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andhumanslovedstories · 10 months ago

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

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

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

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

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

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

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

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

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

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

#nursing tag #i hope this helps at all i know how much it sucks to end a shift like 'cool. i didn't help my patients. feel great about that.'#it sucks when you don't have enough time to take care of people because you have too many people to take care of #anyway also thank you re: pain post compliment. and also thank you re: getting to talk about pain mgmt again #marge simpson holding potato voice: i just think [nursing process and symptom management] is neat!

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microwave-core · 1 year ago

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SWSH Headcanons

I love sword and shield and the chokehold these characters have on me, but if I ever tried to write dialogue for most of them I would have a stroke, so have this instead.

I’ve written a bit for Sonia before, but there is one point that I completely forgot to bring up, and that is how absolutely excited she is to share her research and discoveries with you. She loves her job (most of the time), and is absolutely going to blab to you about it, so be prepared.

You don’t have to understand everything she’s saying, you likely won’t, but that’s okay. Just listening and trying your best to work through what she’s saying will be enough for her. Feel free to ask as many questions as you want, she will answer each and every one of them with incredible enthusiasm. But if you understand what she’s talking about, she would fucking ascend on the spot from happiness.

Please have a girl's night with her. Get holed up in her room while spilling trashy gossip all night while painting each other’s nails over cheap wine, she’ll love you forever. She’d jokingly ask if you had a crush on anyone when you’re already dating and act all innocent and teasing about it, like, “aww, you had a crush on me??” when you’ve literally been dating for years.

Yamper goes everywhere Sonia goes. You can expect him to be begging at your feet whenever you meet up with her, wanting nothing more than for you to bend down and shower him in love and affection. He’s a good boy and he knows it. Sonia might send him off to fetch you when she’s busy, so please trot behind him slowly. He wants to lead you there and doesn’t want to fall behind.

I’ve brought this up before, but Leon would be so supportive. Sonia is his bestie, so when you get into a relationship, he wants to meet you as soon as possible. Man just loves his friends and is so happy when they get into loving, meaningful relationships. He also knows a lot about you because Sonia has gushed about how much she loves you to him on several occasions. He can seem kind of intimidating with his status and all, but he’ll definitely end up thinking highly of you.

And I have to mention Hop as well, because he’s also very supportive. He takes it upon himself to be Sonia’s wingman when she’s pinning. When Leon’s not available, she’ll blab to Hop instead. The second you meet, he begins planning your wedding. Be prepared.

But that’s not all, because Nessa is also Sonia’s bestie. She’s the only one of the three that you really have to worry about, as she won’t hesitate to speak her mind if she has any kind of issue with you, but she ultimately knows how much you mean to Sonia, and so she has no choice but to be supportive. Anyways, if Sonia takes too long to confess her feelings for you, she’ll get Leon and Hop together to form a plan to make it happen. Sonia is mortified.

Nessa… Need I say more? She is the woman of all time, with one of, if not the, best design in the entire series. She’s gorgeous, she’s powerful, she’s described as having an “indomitable nature”, what more do I have to say?

Unfortunately, as both a model and a gym leader, she’s a busy gal, always running to and fro to get work done. She’ll always try to squeeze in time for you, but that doesn’t always work out, much to her dismay. It also means that many, many people are going to be jealous of you. This goes for all of the gym leaders and champion as well, considering they are essentially celebrities in Galar, but Nessa may as well be in a league of her own.

Many people have crushes on Nessa, both young and old alike, so finding out that she’s taken is a crushing blow. You’re gonna end up with weirdos that hate your guts for daring to date their crush, which sucks. But on the other hand, you’ll also have weirdos who are completely obsessed with you and your relationship and want to know every little intimate detail. You decide which is worse.

Speaking of being a model, expect to be roped into a photoshoot every now and then. Nessa loves you and thinks you are drop-dead gorgeous, so, naturally, she’s not above pulling some strings to fit in a shoot or two with you. Expect to at least have a Valentines photoshoot every year, since it’s the most obvious way to show off how great of a couple you two are.

Nessa yearns for the ocean. Having grown up in a sea-side town with fishermen for parents, she’s used to floating out into the ocean and just relaxing. When she’s feeling stressed and pent up, she’ll drift out into the blue abyss with one of her pokemon, staring into the sky above while being rocked gently by the waves. She’d love it if you joined her sometime.

She also really likes fishing. She often comes back to her roots, which leads her to pulling out the full fishing ensemble, “fish fear me women want me” hat included, and getting onto a dinky boat to sail off into the middle of the ocean to fish for hours on end. You are asked to join her on these trips, but they aren’t super exciting unless you absolutely love fishing.

