#poor utah honestly

[boba21521]

The Florida Drugging people saga: (I was bored)

[iscariotapologist]

my best friend is slowly getting in SDA. please send help (or moral support) (and she has a scholarship to their university too *screams*)

that is insane to me. my deepest condolences

[kentjohnson91]

Today we are going to discuss trades/slash free agency signings that have happened this offseason and how and why they made me upset:

Max Jones: Anaheim➡️Boston (free agency)

I love the chaos he ensued with Trevor and the other young guys

Was the first person to post about Jamie Drysdale being traded which was just a video of jamie dancing and smiling but then added like 10 thousand broken hearts

also as a bruins and red sox fan WHY ARE YOU GUYS NOT INCLUDING HIM

Zadorov and Lindholm threw out the first pitch at the Sox game the other night and Max and his wife (i think they’re married but maybe im wrong) were literally there but not invited to do that and also not sitting with the Lindholms and Zadorovs in the nice seats

It was not a numbers thing either because in like 2021 (?) they had like 7 new guys for the B’s on the field at 1 time

Nikita Zadorov: Vancouver➡️Boston (free agency)

As a Bruins fan SO EXCITED

As a fan of chaos i’m sad

Him and Myers reeking havoc on the ice together was so iconic for the short time we were blessed by it😔

Nick Blankenburg: Columbus➡️Nashville (free agency)

This was like one of very few moves i have not approved of by Mr Don Waddell

He was cooking from the start and then this happened

Like Ik he was probs gonna be in the AHL a lot but like for an undrafted defenseman he is good

He’s like 5’9” (more like 5’8 stop lying Nick) and runs around throwing hits on 6’3 or bigger guys

He’s my favorite little man and i want him back. He rounded out the Michigan group on Columbus too well.

Kevin Bahl: New Jersey➡️Calgary (trade)

Ik i say “im not a devils fan i just love him” about like half their team but like i swear its true

I need everyone to acknowledge the childhood friends to NHL teammates arc of him and the Hughes brothers and that is heartbreaking that it is no more

Also i understand it was an underpay for Markstrom but that will always happen for goalies (see Ullmark trade) so all the Devils fans acting like it was a good thing he was gone and not appreciating the time he put in there or the calgary fans mad they got him and hating him already made me wanna cry

Like GIVE HIM A CHANCE

also he just had a baby right before the trade and that means none of his NJD teammates get to see the baby and that will make me bawl (hehe bawl - bahl) like a baby no joke

John Marino: New Jersey➡️Utah (trade)

TOM FITZGERALD WHEN I GET YOU

This poor man who tends to look like a kicked puppy for no reason seemed so happy there

with Jack, Luke, Nico, Kevin, Curtis, Nate like cmon why would you do this to me

Will never cope with whatever the fuck was goin on with him and Luke honestly

WHY UTAH

Ryan McLeod: Edmonton➡️Buffalo (trade)

this was another one like the Kevin one where the fans pissed me off instantly

“the other guy was such a good prospect he was gonna develop more and play for buffalo”

i’m gonna hold your hand when i tell you that McLeod is 24 (almost 25) and 25 year olds can STILL DEVELOP TOO THIS SHIT SHOULD NOT BE NEWS HELLO???

also people who started using what his brother did as an excuse to not want him

while no one knows for sure, randomly assuming with no real reason that he had any knowledge of his brothers part in the 2018 Team Canada Scandal is so unfair honestly

and ALSO they separated him from his pookie (Bouchard) and his gay dads (Leon and Connor)

Not coping

Linus Ullmark: Boston➡️Ottawa (trade)

where do i even begin

no more hugs

no more feeding each other during post game interviews

no more eating cinnamon buns that Ullys wife made them together

no being Matt Poitras dads together

I ofc understand from the business side but it doesn’t make it hurt less

Jake Debrusk: Boston➡️Vancouver (free agency)

This one stung

we all knew it was coming but like

he’s been here his whole career

him and McAvoy were the ultimate duo

scored their first goals on the same night

if anyone saw Charlie McAvoys post about him and Grizz just know i cried for hours over that shit

Matt Grzelcyk: Boston➡️Pittsburgh (free agency)

another one that hurt a lot

once again see charlie mcavoys post

THE ONES OF THEM FROM COLLEGE TOGETHER

ENOUGH CHUCK

also no more amazing interviews with Mr Grzelcyk (Matt’s dad)

He worked in the Garden forever so Matt LITERALLY LEARNED TO SKATE THERE

HOMETOWN HERO AND A HALF

HEARTBROKEN

Anyways if i think of more im forgetting or something else happens before camp ill make another post but anyways

[thoughtfulfoxllama]

Ok, so it's Fast Sunday in my Ward, and I'm eating Graham Crackers in my In-Laws Ward Lobby, so let's talk about Fasting

Fasting in Mormonism is pretty basic: no food or drink for 24 hours or 2 meals. I never said basic was simple though, so let's deconstruct that

For one, why is it 24 hours or 2 meals? Are we supposed to only eat 2 meals a day? Honestly, I have no idea. Pres Joseph F Smith moved the Church's Fast Day to Sunday (it was Thursday before then) in the early 1900s, and defined a fast as evening to evening. So, maybe the idea of 2 meals or 24 hours is whether you eat Dinner before you start your fast or not (in 1976, Pres Nelson wrote an Ensign Article, where he said that Fasts should be 2 Meals, with no indication of 24 hours, meaning that, to him at least, Evening Meals should not be skipped)

Next, what's considered "food and drink?" Does water count, for example? Everything I've found says "it's personal." In Utah, the custom is to not drink water, but in order to understand what's allowed, we must look at the purpose of fasting. The Purposes of a Fast are increased spiritual connection & to help the poor and needy through increased empathy (encouraging is to help them) and generous fast offerings. If you ask me, not drinking water is counterintuitive to the first purpose. So, I understand the traditional LDS Fast to deal with Calories & Pleasure. If you can, abstain from food, and liquids aside from water. If you can't (for example, I need to eat with my medicine), then eat plain foods as needed

But, we're not the only Faith that requires Fasting. How do they do it (there's definitely more, but these are the ones I'm familiar with):

Judaism: Judaism has several fast days. In addition to optional fasting on Mondays, Thursdays, and the day before the start of the month, they have 6 main fasts. 4 of them are from Dawn to Dusk, but the 9th of Av Fast & Yom Kippur fasts are from Sunset to Sunset, with an abstinence from all Food and Drinks (with additional abstinence from Leather Shoes, Bathing, and Sexual Relations on Yom Kippur). And since Yom Kippur is tomorrow, I wish a Meaningful Yom Kippur to any Jewish People who come across this post before the fast

Islam: In Islam, they have the Month of Ramadan. During this month, Muslims will abstain from all Food, Drink, Tobacco, Sexual Relations, and Sinful Behavior (such as swearing) during daylight hours, instead replacing them with Prayer & Study of the Quran. They also have 2 meals, one before the fast, and one after

Christian: Christianity has so many branches, so obviously has the most distinctions. Many Christians practice a Eucharistic Fast (where they fast before taking the Eucharist, or in Mormon Terms, the Sacrament). Early Christians would also fast on Wednesday & Friday, to commemorate the Betrayal & Death of the Savior. There are also 2 seasons of fasting: Lent & Advent. Lent begins with a fast from all Food and Liquid (known as a Black Fast) on Ash Wednesday, and ends with a Black Fast on Good Friday. During Lent, Christians abstain from a certain bad habit they have (such as smoking), and are expected to increase their Prayer, Study, and Alms (or Fast Offerings as we'd call them). On Fridays during Lent (as well as all Wednesdays & Fridays in Orthodox Christianity), they participate in a Lesser Fast, where one lessens food intake (2 small meals during sunlight hours) and only need abstain from Olive Oil, Dairy Meat, and Fish until sundown. There's also the Daniel Fast, which was a diet where only Kosher food could be eaten, but now refers to only eating Whole Grains, Fruits, Vegetables, Pulses, Nuts, Seeds, and Oils (for the Lesser Fast & the Daniel Fast, that's just being Vegan. So I guess Vegans really are holier than I /j)

Faith of the Seven (A Song of Ice & Fire): I know it's not a real religion, but it came to mind when typing. Whenever Priests in this religion saw the need, they would fast from everything except Bread & Water. (Warning, if done for 40 days straight, this can lead to death and being known as a fanatical king)

Long story short: don't judge how people fast. Not everyone fasts the same way, or even can. I fast from everything except water. I also fast at the New Moon. But if you can only handle a Daniel Fast, then as long as you use it as an opportunity to serve your fellow man (direct service or fast offerings), and come closer to God, that's what matters

[connectionterminated13]

Blood

This story takes place in my AU death swap, Basically a lot of the deaths are swapped Charlie is alive Sammy is dead, Michael gets his self grabbed by circus baby and Elizabeth does Michael's role in sister location and gets herself scooped. Now Evan who survived the bite and became a murder guy just like his dear old dad. Is tricking Charlie and Cassidy who Are trying to hunt down scrap Michael who's a giant metal fox because it's cool, Into thinking Michael not just a scared wet cat But actually a killer monster. You know to help his dad with evil stuff!!

