#i'm not worried about the ramifications for tomorrow | Explore Tumblr Posts and Blogs

prnanxiety · 2 months

Text

4/5/24

Rough situation today.

Don't get me wrong, it wasn't a dangerous day or anything. We only had three nurses and no techs for the whole acute unit, which meant I didn't have time to sit and review charts safely, but all the patients were, for the most part, fine. One of my patients was having what I and the other nurses suspected were behaviors to imitate psychosis, on the grounds that the symptoms would routinely stop as soon as he noticed nobody was paying him the level of attention he wanted.

But there was a specific rough situation, and it was with one of my patients. The guy's been here since last week. Bipolar type one, came in for mania. Delusions are (almost completely) fixed and don't recede with treatment. The mood stabilizers are controlling the mania; he's definitely way calmer than he was a week ago. Though, he's still pretty anxious.

Which is hard not to understand why, because he knew today he was going to a court hearing for his right to make his own medical decisions. It's the same thing that happens at the end of every brief hold a doctor initiates where they decide "Yeah, this patient needs care that will last several more weeks," and essentially, petition a judge for permission to do that.

All morning before the case, the patient was irritated and anxious. Didn't want to talk to staff or engage with anyone. But the thing is, the hearing came, and he finally spoke his peace. Told the judge about how he didn't have bipolar one, it was just the doctor's opinion, he was actually fine and he just wanted to leave. The judge was calm and showed he was listening respectfully to the patient. So, after that, the patient was noticeably way calmer. Still frustrated, but willing to engage with staff more. In fact, he was frequently seen in the day room talking with other patients and socializing, after that.

I personally thought he was just, up until that point, anticipating the big important event and worried about how it was going to go. But when the doctors came back a few hours later and told him "the extension on your stay has been granted," he stayed calm and sociable. Started asking me questions about mood stabilizers and blood draws, and what conditions he had to satisfy so he could hurry up and leave.

I was pretty happy about that, to start talking to him about medications and levels and what he needed to know about managing his diagnosis. Here I was, thinking everything was going to be cool tomorrow, when I came in with a technician this time, and would have time for patient education. But then he pulls me aside, ten minutes before the end of the shift, and asks me "What states do they do assisted suicide in?"

I start asking him to elaborate. He's mentioned to nursing staff in the past, "Look, I know I don't got much time left on earth." He usually mentions it in the same vein as saving and protecting the omniverse, or that he's a KGB agent. We're of course never happy to hear him talking about feeling like he's going to die so soon, but I don't know how seriously all of us took it. But here he is, going on about physician assisted suicide. Do they have it in canada?

I know PAS was something being hotly debated when I was in nursing school, and I wrote a few papers on it, expecting to one day be confronted with it in the field and knowing I need to know my position on the subject by then. I've mentioned in past posts its the one time I'm comfortable with someone committing suicide, because its usually when someone's on hospice, has months left to live, all quality of life is gone, and they want to go out with a smile. And without the legal consequences and ramifications of having committed suicide, of course.

So I started to explain, plainly (and without a tone), that usually it takes a few doctor's visits to see a patient and the doctor has to determine the patient's prognosis is otherwise poor, and that other treatments aren't likely to help the patient. Just kind of gently moving into "I don't think a doctor is going to tell you its better for you to die than have Bipolar Disorder."

But I didn't even get that far, before the patient cut me off. "I am not spending the rest of my life on pills." His family doesn't want him around them unless he accepts he has an illness and takes the meds, but he knows he doesn't have the illness and hates the meds. He just wants to get the hell out and travel the country, maybe go somewhere PAS is legal, and end it all. "I don't want to kill myself, I just want to remove myself from the equation." His words, not mine.

He ended our conversation before I could dive any deeper. "Just keep this to yourself, alright?" He said to me. So of course I immediately wrote a nurse's note about it in his chart, and told the oncoming night shift about the exchange. It's not something I could really keep to myself anyways, since one of the other nurse's on my shift also very clearly heard him.

With all that smiling, and engagement with his peers? I doubted it at first, but I doubt it a little less now; I'm worried this guy is at suicidal ideation stage 3. The very rarest stage to ever see, in the hospital setting. I think he wants to do it, and he's made peace with it.

Lack of insight is the real killer, in all mental illnesses. If no one accepts the problem is the problem, nobody addresses it. My schizophrenic patients and bipolar patients who know they're paranoid are so eager to get treatment, my heart goes out to them when they come back as a result of something dumb happening in the community that stopped them from continuing care. But this? It's anosognasia. The meds can control his mood disorder, but they can't make him recognize it. He thinks he's an otherworldly being and that he's going to protect infinite versions of the multiverse, and that his soul is going to be just fine after he kills himself.