She has pictures of you everywhere. In her gym locker, in her wallet, on her phone, around her house, in Sonia’s lab, everywhere. They’re almost entirely pictures that she’s taken, too. While she is by no means a photographer, she knows a few things about taking good pictures from modeling, and loves to use that knowledge to take wonderful pics of you (not that you don’t look wonderful all the time). Her phone’s lockscreen and wallpaper are also pictures of you, obviously.

So I don’t have a sword so I am not as familiar with Bea, but her design alone is enough for me to write for.

Girly pop is stoic, but she’s not unbreakable. It’s not the easiest task, but it’s absolutely worth your time to make her smile and laugh. That being said, it makes her very embarrassed and flustered, so please spare her and her image and only do so when in private.

She thinks about you a lot. Bea’s been trained to remain calm and collected, even in tense situations, which makes it difficult for opponents to read her in the heat of the moment. Little do they know she’s just thinking about what her girlfriend is up to at the moment. Were you doing alright? Were you in the stadium watching her match? Were you cheering her on? She hopes so.

Is not above using you to indulge in her love of sweets. She has the biggest sweet tooth in the league, but has a hard time actually eating them without garnering too much attention. So, when she wants to have something sweet, she’ll bring you with her and play it off like it was your idea, therefore she was just following you and being a good girlfriend and not just getting dessert.

Training never stops with this one. She works out all the time, and will invite you to come sometimes. Her training is incredibly rigorous, though, so you likely won’t be able to keep up. Sitting on the sidelines and cheering her on or helping her workout in some kind of way are more than acceptable in her mind. Easiest way to help her is to sit on her back while she does push ups, it helps her workout while also getting to be close with you. Don’t expect her to be talking too much, though.

Her training sometimes brings her to remote locations in the region, and she sometimes forgets to warn you ahead of time. You might spend your entire day trying to get ahold of her and asking others if they’ve seen her, only to receive a text from her hours later that just reads like “ out training”, no further elaboration.

Bea’s a tad bit touch starved, so she thrives off of your affection. However, she’s not very good at vocalizing her wants, so it falls to you to notice her longing stares. She wants to hold your hand and cuddle and sling her arm around your shoulder when sitting close, but she’s too nervous to initiate on her own due to her lack of experience.

Her only ask is that you keep your relationship pretty lowkey in public. PDA makes her a little uncomfortable, both because she’s shy with affection and also because she knows people are watching. Hand holding is as far as you are gonna get with her before she breaks a little inside.

Melony my beloved. They did not have to cake her up so much but goddamn I am not complaining because ahjdkgh milf. She’s hot and also incredibly caring and sweet and supportive.

First things first: you have to get along with her kids. This is non-negotiable. She already has a rocky relationship with one of her children, she doesn’t need to jeopardize that relationship further, or the one’s with her daughters, for any reason, even for love. It’s a lot to suddenly have five step-kids, especially if you don’t have any kids to begin with, but if you aren’t willing to at least try, Melony isn’t going to be sticking around.

She doesn’t want to overwhelm you too quickly, but meeting her children is something she wants to happen early in the relationship. Once things get serious, she’ll invite you over for dinner which, surprisingly, goes very well, with little family drama being drudged up in the process. It takes a monuementous amount of effort to convince Gordie to come over, but he does, reluctantly. It’s probably pretty stressful because, uh, if you mess up then your relationship is toast, but it’s worth it in the end.

Also, congrats, by doing the bare-minimum, you become Gordie’s favorite mom. This is by default, considering the previously mentioned rocky relationship he has with Melony. She’s just happy that Gordie isn’t upset about her hopping back into the dating scene, same with her daughters, and that they actually like you.

Not normally what I write about with these, or write about in general, but, when it comes to arguments, Melony can be a little difficult because she’s used to being the one in charge. Most of her arguments are with her own children, over both silly and important matters alike, and so she’s used to taking the perspective of “mother knows best”. It’s never her intention to control or demean you, but it can easily come off like that. If you bring it up to her, she’ll do her best to work it out of her mindset (communication is important kids). Not to say that arguments happen often, of course, but they can be incredibly annoying to deal with when they crop up.

Melony loves to cook, and would love to both cook for and with you. It’s maternal instinct to make sure you’re well fed, there’s simply no way around it. Expect her to make you adorably packed lunches and plenty of home cooked dinners. You’ll almost always end up with leftovers, since she’s used to cooking for five people. But she’d love it if you joined her in the kitchen for some quality bonding. If you’re lucky, she might even show you how to make the snomlette.

It’s honestly incredible that she has time to do so many things for you and her children along with her duties as gym leader with time to spare. It’s the mom magic.