This is for the prompt haunting not actual haunting more like haunted by your past kind of haunting :3 @and-stir-the-stars

TW: blood, animal death, manipulation, implied human death, hallucinations

God did Evan hate blood. Sure yes, when it spilled everywhere and the person screamed it was fun. but then after that when the blood was dry and all over his clothes he hated it.. If Evan ever got to talk to God, he would have a long discussion on why Blood was a terrible idea.

But of course Evan did not believe in God..

God did not come to comfort him in those horrible hours before operations or another month or four in the hospital. God did not come to banish the thoughts of blood and death from his mind no matter how many times he begged him.

And now God wasn't going to help him with the gruesome task of spreading this stupid dead Rodent’s, stupid Blood and Guts all over the place. 

Honestly it would have been so much easier if Michael had just mauled something…

But Michael, despite shoving Evans' 6-year-old head inside of a mouth filled with sharp spring locks and sharper teeth, couldn't seem to stomach actually killing something. So Evan had to fake the evidence of Michael being a monster. Which was going to be harder.

For example he was going to have to change out of his now blood covered clothing into fresh one before Charlie or Cassidy woke up. Then he would have to lead them back to this spot and be all sad and dramatic about his brother killing something so brutally. 

Sure he was good at faking emotion, he learned that from his father but it was harder when he liked the people he was doing it too.. And he likes Charlie and Cassidy. They were nice to him but.. Michael was a liability. A liability that needed a bullet through the head and a good place to rust at the bottom of the river 

Evan shouldn't call it Michael, it would be harder that way. No it was the insides of circus baby turned into some horrible mangled monster thirsting for the blood of poor innocent stupid Utah People. It was easier to think of Michael like that, easier to just think of him as the monster that made his life a never-ending Hospital trip..

Don't think of the good parts of Michael, don't think of when he was nice, think of the Mask, of the blood, of the doctor saying you only have a week left to live. Evan stopped, well lost in his thoughts he realized that he had done a pretty good job making the Rodent look like it had been torn apart by an animal. He cared for Charlie, she was like a big sister to him but she didn't know the first thing about animals.. Or the mechanical beasts his father created 

“You're going straight to hell when you die Everett” Evan muttered the words under his breath staring down at his handiwork. There was a light snowfall. The poor creature's blood soaked brown fur tainting the snow that fell around it a sickening red.

Something wild had done this. something that wanted blood, something that would wear his own sister's skin, something that would hang two technicians, Something that was a giant metal and a wire trash fox that still thought it was Michael Afton 

“You're doing bad things again” And of course there was something else wild out here. Evan turned around, he was right fredbear laid on the ground snow Falling on his faded body. Of course Fredbear wasn't there.

The original plush that he had carried around until he was 10, had been burned for the agony by his father. This was a hallucination brought on by brain damage, some mental illness undiagnosed or weird ghost things. And a frustrating hallucination at that. 

“I know you're supposed to be a conscience, but could you be a conscience later I'm doing something” Evan grumbled looking away from the plush as he pulled coils of wire out of his backpack.  “You could still fix things with your brother. You could help him.  You know he won't hurt you, you know he's scared and sad and lonely. Why won't you help him?” 

Oh and there was another reason why Evan hated blood so goddamn much. Every time even a drop of it spilled, this stupid bear came to lecture him…

“Because I'm not fixing things with the giant walking murderous liability that tore out my sister's insides! Now, If you would please leave I'm faking a monster attack.” Evan granted, looking down at himself. There was only a little bit of blood, mostly coating his hands and arms with small splatterings on his shirt. 

Honestly he might not even have to go through the trouble of changing clothes… Maybe he just ran into this creature and tried to help it… it wasn't dead yet and he had tried to save it but failed.. He would cry, Charlie would comfort him and tell him it wasn't his fault. This would be good!

“Why won't you help him? Why do you lie?” Evan rolled his eyes as the little fredbear looked up at him seemingly transported directly to his feet.

Evan pulled out his flip phone beginning to dial Charlie's number. 

“Why do you hurt people Evan?  Why do you hurt innocent little animals? Why are you like this? Why don't you get help? Do you think this will make Dad love you? He only sees you as a tool. You're nothing but a Killer Beast on a leash to him” Fredbear's Voice seem to come from everywhere Evan ignored it looking down at the dead rodent.

“Hi..oello..” Charlie's sleepy voice muttered through the phone.

“Hey Charlie I found something in the woods.. Hurt rodent.. really badly hurt. I'd say it was mauled. I tried to help but it was beyond saving… Charlie I can see its organs.. I-I saw it's little oh God” He let out a pitiful little whimper as Fredbear stared up at him judgingly. 

He cared for Charlie. She was a good kind woman but she still saw him as that same scared little kid, something he could take advantage of.

“Damn! Sure it wasn't a Coyote or something?” She was awake now her voice was panicked, he could hear Cassidy stirring in the background. 

“Why are you doing this? You know she loves Michael, you know you're just hurting both of them so much..?” Fredbear's voice made him momentarily stop sniffling before immediately going back hoping that Charlie wouldn't catch the mistake.

“No Charlie there's wires, it's The fox thing..” Now a full fake sob came from Evan's throat. He hated this, he liked Charlie, he hated that he had to do this. Why couldn't Michael have just stayed down in the facility?

“Okay if you could tell me where you are we'll be there in a couple minutes!” He could hear the commotion of the two women getting up in the hotel room.

“I'm about a 20 minute walk south in the forest. You'll probably see my trail.” Evan spoke quickly he wanted to get the call over with. So the stupid hallucination, of a stupid bear, he owned when he was stupid and small to stop staring up at him.

“All right, see you in a couple minutes.” The call hung up.

“It's not too late,” Fredbear spoke again. “You can still be a good man Everett, you don't have to keep on doing this, you could leave anytime you want..” 

“It's not that easy” Evan muttered kicking a rock looking at the dead animal on the ground that he had mutilated and killed. “Father would come after me..”

Fredbear did not say anything else that seemed to have finally shut him up. Or technically speaking Evan had shut himself up. So he sat on a nearby Fallen Tree and waited for Charlie to come. He also waited for this whole situation to be over so he could be away from the blood that stained his clothes and hands.. Which even if everything went exactly to plan and they killed Michael and fixed Elizabeth's zombie situation he could never ever truly, Escape

[xhudgenssistersconfessions]

hey y'all so i read the hsm chapters on disney high haha so y'all don’t have to! honestly… it’s nothing crazy at all. For anyone who’s curious, I wanted to post the only other main Zanessa bit. I don’t know how to insert an image so I’ll just copy the text so you guys can read it and then i’ll put in my two cents at the end.

So basically the HSM stuff is in two chapters and the Zanessa stuff is a bit in both. The second chapter is basically verbatim from that teen vogue article but for the first chapter here are the deets:

One night, during the two weeks of intense dance rehearsals at the start of production, members of the various posses gathered in Klapow’s hotel room for a rare wild night of intermingling as the Bacardi Razz and Cherry 7UP on ice flowed. The chemistry that Zac and Vanessa had at their final audition had continued to escalate during rehearsals. Vanessa was, by now, head over heels. But Zac had a girlfriend back home, and he had thus far not entertained his co-star’s advances.

“Hey, can I talk to you for a minute?” Zac asked Klapow, as he pulled the choreographer out into the hallway. “I don’t know what to do, man. Vanessa is super into me, and I have feelings for her, too. I don’t want to do the wrong thing with my girlfriend. But I also don’t want to shut Vanessa down and ruin the chemistry in the movie.”

Klapow encouraged Zac to explore things with Vanessa. They were so young, and what happened in Utah would probably stay in Utah. If Zac’s other relationship wasn’t that serious, he should just end things with his girlfriend and test the waters here, Klapow advised.

When the two guys went back into the hotel room, the part vibes had devolved into melodrama. Vanessa was in tears, crying in the locked bathroom with Ashley. It seemed as if the tipping point of her unrequited love had been reached. Corbin tried to console her from the other room until Zac knocked on the bathroom door, and Ashley left the two of them to talk alone.

“I remember the moment that Vanessa and Zac were talking in the bathroom, and then they came out holding hands,” Lucas said. “I mean, it was so high school. It was like, ‘He broke up with his girlfriend and we’re together now.”

From that day on, Klapow said, “Zanessa was born.”

My thoughts:

“He had not entertained co-star’s advances” is CRAAAAZY. Lol. They make her seem like this predator like DAMN. It really was not like that in my opinion. There’s so much evidence that they were both attracted to one another. Do you guys remember there was an interview with Zac’s friend back home and Zac gushing about Vanessa to him and being like she’s amazing and then the dude meeting her and approving. I think it was Booboo something? I dunno. But to pose this as a one sided unrequited love thing on her part or a PR thing is NUTS. I can’t believe they’re still trying to push that angle. Like 5 years of a relationship (and 2 of those years were post HSM) of a PR thing makes NO sense. Also, yeah, he may have had a gf at home but I highly doubt Zac would be like aww my costar likes me let me date her cause I feel bad?? Also I highly doubt he said “I don’t want to ruin the chemistry in the movie.” Maybe he felt that way in general like getting into a relationship with a costar and was just expressing his concerns but yeah I think they twisted Chucky’s words on that part. I still feel uncomforatble with Lucas kinda being like they were so high school and dramatic and basically she was a victim with the “poor girl” thing. Like… hmmm…I dunno. There are quotes from Corbin in the book about random stuff and he never mentioned any of this. Nor does Kenny. Which says a lot.