Man. This case is going to occupy me in the morning. One of my most challenging yet, I think.

#dear diary #diary entry #nursing #psych #psychiatry #psychosis #nurse #schizophrenia #cw: drugs #cw: addiction #bipolar 1 #anosognasia

3 notes · View notes

jirai-bpd · 4 months

Text

1/21/24 ;; 9:21 PM ☆

vent.

earlier when i went to put on pants that i always wear it seemed like they were harder to get on than normal. and like realistically i just washed them, so it's probably just cause of that, but i've been thinking about it like, all day, as i've been eating. eating lunch? i feel kinda bad. eating dinner? this is definitely a lot, i'll toss half. immediately after a snack? i shouldn't have eaten that, i seriously shouldn't have eaten that.

it's so stupid cause i'm so worried about gaining weight. i feel so much pride in being a size XS in everything. and then i just go and eat a ton of shit anyway like there won't be any ramifications. this is why my thighs are fucking huge.

the other day when i went dress shopping with 🍷, i found a pair of dress pants and i was like "oh good they have a zero" and i had to explain to her that yes i understand this is juniors i'm a size 0 in juniors and a 000 in women's. and she didn't believe me. i had to actually show her the pants i was wearing were a 0. it was sort of insulting. she's constantly fluctuating between "you need to eat more than that" and "you need to be careful with how much you eat." why don't you just let me regulate my own fucking weight in peace?

i dunno. i'm gonna be at school for most of the day tomorrow, so i'll probably just have a monster while i'm there. i don't wanna waste my fucking financial aid on the shit in the school store, i don't need any of it. the less i spend the better, cause then it comes back to me, and i can spend it on actually important things. like clothes. and keychains. and gacha pulls.

#🪦 vent #🩹 weight

1 note · View note

tanksforasking · 6 years

Note

YOU'RE OUT HERE MAKING MY *LIFE.* Maybe something where tony gets hit during a fight and thinks he's fine but he's actually either concussed or bleeding internally, and after the battle he's all loopy and they (whoever you like lol i'm not picky on this part) think it's adrenaline, then he's cranky and they think it's exhaustion, then he's collapsing and they're like "oh fuck" (PS if you don't like this i can try again!)

OOOIIIIIEEE IT’S PAST 2 AM AND I HAVE WORK TOMORROW. I AM AN IDIOT. Anyhoo, this one is for you and that adorable prompt @taylortut! Idk if this is exactly what you wanted, but I gave it my best shot! (Also plz tell me if I missed any grammar stuff or if something just straight up doesn’t make sense cause my eyes are too tired to catch everything rn. Also Also this will be cross-posted to AO3 and FFN). Enjoy!

Word Count: 1391

Tony certainly was by no means unfamiliar with crash-landings. It could be said that they had become somewhat of an occupational hazard for him. But, unlike most things he seemed to encounter in his line of work, crashes always seemed a lot scarier then they actually were. Once the initial shock wore off, he could usually just pick himself up, dust himself off, and get right back into the fight. Rarely was one of his unfortunate meetings with the pavement or the side of a building something that actually caused any severe ramifications.

Key word being rarely.

It had been a typical downtown scuffle for the Avengers. Another lunatic that happened to get access to weapons way beyond their pay grade and used them to wreak absolute havoc on the basis of some half-baked ideology and a superiority complex. By all means, it should’ve been an easy takedown.

And it almost was.

Unfortunately, said psycho happened to pack one Hell of a punch, and just before Sam came in for the final, aerial takedown, the jerk managed to land one last, lucky hit...

Right to the back of Tony’s head.

The next few moments seemed to defy time itself. The moment the criminal’s armored fist made contact with the back of his helmet, Tony felt a brief sensation of exploding pain travel across his skull, followed by total, encompassing darkness. When he did come to again, it was just in time to see a cement wall inches away from his face, the distance between he and it closing rapidly. The pain from the impact could barely be distinguished from the lingering ache of the initial strike, the cries of his worried teammates through the coms only aggravating his condition.

Rhodey’s voice was the first he could truly register throughout the cacophony. “Tony, you still with us, man?”

Tony grunted, shifting under the light rubble that now covered him. Despite the natural aching in his head that would come after such a blow, he couldn’t detect any major bodily damage. Unfortunately, after several tries, he was unable to activate FRIDAY to confirm his theory, the AI system most likely having been damaged in the crash. It was something he made a mental note to check on later.

