fuels reduction. The weather this week was amazing. It didn’t rain at all, which on the West side of the Cascades in Oregon in April is pretty weird. It was nice for us but Oregon was and maybe still is in a drought. yikes! anyways. this is when we went on a hike to Blue Pool in the Wilamette National Forest. We camped at a little municipal park with another crew! It was weird being around another crew again because we’d spent so long just on our own that we all starting to lose it a little. But the other crew was super nice and we played frisbee in the dark with them the first night we were in the area. The project? was amazing. We worked on private project with a conglomerate of partners in doing fuels reduction. This conglomerate of partners did a whole bunch of other stuff but we only did fuels reduction. That was a week of working in a burn zone moving sticks. Moving sticks and swamping and making sure piles were neat to be able to be chipped. We learned about dispersing and how to remove ladder fuels and where to leave small logs on the ground for ground fuel. My crewlead showed us hazard trees and took a few out. I really loved this project. I loved the “grab stick go” part of it. It was so much fun. I also got to run a lot of saw which was nice. And this property bordered a parcel of BLM land which wound up being the spot we went to go pee at. If you’ve never been West of the Mississippi river, which I hadn’t(!) you’ve never had the opportunity to be on BLM land. There is no BLM land in the East. I wanted to go on all five of big public land holders in the US and that’s the one I don’t have access to here at home. We actually wound up taking a “nature appreciation walk” because we finished our work early around this little nugget of land and it was so cool. It was right on the McKenzie river and it was beautiful. I found our second crew pet/mascot there, a large palm sized egg shaped rock named “Egg.” We were so filthy there. Four 10s in a burn zone makes ya pretty stinky when you dont get to shower. Actually, we weren’t as stinky here because we just smelled like ash. I had ash everywhere. We went out to eat after the last day and my crewlead hadn’t washed his face in four days and was completely covered in ash.

Our last project took us 8 hours back into Washington. It was a long fucking drive. We stopped at Voodoo Doughnuts in Portland tho which was incredible. We rolled into our spot in Washington at 12:40. We slept with our sleeping pads and sleeping bags under a pavilion and were woken up by a ranger the next morning who thought we were homeless or illegally camping. This last project was also kinda bullshit. We were working with the Feds who kept telling us to slow down. We were at this project site for three weeks. The first week we cleared trails of downed trees and brushcut. The second and third weeks we helped General Maintenance take down trees and did so many runs to the dumpsite. We moved a lot of sticks and logs and my arms still look super scratched from moving branches. This spot was in the high desert of Eastern Washington and it was actually super pretty. I didn’t think I’d like the desert all that much but there was definitely a beauty to it. There wasn’t shit out there other than the dam. From there tho we were able to go to Leavenworth, this funky little Bavarian themed village up near the Cascades. We also went to Lake Wenatchee, which wasn’t as fun because we had to go move a fridge for the office staff. We spent about seven and a half hours on our last weekend doing this. I’m not salty. But it was super beautiful so. It’s okay. And we passed a prescribed burn on the way back to our site.

There’s still so much more I want to write and talk about. I have to say I’m overall. just so glad I did this. I had the absolute time of my life. I have never had so much fun. I learned so much. I learned how to really put out a fire with a pulaski from my crewlead. He taught us how to use the Incident Response Pocket Guide to cross reference and look at the probability of ignition. I learned how to use a chainsaw decently well. I did a lot of things that were far beyond my comfort zone. To fly literally halfway across the country, from Ohio to Oregon, for two months and to live in a tent and work on a conservation corps, it was super beyond my comfort zone. I did things with a saw that were beyond my comfort zone and I had to trust in my ability to saw and trust in my crewlead to let me do something he felt comfortable with me doing and thought was in my capability. And it was it was so fucking cool. I really bonded with everyone on y crew too. I made some good friends. And just like. The things I was able to see and do were amazing. And it was so nice to spend so much time outside. I didn’t spend more than an hour or two at most in a building in two months. I worked in 50s and rain wearing rainpants and chainsaw chaps and I worked in the 80s and sun in chainsaw chaps. I was able to lift a full 5 gal of water (40lbs) onto my shoulder and I’m still super proud of it. I watched a ton of movies in the rig with my crewlead and one of my crewmates. I got to use my crewlead’s chainsaw which was a lot cooler, sharper, and bigger than our corps saws. I cried about trees a lot. I celebrated my 20th birthday in a state park with people I didn’t really know too well who surprised me with homemade rice crispie treats and snacks from the Chevron we were regulars for that week at. I hiked some really pretty trails. I gave a lot of hugs and got a lot of hugs. I became not as terrible at hacky sack. I realized that There Are People In My Life Who See Good Things In Me and I Just Want To Keep Making Them Proud. I realized that I’m incredibly hard on myself. This whole thing furthered my belief of goddammit if I wanna do it by god I’ll do it. It’s been a dream of mine since I was 15 to go be on a conservation corps. I got interested in corps life at 15 because of Youth Conservation Corps posting in Wayne National Forest in southern ohio and since then had just. Always wanted to do it. And that literally changed my life - because of just hearing about corps I got super into parks and researched it and was like “oh i wanna be a park ranger” and I started working at the park doing maintenance and went to school briefly for parks and rec management and then dropped out to work more in parks. but then this year, after five years of wanting to do it, I finally did a conservation corps. Not a youth corps but an adult corps. Five years! The biggest dream I had was to work on a conservation corps. I just wanted to use a pulaski on a trail once. And I did at our last project site, even just removing invasives. But just. This experience was something I’d wanted to do for so long and to finally do it and have it be as amazing as I thought was just amazing. My crewlead saw me taking pictures in Washington along the Willapa bay and was just like “corps is a slippery slope. You either hate it or you get addicted to it.” Tragically I’m addicted to it. I can’t wait until next January and March to get back out there. It was such an amazing experience and I feel like I learned a lot of really good soft skills and really good hard skills. I can’t possibly explain to anyone the full extent of what this meant to me and all the fun I had but. This is a long post and I have to go replace my phone so this will be it for now. In the off chance anyone made it this far, thanks.

#personal #ra ra rasputin #park posting

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januwary · 4 years ago

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Thank you

N95. Check. Face shield. Check. Gown. Check. Gloves. Check.

I proceeded into one of the Covid isolation rooms to see my patient. He was in Bed B, the bed farther from the door. He recovered surprisingly well and was ready to return home soon. As I finished speaking to him and made my way towards the door, his roommate, an elderly gentleman, looked at me with his kind eyes and quietly said, “Thank you so much for all you do. Thank you. Thank you.” He was on a significant amount of oxygen supplementation but somehow still managed to gather the energy to thank me before I made my exit. I said, “Of course, we are here for you.” I closed the door.

I held back my tears as I took off my PPE outside the room. I wasn’t sure what it was about our exchange but I kept replaying the moment in my head. It was a difficult time for so many of us and to hear such genuine words in the midst of all this chaos was comforting. I felt deeply moved, but also undeserving of such a compliment. I’ve witnessed too many innocent lives succumb to the wrath of Covid. I’ve seen too many individuals die alone, not having the opportunity to spend their last days with the ones they cherished the most. And I’ve never felt so helpless. I really wanted to tell him everything will be okay, but I couldn’t because I knew there was no guarantee.