On the flip side, I do think there was pressure that if their relationship failed the movie might fail (as Vanessa said in that podcast once when kenny was so concerned) and while i’m sure there was emotions on set (because they were teens duh!) I don’t think they stayed together for the sake of the movie… I think they had their down moments like every couple does which is then 100x exaggerated as a teen because of hormones lol and childhood stardom but other than that they were okay. I mean - if ALL anyone has to say after all these years is that they were a bit emotional at times and can recount one major fight on set…. that’s pretty incredible since 99% of their stories are about them being cute and super in love with one another.

Either way, take everything this book says with a grain of salt. Remember, journalists ALWAYS want a juicy back story. Literally the promotional article for this book is all about this Zanessa “fight” but I just love how at the end of the day they were like nope there’s nothing to tell here but good luck trying. We stan our unproblematic king and queen. :)

[zonie-az]

I get that, I do kinda project with a lot of characters. Honestly tho I’m kinda grasping of of little character interactions he had like w/ Florida. It screams sibling rivalry and would make interesting interactions with the chaos duo Florida and Louie. Even more than that, as little as it was, I for some reason couldn’t stop thinking of that one little interaction with him and Alaska. So now I’m thinking of what interactions they would have and everything. But just AZ interactions in general.

I have projected so much onto Ari,

I do think he can cause lots of chaos, I always have him running around yelling.

my boys are the four corners so I usually have Ari with them, I love love love him and New Mexico together.

he throws water bottles at people and yells at them to drink water but then doesn't drink water himself. cause he a desert he doesn't need it (someone probably Utah yelling at him that that's not how that work)

I also have him love all his desert animals while I haven't seen it in the videos much we do have a decent amount of laws to try and keep our desert safe and not hurt it more. He will 100% pick up bark scorpions and move them cause they get stepped on in the road. the poor baby. also hurt his cactus and he will murder you put you in jail

[funtomb]

diane notes.

born in manchester in the uk in the early 40s, went to uni in america where she met her husband ( william ), settled in utah.

went to school for dance, but was slightly above average at best. wild success socialising, though -- very popular, very queen bee. she dropped her accent fast, adopted american fashion, and started networking. her boyfriend / husband was a pet project for her -- see how she can transform a greasy antisocial nerd into a passable, datable member of society!

bloberta mor/al or/el coded.

also amy go/ne gi/rl coded.

she is not ballora. she is not in ballora.

she was not a good mother. she was, at best, absent, and at worst, accepted william's abuse of their children as part of running a normal suburban household. ( an ode to the fridged women and also to their children who have to hear them talked about as madonnas and saints regardless of who they were in life, can we not speak honestly of the dead? )

she isn't dead. she isn't divorced, either. she simply vanished. this is a woman who came out of a situation where playing the social ballgame was essential, and she was a big swinger. she was not going to go through a divorce in mormon utah. it would have ruined her life. she took advantage of the 'trend' of missing people and staged her own disappearance. she took off, changed her name, moved to california. she is missing, presumed dead, but she's very much alive.

she had children for the reason a lot of women in communities like hers have children -- because being pregnant is a status symbol, and she liked fitting in. if you weren't pregnant, if you stopped at just one child, something was assumed wrong. it was also a great way to keep her husband close. she had a child every four years, or whenever she perceived their marriage as slipping. they did not fix it, and in fact made it worse, but it helped to maintain the image of domestic perfection that she was so obsessed with.

she ran a dance school in town. despite being a frankly brilliant businesswoman and marketing director for her own business, she was not a good dance instructor. she ran that place like the military and in the same way that her husband ruined lives at freddy's, she gave those little girls complexes that would last forever.

of course, with a restaurant, the metric of success is selling enough food ( and games, and merch ) to turn a profit, whereas dance instruction is a little more ephemeral. getting enough students to sign on and keep the business open was essential, of course, but it was difficult to track accomplishments the same way william could track his on a sheet. and given the state of freddy's -- the incidents, the police investigations, the poor hygiene, all of it -- she often felt that her husband was failing upwards while she was spinning her wheels, and especially thought that this was unfair since she gave him the social boost that put him in contact with henry in the first place. she played a role for investors, she showed up at press events, she was once again social where he was not. to see her dance studio... not quite crumbling, but not going anywhere ( those girls were in the TRENCHES ) while freddy's failed and thrived made her want to eat cement.

if you can't fix him and can't divorce him and don't care about the kids, DIP.

she's fat and she's desirable. you don't have three children without forming hips and she has more than that.

[daytonicuconsulting]

How the ABCDEF Bundle Can Help Mitigate RN Burnout

Nurses enter critical care medicine to alleviate human suffering, support patients in their most vulnerable moments, be patient advocates, do no harm, and save lives.

But being a critical care nurse is physically, emotionally, and mentally challenging.

Many factors have resulted in the loss of thousands of expert nurses, creating the staffing crisis we’re currently facing.

Poor support for nurses, lack of career fulfillment, moral injury [18], high emotional exhaustion, and low personal accomplishment [33] all contribute to RN burnout.

Moreover, the current practice of automatic sedation and immobility for every intubated patient has exacerbated the challenge of keeping ICU nurses at the bedside, ultimately increasing RN burnout through increased workload, less team support, and poor patient outcomes.

Other side effects of these outdated practices, such as high rates of delirium and ICU-acquired weakness, are also worsening the nursing crisis.

But now that we have the ABCDEF Bundle, there is no reason for things to continue this way.

The ABCDEF Bundle [35] is a readily available toolkit to help guide clinicians on how to use evidence-based sedation and mobility practices.

Failing to put these practices in place deprives nurses of accomplishing their mission and having the satisfaction of watching their patients have the best outcomes, and I’ve experienced this firsthand.

I started my nursing career in an Awake and Walking ICU, where nearly all patients were awake after intubation and doing their highest level of mobility shortly thereafter.

But after a few years, I started working as a travel nurse and was shocked to find that this was not standard practice throughout the nine other ICUs I worked in.

I was losing my love of nursing and briefly considered leaving the field.

When I returned to the Awake and Walking ICU, I realized that my job was far more fulfilling and manageable because of the changes in the use of sedation and increased mobility afforded by the protocols outlined in the ABCDEF Bundle.

These evidence-based practices helped preserve my patients’ mental and physical capabilities, which reduced their delirium, decreased their length of stay, and increased their participation in their care.

Keep reading if you want to learn more about how these protocols can help to mitigate RN burnout.

But before I continue, I want to give a special thank you to all the ICU nurses who contributed to this article, including Roni Kelsey, Jessica Williams, Liz McQueen, Richard Woods, Tara Arroyo, James Fletcher, Allison Diburro, Tara Dagesse, Sarah Vance, Sean Karbach, Annie, and those who chose to be anonymous.

Delirium and RN Burnout

Delirium is a life-threatening brain dysfunction that increases the psychological burden, risks, liabilities, and staffing demands on nurses [36].

Nurses report high emotional stress, strain [23], and burden [25] when caring for patients with delirium.

Protecting and monitoring patients who are confused, scared, combative, and impulsive during hyperactive delirium is a significant challenge for nurses, and the responsibility to keep patients safe with their lines and tubes intact can be a heavy burden.

Yet they are forced to work in an environment that leaves both patients and nurses vulnerable to the complications of delirium.

Delirium is at the root of many adverse events in the ICU.

For instance, delirium increases the risks of unplanned extubation by 11.6 times [24] and increases the risk of all line and tube removals [42].

The sooner my ICU patients are sedation-free, honestly, the easier my job is to care for them. Even intubated, they are better about caring for themselves, communicating their needs, and they end up protecting their ET tube. − Richard Woods, Utah                                                        

Over 50% of falls in the ICU occur in the setting of delirium, delirium increases the risk of falls by 3.85 times [26], and previous sedation and analgesia infusions increase the risk of falls by 60% [45].

Deep sedation is also an independent predictor of mortality and delirium, as it doubles the risk of dying in the hospital [34], and for every one day of delirium there is a 10% increased risk of death [15].

What’s more, delirium not only increases harm to patients, but also increases the amount of violence nurses [21] have to endure, causing them to fear for their safety and suffer from diminished self-esteem and inner conflicts.

Delirium also increases time in the ICU on average by 4.47 days and 6.67 in the hospital [12], doubles the nursing hours required for care [38], contributes to difficulty interpreting patients’ needs, and can increase nurse discomfort [39].

Caring for delirious patients also contributes to nurse burden [2], and delirium severity is actually a predictor of nurse distress [4].

