#be it time or management i don't know

[floccinaucinihilipilificationa]

[egophiliac]

at this point I'm not going to finish this, but I need everyone to know that I don't CARE that it was Kamejim, this scene has been replaying itself in my brain for the past week --

[ren-144p]

something about the first few episodes of the terror having so many numbers. the men, the provisions, the inventory; but also the tension of counting. the scene where goodsir takes a picture of john franklin and his men and he's counting down the seconds. the lashes being counted down during hickey's punishment. and something about how in later episodes, numbers get lost. dates get forgotten. counting just stops. all of it becomes insignificant. like it was a countdown at first but now the time is just running out instead

[chiptrillino]

I think people will not spot it but... 

-points to the isopod-puppy 'carving' on the wall- 

I don't think they would pop up as well in real life... (in my experience I highly doubt that... )

but hey! this is a drawing

art-blog: chiptrillino-art

[ID: Two Fanart images portraying the southern water tribe family from avatar the last air bender. which include: father Hakoda, mother Kya, older brother Sokka and younger sister Katara. 

the first image shows, a family of four, in bed. In the background on the left side, the snow-withe-floor is covered with a white pelt with cheater spots covering it. a snow step with a blue blanket resting on it leads up to the bed. On the wall is built-in a smaller shelf with small carved toys and a wooden boat toy. a decorated boomerang with a wolf painted on it fell out of it. a doll in a blue parka is resting at the top of the head of the bed. the bed is made out of straw mats two big fur pillows, and soft pelts in shades of dark grey and brown. the walls with visible snow blocks on the right side of the image area are covered in small carvings that look like children's drawings. on the right side close to the wall, bundled up in furs that resemble sheepskin is kya, peacefully sleeping. her head is resting on her husband's left shoulder. she is wearing her iconic necklace. peacefully sleeping in her mother's arms is little katara. who wears a light blue top and has her hair in two braids. she is bundeled up in a embordied blanked. bears and otter penguins hunting small fish are sewn on it. 

in the centre, sleeping upside down with limbs spread out is Sokka. mouth open tooth growing out. arms above his head. he is just wearing pale brown-grey pants held together by a dark blue ribbon. he must have gotten out of his blanked during his sleep. his legs are spread atop his father's torso. one foot getting into Hakoda's half-asleep face, pinky toe stuck in his father's nose pulling. Hakoda is not amused. but resigned himself to his fate till his family decides to wake up. he wears his hair open, a bone necklace around his neck. and dark brown pants. over his legs is draped a fur banked.on the right side of the image is a small text saying "please don't repost" below in the centre is the artist's signature "chiptrillino . 2022" 

the second image shows the family doing her morning routine. 

Kya sitting behind Sokka wearing a blue Kuspuk. her hair styled with beads in it. a ribbon is stuck between her teeth while she smiles and looks at her husband. she is doing her son's hair. Sokka is still half-asleep in front of her yawing. bundled up in an embroidered blanked with otter-penguin and bears on it. on the right of the image is Hakoda yawing just like his son briding his daughter's hair, he is not wearing a shirt, just his pants in which he slept int. on top of his crossed legs sits katara. wearing a light blue kuspuk with a small blue raindrop pattern on. happily dangling her feet and playing with her doll.

on the right side of the image is a small text saying "please don't repost" below in the centre is the artist's signature "chiptrillino . 2022" End ID.]

[potofsoup]

Happy 10th year of me doing this dorky comic! Hope people don't mind the fact that I haven't really dabbled in Cap stuff for a few years, except for my weird yearly July 4th ritual. On AO3 here, and tumblr tag here. (2022 was about Dobbs, 2020 was about seeing the stars, 2019 was about building new systems, 2018 was about voting, 2017 was about immigration.)

@histrionic-dragon tagged me yesterday and posted a bunch of cool links of ways to help: https://histrionic-dragon.tumblr.com/post/721837010124488704/almost-captain-americas-birthday

Rail workers paid sick leave: https://www.ibew.org/media-center/Articles/23Daily/2306/230620_IBEWandPaid

Lots of posts out there on the 2023 Minnesota legislative session, but here's the OG tumblr roundup post.

California is trying to divest its two largest pension funds from fossil fuels, but apparently today they decided to table it until next year. :/ I guess more meetings are needed! (productive ones, not ones that could have been an email.)

[tzarrz]

to all people who said PART 1 made them laugh - i lov u 💗 this is for u

[canisalbus]

lmao i remember when i sent an ask asking about machete and vasco’s first kiss and now we have all these science experiments trying to figure out how they actually Do That and if they even can. nature is cruel and homophobic 😔

The power of team effort.