He eventually ended up in the ICU intubated. I later found out his wife also had Covid and ended up intubated in the ICU. It’s been over a month now and they’re both still there. Sedated. Unable to communicate. Physically together in the same place in the worst way possible. I cannot fathom the pain his family must endure during this trying time.

I will never forgot this man. For a long time since the pandemic started, I felt numb to everything and everyone. I was working long hours and all I could think about everyday was finishing my job and getting home. I was exhausted and lost the energy and willingness to emotionally invest in others. I forgot how to be human, but this man reminded me with his kind words. He showed me that our presence can mean the world to someone in a time of uncertainty and fear.

Two days after I write down my thoughts on our exchange, I find out from a coresident that he passed. His wife, still in the ICU intubated. Their daughter, not ready to let go of her mom yet.

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mgatala · 4 years ago

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random

why? this pandemic got me so stress than id ever thought i could, countless anxiety attacks, nobody knows.

how? this is how the only thing i could ever think to vent things out.

what? maybe things that happened and thoughts that been on m mind lately.

first

when the lock-down lifts up, the first thing that was my concern is my academic status, its not a good time (march) to stop the school, perhaps i didn't even redeem myself for all the quizzes and tests. then, it was suspended that they just have to based our grades to whatever we’ve done, and i know im lacking. then May came, grades are released. Ive got two failing grades, two major grades, i cannot stress enough how depressing this for me, I’m on my fourth year of college and this the first time, Ive failed on a subject. In this time of pandemic, this. I’ve been disappointed with myself, the people around me, and literally lost some support financially, scholarship. i didnt know what to do, i dont want to run to anyone, this is just a burden, i accepted it thinking that I can be better, i know I am. I dont want to think this too often I am shifting my thoughts to more uplifting and postive because my health and my family is okay and that is more than enough.

then,

June came, birth-month. we all thought or hoped that sooner everything will be better but guessed what the government and some people didn't take this pandemic seriously, the cases are getting worst, and more deaths are on the row, still they wanna go out. the quarantine turns to GCQ a little lighter and not that strict protocol but to observe social distancing and wearing face masks and ppe. but still the virus is still here, the employees doesn't have the choice but to get off their asses and attend their offices because apparently they wanted to open for the sake of economy, and being on this country with having a poor public transportation, the people cant focus on social distancing they all can think about is how to get on the train, the jeep and the free ride some good Samaritan offers, they risk their life not because they are stubborn but because its their natural instinct for survival not for themselves but for their families, and to all of my friends that opened their online stores, you know I can only support by liking and sharing it to others, and to all who is also have to battle with mental illness, we all can come through it and choose to move forward.

Salute to all the front liners and to all the person that choose to risk. but to the government that is using this pandemic to abuse their power for their own goodwill, middle finger up folks.

I forgot that I mention its my birth month, well there’s nothing special I do when its my birth-month, but for some reason this month (june), ive come to realize that my family isn't that strong. my parents been living together for the sake of their kids, I don’t have any idea that this would happen to me, I always thought that we were happy and whole. and im very thankful that we were, my papa tell me things that happened in the past that he cant seem to let go, and i cant do anything about that. he already closed his mind, and decided that he’s done with everything they been through. The house doesn't feel like home, we are all here but the strings that i thought were there was long gone. Maybe that’s why i never really see the love that I’ve wanted to feel. there were no role models, they were neglecting each other and always tell tat they didn't really love each other, before it thought they were so in denial but now, its all a missing puzzle pieces to my questions when I was a child, I am grateful that they raise us, as a good person (I wanted to think so), they were a good individuals, very humbled and a God’s follower. but ive know this before that this is just them being a decent parents. I am still healing from this, trying to ignore the words that is murmuring inside my head, after this incident im having nightmares from my childhood, repetitively. but im moving forward.

lastly, now that I’ve finally committed to someone, knowing my love language was physical touch and quality time, I AM STRUGGLING. at first phase of this pandemic, we’ve encountered a lot of misunderstanding, I cried a lot cause i felt like I am not held right. this long distance is my nightmare, fairly even before on my past potential lovers. in all fairness to my partner, he tries to understand where all my fusses are coming from, that i am just missing him and being together was all I can think about. I was frustrated, for him to understand me i really say things what I feel. sometimes also, when i felt like saying ‘i miss you’ and haven’t been able to prove myself is holding me back to say it. like i wouldn’t say things that i cant do and proved. and on his side that I think was his love language is words of affirmation, perhaps I also frustrates him. I wouldn’t say a thing if I felt like not doing so, I wouldn’t reach out if i thought it just doesn’t make sense to say things, but for him that’s everything, he can again function to hear things from me, but me, I don’t know where to get the will to think is this gonna work out, will I let myself be my old self again, that run from things that I cant seem to fathom, from things I don’t see working, I wouldn’t force, i wouldn’t risk. but that was before, before i love with so much reservations and too much focused on myself. I tried to contemplate, is this my partner also wants, does he deserve that ive been treating him very oddly, is he not trying. and all my questions were he just keeps proving himself that I was just overthinking things, I shouldn’t worry, this all just a phase and everything will work out. he never failed to remind me that he is willing and deserve all the love I can give, even when sometimes im hard to love. And i also see that even we cant see other for now, his strong presence when im on my downtimes he’s there, always. trying to crack a joke (corny), lifts me up with his words, and listen to me when all he can hear was me sobbing and complaining why life is like this. There is just too many green flags for me to ignore it, and embrace that someone is willing to understand me, and love me unconditionally. When im having my episodes he knows what to say, he always have the right words for everything. “just have a little faith” as he would say, and i would calm as if i was wrapped in his arms, stroking my back, and me knowing, Ive got some good thing right here. I wish right now he was sending me home, we’re having our casual story time, laughing and getting him mad but still can bear me. but right now his health is still my first concern, see u soonest xx

#random #thoughts #pandemic

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too-young-to-be-too-old · 2 years ago

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6/21

I nearly forgot that it is supposed to be my birthday on Friday. How can something that I used to spend months getting excited about suddenly turn insignificant? Is my perception of myself and what I care about turning insignificant? I can feel my thoughts slipping away as I try to just survive into the next day, sweating through my layers of PPE and the insults that are thrown at me like tomatoes thrown at a lackluster improv show. Maybe I'll reclaim what is inside my head.

If I can figure out what that is...

------------

I'm being emo. I know. I don't care. I am speaking into a void that exists within a hellscape.

Earlier today I had a thought. I think I already know the answer, but it is still interesting to ponder. What's the connection between suicidal ideation and nihilism? Because I certainly feel like I'm walking that line like a tightrope above a pool that hasn't been cleaned in too long and there's something lurking in its water that's just out of sight.

I feel like a burden to everyone around me, but I also feel like I am wearing a mask of someone who is okay but that mask has been fused to my face for so long that it feels like I am suffocating in my own skin. I don't know. Putting these feelings to words helps, though. It lets me at least begin to understand how I feel so that maybe one day I can fix it. I can't remember when I didn't feel like this, though.

I've been waiting my whole life to get to this point where I have finished my education and started living my adult life, but all I feel now is a sense of dread and longing for a past that I never had. I was so focused on growing up and being mature when I was young, telling myself that older me would thank younger me for it, but now all I feel is a sense of loss for the childlike wonder of the world that I never had. I wish I could go back in time, sit younger me down, tell them a few key sentences and hold them while they processed them:

"You are worthy of love even if no one shows it to you. The love you deserve just needs a different environment."