“Yeah, Rhodes, I’m here. Did Sam take down crazy?” he finally answered, steeling himself to get back up and fight if needed.

The sigh of relief on the other end was nearly tangible. “You have us worried for a moment there, Tones,” he chuckled, “and yeah. Sam’s got him detained and DODC’s already on their way to clean out his warehouse. We’re all done here. How are you?”

Tony mentally scanned himself again. Admittedly, it was difficult to tell if anything was out of place with the throbbing of his head overwhelming almost every other sensation, but nothing seemed to be horrendously wrong, so he diagnosed himself as fine and began to dust the rubble off. “All good, just gotta dig myself out a bit.” In the distance, Tony could hear sirens, confirming for him that first responders were almost on the scene and their job was done.

Rhodey’s voice crackled through the coms again. “We sent your Spider-kid your way just a moment ago. You should have some help getting you out of there pretty soon.”

Tony sighed, offered a quick thanks and surveyed his surroundings once more. The dust was clearing, and it seemed like it would be fairly easy to get out on his own. Still, with the lingering dizziness that wasn’t seeming to lighten up with time, he wasn’t going to turn away the extra help. Who were they sending again to him again? Was it Sam?

Before he could recall, his question was answered by the overly-cheerful shouts of Peter Parker as he approached.

“Hey, Mr. Stark!” Peter’s voice seemed to reverberate through Tony’s brain, leaving his ears ringing. Or had they been ringing before? He honestly couldn’t remember. “Ya good down there, sir? Mr. Rhodes sent me to come get you outta here!” Peter called out again as Tony winced, struggling to comprehend exactly what the kid was saying through the pressure in his skull. God his head was pounding. Was it normal for the pain to last this long? He felt like it wasn’t.

“Hey kid…” he mustered up the strength to speak, but even so, his words came out slightly slurred. “Couldja maybe use your inside voice? My head’s still a bit on the tender side right now.”

“Oh, yeah! Right!” the younger of the two replied in a sort of loud whisper. “Sorry! I uh… think I just gotta move this one last block and then you’ll be good to go!”

“Thanks kid...” Tony grunted before letting his eyes fall closed, the inky blackness being the only measure of relief from the pain he could find.

He didn’t know how much time had passed before he heard Peter calling his name once again.

“Mr. Stark? Mr. Stark! You can get up now! I cleared a path for you!” Peter’s loud whispers echoed in his ears again, every harsh syllable feeling like a hammer against his frontal lobe.

Tony groaned, moving to stand before he was pulled back down in a wave of dizziness. His vision was swimming and everything was fuzzy. Who was talking again? Why was it so loud?

Getting unsteadily to his feet once more, he stumbled blindly forwards, trying to grasp onto something, anything to steady him.

He soon felt some slight support, as if someone was grabbing his wrists and trying to hold him upright.

“Woah… Mr. Stark, maybe you should sit down…?” a quiet, worried, and high-pitched voice rang out in front of him.

Peter. That voice was Peter. Peter was the one holding him up right now. He sounded worried. He was worried… about him? What had happened?

Oh… yeah. The crash. That would at least explain the pounding in his head.

He needed to keep Peter calm. After that, he just needed to get back to the compound and sleep the rest of it off. Then everything would be okay.

“No, it’s fine, I’m just - ”

Peter cut him off before he could finish a proper excuse. “Mr. Stark, lift up your mask for a sec?”

Perhaps against his better judgement, Tony obliged, squinting and blinking as the now unfettered sunlight hit his sore eyes. Everything was out of focus and the world felt like it was spinning. But, through the fog, he could still hear Peter’s voice of concern.

“Woah your pupils are like, totally uneven. I’m pretty sure you got a concussion, sir.”

Tony mumbled out a half-hearted rejection, not having the strength to fully refute what was so obviously true. Hell, all really cared about at the moment was the hope that the world would stop spinning.

“You’re showing all the symptoms. We learn about this stuff in health class, ya know.” Peter chuckled slightly, obviously trying to make light of what was probably an uncomfortable situation for him. “Why don’t we get Mr. Rhodes to take you back to the compound and get you an appointment with medical, eh?” Peter’s awkward laughs continued as he wrapped his arm around Tony’s middle and guided him out of the surrounding rubble, com already activated. “Mr. Rhodes, we’re gonna need an evac over here. Mr. Stark probably… well, more like definitely’s got a concussion. Probably not the best idea to have him flying back on his own like this.”