Caring for another human that you just met takes a special kind of energy. But to care for a confused and combative stranger that you are also tasked with keeping safe is even more stressful and requires even more time and energy. − Roni Kelsey, Washington

Hypoactive delirium can be “safer” and “easier” to manage, but patients depend on nurses for turning, toileting, bathing, and nutrition.

In any case, when patients suffer from delirium, nurses lose the opportunity to have calm, compliant, awake, and engaged patients. They are deprived of connection and communication with those they work diligently to serve.

I honestly think losing that connection with patients during COVID was the hardest part for me. I lost a huge portion of the most satisfying part of my job and it hurt. − Tara Arroyo, Salt Lake City, Utah

When patients are sedated for prolonged periods of time, the burden falls on their nurses, who must do the awakening trial to unmask the delirium and agitation the patient is suffering from under sedation.

Nurses are held liable for unplanned extubations and yet they are often left alone with confused, scared, and hyperactive patients. This increases risks for nurses and patients and can contribute to RN stress and exhaustion.

Moreover, nurses are challenged and expected to perform all elements of care from medication passes to activities of daily living, all while patients are unable to participate in their care or voice concerns when heavily sedated and faced with an increased risk of having poor outcomes.

Watching patients suffer and then die despite great effort and care comes at a high price for nurses.

I extubated a patient and transferred them to the floor. I lost it and started crying. I realized at that moment that it had been so long since I had extubated a patient and they got better. − Liz McQueen, Colorado [7]

ICU-Acquired Weakness and RN Burnout

ICU-acquired weakness is the devastating loss of muscle mass and function that occurs in 50% of patients in the ICU [5]. It results in significant limb weakness and is associated with diaphragm atrophy and dysfunction.

This dangerous and burdensome condition rapidly develops as patients can lose 40% of lean muscle mass within one week of bedrest [43].

ICU-acquired weakness leads to more time on the ventilator and in the ICU, higher rates of hospital-acquired infections, and poor outcomes for patients.

The profound loss of physical function and prolonged time in the ICU increases the demand for nurses as patients become dependent on total care. ICU-acquired weakness also increases failure to wean from the ventilator by 15.4 times and time on the ventilator by 20 days in sepsis patients [17].

Patients who develop ICU-acquired weakness also require more nurses and ICU staff to initiate mobility.

Here’s what Tara Dagesse, an ICU nurse from Connecticut, shared about caring for patients with ICU-acquired weakness:

I cared for a VV ECMO patient who had a severe ICU-acquired illness from sedation and immobilization practices at a former hospital. They had been extubated but were previously on heavy sedation.

I organized to get this patient hovered to a chair and set them up with bicycle pedals. I did this when other colleagues were available to help with lines, tubes, and wires during the hover, but the rest I did on my own. I hadn’t consumed much water that day because the break room was far from the patient’s room; I actually went to my own emergency department after my shift for a kidney stone from the lack of access to drinking water during that shift.

It had taken such significant effort and organization because of the patient’s severe neurologic and physical disability from the sedating medications that we gave them. Their lungs were recovering via the ECMO, but we irreparably damaged this person’s brain and body from sedation in the process.

It is not an easy task to mobilize such a patient, and even though I was determined, organized, and motivated, I ended up having to put my own basic human needs last to provide what I felt was a successful physical therapy day for my severely debilitated patient. 

I was proud of the result for the patient, but I was unsustainably fighting the impenetrable heavy sedation culture. I had little support for my patients to be successful and have good outcomes from that program, and the oversedation culture directly affected my mental health. 

When we would eventually have patients awaken, they had ‘dead eyes’ and were fully dissociated or otherwise neurologically withdrawn from the lasting effects of the continuous heavy sedation.

Families don’t question the need for sedation because ‘they seem comfortable,’ but this was an unfulfilling way to practice nursing. I did not go into this field to harm patients and that’s exactly what we were doing. I considered leaving nursing altogether like so many of my colleagues because I was told ‘the grass isn’t always greener.’

I eventually left that ICU after realizing I could no longer ethically care for patients in that environment.

I now work for a different hospital with better working conditions and unit-wide support for limiting sedation and keeping patients awake and active on the ventilators so they can be part of their own care and interact with their families.

It’s much more rewarding and exciting to care for critically ill patients that actually get better because we utilize the ABCDEF Bundle as it was intended.

RN Burnout and the ABCDEF Bundle

Despite the challenges that delirium and ICU-acquired weakness pose for nurses and patients, the prevailing ICU culture of automatic sedation and immobility drastically increases the risks of these conditions.

Mechanical ventilation is not an independent indication for continuous sedation [14], yet in most ICUs, sedative drips are routinely started after intubation on all patients.

Sedation increases the risk of delirium by 2.268 times [30] and the severity of delirium [29]. In one study, patients who were free of sedation spent 4.2 fewer days on mechanical ventilation and 3.67-9.09 fewer days in the ICU than those who received interrupted sedation [40].

Sedation also causes the quickest and highest rates of muscle loss compared to other causes of muscular atrophy [31].

Nurses have the burden of keeping patients safe from adverse events such as falls and unplanned extubations. However, nurses are also trained to increase and prolong the use of sedation, which ultimately exacerbates delirium and ICU-acquired weakness, increasing these adverse events and the demand for nurses to provide total care.

The ABCDEF Bundle guides ICU teams to avoid sedation, provide prompt mobility, and protect patients and nurses from the risks and burdens of delirium and ICU-acquired weakness using the following tools:

A: Assess, Prevent, and Manage Pain B: Both Spontaneous Awakening Trials (SATs) and Spontaneous Breathing Trials (SBTs) C: Choice of Analgesia and Sedation D: Delirium: Assess, Prevent, and Manage E: Early Mobility and Exercise F: Family Engagement and Empowerment

A large study found that, on average, the ABCDEF Bundle decreased delirium by 25-50%, time on the ventilator and physical restraint use by 60%, 7-day mortality by 68%, discharges to anywhere but home by 36%, and readmission to the ICU by 46% [32].

Another study showed that ambulating patients within 36 hours after intubation increased their return to baseline functional status by 24% and decreased the duration of delirium by two days [37].

It’s also been shown that every additional 10 minutes of physical or occupational therapy decreases time in the hospital by 1.19 days [22].

At this point, it’s important to note that the ABCDEF Bundle requires interdisciplinary teamwork from physical therapists, occupational therapists, pharmacists, primary physicians, bedside nurses, respiratory therapists, and family to foster this all-encompassing, patient-centered approach [1].

The ABCDEF Bundle also fosters more team collaboration and improves the workplace environment. For example, one of the key tenets of these practices is mobility, which is a powerful tool for preventing and treating delirium and ICU-acquired weakness.

However, when patients are sedated, physical and occupational therapists are unable to provide meaningful therapy.

The main barriers to early mobility are sedation and agitation [41], which often leave nurses to struggle with agitated, delirious, and deconditioned patients by themselves.

But by allowing all disciplines to work together early on in an ICU admission to keep patients awake and mobile, most patients can remain cognitively and physically intact, which allows for more engagement in turning, mobility, and the care process in general.

Overall, as patients preserve their muscle mass and function at higher rates, less staff and equipment are likely to be required for mobility, and patients are likely to be liberated from the ventilator and transferred from the ICU far sooner.

This kind of collaboration, and the ability to ease workload offered by the ABCDEF Bundle, is demonstrated in the following case study:

A 32-year-old male patient with a history of obesity and polysubstance abuse was admitted to the ICU due to fentanyl overdose and aspiration pneumonia. He was intubated in the ICU and required a PEEP of 16 and 100%. A propofol intravenous drip was initiated at 30 mcg/kg/min. He became agitated and his propofol was then increased to 50 mcg/kg/min and he received midazolam pushes overnight.

The next day, the ICU team collaborated to investigate this patient’s condition and needs through the lens of the ABCDEF Bundle. As a result, it was realized that his agitation may be rooted in opioid and benzodiazepine withdrawal.

Enteral doses of opioid and benzodiazepine were given and propofol was discontinued. Six hours later, the patient was awake. He was given a whiteboard to write with and he remained awake but anxious at a RASS of +1 and CAM negative. While in bed, his oxygen saturations remained between 89% and 90%.      

The following morning, the patient sat himself at the side of the bed with physical and occupational therapy. His oxygen saturations immediately increased to 93% while on a PEEP of 16 and 100%.

His anxiety and tension dissipated and he got himself to the bedside chair with the minimal assistance of line and tube management. He spent most of the day in the chair free of restraints and sedation at a RASS of 0 during the following three days before being successfully extubated. He was independently walking around the ICU and transferred from the ICU shortly after.

Unfortunately, the reality is that without utilizing the ABCDEF Bundle approach, this patient likely would have remained on high-dose propofol and would have been at high risk of delirium and ICU-acquired weakness.

The nurses attending to him would have also been saddled with the risks and challenges of turning a 350-pound flaccid body for days or even weeks.

His muscle loss from myotoxic propofol [46] and immobility would have led to severe and prolonged dependence on the ventilator and nursing staff. Delirium he would likely experience could result in agitation, failed awakening trials, more stress and monitoring, and days to weeks longer in the ICU.