"Your worth is not tied to how productive you can be, how out of the way you are, how grown-up you act, or how many other people's problems you're balancing on top of your own."

"You need to find what you love now before it's too late. Make that your ambition."

Maybe if someone had told me these things then I wouldn't vent to a piece of metal on my lap...

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histologyapology · 7 years ago

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Quiz Review #3: Mayer mucicarmine, alcian blue and muller mowry colloidial iron

Today’s flavor is: Mucin! that’s a horrible statement to start off with and i’m already hating this. we’ll start withMayer mucicarmine, let’s go.

I’m gonna just begin by saying that I’ve never done this stain and have never seen it done, BUT reading this procedure is making me dread the day where I’m asked to do it. But let’s start at the beginning.

Mucin or mucosubstance is a secretion found in many epithelial and connective tissues. It is generally PAS positive, metachromatic and basophilic. Mucins are often stained with alcian blue and colloidial iron methods, especially if they contain acid groups. They are primary used to provide lubrication and protection from friction, but some membrane bound mucins are also used to control cell adhesion and proliferation. Mucins can belong to several subclasses of carbohydrates:

Polysaccharides

Composed entirely of carbohydrates

Glycoproteins

proteins that have covalently bound oligosaccharide chains

Proteoglycans

long polysaccharide chains covalently bound to small core protein

Now why do we care about finding mucins in tissue? Several reasons:

Some intestinal carcinomas and certain inflammatory diseases will cause the surrounding epithelial cells to secrete large amounts of mucin; it can be imagined as a distress signal in this context

it can also be used to pinpoint the site of a primary tumor

it can help distinguish undifferentiated mucin negative squamous cell carcinoma from mucin positive adenocarcinoma

certain collagen disease are signaled by having too much or too little of certain acid mucosubstances

used as a diagnostic tool for Barrett’s esophagus, in which long term damage to the esophagus from acid reflux gives rise to abnormal cells just above the esophageal sphincter which may in turn become esophageal adenocarcinoma.

mucicarmine stains are a very handy test to detect Cryptococcus neoformans, the causative agent of Cryptococcosis (an opportunistic fungal disease found mainly in immune compromised patients). C. neoformans has a fungal capsule that contains large amounts of glycoprotein.

Fixation:

BEST- Carnoys or formol-calcium (ie alcoholic fixatives)

OKAY- aqueous fixatives such as formalin

AVOID-gluteraldehyde (will lessen stain intensity of acid mucosubstances)

Warnings and concerns:

The mucicarmine stain is fairly dangerous and is one of a handful of stains that should be performed entirely under a fume hood if at all possible. The official Carson version uses a boiling water bath; the technique my lab uses does not bother with this. The hazards for each component of the stain are as follows:

Mucicarmine stain (overall)

flammable

skin/respiratory irritant

Weigert’s iron hematoxylin

corrosive and flammable

inhalation and skin irritant

Mentanil yellow solution

flammable (at high temps; tho aren’t most things?)

inhalation hazard and skin irritant

How it works:

The aluminum in the mucicarmine stock solution act as a mordant and form a chelate complex in which carmine dye is the ligand. This complex has a net positive charge and is attracted to the anionic acid groups of the mucins present in the tissues. This forms a dye lake. Nuclei are stained by iron hematoxylin and mentanil yellow is used as a counterstain to provide contrast.

Control:

Colon, small intestine and appendix are all acceptable controls but try to get them as fresh as possible. Mucosubstances degrade very quickly after death and autolysis makes it difficult or impossible to find goblet cells that contain mucin.

General procedure:

Stain in weigerts hematoxylin, 7 minutes

wash in running water for 10 mins. Check under scope. you want to see black nuclei but not much else.

stain in working mucicarmine soln for 1 hour. Check under the scope. If at the end of this hour you find that the slides have come out dull, you can incubate them for additional time in the oven until they are bright enough. you want to be able to see red mucin and black nuceli at this step.

rinse in two changes of deionized water

counterstain with mentanil yellow for 30-60 seconds; if you’re nervous, dip a few times and check under the microscope.

Expected results:

Mucin and cryptococcus will be deep red to rose, nuclei will be black and other tissue elements will be yellow.

possible Issues and their solutions:

Weak or no Mucin stainin-check your mucicarmine stain. You probably forgot to add alum, so you didn’t get a dye-lake complex, hence no staining. More time in mucicarmine could help. Also keep in mind that stock solution must be kept refrigerated and won’t last for more than a day at room tempureature. It’s also possible that your mucicarmine is fine, but you overstained with either hematoxylin or mentanil yellow; in the case of the latter everything will look kind of coppery orange.

weak mentanil yellow-mentanil yellow is alcohol soluble, so run it down fast (10 dips per graded alcohol max).

Big disclaimer: Carson basically says that mucicarmine is a pain in the butt and that alcian blue and colloidal iron basically do the same things without being as obnoxious. so, onto them.

Alcian Blue 2.5

Stains for acid mucins, aka mucins that react at low pH values. It’s not a good fit for neutral mucins, but it is compatible witht he PAS if you want to stain both acids and neuturals on one slide. The alcian blue 2.5 stains for weakly sulfated mucins; strongly sulfated mucins are better demonstrated with the alcian blue 1.0 stain.

Reagents and their concerns:

3% acetic acid:

corrosive and combustable

respiratory irritant

skin/eye irrirant

always prepare anything using glacial acetic acid under a fume hood with full ppe. It’s not just vinegar folks it’s real dangerous stuff.

always add acid into water, not water into acid.

any excess made should be neutralized with 1M sodium carbonate and flush down the drain with lots of water.

1% alcian blue:

flammable

inhalation hazard and skin irritant

Nuclear fastred

inhalation hazard

skin/eye irritant

How it works:

Alcian blue gets its color from copper. it’s cationic and is attracted to anionic (acid) mucosubstances, forming salt linkages. Once bound the dye is insoluble in both water and alcohol. We counterstain with nuclear fast red for contrast.

Fixatives and control:

Formalin or bouin solution are preferred. Colon, small intestine or appendix make good controls (but again, get em as fresh as possible).

I’ll put the procedure in later, I just realized I didn’t do laundry and I have to go get my scrubs from the basement before i go to sleep FUCK

expected results:

Weakly acidic sulfated mucosubstances, sialomucins and hyaluronic acid will stain dark blue. All other substances will stain pink to red.

Issues:

if it didn’t turn out right then you probably skipped a step. a good trick is to remove reagents from your bench after you use them.

Jesus christ okay last one

Muller-Mowry Colloidal Iron

This bad boy is looking for acid mucins but much like alcian blue it won’t stain strongly acidic ones. It is not as specific as alcian blue, but it does tend to give more intense color. It’s often combined with the PAS to distinguish between neutral and acid mucins.

Reagents and their dangers;

2% potassium ferrocyanide

actually pretty safe, just don’t heat it

2% hydrochloric acid

strong irritant to eyes, skin, respiratory system; real corrosive stuff

fume hood time

full ppe

acid into water the way that you otter

store acids away from bases

12% acetic acid

listen if you dont get that acetic acid is serious business at this point then i can’t help you

Nuclear fast red

scroll up scrub

How it works:

Colloidial iron in the solution is absorbed by the acid mucins in the tissue. The Prussian blue reaction happens and then, you get, some blue. you know how it is.

