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having mutuals who i think are really cool and get like. starstruck when they interact with me. is so weird. like why am i reacting like this. we’re literally both on tumblr

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Honestly, with all the tradwife cooking trash circulating, it only makes me love B Dylan Hollis more for baking vintage recipes while being openly gay, making sexual jokes, and screaming at the ingredients. He's the antithesis of every soft-spoken cishet woman cooking for her husband and children. You don't have to be an idyllic cottagecore housewife to cook.

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little scruffy arctic fox l Kevin Morgans

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Generational toxic masculinity.

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my turtle goes trick-r-treating

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Forgot to post my costume: cybertruck driver

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When a person with ADHD complains of severe anxiety, I recommend that the clinician not immediately accept the patient’s label for her emotional experience. A clinician should say, “Tell me more about your baseless, apprehensive fear,” which is the definition of anxiety. More times than not, a person with ADHD hyperarousal will give a quizzical look and respond, “I never said I was afraid.” If the patient can drop the label long enough to describe what the feeling is like, a clinician will likely hear, “I am always tense; I can’t relax enough to sit and watch a movie or TV program. I always feel like I have to go do something.” The patients are describing the inner experience of hyperactivity when it is not being expressed physically.

At the same time, people with ADHD also have fears that are based on real events in their lives. People with ADHD nervous systems are consistently inconsistent. The person is never sure that her abilities and intellect will show up when they are needed. Not being able to measure up at the job or at school, or in social circles is humiliating. It is understandable that people with ADHD live with persistent fear. These fears are real, so they do not indicate an anxiety disorder.

holy SHIT

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Beau only has two modes

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just so you know, you have some followers who enjoy/write fanfiction. not saying their urls rn bc i don’t wanna air out dirty laundry in public but if you want them so you can block and report, just say the word and i’ll dm you a list

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Last two shifts I worked, I had the same patients but was precepting (training) different nurses. So two nights in a row, I have a patient with a post-op complication (guts not moving) that the surgeons are taking a conservative approach to (wait and see if the gut starts moving). This treatment plan makes sense for the specifics of this patient, but that means we’re doing a lot of symptom management without directly treating the thing that’s causing the symptoms. In this case, symptoms are pain and nausea so bad that the patient said if they’d known this is how they’d feel after, they’d have skipped the surgery and just rolled the dice with what that colon polyp would do if left alone.

So we’re throwing meds at this patient, we’re walking them so their bowels can get moving, we’re giving ice chips and gum and cold wash clothes, we’re giving IV fluids (which is SUPER rare in the hospital right now because due to one of the recent hurricanes, we are critically low on IV fluids), we’re doing basically all my tricks short of putting another tube in this guy. And it’s working okay. Like we’re keeping pain and nausea just below “intolerable” but not by much.

That first night I have that patient, while I’m talking to the surgeon on the phone, my preceptee is in the room talking to the patient. I don’t get any new orders because most usual meds that would help are contraindicated in this particular circumstance. I’m feeling frustrated about that—I HATE when I can’t get symptoms significantly under control—when my preceptee comes up excitedly and says that the patient says they’re feeling much better after the therapeutic intervention my preceptor did. The intervention was hanging out in the room for 15 mins and talking with the patient about their hometown in Canada.

(Which, hell yeah. Very proud of that new nurse because she said one of the biggest things she wanted to work on was being less nervous talking to patients.)

Next night, I got the same patient, still miserable, and a new preceptee. We’ve got more meds this time, but still only marginal success with managing symptoms. I tell my preceptee, “next time you’re in the room, plan on staying and chatting with the patient for like ten minutes.” Next time we’re in the room, we do just that—we talk sports, hobbies, plans, past surgeries, how much this surgery sucks, just the three of us shooting the shit for a while before we have to go give pain meds to another patient. (It was a surgical floor. That night was mostly handing out ice packs and oxy.)

Anyway, the patient tells us that this chat has been the best they’ve felt all night. My preceptee comes out of the room, and my preceptee is like “wow that really was our best intervention.” And I get to be like “yes witness the power of chit chat as nursing intervention.”

Reflecting back, I’m grateful that the patient was so expressive about what we did that was working. I told the patient at one point, in the midst of their most acute misery, that we were going to give them everything we had available, and if that didn’t work, I had backup plans in mind. Like you might spend the night miserable, but it’s not because we didn’t keep trying stuff. And after I say that, the patient goes, “that was good, I like that you said that, that comforted me.” Which was very nice and convenient because before we’d gone into the room, I’d talked to my preceptee about how to make patients feel supported and cared for, even when none of the care we do is working. When we left after that, my preceptee was like “wow, you’re right, that really worked,” and I was like, “I KNOW, that’s cool right? I mean you always hope it works, but sometimes you just can’t tell if it actually does.”

I love really open patients, they are such fantastic teaching opportunities. For example, I had another patient both night who was also very open, specifically about what a bad job the hospital was doing and how everyone should just stay the hell out of their room. Considerably less pleasant feedback, equally valuable, about essentially the exact same situation that the first patient was in. Talking through that patient with my preceptees was also very useful and very easy, because the patient had been so explicit in their feedback.

It’s always odd training nurses because you don’t want bad things to happen to your patients, but you also need to new nurses to see bad things. And sometimes you get a patient assignment that is so good for teaching, it’s like it came from a textbook. Very convenient for me personally as a preceptor. Feels weird to say that about patients who are having absolutely miserable times, that their misery is useful to me, but (as preceptors normally say about stuff like this) if it’s happening, at least it’s happening where we can learn about it. Anyway, great couple of shifts to practice therapeutic communication.

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I was not ready for the husband's costume

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reblog if you made it this far somehow

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