The challenging irony is that although adequate ICU staffing ratios are required to practice the ABCDEF Bundle [3], failing to practice it puts even more strain on staffing ratios through increased time on the ventilator, time in the hospital, manpower to care for patients, readmissions to the ICU and hospital, health care costs, and the burnout of nurses.

All things considered, one of the most powerful tools to prevent and treat delirium and ICU-acquired weakness is mobility.

Because of this, many nurses are expected to mobilize critically ill patients, but unfortunately, they are often untrained and unsupported in mobilizing them.

This leaves nurses with the burden of continuing to provide exhaustive total care and monitoring to confused and deconditioned patients for prolonged periods of time without the ability to truly treat and resolve delirium and ICU-acquired weakness.

Luckily, the ABCDEF Bundle offers one of the most effective ways to advocate for adequate staffing ratios, as delirium increases hospitalization costs by 39% [27], ICU-acquired weakness increases costs by 30.5% [19], and the ABCDEF Bundle can also decrease health care costs by at least 30% [20].

A nurse-led early mobility initiative in a medical ICU resulted in a 57% decrease in mortality, a 33% decrease in time on the ventilator, and was projected to have saved $2,070,000 that year [13].

Another ICU found their nursing-led mobility initiative increased mobility by 43% and resulted in a 50-100% decrease in hospital-acquired complications [44].

These stats are useless if the resources needed to mobilize patients are not available to nurses. I don’t doubt their efficacy − but most ICUs just do not have the resources (specifically staff) to safely mobilize their patients. 

Why is this? We would never deprive surgeons of soap and water to scrub with before surgery, as we have data that clearly shows the benefits of hand hygiene for infection prevention. If we have data that shows early mobilization in the intensive care setting results in better patient outcomes, why then do hospitals deprive their staff of the resources they need to provide their patients with high quality care? − Allison Diburro, Massachusetts

Still, the fact is many nurses may be unaware of the increased burden of sedation and immobility, and what is “normal” and familiar is often comfortable and accepted as unavoidable.

These practices may even be preferred, but nonetheless, even when unaware of the risks of these interventions, nurses are subjected to dealing with the psychological toll of seeing frequently poor outcomes for their patients.

Patient autonomy and nonmaleficence are core principles of nursing ethics [16], but sedation deprives patients of their voice and their autonomy.

Depriving patients of the ability to participate in end-of-life decision making can lead to prolonged treatments and severe ethical turmoil for nurses.

Nurses often struggle with the idea of providing treatments that they perceive as prolonging suffering or doing harm to patients [28].

We used to do things for patients and now we do things to patients. I used to leave work and had a sense that I made a difference. I missed time from family and friends for a reason, but now I have those moments less and less. We have the technology to do more and so we do more for a prolonged amount of time and we start to see the slow decline of a human into a failing body.

When you add sedation, you remove the patient’s voice, and delirium amplifies this tenfold. The patient can no longer advocate for themselves and families are left in moral distress deciding what to do. − Roni Kelsey, Washington

Nurses that know the harm of sedation and immobility, but lack support from their teams, face unbearable moral injury when unable to provide optimal evidence-based care for their patients.

They are forced to witness and struggle to treat the often preventable harm of delirium and ICU-acquired weakness [10], and when they know the life-long damages and increased mortality survivors will face from these conditions after the ICU, they are left with severe ethical turmoil [6].

I left my critical care training position due to a toxic work culture and my own moral distress of watching patient after patient be put on a pathway to delirium.

My introduction to the ABCDEF Bundle occurred on the final day of didactic training. The only motivation provided for adhering to the bundle was that we had to demonstrate proper charting of the elements or else face consequences – there was no explanation of the inherent purpose or value of the bundle itself.

In practice, I observed patients appearing significantly oversedated, with RASS assessments that seemed inconsistent with the clinical presentation. Spontaneous awakening trials were attempted sporadically and incompletely. When I raised concerns regarding these issues, the responses typically referenced patient comfort, with explanations such as ‘it’s not nice to have a tube down your throat’ and ‘the patient needs to sleep.’ Potential consequences of oversedation, such as delirium or delayed weaning, were not discussed. 

I went into the ICU excited about being challenged with complex medical puzzles. But in the end, the moral distress of putting patients down the path of deconditioning, oversedation, delirium, and long-term consequences, such as permanent disability, was too great for me to participate any longer. − Annie, California

I often shared awake and walking concepts with my coworkers and attempted to convince others to remove restraints, use other forms of treatment for agitation, rather than sedation, and advocate for extubation.

Repeatedly my attempts were shut down. I witnessed so much dehumanizing care that caused an amount of moral distress through which I could no longer work in the ICU. My own patients benefited from the removal of restraints, being allowed to be awake, move freely, and make their own end-of-life decisions while on a ventilator. I could not understand why others would not be willing to do the same. − Anonymous ICU nurse from Missouri

Nurses work incredibly hard for their patients, but they need to have as many calm, communicative, compliant, and functional patients as possible in order to ease their workload.

It is time for them to have real human connection and communication with the souls that they are diligently serving, and in order to do this, they must practice the ABCDEF Bundle, which enables optimal teamwork, collaboration, and support of nurses.

They also deserve to know they are giving their patients the best chance to survive and thrive and have the reward of watching patients succeed and walk out of the ICU doors [9].

When we started the ICU Liberation Bundle in our ICU one of the nurses was so excited to help his intubated patient have a ‘normal’ bowel movement in the commode instead of a loose stool in a bed pan. He was able to give his patient back some dignity and felt like while he did more work, it was more rewarding work. − Roni Kelsey, Washington

As we deal with this current nursing shortage, it’s important for us to make use of evidence-based sedation and mobility practices, which can lead to improved outcomes for both nurses and patients [11].

We must support nurses in their quest to master the ABCDEF Bundle so they can better handle their workload, workplace environment, bed flow, human connection, job satisfaction, and burnout [8].

The whole point of doing the ABCDEF Bundle is not to do the ABCDEF Bundle. It’s to facilitate better and more nurse-rewarding outcomes. ABCDEF is not the goal. The goal is what the ABCDEF elements bring. 

As someone who has done trauma, ER, MICU, COVID, and now does a lot of surgical heart work, the ABCDEF Bundle gets my patients to where I enjoy the care.

Getting my patients awake so they can get better gives me satisfaction and joy. Getting them awake to communicate with loved ones is hard work but it feels better than just turning every two hours for sedated, flaccid, and atrophying bodies. − James Fletcher, California

Do you want to turn your ICU into an Awake and Walking ICU? Contact us today to find out how we can guide you through the transformation.

References can be found here.

[ao3feed-destiel-02]

Chances Are You've Made A Very Poor Career Choice

read it on AO3 at https://ift.tt/GrSeAKH by HeartOfStars The year is 2013. Sam has just taken on the trials to close hell, Dean is simultaneously trying to make sure his brother doesn't die and continuing to process everything that happened in Purgatory, and when they need him most, Castiel is nowhere to be found. In the midst of all this, a case springs up in the middle of Utah involving an ancient pizzeria, possessed animatronics, and the realization that the brothers may have been there before. At the same time, as well as twenty years earlier, the year is 1993. Mike Schmidt has just accepted the job of his dreams. AKA the Supernatural-Five Nights At Freddy's crossover that somehow doesn't already exist (at least, not the way this has been written). Is this an absolutely insane idea? Yes. However, it was begging to be written, so here it is. Enjoy. Words: 3017, Chapters: 1/?, Language: English Fandoms: Supernatural (TV 2005), Five Nights at Freddy's Rating: Mature Warnings: Creator Chose Not To Use Archive Warnings, Graphic Depictions Of Violence Categories: Gen Characters: Dean Winchester, Sam Winchester, Michael Afton, Henry Emily, Castiel (Supernatural), William Afton | Dave Miller, Marionette | The Puppet, Mike Schmidt (Five Nights at Freddy's), Classic Animatronics | Five Nights at Freddy's 1 Animatronics, Jeremy Fitzgerald, John Winchester, Original Male Character(s), Original Female Characters (s) Relationships: Dean Winchester & Sam Winchester, Michael Afton & William Afton | Dave Miller, Castiel/Dean Winchester, Castiel & Dean Winchester, Michael Afton & Henry Emily, William Afton | Dave Miller & Henry Emily, Michael Afton & The Crying Child, Dean Winchester & John Winchester & Sam Winchester Additional Tags: Supernatural-FNAF Crossover, yes I understand that that is kind of an insane combination, but also fnaf feels like a thing that could very easily have been a supernatural episode, Alternate Universe - Fusion, Horror, in both the supernatural and fnaf sense, so be careful, Gen or Pre-Slash, honestly you can read the casdean interactions however you want those bitches are weird, Angst with a Happy Ending, Michael Afton is The Crying Child's Older Brother, Sam Winchester Needs a Hug, Michael Afton Needs a Hug, Everyone Needs A Hug, Psychological Trauma, Time Shenanigans, it's confusing but it'll get explained later, Michael Afton Doesn't Get Scooped, Dean Winchester Being Dean Winchester, Season/Series 08, Body Horror, Child Murder, Mike Schmidt Being Funny, really he's a riot, Parent Henry Emily, Hurt/Comfort, Blood and Gore, Springtrap Being Generally Terrifying, good old family bonding time, Bad Parent William Afton | Dave Miller, Bad Parent John Winchester, god these tags are a doozy, Have fun everyone read it on AO3 at https://ift.tt/GrSeAKH

[nickgerlich]

Law Have Mercy

Mark Twain once said, “Travel is fatal to prejudice, bigotry, and narrow-mindedness, and many of our people need it sorely on these accounts. Broad, wholesome, charitable views of men and things cannot be acquired by vegetating in one little corner of the earth all one's lifetime.”