Controls and slide setup:

this one’s a little different. you need a control slide (non-patient tissue), then a patient test slide and a patient negative slide. the negative slide will recive only Prussian blue reaction, which will demonstrate the presence of ferric ions in the tissue that are NOT bound to acid mucins

Procedure:

hmmmmmmm yeah i;ll fix this tomorrow heckheckheck

Results, hopefully:

Acid Mucopolysaccharides and sialomucins will stain deep blue. Nuclei will stain pink to red and cytoplasm should be a lighter pink.

Issues:

This is a really time sensitive stain. If you go over or under time limits you’re going to be able to tell.

Alright i am real tired i gotta. go to sleep. same time same place next week, I promise I won’t start as late tho i was traveling a lot this weekend.

#this has been an Apology Original #histology #mucin #mucicarmine #alcian blue #colloidal iron #special stains

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lettersfromthepandemic · 4 years ago

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Letter Five: Put yourself in a 2020 nurse’s shoes

Dear future generations, Put yourself in a 2020 nurse’s shoes:

We have all developed new rituals.

It’s been 60+ days now, impossible not to. The alarm goes off not enough time for the snooze button. The morning routine is the most unchanged, except for what you bring to work with you. Extra clothes, disinfectant spray and wipes, and my own p100 mask in case today is the day there are no more n95s. That’s the biggest fear at work, no more PPE. You’re a float nurse, but no longer bother to check the assignment for the day. You know where you’re going. The covid care wing, three separate units combined to make one large area for non-ICU Covid positive patients. One charge nurse, 50 plus beds, only two with negative pressure capabilities. You spend the day trying to be positive, for your patients, your coworkers, yourself. You feel suffocated by your n95 mask that you had to fight administration to get and now are required to wear constantly. You wear your gown and your face shield and you never know this kind of hot before. You have to drink your own sweat off your lip inside the mask.

Every cough, sneeze, and sniffle from patients or coworkers is louder than a bomb.

You always end up staying in a room longer than you meant to and almost always forgot to bring something in you needed. Sometimes you have to feed your patient every meal or spend 40 minutes combing their matted hair because they are too weak to do it themselves. Some patients are doing ok, but you just can’t seem to get them off oxygen no matter what you do.

There is always bad news from the ICU. You see the patterns of infection essential workers, poor, black and brown, un and under- insured. You try to think ahead, cluster your care, comfort your patients but manage their expectations. Provide them mental support when you need some yourself.

You silently pray for your patients as they tell you about their other family and friends who are also hospitalized or have died. You think about your own friends, family, and coworkers who are hospitalized or have died. Some days, most days you get lunch donated. It’s nice to get food, the problem is finding time and space to eat it. We have to practice social distancing in the hospital too. It’s almost impossible. and completely impossible when it comes to your patients.

Later on, time to go, but then the real rituals begin. You give report and collect your hospital backpack where you keep your face shield and n95. Wipe down your visor and bag. Your label and return your n95 for “reprocessing”. Grab a small trash bag and head to your locker. Remove and toss your shoe covers wipe down your shoes. Remove your hospital supplies scrubs and place in your trash bag. Wipe down all your exposed skin and change back to your own scrubs to go home. Put a plain surgical mask back on before leaving, its required of all staff while in the building. Trek down to the basement and trade your dirty hospital scrubs for a clean set. And then trek back up and over the bridge to the parking lot.

Out the door and finally reveal your face and get unobstructed air into you lungs, on your skin. You get in the car. You make it home. Sometimes you cry on the way.

Sometimes call home to warn them and to stay away from the door. Once home out of the car, spray with your disinfectant wipe down the wheel. Spray your work bag and everything in it. Get inside shoes off and sprayed again. Cleanish scrubs off and straight to the hamper. Shower on hot. Antibacterial soap head to toe. I personally shower in a separate bathroom that only I am allowed to use. I feel lucky to have that option. I wear a face-mask in the house too in case I run in to someone accidentally. I stay separated even from the people I would usually see everyday. Hugging or touching anyone is out of the question!

I go upstairs and never come down. Sometimes a plate of food is left at the bottom of the stairs for me and I’m lucky to have that too. Just in case one more spray or wipe down of the work bag and its contents and my jacket and keys. Then set up the bag and snacks and my morning breakfast smoothie all over again for the next day. Its alot of mental work constantly cleaning, spraying, wiping everything. Trying to think of and circumvent all the possible ways you might infect someone you love. You can never make everything perfectly clean or safe. So you stay away from the people who might give you the most support.

Days off you are exhausted and you weigh the need to really leave the house.

Only for necessary supplies. Being out in public where people may or may not be wearing a mask. Those who do, usually aren’t wearing it properly. Some don’t quite understand or respect the social distancing rules and you have to weigh being understanding or saying something to correct other’s behavior. You wash, spray, or wipe down whatever you brought home. You do your best to check in on people you haven’t heard from or you think might be struggling. You try to sign and share petitions about frontline workers whose situations are worse than your own. Or get involved in someone’s project to donate funds or phone chargers to hospitals for patients.

You try to ignore the people claiming this is a hoax or a violation of their right to leave the house and you wonder why a haircut is more important than a hospital workers safety.

You wonder what’s the harm in taking extra precautions especially in the name of other peoples safety. Wearing a cloth or surgical mask face covering while out and about is seriously NOT that hard compared to the N95, surgical mask, plastic visor and gown (or garbage bag) others have to wear for 12+ hours. You know it’s hard out there for people. You know others are struggling harder than you are. You are grateful you get to go to work and have a paycheck. But some days you wish you got to stay home too (and then feel infinitely guilty for even thinking of not going to work).

A nurses job is to think ahead, anticipate needs, have a plan for declining conditions, and to act fast when things go bad. But we can’t do it all. We need our support staff.

Our doctors, our nurse techs, our house keepers, and respiratory therapists. We need to collaborate to get our job done. We are not the only ones trapped in a cycle of mental and physical work never asked of us before. What we need most is the collaboration and cooperation from our hospital administrators, our city state and federal leaders, and most of all our communities. We need everyone to do their part and wear a mask in public, wash your hands, social distance, and stay home when possible.

Even once restrictions begin to lift we need people to stay engaged and be vigilant with the necessary precautions.

We are not asking people to give up their freedom. We are asking people to modify their habits for the benefit of the most vulnerable. We can’t do it with out you. Nursing doesn’t work like that. The world doesn’t work like that.

-You

P.S. If hearts and souls all over the world weren’t hurting enough. They have begun killing black people openly in the streets again. It has been going on so long and seems to have ramped up again. Each murder more egregious and arrogant. Beautiful black men and women all infinitely worthy in their own right, robbed of their lives by police. As if black people disproportionally dying of coronavirus wasn’t racist enough, police and white people around the country have taken it upon themselves to strike terror in the hearts of black people everywhere. There is so much disgust and hatred in your heart for these emboldened and brazen racist displays. That’s what they are, deliberately done for the world to see. You feel scared and hopeless, there is a constant pit in your stomach. However you are white. You have hardly an inkling of what a black person feels everyday, with every police interaction perhaps every white person interaction. There is not much you can do about what is happening. But there are a few things you MUST do. Be quiet. Listen. Learn. Invest your time and money to aid in black and antiracist causes. You need to stand up for, stand next to, prop up if necessary, and shield your black friends, family, colleagues, and strangers. There is no other way. You need to use your white skin as a defense for black skin that has been weaponized and criminalized everyday since 1619. Offer your support in actions first and words second. Examen your own privilege and bias and work to change. Take criticism of your words and actions humbly and not defensively. When you feel uncomfortable and challenged do not retreat or disengage. Know that black people are the best historians of their own stories. Find understanding and compassion in the events following the murder of countless humans and REALIZE that property will Never be more valuable than PEOPLE. BLACK PEOPLE.