Tony was vaguely aware of some affirmative banter between the two before he decided to object.

“Alright, alright kid. No need for any of that. I can make it back on my own.” He figured his argument would have been a lot more convincing had he not nearly tripped and fell as he finished the thought.

Peter smiled a bit, obviously trying not to laugh before setting his features again in what seemed to be an attempt to appear stern. “Uh-uh, sorry Mr. Stark, but you wouldn’t let me do this on my own, and I’m not letting you!”

Tony couldn’t help but smile as the boy’s grip noticeably tightened around his waist. Later, he’d blame the sentimentality on the concussion, but deep down, he knew that he had a good kid.

“Dang it, kid. Stop making such great points.”

50 notes · View notes

soul-dwelling · 2 years

Note

Yeah how in chapter 303 its allways repeated "wow shinra this world really is crazy!!!" it just comes of like Okhubo has a very narrow and childish view of the world. To him the solution to despair is what, generic fantasy dnd escapism,because thats what it is "yeah you are as strong as your soul and go hunt cool monsters, isn't that exciting! Maybe if you have the taste and logistical understanding of the ramifications of such a world of a 5 year old lol. Everyone love living in fear of monster

If I may self-critical about myself, maybe I need to remind myself that Ohkubo's works do not have to be realistic and don't have to be some reflection on how the world is or how it should be. This is one author's work that satisfies what he thinks his story should have.

And it's not as if that kind of excitement and wish fulfillment--"I get to be in a world where I hunt monsters!"--doesn't have its own appeal. Isekai stories are popular because there is wish fulfillment at the heart of them. While the "best" isekai stories are probably those that still are self-critical of escapism, or use those stories still to allegorize real-world concerns, there is nothing wrong with wanting a story where you just enjoy being powerful and not having to worry about real-world concerns.

Not every story needs to be grounded in realism: sometimes, you want a story where you have fire powers and can fly, or where everyone has a superpower, or where relationships are easy and life is carefree and easy. If you're having a bad day, or dealing with problems, or really depressed, I completely understand not wanting to pick up a story that is grim and realistic and depressing: sometimes, you want a story where the bad guys are bad guys, and the good guys win because their goodness translates into the power to stop bad guys from being bullies and hurting people.

Ending a serious-enough series like Fire Force with a happy ending isn't a bad thing; I just don't quite see how this ending is happy for everyone. (Seriously, Joker just has to know the guy who abused him all this time was resurrected?)

That being said, I do think, if you're going to share a story, it should strive to not only express yourself but try to tap into something you think an audience would want out of it. That becomes the challenge: you challenge the audience too much, or upset them too much, then you get no audience; if you cater to what you think an audience wants, it may become derivative, cliche, or boring.

But I do think the story has to say something, and I never got a sense Fire Force, in its last arc, said much of anything, or said anything that didn't contradict the better messages earlier in the series ("life deserves to be protected," "don't get yourself killed because you think self-sacrifice is more noble when staying alive to help as many people as you can is more pragmatic," etc).

I have said repeatedly that enough time has passed since Ohkubo started Soul Eater that I would hope he would have something more mature in Fire Force--and this ending seems to have inspired only one reaction from its audience: "OMG Ohkubo is the GOAT." This isn't it. I don't see this world of monsters as topping the excitement of Joker teasing out to Shinra what happened to his family, or Joker's back story, or the first Nether fight. This ending, with a "world of madness" and "monsters" running around, seems like mere spectacle--fine for an epilogue, I guess, but not for an ending to the series, and not for some connective tissue to Soul Eater. Again, this seems like regression: why didn't Ohkubo just wrap up Fire Force on its own terms, instead of trying to connect to what should be a "less mature" series because he wrote it earlier when he, likely, would have been less seasoned and maybe less good at writing and illustrating?

And maybe I'm not being fair: Chapter 304 leaks likely come out tomorrow, and at that point maybe we will see real-world ramifications (what Maki and her dad are dealing with back at home, trying to actually manage a world that is fundamentally different now), but I'm not holding out hope there. I keep catching myself about to say that I want a story that is more "realistic," but that's not a proper standard to judge a story. Rather, I want a story that is believable--and it is hard to believe, up to now, the kind of characters we see, and just putting myself in the shoes of the characters, that if the world changed this much, that I would be like Honda and Juggernaut and just say "whatever": I would think that there is still despair and chaos because the world has changed so dramatically, and not all people are going to handle it well.

#ask dwells #spoiler #spoilers #long post #cw: child abuse

0 notes