It’s a great quote, because travel truly is the antidote for prejudice. It’s just that when you travel, whether abroad or within the US, you may have your eyes opened to more than different people and different cultures. You see, you will also run up against different laws that simply make no sense to you. You get the bad with the good.

I recall driving up the east coast with my wife five years ago. We had left sunny Florida and kept as close to the water as we could, stopping for every historic lighthouse, more than a few craft breweries, and lots of beaches. We took ferries whenever possible, dined locally, and stayed in a variety of places.

It’s just that I had completely forgotten about one state’s archaic law. It had been a long time since I had been in New Jersey. Earlier that morning we had taken the ferry across the Delaware Bay to Cape May. We absolutely loved the gorgeous mansions overlooking the shoreline. Off we went a few miles to Wildwood, the Doo Wop capital of America, and the little orange light had come on. So I pulled into a Wawa.

Doing what I normally do, I exited my car and started to do my duty, only to be issued a rather stern “Achtung!” or something like that. A man in a neon vest intercepted me and told me to get back in my car. Oh yeah. New Jersey is one of two states—the other being Oregon—in which drivers cannot pump their own fuel. Good grief, this is not rocket science.

Later at the Caribbean Motel (which I highly recommend for a retro experience), I did a little digging. The official stance behind the law is that having a “professional” pump your gas promotes public safety. Right. Because I hear about gas stations blowing up all the time. Why don’t they just be honest and say that it’s all about protectionism? Just think of all the low-skill jobs protected by this law.

Since then I have driven in all but two of the Lower 48 states, and I can now honestly say that every state has its crazy laws. It’s the result of our system of governance, in which the states are left to make their own laws on anything and everything.

I recall with a chuckle how, many years ago, I had an older gentleman in my Retail Marketing course. He managed a local convenience store at the time, but had spent a number of years prior in management at a Safeway supermarket. He told the class about the Texas Blue Laws that once gripped the Lone Star State, leaving store owners to rope off entire supermarket aisles, or portions thereof, one day a week and often with no rhyme or reason.

Sundays, you see, were supposed to be for worship followed by rest, and lawmakers years ago sought to pass judgment on certain things as being unnecessary. I just pity the poor women back then who could not even buy a pair of stockings before heading to Sunday meeting, because…well, you know…pantyhose must be the devil’s handiwork. Ladies, what do you say?

Thankfully, most of our Blue Laws have gone by the wayside, but you still cannot purchase liquor on Sunday here (aside from at a proper restaurant or bar). And autos can only be sold six days a week, with dealership owners having a gentleman’s agreement to make Sunday their day off.

Alcohol is especially prone to odd local laws. In Montana, craft breweries must close at 8pm, with last call at 7:30. An owner told me this summer that when the craft scene first started, traditional bars, retailers, distributors, and so forth were worried about this new breed of competition. The law still stands today, because no one wants to risk losing donors by rallying for more sanity.

And then there’s Utah, where you can’t walk around the restaurant or bar with a beverage in hand. In fact, you can only order two at a time, because that’s how many hands you have, right?

I could go on. Some states allow liquor to be sold in supermarkets and drug stores, while others do not. In Wisconsin, cheese standards are regulated (no surprise). In Missouri, you can’t have more than two garage sales the same year at one location, meaning your garage. Wyoming and California allow patrons to go to special taps to pour their own beers, as long as they are wearing a special bracelet with a chip linking it to you (40-ounce limit). Why can’t all the states be like this?

But there is one shining example where pretty much anything goes: Las Vegas. Why not? We are already know it as Sin City, and it would be incongruous for them to have some silly law that protected Sunday or some other religiously-based notion.

If you don’t care for the freewheeling ways of Las Vegas, there’s always the internet, which has helped override many of these laws, even alcohol, provided it can be shipped to you. Amazon lets you shop for anything regardless of the day or time. Facebook Marketplace, Etsy, eBay, and CraigsList have helped render the garage sale obsolete.

I don’t begrudge anyone their religious beliefs, nor their sometimes misguided efforts to protect their pals in business, but we are slowly but surely moving beyond our archaic ways. We still have a way to go, but until then, anyone choosing to live and/or do business in any US state, you’d better be ready to be blindsided by homegrown laws that will leave you scratching your head.

And letting someone else pump your gas. The control freak in me hates this. I’m pretty sure that Mark Twain would agree.

Dr “Live Free Or Die“ Gerlich

Audio Blog

[aristocratic-otter]

Get To Know Me

Thanks for the tag @cutestkilla, @you-remind-me-of-the-babe and @angelsfalling16. This looks interesting!

Under the cut for length

Relationship status: Married and I just had my 25th wedding anniversary. So married for a long fucking time!

Favorite color: kinda depends on the use! Silver is my first response, but to wear I like jewel tones and for decorating I like ocean colors. So all over the map, but I can definitely say I love color!

Favorite food: My family likes to joke that everything I eat is cheese and bread. Grilled cheese, pizza, quesadillas, macaroni and cheese. I've got the palate of a five year old. I do love popcorn and chocolate though!

Song stuck in your head: If it gets stuck, it's almost always something from Hamilton. Shit's catchy, man.

Last thing you googled: "Jacob's Inn, Oxford" for a fic, but you'll have to wait and see which one.

Time: 11:41 pm

Dream trip: The British Isles. So much of the history I love to explore is found there. I come from a place where the oldest house is probably fifty years old. I want to stand in a place where the history is reckoned in thousands of years, not tens of years.

Last book you read: Just relistened to Boyfriend Material in prep for the new book coming out. There's a lot of that going around, I've noticed 😏

Last book you enjoyed: Same. I mostly read fanfic these days.

Last book you hated reading: I'll probably get a ton of shit for this, but it was Song of Achilles. Not because it's sad. That's a perk, honestly. I just couldn't get into it. The writing style was too dry and unemotional for me. I still have it on my dresser to finish, and I probably will because my daughter got it for me for Christmas, but I'm not looking forward to it.

Favorite thing to cook/bake: I'm not much for householdy things, but I do love cooking pancakes. There's something aesthetically pleasing about waiting for the bubbles to form and pop and finding the exact shade of golden brown on the other side.

Favorite craft to do in your free time: I've been trying to learn origami without much luck. I'm not particularly crafty, but I do love scrapbooking, I just don't have time for it.

Most niche dislikes: Onions. It's a constant trial because nobody believes that I can actually hate onions that much. They hit my Autistic texture squick and I hate the flavor, so it's a double whammy. But most of the people in my life think I'm a drama queen for constantly questioning wait staff about the onion content of the food on the menu.

Opinion on circuses, now and in history: Hmm...I enjoy the idea of them, the circus life. I like reading stories about it. Historically they're pretty horrific, but the idea of a life on the road, free of care except for caring for each other...it's pretty attractive. I've seen both Ringling Bros circus and Ka from Cirque de Soleil, and they are quite the pretty spectacle, but not something I seek out in my life.

Do you have a sense of direction, and if not what is the worst way you’ve gotten lost: I inherited my mother's shitty sense of direction, but I'm self aware and use directions apps constantly, so I seldom get lost. That said, I definitely have a getting lost story, though my husband was driving. We were driving to Bear Lake, Utah in midwinter because that's when I had time off. It started snowing as we drove up the state of Utah from St. George, and never stopped. The roads got slippery and icy, and we're Californian. We don't know how to deal with that. So we drove like snails, and therefore didn't arrive at the turnoff to our resort until one am. Now, the road to the resort was a single lane switchback and it was coated with snow. We couldn't even see the lane lines. We stopped and my poor husband spent half an hour out in the freezing weather to put chains on our tires and then we inched our way down the mountain in utter terror. We arrived at the town of Bear Lake at past two in the morning. NOTHING was open. We drove to our resort; they'd told us there'd be a key waiting for us in the box outside the office. We drove up a driveway covered in unbroken snow and found an office, and a box, but no key.

At this point, we were shivering in insufficient heating in a tiny compact car, me, my husband and our three year old son, and we were facing having to maybe spend the night in the car until something opened. We drove around the property several times until we realized there was a different office and found our key. Then we drove to the block of rooms, and dragged ourselves, our luggage and my kid through the snow, past every downstairs room and couldn't find one with our room number. All of the upstairs rooms appeared to have employee names on them. We circled the building. I was crying, the baby was wailing and we were all exhausted and terrified. Then we found that there were a couple of upstairs rooms that weren't set aside for employees and one of them was ours.

It was the closest I've ever felt to dying, honestly.