Ruminate and repeat as often as necessary.

Letter Author: Kristin Perez; Chicago IL USA

#lettersfromthepandemic #pandemic2020 #nurse #healthcareworker #submission

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noheroes-allowed · 4 years ago

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week 3

I’m struggling to find the balance between being an advocate and letting my voice be heard with the action of stepping aside for those who know more than me. I also think it’s selfish for me to put my mental needs above someone else’s needs who is in a tougher situation especially in this critical period. the past 24 hours I’ve been wrestling a lot with our specific org’s contribution to blm. ultimately I agree with our final decision and I’m glad I raised my point again to be revisited. I’m also proud of myself for setting aside my pride and pushing keith to voice his opinion bc he was hesitant to add another layer of complication into our discussion. I appreciate him. he was the one pushing us to raise our donation by more than 50% than what someone initially proposed. when I asked him on the boston car ride what issue he talked about in his segc application, this was it. and I saw it yesterday and today in him and I genuinely love that about him. he does make me want to be a better person. I know it’s not an idealization bc I’ve seen it now. I’ve seen concrete proof of it and my initial thoughts about him have been confirmed. when I raised the possibility initially and when we called today, he was in my corner. he apologized for not agreeing with me last night. even though we ultimately decided to stick to our original plan after contacting and getting more info from the campus coalition, I liked that he apologized. I liked when he said ‘lucy put it really well’ at our meeting yesterday bc I felt acknowledged. I also like that he sent a picture of three gatorade bottles to my friend bc sir why did you need to do that

keith venmo’ed me an amount that was greater than the contributions I’d donated beforehand. I know he’s from a more privileged and well-off background than I am. but the past week, I’ve been wrestling with what my monetary contribution should be. those stupid bingo card memes of privilege within the college student community, I’d coincidentally donated the exact amount I supposedly could afford before those memes started circulating. but then I saw the fb post that added zeros to all the numbers, calling me out to raise my contribution by a multiplier of 10. it was the guilt inside of me that made me match keith’s donation. it’s the guilt from benefiting from the system, harboring prejudices, not having the courage to fight for causes I believe in, now and in the past. our world is broken and I’m afraid we can’t fix it. I’m afraid our planet will burn before we get the chance. I’m afraid the ones with 99% of the world’s wealth will rule our economies, political systems, and social institutions forever. in the future, will I have the courage to fight for causes I believe in? to be very honest, I’m not sure I will. I need someone to come up with step-by-step plans, I need to see the economic and budgetary breakdowns, I am unhealthily realistic. pessimistic maybe in other people’s words. internally, I look down on people who call for change but cannot outline the process to do so. it is wrong of me I know, for it is harmful to put down the hopeful. but how will programs be funded? where does the money come from? how can they be enacted? what is the timeline? whose political voice do you have in support? in our deeply divided country, I fear no change will ever come about. there will always be a push-and-pull, a tug-of-war cycle that repeats itself. for every step forward, we’ll take a step back when the other half refuses to relent.

everything is so interconnected, I fear change will never come about. the bureaucracy of legislation. the rolling back of past administration’s legacy. the money tied to everything. it makes me sick. dc, police, prisons, college, climate change. my friend urged me to vote last week, and if you’re readying this, you’ll be happy to hear I did. I think the issue for me is, everything sounds like empty words and empty promises. of course I want change. of course I want to elect someone who can do that for us. but what about the chokehold lobbyists and super pacs have on our politicians. what about the republican-led senate where all house bills go to die. what about the fact that mortgage-backed securities are essentially still being traded despite collapsing our economy in 2008 and requiring million dollar bank bailouts at the expense of taxpayer money. what about the reversal of the paris climate accords. what about the nra funding gun violence in our country, no change after sandy hook, orlando, las vegas, parkland. what about the cdc’s bullshit response to covid, the lack of federal support to keep employees on payroll, the nearly 20% unemployment rate, the failure to restock our PPE when states literally had to outbid each other to save people’s lives. what about the fact our supply chains are so broken, farms dumped milk and slaughtered animals instead of being able to feed the hungry, and there might not be enough vials for when a vaccine is finally created. what about the head of the epa having connections to oil and gas companies. this revolving door of industry professionals and government appointments has to stop before I can believe in anything. veep is a comedic show but it made me extremely depressed last year. I know it’s fictional but it opened my eyes to another world of closed-door deals that happen in washington against society’s best interest. I know empty words and empty promises are better than the greater enemy though. I know that. I just wish I could believe what our candidates say they’ll do for us. I feel like I’m voting just to kick the greater evil out, not to bring good in. I know that is still something. but that’s why I was so detached when we spoke. the interconnectedness of everything defeats me. how can voting enact change when washington is part of the problem? the system is designed such that we are not a democracy. we drag our feet and jump through hoops and nothing changes. money is a weapon to make things go their way and not ours.

it has almost been a year since I’ve become naturalized. this is my country now. I feel like I have to participate in this movement despite my visionless view. all the circulating materials and donations now, I fear it will just be commotion we look back on by the end of the month. is that not what happened with the insurgence of blm in the past? is that not what happened after every gun shooting? is that not what happened after greta thunberg left the news cycle? I even forgot her name just now. this is what happens. I know I am part of the problem. it’s my responsibility to make change happen too. I just don’t believe it. and in order to believe it, I need organization. I need the step-by-step goals. I need the data supported conclusions. I need to see what my money is being used for. I need to see each org’s financials and I need to understand how impact is maximized.

this was my week 3. I was distracted all Tuesday morning instead of working on my project. I wanted to hear different people’s views on everything but work is work. I hate when people talk down to me. I feel like my mentor is not listening to me on what I want to explore with my project. I’m stressed about this innovation group challenge I signed up for. I keep piling things onto my plate instead of realizing I need a break. is this how we’re destined to be? in this world of amazon prime, shortened attention spans, constant social media feeds, are we destined to not just breathe?

I have not been outside for a week bc I’m scared of my neighborhood and the dark and. it is selfish of me to say this I know, but I wish no one had died at the reservoir. I feel more trapped than I have before and outside is no longer a solace with the midday heat and the suspicious dark. there are too many things on my mind. too many deadlines, too much work. I wish I was 12, my brother’s age. I read a book today and its main storyline was on specific family relationships. siblings are weird bc we have the same parents and inherit the same genes but our experiences are still so different. my brother has lived a completely different life than me. what will he remember about 2020? is it just a time for him when he gets to stay home and play video games instead of doing hw? that is so different from my 2020.