Marnie, despite being punk, is shy and sweet in equal measures. Even as a gym leader, she has a streak of being a little stand-offish and awkward. That’s not to say that she’s meek or a push-over, or that she gets nervous in front of a crowd. She’s just easy to fluster and is usually on the quieter side.

Like many others, Marnie’s got a lot on her plate. Of course, she’s got her duties as a gym leader to tend to, but she’s also working on restoring Spikemuth to its former glory. These don’t just eat up her time, they also leave her tired. Please hold your arms out for her to fall into when she walks through the door after a long day, it’s her favorite way to recharge.

Morpeko loves you more than anyone else, a blessing you should be thankful for. He’s kinda like a cat, in that he can be very sweet at times and an asshole at others. Oh, and he shows his love through biting. He likes Marnie well enough, but she’s not safe from being bitten or scratched. You, however, are a different story, as he seems to always be sweet when you’re around. Marnie’s convinced he does it out of spite.

Keeping up with the theme of “talking about other character’s important to this specific character”, Piers. He wants the best for his baby sister, considering that he basically raised her and all, but he doesn’t even try to be overprotective or intimidating. Does it sting to watch Marnie grow up, seeing her get into her first real romantic relationship? Of course. But he knows that she’s got a good head on her shoulders, so he sees no reason to butt into her relationship.

He’s an overall chill guy with a lot more time on his hands since he’s no longer a gym leader. As long as you’re chill, he’s chill, and won’t mind your company. Hell, he might even start looking forward to hanging out with you, thinking of you as part of the family, when you’ve known each other for long enough. The only issue he might have with you is your music taste.

This is a bit more general, but I like to think that Marnie and Hop are good friends. They didn’t know each other too much during the gym challenge, since all they really had was a common friend/rival, but they actually got to know each other once the champion cup was over. It’s not super easy to hang out since they’re both striving towards their own goals, but they find a way.

It’s funny, because I don’t think they would have much in common outside of their music taste, but they’re still friends who hang out and complain to one another. While he’s dropped his dream of being champion, Hop still gets excited over the gym challenge every year and loves to watch her matches. Marnie’s not the most knowledgeable when it comes to pokemon research, but she finds it all interesting and tries to lend a hand. She’s not that helpful. She also is the only person preventing Hop and Bede from throwing hands when they run into each other.

Oleana is the pinnacle of “very busy and very tired”. Gatekeeping, gaslighting, and girlbossing all day takes a great deal of time and effort. She’ll trudge home and fall face first into the couch, perfectly content to call it a night if you don’t step in and make her come to bed.

She loves the chairman dearly, but he also stresses her out immensely. There’s really no point in going out to meet loyal fans on the way to business meetings, but that doesn’t stop Rose from doing that anyways. She badgers him to the best of her ability, but he still takes his sweet time. While she appears composed, she’s screaming internally, waiting until she can go home and scream about it externally when venting to you.

Speaking of the chairman, it seems as if she cares more about him than she does you at times, but she does her best to reassure you otherwise. The chairman is, unfortunately, her priority due to being her boss, but that’s more about admiration than love. Consider the fact that he (unintentionally) makes her incredibly stressed, whereas you don’t. That alone gives her a reason to love you.

Also consider that the idea of coming home to you at the end of the day is part of what keeps her going. Sure, her job is stressful, considering the fact that she is essentially the backbone of the Macro Cosmos company, but she always gets through the day because she gets to see you once it’s all said and done. The tension within her bones dissipates upon walking through the doorway. Hold her in your arms, brush your fingers through her hair, get shitty take out to eat over trashy TV that neither of you are really watching, and you’ll win her heart in an instant.

While she shows her more… aggressive side to you when ranting passionately about all the issues involved with her job, she reverts back to her poised and punctual state whenever in public. Due to her professional nature, expect little PDA. The most you’ll get is hand holding. Unless she’s jealous, at which you’ll get a hand wrapped around your hip which grips just a little too tight until she calms down.

Date nights are typically spent indoors unless she has a day off, which is incredibly unlikely to happen. Firstly, she wants to rant, and she can’t do that in public without destroying her public image. And secondly, she’s tired of dealing with people given how much shit and disappointment she has to deal with throughout the day. You get her, so why would she want to be around anyone else?

Also! Garbador is an absolute sweetheart. She knows how much you help Oleana and that makes her so happy. She tries to show her affection but is a little awkward about it because she doesn’t want to gross you out since she’s… literally made of trash. She usually just watches from afar, all smiley and happy to see you two being happy, getting embarrassed if you catch her doing so.

