#thank you for all of the pain | Explore Tumblr Posts and Blogs

andhumanslovedstories · 3 months

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

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

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

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

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

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

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

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

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

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

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

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itsevansart · 5 months

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soon.

make my day by reblogging and not reposting!

#my art #fanart #harry potter #itsevanffs finished works #hp fanart #fic fanart #anabiosis au #2 more pieces to come; one for each chapter #the third chapter is very close to being done! thank you all for being patient <3 #his hair's a pain and i know i can do realistic hair but not with this brush and not right now lol #anyway i was gonna post this one before i got horribly sidetracked by that fiasco on my writing blog but fuck it!#i've lived through that once i can get through today and go on with my normal business >:3

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luxaofhesperides · 5 months

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"I see you, and I love you" + hurt/comfort ; requested by @oops-i-dropped-the-galaxy!

Danny can handle being a halfa. He’s had years to get used to it, switching between dead and alive, living boy and ghost, always living in flux. He’s settled into his identity as one of the few halfas in existence, navigating the living world and the Infinite Realms with ease after years of practice.

What he can’t handle is becoming an Ancient.

Apparently, while most Ancients are born into the role, ruling over their domain, some can grow into it. It’s rare, practically unheard of, but not impossible.

Danny is growing into the Ancient of Stars, changed from the inside out by his love of space.

He would be happy if it didn’t hurt so much.

Danny can’t sleep at night anymore. When the stars are out, he can hear them singing, each windchime voice echoing through his ears. Though he can’t see them from beneath Gotham’s cloud cover, he can feel them shining brightly far above him.

He lays in bed with Duke, curled up in his side, trying to muffle his whimpers as his bones creak and hollow, his soul growing too large for his body to handle. He is space contained in a human body. It wants to be free, to stretch from its suffocating confines and fill every dark space with cold light. His skin feels too tight and his teeth ache.

All Danny can do is clench his jaw, wrap his arms around his stomach as tightly as he can, and try to weather through the pain of changing.

The agony of it comes in waves. He doesn’t know how long it takes until it recedes enough for him to feel like he can breathe again, trying to suck air in as his lungs are crushed by his ribcage. Slowly, Danny pushes himself up, taking care not to wake Duke, and stumbles out of bed. His throat is dry and feels as if its been scraped raw by sandpaper, and all he wants is water.

He gets halfway down the hall when the next wave hits.

Danny collapses, gasping for breath, and can only watch through tear-filled eyes as his fingers go dark, the same black as deep space. His body shifts, bones cracking and muscles stretching like taffy, and suddenly he’s big larger than life a galaxy a black hole there is darkness everywhere it is alive it is full of stars the stars are singing the stars are singing the stars are si

“Danny? Hey, sweetheart, are you okay?”

That’s Duke’s voice. He’d recognize it anywhere, even from miles away, even when he’s sure he doesn’t have ears anymore. It takes all his effort to pull himself back to Earth, back into their apartment, blinking up at Duke as the stars in his eyes fade away.

Duke kneels before him, concern clear on his face, gentle hands reaching out to hold Danny steady. The feel of his warmth grounds him, keeps him more securely in his body. The pull of space is still there, tugging at him, trying to pull him out of humanity and into the form of an Ancient, but Danny can resist it so long as Duke keeps him tethered to the ground.

“It hurts,” he croaks, shivering.

“Shh, I know, baby. How can I help? What do you need?”

Danny leans forward, burying his face in Duke’s chest as tears slip out of his eyes. “It hurts,” he says again, voice shaking. “I keep changing and growing and my entire body is being torn apart and—” he gasps, cutting himself off. “I keep disappearing. I don’t want to disappear. I want to stay here but it takes me away and then I’m too big and no one can see me and I’m alone—”

“You’re not alone, Danny,” Duke says, holding him tightly as if his arms will be enough to keep Danny from breaking out of his own body, ridding himself of a mortal vessel, his only remaining tie to this world. “I see you, and I love you. Even if you have to change and go far away to be happy, I’ll find a way to follow you there, okay? I’m with you for as long as you want me.”

“I don’t want to hurt so much,” Danny whimpers, black fingers speckled with stardust clawing at Duke’s arms.

“Just breathe through it, sweetheart, you can do it. Let it pass through you. I got you, okay? Just let the pain pass and you’ll be fine.”

He wants to snap at Duke that it’s not fine, that the pain will be forever, it’ll linger in every one of his joints, that he can’t just stop fighting it because it’ll hurt even worse then. But his jaws are aching, his teeth sharpening, and there’s a black hole in his throat that he refuses to let loose. He lets out another pained whine, shivering, and in his chest a star is formed, burning bright and angry.

“Breathe, Danny, breathe,” Duke soothes, rubbing a hand up and down Danny’s back.

It’s habit to relax into his touch. They’ve spent so many nights working through night terrors and injuries, comforting each other through gentle touches. The pain eases a bit, and Danny sighs, frost on his breath.

“There we go, sweetheart, that’s it. You’re doing just fine.”

Another tear slips down his face, but the ache in his entire body as his growing ghost form tries to escape begins to fade.

He’s spent so many nights in pain, waiting for the sun to rise to muffle the singing of the stars. If he can get any relief, he’ll take it, even if it means losing his human form.

Danny stops fighting. His resistance to this change falls away. There’s a moment where the pain disappears entirely, the world going still, but before he can let out a relieved sigh, the change hits him like an asteroid, sudden and instant and inevitable.