#remarks #you know Nolan called me 'bright-eyed' and said he was the same when he was an intern #but uh sir I do not believe I am #I watched when they see us on thurs night #it made me want to throw up and I had a weight on my chest for four hours straight #it was so horrible and I wasn't even the one going through it #I've also had a headache for the past 24 hours #can someone just give me all the answers #also the university relations team made us have online office olympics #and god they were lame #couldn't we have a conversation? address what's happening in society?#idc about coming up with silly team names and random trivia #I know people are allowed to have fun. I just. why's there such a lack of conversation outside of social media or those who protest?#WE HAD A FUCKING BUSINESS DIVERSITY GROUP FAIR AND NO ONE ADDRESSED OUR CURRENT CIRCUMSTANCES. WHY. IT'S THE GIANT ELEPHANT IN THE ROOM #I'm mad bc deep down I know we couldn't have. bc individual employees can't be saying things in the name of our company #even if it's our own thoughts and not through a company email or any social network #we are all lab rats #but then what am I supposed to feel when they treat us well and give us good benefits and care about employees and serving the community #and matching up to $1000 of my donations #am I buying into their image? is this all a company can do #I AM UPSET WITH MYSELF AND EVERYTHING ELSE bc I just want someone to tell me what the fuck to do and feel and act #and I want inspiration and I hate that I cannot find it

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deadlydollies13 · 7 years ago

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The Potion Master’s Grace ch. 20

**TRIGGER WARNING: Mentions of past abuse.**

Grace made her way down to the cellar to find Severus at work in his potions lab, “You wouldn’t believe what Draco and Rolf did today!” Severus sighed, he had become used to Grace bursting into a room or dropping her phone and repeating to him what gossip Grace had to spill about her classmates. Needless to say, he found out way too much about some of his students, but some part of him was glad Grace had so much trust in him to talk about these things to him. However, this time he couldn’t tell whether Grace was annoyed, shocked, or amused, “What did they do?” “They potty trained Merlin!” she said grabbing an apron and her Quidditch goggles she used as PPE to join him. Severus raised a brow, “Isn’t that what they were supposed to do?” He continued on with the potion he was working on, he had to be very meticulous. “On the actual toilet!” she took her spot by his side, as she had done dozens of times before that summer. “He flushes and everything with his lil’ paw! They’re such jackasses!” Severus found it quite hilarious, and Grace’s serious face made it even funnier, and he couldn’t help but double over laughing. He also forgot that he was holding an ingredient in his hand and accidentally poured too much into his cauldron.

There was a loud bang, Severus quickly moved out of the way, and a large puff of smoke enveloped Grace, who had covered her face with her arms and screamed. When Severus finally made sense of what happened, he pulled out his wand and cleared the smoke, only to find a tiny, frail, ash-covered, redheaded girl in the spot where his daughter was standing just moments ago, “Bloody fucking hell.” The girl looked up at him, trembling, with big blue eyes that were quickly filling with tears. “Grace, I-“ he tried to reach out to her, but she shrieked and cowered into the corner. He tried taking a step towards her, but she only screamed louder. “Phoebe!” he called up the stairs. Phoebe came downstairs, glanced at the now younger Grace, to the mess of a potions lab, back to Severus, “Severus Tobias Snape, what the fuck did you do?!” “I…” “Well I fucking see what you did, but I can’t believe you did it! Oh my god, Severus! Oh my god! You never fuck up anything and of course, now, you fuck up big-time! Fucking idiot!” And at that, Grace broke down sobbing. She was severely trembling and hugging her sides. Severus’ instincts kicked and took a step towards her to comfort her, but she looked up at him with such fear and screamed, “No!” and continued to cry. He could feel his heart break, Could she not remember me? Phoebe’s anger soon left her and slowly made her way to the little girl’s side. She placed a gentle hand on her shoulder, “Grace, sweetheart, do you know where you are?” Grace shook her head. “Do you know who any of us are?” Again, she shook her head. “W-where’s my ma and da?” “Where did you last see them?” “A-at home. I took a nap and woke up here. I don’t know where I am! I want to go home!” It wasn’t like the potion had just made Grace smaller; it was like they had pulled this Grace straight out of her past. Through her screaming and crying, Phoebe slowly explained that Grace didn’t live with her ma and da anymore, and that Severus was her new da, and that Phoebe was dating her da, so it was okay if she called her ma. “It’s just until you find a counter-potion for this muck-up, Severus Snape,” Phoebe said. “So, you’d better get on it. Now!” She took Grace upstairs, “Luna.” Luna looked up from her book, shocked at the site of a younger version of her best friend, “Holy shit!” “Language! I need you to go home and find any old clothes you might still have that will fit her.” Luna nodded, still shocked, and looked Grace up and down to get a good idea of what age she might be, she guessed four. With Severus working in his lab and Luna rummaging for old clothes, Phoebe took the child upstairs to get a bath; she was covered in ash. As they made their way to Grace’s room, her eyes went wide with wonder as she looked around the large manor and all of its pretty things held inside. “This is your room, Gracie,” Phoebe said opening the door. “Really?” Grace stepped inside, spinning around to get a good look, a slight smile hinted at her lips. “Yes.” “It’s so pretty,” she reached out and touched the bed post. “I never had a bed that was off of the floor before.” Phoebe understood what she meant; Grace must’ve slept on a mere mattress as a child, with maybe a single pillow and blanket. “How old are you, Grace?” “Seven.” Phoebe was shocked. Grace was far too short and skinny to be seven. She looked four-years-old, not seven by any means. She made a mental note to cook a very large dinner and make sure the child was well-fed. It was a huge fuss to get Grace in the tub, even after putting lots of bubble bath inside. But Phoebe assured her that she was a nurse, and that it was okay for her to see Grace in the nude because doctors and nurses have to make sure that a child is healthy. Finally, Grace agreed. She was covered in so much soot and ash from the explosion, her body was almost entirely gray. A good, hard scrubbing and she’ll be good as new, Phoebe thought. But instead, she found Grace’s body littered in bruises. There were a few dark ones on her arms and wrists where it looked like she had been grabbed, she also had a burn mark on her upper arm from what Phoebe assumed was a cigarette. She also had a few bruises on her calves and knees, along with some scrapes. The worst of the bruises was one around her thin neck, and two others on each of her hips, in obvious shapes of large hands. “Grace?… Who did this to you, sweetie?” her voice was a whisper and she was trying to hold back tears. Grace looked down shamefully, “My father…” Phoebe paled, and suddenly felt the strong urge to hold the child close and rock her while also crying, for the walls the older Grace had built around her mind had finally come tumbling down and Phoebe was overwhelmed by the gigantic wave of memories of past abuse; mental, physical, and sexual. “I… I’ll go see if Luna has your clothes…” Phoebe got up and left the bathroom, shutting the door behind her. She was met with Luna placing a box of her old clothes on Grace’s bed and a very worried Severus in the doorway. “Is she okay?” Severus asked. The tears Phoebe was trying to hold back for the sake of Grace finally flowed down her cheeks. She covered her mouth to silence her sobs with her hand and shook her head. Severus started to make for the bathroom door but Phoebe stopped him in his tracks, “Severus, no, you don’t want to see.” “She’s my daughter!” “And Grace would not want you to see her like that!” While they were arguing, Luna snuck into the bathroom, her eyes widening at the giant bruise on Grace’s neck, but nevertheless smiled and pretended she didn’t see it. Grace was playing with the bubbles, stacking them on top of her head, having fun as a child should be. “Hi!” the younger girl said, with a big smile on her face despite her outer appearance. “Hi,” Luna replied and held up two outfits; one blue and one green. “What’s your favorite color?” “Blue!” She smiled and nodded. Of course, she knew that Grace’s favorite color was blue, but how similar was the Grace she knew to the Grace eight years prior? Severus, with the bathroom door open slightly ajar, caught site of the bruise on Grace’s neck, along with the bruises and burn on her arm. His concern turned to anger, “I’m going to kill him.” “Who?” “Her father!” he growled. “Severus, you will not do anything drastic! Now go get some balm to get rid of those bruises!” “But!” “Now!” and she pushed him out of the door. Severus came back with a few things from his lab. Phoebe put them on Grace’s bruises, but they only faded slightly. She wondered if there was any serious internal bleeding or something broken; the balm should have made them disappear completely. She dressed her in clothes that were still too big for the too small seven-year-old and braided her hair in two side-braids. Grace had made herself (re)acquainted with Merlin until the pup had tired himself out and curled up into a ball in his bed. So, Grace decided to make her way downstairs. The man with dark hair, who was supposedly her new daddy, was reading on the couch. Grace’s parents never read, not books like this. They had stacks of magazines, though. Mostly with pictures of naked women in them. But Grace loved to read, even if she had to hide the books she brought home from the library from her parents. Seeing her new da read so openly intrigued her, and so she tentatively took a seat next to him. “What are you reading?” she asked quietly. Severus flipped over the book to show her the cover; the book was very old and its pages were aged like historic documents, and the cover was fading, but she could make out the word “Potions.” She assumed it was a fantasy book about magic and sorcerers, but when she craned her neck to have a peek at the contents of the book, all she found was a few paragraphs with words she had never seen before and what looks like a cookbook. She continued reading the strange book over Severus’ arm, trying to make sense of it. Something in her told her that she knew exactly what she was reading, but her brain said otherwise. Severus watched the younger version of his daughter try to make sense of the different potions. He was scouring every potions book he had to try and find a reversal potion, but some part of him wanted to procrastinate, just slightly. Grace had tried to rewrite some of her own history in her head; make it less painful to remember. Maybe if we really could rewrite it… “Severus Tobias Snape, don’t you dare!” Phoebe called from the kitchen; obviously, she had read his mind. “What’s the worst that could possibly happen?” “Um, how about she’s stuck that way forever? Haven’t you learned anything from literally every movie about time travel? You don’t mess with the past!” “Daddy, what’re talking about?” Grace asked, now reaching over to flip through the pages herself since her dad was too preoccupied to read with her. Severus’ heart swelled and he looked at Phoebe pleadingly, who shook her head in response.