Funny thing is, that trip on our return found us passing through a hundred-year flood in Utah, where half the city of St. George was underwater, so this trip definitely gave me years of stories to tell!

Tagging some friends! @artsyunderstudy, @bazzybelle, @carryonsimoncarryonbaz, @fight-surrender, @fatalfangirl, @facewithoutheart, @johnwgrey, @krisrix, @moodandmist, @otherworldsivelivedin, @giishu, @frjsti, @ivelovedhimthroughworse, @penpanoply, @prettylightsbigcity, @palimpsessed, @subparselkie, @tea-brigade

[rucbarthatbowtiesarecooldw]

Sunday Afternoon Session

Conducting: Dallin H. Oaks

Glory to God on High

Where Can I Turn For Peace

Garrit W. Gong

Are we running from our Heavenly home?

Whether we are running from home or going home, God is coming to meet us

Keep the light on for each other

Trust is an act of faith – God keeps faith in us.

When trust is challenged it can be hard to trust again

How do I learn to trust again?

Cast your burdens upon the Lord and trust in His constant care. There is no burden He will not share.

Trust God’s inspiration to discern wisely

Only you can separate yourself from God and Jesus Christ through your choices

The Saviors atoning love is infinite and eternal and when we are ready He offers us that love

Our job is to open the door and let them in

Parable of the two sons

Our life journeys are individual but we can come back to Him by trusting

Earth has no sorry that heaven cannot heal

L. Todd Budge

What does sacrifice mean to you?

Latin roots: Sacer meaning sacred or holy. Facere meaning to make

Sacrifice is the process of becoming holy

Sacrifice is less about giving up and more about giving to the Lord

We give our holiness to the Lord

“Give said the little stream”

I’ll Follow Him In Faith

Anthony D. Perkins

Starts with talking about his cancer – ouch poor guy

A lot of the time sin does not cause suffering – most likely this was a task you chose to take on

1 Suffering does not equal God’s displeasure

2 Heavenly Father is intimately aware of your suffering

3 Jesus Christ offers His enabling power to offer you strength to help you endure things well

4 chose to find joy each day

Michael A. Dunn

Begin at a small scale, especially if you are feeling overwhelmed or discouraged.

Small steady spiritual improvements are the steps that God would like us to take

Sean Douglas

“When dark clouds of trouble hang o’er us and threaten our peace to destroy, there is hope smiling brightly before us” hymn 19 vs 2

Satan seeks to lead us to the breeding ground of doubt

“I know that Jesus will hold my hand”

Rejoice the Lord is King

Carlos G. Revillo Jr

1 faith

2 repentance is turning away from sin and toward God for forgiveness

A lot like soap because they are both a cleaning agent

Alvin F. Meredith

Are you only looking at what is directly in front of you or are you looking forward down the road?

The eternal things down the road are a key part of this life

1 focus on Jesus Christ

While you are focused on Christ you can do many amazing things

There is no discipleship without discipline

2 beware of distractions

When you look away you will begin to sink

Be intentional about looking down the road

Neal L. Anderson

The name of the church is important

I honestly wasn’t listening very much, posting a rant/support post.

Russell M Nelson

What can you control about how you will react to the words from this conference?

Temples!!

Kaohsiung, Taiwan

Tacloban City, Philippines

Monrovia, Liberia

Kananga, Democratic Republic of the Congo

Antananarivo, Madagascar

Culiacán, México

Vitória, Brazil

La Paz, Bolivia

Santiago West, Chile

Fort Worth, Texas

Cody, Wyoming

Rexburg North, Idaho

Heber Valley, Utah

Sing We Now at Parting

[witchyangela]

Take this with a grain of salt but some Twitter user said When she met smeyer at a book signing she asked if Jacob was based off a real person and smeyer told her Jacob was based off a native boy from a reservation in Utah she danced with as a kid ( I’m guessing this was when she was at byu)

https://twitter.com/inkylabyrinth/status/1330665400191762433?s=21

HUH... okay I honestly can’t put into words how I l feel about that.. but interesting to know!! thanks anon!! Imagine being that poor boy and ur like “oh I remember dancing w a weird Mormon girl called Stephenie wonder what happened to her?” And then u google her and find out shes a supernatural romance writer who based one leg of a love triangle off you..

[purple-fireflies]

Almost every single one of my thoughts of E1 S2 of HSM:TM:Ts

Cause I love this show and wanted to do this.

Ms. Jenn just doesn't know how to use a camera huh

Time to put something in the air on repeat again fun

*the following is something in the air commentary*

aw ashlyn and big red

nice dancing

jeez this is one take woah

awww seb

Gina made the dance number

They just jumped out of a locker is that not uncomfortable

but like they're cute so gj

*right after something in the air*

RICKY IS WEARING THE DOG TAG AWW

Mr. Mazzara character development nice

Are Ashlyn's parents never home how is she always able to host a party without them being there

But i love that her house is the unofficial cast hangout spot go you ashlyn

Ricky is so excited to do the musical with nini...girl you have to tell him

NINI JUST TELL HIM

Kourtney yes she better flourish during this season outside of nini's plotline

"age of kourtney" IM HERE FOR IT

ASHLYN AND GINA FRIENDSHIP OML Y E S

I really connect with Gina i mean I moved so much so I understand how she feels and the pressure to be the best PLEASE DONT PUT GINA THROUGH TOO MUCH

"I thought I was taking tenor" BAHAHAH

also S E B L O S

Ricky's mom couldn't have flown down to Utah for like 2 days to spend Christmas with her kid?

Give the poor guy a break hes moving houses too

Nini just tell him ur leaving rip off that band aid

aww she got him a skateboard

awww he misses his mom

Ricky no don't suppress your feelings

HE. WROTE. HER. A. SONG.

I love this song oml

wow they're all-in for a couple of high schoolers

oml ricky is so excited for that musical SOMEONE TELL HIM AND PUT ME OUT OF MY MISERY

Carlos is an icon --> " why are you hiding from a cute guy with no wedding ring?"

MS JENN HAS AN EX BF

THIS GUY BETTER NOT GET IN THE WAY OF MS JENN AND MR. MAZZARA OK

LOL she pretends she doesn't remember him comedic gold

BET ON IT OML AHAHAHAHA RICKY

the drums what was that for

Big red is genuinely worried for you ricky

AWWW BIG RED UR SO ADORABLE ASHLYN LIKES YOU TOO

no dont make him work hes gotta talk to ashlyn come on mrs. red

ricky the cologne didnt work for you dont give it to big red dude

wait carlos is rich? is that the seblos conflict? huh

Ashlyn and Gina friendship Y E S

Carlos rly wants to keep HSM 2 a secrert then

CARLOS YOUR ONE LINERS

seb ur ALLERGIC get the cashmere away from you

EJ SHAVE PLS

awww big red and ashlyn's texts so pure

Ricky dude you are SO excited for HSM 2...

NO GINA DONT BE SAD NOOOOO

I ship rini but dang the writers are making them sickly in love

We all know EJ wont get into duke right

But I love his character development

"My cows" AWWW SEB

Ricky guessed Gina that doesn't bode well for rini...

ashlyn youre a wueen trust meh big red likes you

non don't run away from her big red

MORE MUSIC YAY

YES I LOVE THIS COVER OF FABULOUS CAN WE GET A FULL VERSION PLS

Ashlyn and Gina's voices sound so good together

I love Rini's version of you are the music in me but like wow they're laying on the "they're dating and in love" and im not sure if Im sick of it or if I love it

I wanna be at that party

awww big red/ashlyn kiss

Finally the beauty and beast announcement

Poor ricky he doesn't get to play troy again i know people (aka me) would pay good money to see bet on it live

Not ms jenn living vicariously through her cast

Couldn't nini have found a better time to tell Ricky? She had like 13 days to do this? (honestly it seems kinda OOC is it just me)

Oh cliffhanger fun

[echodrops]

The Promises I Made (2021)

Well... um... I’m alive? And if you’re reading this, you’re alive too! That’s something to feel okay about, at least. At the end of 2020 I really thought things could not possibly get worse, but 2021 was, without question, one of the worst years of my life. At the beginning of the year I experienced a series of serious medical complications that put me in and out of the hospital five times, which left me with more than a thousand dollars in medical bills and forced me to move back in with my family in California for more than six months while recuperating. Then the freeze in Texas ruined both my water heater and my air conditioner and caused the collapse of a large tree into my house, costing me a combined total of $7000 on top of my medical bills. My young cat was let out of my parents’ house by a family member and was hit by a car and killed in April. My boss abruptly left her position and I was essentially the only employee who could take over for her, so I was given a “promotion” to department chair a week into the fall semester with no time for training and with no support and the job is so stressful it’s literally giving me grey hairs. My beloved dog who I’ve had for 11 and a half years is now 12.5 years old and the vet has confirmed that he will likely only live a couple months more...

But ummm, I’m still here! I’m finally starting to get on a medicine regime that is actually making a difference in my health situation! I’ve almost paid off the debt from this year! I’m going to face 2022 with as much confidence and hope as I can. So, with that said, here’s a look back at the New Years Resolutions I made last year!