Sooo I wasn’t originally gonna write anything for Klara because, again, I don’t have sword and am not as familiar with her as I am Bea, but thoughts started rolling so here we are. Also kinda toxic behavior incoming because it’s Klara.

Girl is a pop star, or is at least trying to be one, which means she’ll naturally write love songs about you. And by love songs I mean songs that describe how much she loves you but are also not really love songs because they’re lowkey toxic? Listen, it’s Klara, what else do you expect when that is literally her thing. She also has songs about her exes, which contain… worrying content, but that’s neither here nor there.

In general? Don’t break her heart. She will key your car and slash your tires and will attempt to instigate physical fights and will also write a song about you and how much she hates you and all of the things she hopes happen to you. Again, it’s Klara. But if she loves you with her whole heart and soul, then you have nothing to worry about. She’ll be more than happy to do all those things towards people you don’t like instead.

She's not the best at showing her love. Her goal in life was always to be loved by everyone around her without having to do much in return, but your existence has disturbed that goal because she actually really likes you and actually wants to try for you? And she kind of hates that, and it takes her a while to even figure out what the hell was wrong with her, and she ends up resenting you for a hot minute for making her feel so weird.

But she gets over that and decides to put in actual effort into your relationship, trying to be a better person both for you and herself. She takes the time to listen to you and work out your likes and dislikes, and puts effort into coming up with cute date nights, and does her best to be there for you when you’re down or need to get something off of your chest. Just normal girlfriend things. She’ll never admit to changing how she acts, though. This unintentionally turned into an “I can fix her” post whoopsie.

Klara loves to take pictures of herself and photoshop them, so expect to be sent most, if not all, of them. Sometimes, she just thinks she’s looking exceptionally cute and just needs to share her hotness with someone else. She also expects you to send pictures back in return, as it’s only fair. Like Nessa, she has a large portfolio of pics she’s both snapped and received of you.

Anyways, Klara posts shit like “I love doing wifey shit for my girlfriend <3” while burning down the kitchen trying to make you scrambled eggs.

I also originally wasn’t going to write anything for Peonia but I had a change of heart because, after thinking of it, I couldn’t not write embarrassingly supportive supreme dad-of-the-year Peony hyping her up.

Peonia’s biggest mistake in life was coming out to her dad, because the man is simply too supportive. The moment she tells him this vital information, he is searching every store and market for all of the lesbian flags he can find. She has an entire pile of them in her room because she literally doesn’t have any space on the walls to hang them on. He also sews smaller ones onto her clothes and jackets upon being asked to do so,

If he ever sees her talking to another girl, he’ll ask about her afterwards. He just needs to know if she’s into this new person he’s never met before. Peonia always tells him off in an attempt to subdue her embarrassment. Thankfully, he at least waits until the other girl leaves, or else she would literally combust.

That being said, don’t think you can date Peonia without Peony putting up an overprotective fight. At the end of the day, that’s his baby. His darling. His pride and joy. Sure, she’s grown up and is more than capable of making her own choices in life, including her choice in romantic partner, but he’s still her father. He just needs to make sure you have her best interest in mind, then he’ll back off.

But once you’ve gotten past the over-protective dad phase, you get yourself a new father figure. He’ll come to think of you as one of his own. He’ll also provide you with plenty of embarrassing childhood stories. At some point, he’ll start referring to you as his daughter-in-law. Every minute you spend talking with him makes Peonia rip her hair out. Again, Peonia is happy that her dad is supportive of her sexuality and your relationship, but she’s also on the verge of dying from embarrassment.

Even though she is incredibly embarrassed by her father’s antics, she can be super supportive and exciting when it comes to doing anything with you. The apple doesn’t fall far from the tree, and when she realizes how she acts similarly to her father when it comes to spending time with you, she dies a little inside.

Enough about dad. Please go with her on Dynamax Adventures. Not only does she have a blast with them, but she can show off how cool and strong she is as a trainer. Please swoon over her and how cool and brave she is, being as dramatic as humanly possible. RIP to your teammates who are forced to third-wheel on the adventure, but at least Peonia is having fun.

Also, please help dye her hair. The pink looks great but it was a pain to do by herself, and she’s too embarrassed to ask her dad for help. Besides, it means you get to hang out and she gets your input on what color to use.

#pokemon x reader #fem reader #today I bring you self-indulgence #tomorrow? who knows #i dont care what canon says leon and sonia are best friends #do not seperate them #do you know how hard it was to not write him as everyones friend #man is just friend shape #can you tell i like leon #marge simpson voice i just think he's neat #incoming tag hell #sonia x reader #nessa x reader #bea x reader #melony x reader #marnie x reader #oleana x reader #klara x reader #peonia x reader

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