There wasn’t much Grace could do with her time as a seven-year-old, not that she knew she couldn’t do much. Luna kept her occupied by coloring or playing games with her. Severus got easily distracted when Grace was around and wanted to spend time with his daughter rather than spend time trying to get his daughter back to normal. So, Luna and Grace spent most days outside with Merlin and Phoebe kept Severus locked up in his lab. But, a man can only do so much before his brain becomes fried for the day, so when he finally tired of the research, he and Grace would take Merlin for a walk and he’d just let her ramble on and on about absolutely nothing. He didn’t mind at all that he didn’t understand a word she was saying, only that she was smiling. Whoever said Severus Snape didn’t like children didn’t know the true Severus. He loved teaching and loved the students and especially adored those in his own House. (He was the Head of House, he was allowed to). It’s just that he expected better from his students, sometimes too much, but he wanted them to be successful, and if that meant being strict and making them a bit afraid to mess up in his class, then so be it. It worked for the most part. Grace also met Draco in the few days she was seven-years-old. “This is insane,” Draco muttered. “Right? It’s like, I know it’s Grace, but it’s not!” Luna agreed. “I mean, she’s my girlfriend. This is technically pedophilia.” “Ew, Malfoy. Keep it in your pants.” “I didn’t mean- Nevermind.” “You’re pretty,” Grace said looking up at Draco from her drawing. “Thank you,” Draco smiled. “You’re very pretty too.” “Okay, I’m weirded out.” “Yeah, me too. Uncle Sev needs to change her back. Quickly.”

It was somewhat hard for Phoebe to watch Severus with the younger Grace. It was very cute and very sweet to see the two of them. Severus was so in love with that little girl, and she absolutely adored him. When she and Luna weren’t keeping them apart so Severus could work, they were inseparable. Severus by no means spoiled the older Grace. He gave her what she needed and what she had been deprived of for so many years and showed her that she didn’t need to do absolutely everything alone, but didn’t spoil her… much. But with the younger Grace, it didn’t take much of anything at all for him to melt like butter. The girl had him wrapped around her little finger. It was a simple, “Please, daddy?” a flash of her big blue eyes and her crooked little smile, and Severus would sell his soul for her. It was over silly little things, too, like having ice cream for breakfast, or getting him to read her a bedtime story, and then another! The worst part about it was that it would be over once Grace was back to normal. Their relationship wouldn’t change; they were still just as close. But it was the silly small things, like giving Grace a normal childhood. Perhaps that’s why he was giving in so easily, Phoebe thought. Severus was hoping that if Grace remembered anything from this, it would be all of the happy memories, like eating ice cream for breakfast.

Severus had found the recipe to reverse the effects of the potion, but it had to simmer overnight. So the two of them sat on the couch watching old episodes of Gilmore Girls with a bowl of popcorn between them. Grace tried countless times to throw a piece of popcorn in the air and catch it in her mouth, only for it to hit her face or for her to completely miss, and then Merlin chased after it and Grace laughed like it was the funniest thing she had ever seen. “I wanna drink coffee like Rory.” “No, it’ll make you hyper and you won’t be able to sleep.” “So? I’m hyper and can’t sleep right away now,” even at seven-years-old, she always had a damn answer for everything. “Do you think Lorelai will ever get with Luke?” Severus just shrugged. He knew they got together, broke up, and then got back together. But he wouldn’t tell her that, they were only watching the first season. He also hated the fact he knew that since his damn daughter had him binge the entire series with him. “If I’m Rory, then that means you’re Lorelai.” “Oh, is that right?” he raised a brow. “Uh-huh. ‘Cause you’re my dad and my best friend,” she said it so plainly like it was natural law. And maybe Severus was a fool for not thinking the same way. He never realized because the Grace he knew already had a best friend, Luna. But was his relationship with the older Grace and younger Grace really any different?

The next morning, Grace took the reversal potion, and everything was back to normal— whatever “normal” was anymore— except Grace had a splitting headache. She and Severus sat at the kitchen table drinking coffee. “Good job screwing up my timeline, dad,” she said taking a sip of her coffee. “What do you mean?” “Well, to me, it’s all in a fog now, but I remember my shitty parents sending me to some big house for a few days to get a break from me and the family was super nice and loving. It just made meeting Luna and you again all the more interesting,” she smirked. “Shit.” “You remember it differently?” “Yes, I remember it like it really happened, just over the past few days.” “Well, aren’t you glad I never brought it up? Would’ve been a bit awkward,” she finished off her coffee. “How’s your head feel?” “Like someone is drilling into it,” she rubbed her temples and winced in pain. “Go get some rest, Gracie.” “Sleeping the day away sounds good,” she said as she placed her mug in the sink. “I’ll see you… I don’t know. Maybe I’ll wake up for dinner.” He snorted, “Okay, Grace.” She went upstairs to her room, her small potato of a puppy following her with his short stubby legs. She was about to just flop on her bed and pass out, but something caught her eye on her doorframe. There was a black line not too far off the ground and in childish handwriting said, “Grace Age 7.” She smiled and grabbed a Sharpie, standing with her back up against the doorframe and marked where the top of her head was, drawing a black line and writing in much neater handwriting, “Grace Age 15.” She hadn’t grown much at all since then.