Promises I Made (2021):

1) Complete the window well on the new basement window so I can finally call that project good.

Status: Kept, but Jesus Christ this was a hassle and a half for sure.

2) Get the Utah house sprinklers working again to prevent dead grass.

Status: Kept, they ran for most of the summer, but there are still some problems with them so it’s back to the drawing board again in the spring.

3) Get the back fence back into place and the greenery trimmed.

Status: Broken. There was so much ease to do, this simply wasn’t possible.

4) Get the patio replaced before it honestly does just fall down on someone.

Status: Kept, but it was also a major hassle. Getting any work done in Utah is a nightmare, the workers are such poor quality.

5) Get an official exercise routine including walking/jogging, please.

Status: Broken. I was doing okay for a while there but it’s so hot through the summer and fall here that being outside is miserable...

6) Related to the above, lose 15 pounds. Teaching from home basically meant I spent all of 2020 sitting in front of computer, not moving, and it shows…

Status: Broken. I did not lose any weight. In fact, I probably gained some. 2021 was too hard.

7) Successfully use the new Roomba my parents got me to keep my floors cleaner. (So much… dog hair…)

Status: Broken. Currently due to my dog’s age, he can’t move around much, and I don’t want to bother him with a Roomba, so I’m waiting on this.

8) Get my wisdom tooth removed. (Holy shit, please Echo…)

Status: Kept, although in the end it came down to being forced to due to the medical situation lol.

9) Get a haircut. (No, really, I didn’t get a haircut at all in 2020 and my hair is so long I’d make Sailor Mars jealous.)

Status: Kept.

10) Find a real doctor to renew my medicine prescriptions so I don’t have to use an asthma inhaler that expired two years ago… please…

Status: Kept. And then the real doctor referred me to like four other specialists because my health situation is so fucked up, so...

11) Fix the back Texas lawn because I let it get pretty bad.

Status: Broken. I spent about four months of 2021 actually in Texas, all of them frantically working.

12) For that matter, uhhhh, let me fix the front yard too.

Status: Somewhat kept. At least in the sense that after the freeze killed uhhh EVERYTHING, I did have the dead trees and such removed, so the yard does look more professionally groomed now.

13) Find a credenza for the foyer. Even if it’s expensive, just buy one already Echo.

Status: Kept. And I got one at a decent price, so this wasn’t too bad.

14) Finish at least seven new books this year. (This goal feels so small, but when do I ever get time to just sit down and read nowadays?)

Status: Broken. From January to April I wasn’t able to focus on anything other than my medical situation, and then from April to August I was working on home renovations, and then from August to now I’ve just been doing my exhausting job... I want time to myself, please...

15) Organize my documents (especially student papers)—my desktop and documents folders give me nightmares just looking at them.

Status: Broken. Honestly I just forgot I made this promise and so I didn’t do it. I should do this though, yikes...

16) Get a decent paper shredder to shred old mail.

Status: Broken. I do need one though...

17) Talk to an HR rep about my retirement savings so that I can consolidate my retirement accounts.

Status: Broken. I wasn’t too busy calling insurance constantly...

18) Do at least one artwork to actually use that new paint program I bought.

Status: Broken. Oof. One day, surely...

19) Get the dishwasher fixed… even if I don’t quite know what’s wrong with it.

Status: Broken. But I did call a repair person at least... So maybe they’ll call me back after the holiday and come look at it...

20) Pay my credit card down by at least ½. I made good progress this last year but I need to get it down a lot more before I’ll really be feeling good again.

Status: Somewhat kept. I did pretty well on this, but I didn’t quite make it to 1/2 due to all the extra expenses that suddenly hit me last year. At least it’s a lot better than it was before.

21) Have all class changes and updates done before classes begin so I only have to worry about grading, not prep too. (There’s always new prep… I never get a break…)

Status: Kept. I actually managed to do this one, thank goodness, or I never would have survived the fall.

22) Get the toilet in the Texas house fixed as well as the water heater checked because the shower in the back bathroom is cold, blech.

Status: Somewhat kept. The water heater had to be replaced due to the freeze, but I still need to get the toilet looked at to see if there is a valve leak in the wall.

23) Help King lose weight to help with his arthritis. Aim for 85 pounds!

Status: Somewhat kept. He did lose quite a bit of weight, 11 pounds so far, but honestly I don’t think it’s really a good thing. I think he’s losing the weight from declining appetite due to his body slowing down. T_T

24) See a groove-billed ani. (It’s another type of bird.)

Status: Broken. I tried but failed to find this bird. 2022 will be the year!

25) Make it to 3000 followers on tumblr. Can I do it? Maybe if I posted actual content once in a while…

Status: Kept. Thank you for following me, everyone!

26) Update HaaH at least once. Please. At least once…

Status: Broken. I’m so sorry...

27) Force Convince my father to fix the fixture in my parents’ front bathroom so my mother will finally stop complaining to me about the leaking sink.

Status: Kept. New sink, no leak!

28) Buy a new pair of shoes. I’ve literally worn the same pair of shoes almost every day for the last four years and it’s like… time to let them go.

Status: Kept. They’re not as comfy as my old shoes though. I miss you, Coach tennies...

29) Finish streaming the Fruits Basket remake with Kacchan.

Status: Broken! We made it to the end of season two I think? But we did stream literally all of the Marvel movies together so like we just watched other stuff instead; does this count?

30) Finish the other two courses I was offered because bonus money…

Status: Kept and passed with flying colors, thanks.

31) Save up to finally buy one of those Ember heated tea mugs.

Status: Broken, mostly because I had to really cut down on my tea and coffee consumption this year due to medical issues. But I do still want one of these, so maybe soon.

32) Help my parents save money on their bills by consolidating their services and making some calls to retention of these companies for them.

Status: Broken. I did talk to them about this though, but they abhor change of any kind. More likely to get blood from a stone then get them on a new service.

33) Get vaccinated for Coronavirus as soon as the vaccine is available.

Status: Kept and I got my booster too!

34) Play the new TWEWY game (if it isn’t delayed)–I’m so excited!

Status: Broken, I haven’t played it yet. But my brother got it for me for Christmas so maybe if I get a break soon I can.

35) Find a way to spend more time with my coworker. She does so much for me; I really need to repay her kindness more.

Status: Kept, somewhat forcibly in that she had to drive me to the hospital so many times... @_@ No, more seriously, we did spend a lot more time together this year.

36) Do a video chat and bake with Kacchan since we can’t meet in person to bake together this year!

Status: Broken. My family came to Texas from out of town and took up all my free time over the holiday break.

37) Learn to take better FFXIV screenshots. I need to learn how to use Gpose better.

Status: Broken. I didn’t really take the time to play around with glamour/screenshot stuff this year in between everything else I had to do.

38) I will go birdwatching at least six times this year.

Status: Kept. I did a lot more birdwatching this year than last year!

39) I will use the exfoliating mask and sugar scrubs I was given for Christmas. I will this time, I really will!!

Status: I did not.

40) I will get my kitty Gremory to the vet because there’s something not quite right with his claws and I want it checked out.

Status: Kept. Unfortunately, one of the worst things to happen this year was the loss of my precious kitty Gremory due to one of my family members letting him out of my parents’ house and us not being able to get him back inside before . I am still heartbroken.

41) Get a bedframe for the new guest bedroom bed I was able to buy.

Status: Kept.

42) Eat fewer snacks in 2021–stop buying Oreos, Echo. You can do it.

Status: Look man, it was 2021. I don’t even blame myself.

43) Help ensure that the Todoroki family zine makes it out to everyone who ordered and we are able to close out that zine project strong!

Status: Kept! We did it and the zine looks so good!

44) Get all of the wolf mounts in FFXIV, finally. I never bothered to grind these at all lol.

Status: Broken. I didn’t bother. I’m still missing... Tsukuyomi, Seiryu, and Suzaku, I think?

45) I will help my mother go through all the family’s Christmas things because the house is so overloaded with Christmas stuff it’s actually becoming a big nuisance. (My family’s Christmas obsession could probably be a plot of a Christmas comedy movie at this point…)

Status: Broken. We did go through them, but she didn’t want to get rid of much, oof.

46) Actually watch the Downton Abbey movie, finally.

Status: Broken. I bought it, but haven’t watched it. T_T

47) Take ten “really good” photographs this year.

Status: Kept. I don’t know if every one is really TOP TOP quality, but I got some really gorgeous owl pictures and I’m happy with them.

48) Spend more time with my aunt; we don’t see each other nearly enough.

Status: Somewhat kept. I did go out with her a few times but it was a hard year.

49) A promise provided by a friend: “Try a new Mexican dish. One that doesn’t have mole on it, for once.”

Status: Broken. I left Texas for most of the year and did not really go out even after coming back. Next year, hopefully.

50) I will keep these promises. LOLLLLL.

Status:

Kept: 19

Somewhat Kept/Somewhat Broken: 5

Broken: 25

Honestly, not that bad for literally the worst year of my life. I’m calling it good!

2022 will mark 15 years of making 50 promises, so I’ve got to do my best to come up with some good resolutions this year... Uh, we’ll see...