[laney-rockin]

SO HERE ARE KIRK AND SPOCK'S TOTALLY NORMAL DESCRIPTIONS FOR EACH OTHER:

Yeah- so platonic ik.

ALSO!! I found out (VIA a livejournal that told me the difference between the censored and uncensored versions of this book) THAT I- SOMEONE THAT WENT TO THE BOOKSTORE AFTER SCHOOL JUST TO GET THIS- MANAGED TO FIND THE ORIGINAL UNCENSORED VERSION OF THIS BOOK.

So y'all have it on VERY good authority that what y'all are seeing here is meant to be gay asf.

ALSO SPOCK KNEW SUBCONSCIOUSLY THAT THE MAN IN HIS DREAMS WAS HIS T'HY'LA- AND THEN HE SEES KIRK AND HE'S LIKE "YOU ARE THE T'LEMA! THE MAN WHO WALKS IN DREAMS!"

I JUST LOVE THIS BOOK SM

[poorly-drawn-mdzs]

Smell Check [Easy: Failure]

MDZS Disco Elysium AU part 1 (part 2 - part 3)

[pinkd3mon]

Kirby deals with existential crisis and Bandana is a good friend

[aeymii]

Sometimes, you just gotta sit back and draw this a-hole✨

[egophiliac]

GREAT GOOGLY MOOGLY, THE NEXT BOOK 7 UPDATE FOR THE JP SERVER IS SET FOR MARCH 1ST.

HOW WE FEELIN LADS!?!?!

AHHHHHHHH NOOO I'M NOT READY, I thought we'd be getting the fourth anniversary first and then Sebek's birthday and then maybe some more episode 7, I didn't -- I didn't think it'd be Friday --

oh god and they're rerunning the story cards, they didn't say this was the final part but it feels like...maybe the penultimate chapter? could the end of episode 7 finally be looming in the distance?! WHAT AM I GOING TO DO

[andhumanslovedstories]

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

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

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

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

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

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

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

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

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

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

[molekel]

Amphibiuary Day 29: Leap

[mortiscausa]

i can't stop thinking how funny it would be if gareth's brothers did in fact recognise him and were just like 'well clearly he has his reasons so let's all be good big bros and pretend we don't know him' and then spend the next few weeks before he goes off on his quest pretending extremely badly that they have never ever met this kitchen boy before nope not at all even while other knights are looking at them and looking at gareth and going 'hmmm'

[kiragecko]

One of the first things that made the social model of disability really make sense was this:

My new doctor hadn't been doing reminder calls for the 2 years I'd had her. I FINALLY got my act together and talked to the receptionist to opt-in.

"We don't do that."

And I froze. What? How could they ... they just ... refused to remind people of appointments? I politely asked if they could make an exception, got turned down, and was in a fog for the next half an hour.

Because I couldn't get to appointments consistently without a reminder. It was hard to get there WITH a reminder, but I was simply unable to without.

Suddenly, I was disabled. Without assistance from my husband, I lacked the ability to get medical help.

-

I'm thinking about that a lot, today. My husband's back at a physical office for work. I have an appointment with NQ's school. And all day, I've been carefully checking my backups.

If I miss the appointment, I'm only 5 minutes away, so I can get there quickly if called. The resource teacher will be understanding if she needs to remind me - she's willing to ask if I'm capable of talking at the beginning of every phone call, and we've set up back up forms of communication if I can't!

Even with my husband unable to physically check if I'm leaving, I have ways to ensure I get to this meeting.

-

With automatic reminder calls, or husbands by my side, I can sometimes forget just how vulnerable I am on my own.

But there's a reason I can regularly see a counselor, but not a general practitioner. There's a reason my husband used to have to take the afternoon off work every time the school set up a meeting, but today I won't be seeing him until this evening.

(There's a reason that I partially started auditing because I showed up at the wrong time and place for almost every university exam, and the stress was destroying me.)

I think that's what the social model of disability is about. It's society in general bearing a slight cost so that vulnerable people don't have to bear an extremely heavy one. Paying slightly more to design buildings that mobility aids can navigate. Banning really dangerous allergens from some public spaces so that people can use them without dying. Normalizing flashing light warnings to avoid seizures.

There are only so many slight costs society can bear before they pile up into a heavy one. I'm not sure how much diversity a society can reasonably support.

But I really appreciate it when an organization is willing to send me reminders. Because my memory and sense of time SUCKS.