#harry potter #harry potter au #modern au #severus snape #original character #Grace McClivert #The Potion Masters Grace #luna lovegood #draco malfoy #Draco Malfoy x original character

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mhsn033 · 4 years ago

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Coronavirus: How an aged care crisis seized ‘ill-prepared’ Australia

Image copyright Getty Photos

Image caption Victoria has now viewed nearly 100 outbreaks in ragged care properties

“I grew up in a battle; I’m no longer death in a pandemic.”

Margaret Alcock sheltered from bombs during the Blitz, crossed an ocean to stay in Australia, and was evacuated to security in the course of closing season’s bushfires.

The 89-year-light – who is my nanna – frail stoicism and dark humour to cope in the course of these times. Or no longer it’s miles the identical now with Covid-19.

“I pause most steadily marvel how on Earth I’ve ended up here with coronavirus round me,” she tells me over the phone from Original South Wales (NSW).

“But I’ve viewed worse issues occur, and I develop no longer difficulty about it.”

When the coronavirus reached Australia in January, my household assumed that my grandparents – each and every of whom stay in ragged care properties – had been in the safest space doubtless.

Five months on, the sector has viewed ratings of outbreaks and 156 of Australia’s 247 virus deaths. This involves 12 of the 15 announced on Wednesday – Australia’s deadliest day but.

In a deepening disaster, some providers were accused of failing to shield society’s most susceptible contributors. Order and federal governments are also facing questions.

Image copyright LUCY MARTIN

Image caption The creator alongside with her nanna, Margaret Alcock

More than 180,000 contributors stay in Australia’s residential ragged care properties, which are managed by no longer-for-profit groups, non-public firms and authorities organisations.

Somewhat plenty of these providers had been hasty to impose their very have lockdowns. Some went beyond the authorities’s legitimate suggestion by banning guests, halting activities and confining contributors to their rooms.

Margaret has been quite lucky. Even supposing guests had been forbidden for a whereas, residents at her dwelling in regional NSW can switch round freely.

But my other grandma – ragged 87 and likewise named Margaret – has no longer left her care dwelling in Melbourne, Victoria, since March. And prior to now month, Melbourne has viewed infections surge.

Grandma is confined to her room other than rapid walks down the corridor. She sits in her armchair and eats meals by myself.

Despite this, she has most bright reward for group at her dwelling who’re working below unparalleled tension. Grandma has upped her word search sport and plays “hallway bingo”, where residents sit down in doorways as a bunch member walks up and down shouting numbers.

“The lockdown is onerous however I’ve accredited that it’s for my have welfare,” she says.

“I develop no longer stir to bed caring about it. Or no longer it’s onerous no longer being in a field to search files from my household however appropriate because they’re no longer here would now not indicate they develop no longer like me.”

Image copyright LUCY MARTIN

Image caption Margaret Martin is locked down in Melbourne, where infections are surging

The firm that runs her dwelling says it has a entire infection opinion, a corpulent stock of non-public maintaining equipment (PPE) and strict hygiene measures.

But across the 2 states, many households were left heartbroken because lockdowns in other providers dangle failed to prevent the virus spreading.

‘We did now not listen in on in a international country’

Or no longer it’s no longer onerous to seem after why ragged care properties are so at risk of this virus.

They dangle elderly populations with underlying conditions, restricted scientific providers and a pool of workers who most steadily work across multiple net sites, increasing the probability of spread.

In February, harrowing tales began to emerge in regards to the “restful bloodbath” of Europe’s care dwelling residents.

It would want to were obvious that Australia was at risk of a identical scenario, per Professor Joe Ibrahim, who is head of health law and increasing outdated be taught unit at Monash University.

“Australia’s response was inadequate, underprepared and none of it could perhaps well well presumably need to were a shock,” he stated.

Melbourne’s ‘sigh of catastrophe’

“Folks spend the word ‘inevitable’ however that’s no longer precise since it provides the affect there was nothing lets pause. We did now not acknowledge the accurate risk that Covid-19 [posed] to ragged care and we did now not listen in on what was happening in a international country.”

On 3 March, an employee of the Dorothy Henderson Lodge in Sydney examined sure for Covid-19. By the purpose that outbreak was declared over in Could additionally, 21 residents and group had been contaminated and six had died.

Yet any other Sydney facility – Newmarch Apartment – determined to quarantine contaminated contributors in their rooms somewhat than ship them to clinic, in spite of combating group shortages and a scarcity of PPE. Nineteen residents died and dozens more had been contaminated.

Image copyright Getty Photos

Image caption Relatives of residents at Newmarch Apartment protested over their treatment in April

Those cases raised many questions however to this point there are few answers. Now it’s happening again.

The sigh of Victoria is experiencing a brand recent outbreak in each and every the broader neighborhood and care properties. Currently shut to 1,200 active cases are linked to 97 separate ragged care outbreaks there.

Prof Ibrahim says lockdowns by myself had been never enough to retain the virus out. “We did now not dangle optimistic policies or a clarify structure in space [for when a case did occur],” he stated.

“The federal authorities is accountable for ragged care however the general public health authorities in every sigh are accountable for outbreaks, so there was confusion about who steps in and when. There was also confusion about whether or no longer to supply care [for Covid-19 patients] in the properties or in hospitals.”

Opposition leader Anthony Albanese has assuredly is called for large-ranging scrutiny, announcing this week: “Why weren’t the classes learned from Newmarch, which took place months ago in Original South Wales?”

A recent retain an eye on centre has been role up in Melbourne with each and every sigh and federal companies working together to retain an eye on the disaster in Victoria.

Prof Ibrahim would grab to search files from a national centre role up to assess every care dwelling in Australia.

“That arrangement we would be optimistic about which locations are at risk and where to procedure sources,” he stated. “The response have to unexcited be swift and definitive – there could maybe well presumably additionally be no equivocation.”

Image copyright Getty Photos

Image caption The Australian Defence Force has been called in to aid stem the outbreak

A authorities inquiry has been role up to examine the sector’s response. It has heard accounts of group shortages, lack of practicing and internal most maintaining equipment and delays in accepting aid from health authorities.

But the Australian Medical Affiliation has called for the greater scrutiny of a royal commission – the highest affect of public inquiry. Its Victorian president, Julian Rait, instructed Nine newspapers the disaster was a “foreseeable tragedy”.

For now, it’s inevitable more elderly Victorians will die, per Australia’s Neatly being Department secretary Brendan Murphy.

My loved ones are lucky – their care properties stay freed from coronavirus. Whereas Margaret Martin remains in strict lockdown, Margaret Alcock is being allowed guests over again. My mum visited on Saturday to attach rollers in her hair.

They laughed, they hugged, they bickered, and, appropriate for a moment, they forgot about Covid-19.

Nanna thinks getting the virus would doubtlessly be the quit of her, however she’s no longer happening with out problems.

“I was chased by a form of geese when I was younger so I doubt coronavirus goes to get me.”

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