A cry is ripped from his throat, but it doesn’t sound like him. It echoes, deep and inhuman, and suddenly Danny is every dark space surrounding the stars, the arms of every galaxy, suns burning bright and dying, supernova, cold and ice and the slow drifting of planets in orbit. His body grows, expands, no longer a ghost but an Ancient, body curling into itself to stay within the walls of the too small apartment, large hands cupped around Duke to keep him safe.

He can feel the cold of space. Orbits dance in his mind. Meteorites and asteroids drift without pattern across his chest. Danny can see everything with too many eyes, and he can cup planets in his palms, so much larger than possibility. His chest opens and expands and his body can curl around Earth and keep it safe.

He feels settled in this new body, senses stretched in every direction and the universe is so much lovelier than he could have ever experienced it in a halfa’s body.

Danny, Ancient of the Stars, hums and the universe shivers, singing back to him.

The pain is gone completely. He wonders why he resisted so hard; this is what he’s meant to be. He’s never felt so right before.

“Danny?”

Duke’s voice is small, but only because he is small when compared to Danny in his Ancient form.

Duke, he tries to say but his vocal chords have changed. Instead of words, a deep hum erupts from his throat, similar to the purr of a particularly large cat.

“Hey, sweetheart. Feeling better?”

Danny nods, pulling himself back together to feel his body more keenly, no longer stretched across the universe, cradling every star in his reach. Duke reaches a hand up and Danny reaches back, folding himself back into his body. His human eyes return and he realizes the apartment is completely covered in darkness with stars sparkling all around them. It recedes as he fits himself back into his body, the black on his fingers fading away until his hand is indistinguishable from a normal human’s.

He takes hold of Duke’s hand and tries to stand. His legs are weak and unsteady and he falls onto Duke, who catches him with ease and sweeps him up into a princess carry.

“There you are, honey,” Duke says, voice warm and relieved. “You alright?”

“Yeah. Yeah, I feel a lot better.”

“Good. Do you need anything? Hot chocolate, heating pad, sleep?”

Danny thinks for a moment, then says, “Hot chocolate.”

“You got it. Let me just set you on the couch and I’ll have it out in a minute.”

He carefully sets Danny onto the couch, then tucks the blanket they keep folded over the back around him. Once he’s satisfied Danny is comfortable, Duke heads to the kitchen, flicking on the light as he does.

Danny sinks into the couch cushions, carefully moving all his fingers and toes to make sure they’re fine. He’s a little sore, as if all his bones where put through the ringer, but it doesn’t feel any different from when he has a particularly rough training day.

What’s more important that his physical body is the fact that he can feel his core, settled deep in his chest. It’s no longer the cold of ice, but it burns coldness, a white star embodying his soul, a changed core to reflect his transformation into an Ancient.

A baby Ancient, technically. He still has some growing to do, but the rest should be easier and, hopefully, less painful.

He closes his eyes and begins to drift off when he hears Duke return. It takes some effort to open his eyes, and his smiles softly and sleepily when he sees Duke set down two steaming mugs of hot chocolate on the coffee table.

“Love you,” he mumbles, freeing a hand from the blanket to try to pull Duke down to join him.

Duke goes to him easily, sitting next to him and pulling Danny in to cuddle against him. It’s been so long since he last felt so comfortable at night, not writhing in pain and biting through his lip to keep quiet, that he can’t help but sink into it. A purr starts up in his chest, and Duke startles.

“Sweetheart, are you purring?”

Danny flushes and tries to hide his face. The purr doesn’t stop. He’s always been able to purr after becoming a halfa, though purr is just an easier way to describe it. It’s less of his vocal chords vibrating and more of his core rumbling in contentment. Usually, it’s unnoticeable, barely able to be felt let alone heard. Apparently, becoming an Ancient and therefore a much stronger ghost means his purrs are also stronger and louder.

“You’re so cute,” Duke says, pressing a kiss against Danny’s forehead. “Drink your hot chocolate, and then we can go back to sleep.”

He makes grabby hands at his mug, and Duke laughs and picks it up for him.

“Love you,” Danny repeats, voice less muffled.

“Love you, too,” Duke says. “I’m glad you’re feeling better.”

“I’m glad you were there to help me. I don’t know what I’d do without you.”

“It’s a good thing you’ll never have to find out. I’ve got you, sweetheart, always.”

Believing him is the easiest thing Danny has ever done. If Duke says he’ll be there for, then he will.

Always, always, always.

. . .

[send me ghostlights prompts!]

#ghostlights #dc x dp #dp x dc #dcxdp #dpxdc #dc x dp fic #prompt fill #my writing #you ever think about how painful transformation must be? especially for eldritch danny turning into something human into something not?#yeah :) hurt and comfort!!#duke best boyfriend of the year tbh we all need a man like him in our lives #imagine the next time duke is in danger and danny comes to help and this human guy suddenly GROWS and his body unfolds and a mass of stars #and space comes out demanding in a voice that makes ears bleed that they leave signal alone or face the consequences #anyways after that gotham knows that the signal is loved by some monster/god so they try not to piss him off too much #this is all good and fine until goons and criminals make danny shrines and leave gifts and snacks on it so he'll show them mercy #and duke has to scold danny about not eating suspicious shrine snacks #thanks for the prompt!!

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medicalunprofessional · 5 months

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, What went wrong ?

#nightmaretheater #caligosto loboto #psychonauts #sorry for making the most upsetting painful fanart known to man. Its my job #Some of this is.Personal.#some personal feelinfs… ya get me?#you even ‘this is just a doodle :)’ then spend several days on it #yeah………….. I need my adhd meds #Ughhhhh..^Ughhh collapses #Thank youuu……wheoevr is reading.send me tour willpower i need it ive got actual work to do in a few hours #Bbbbwbhehehagghh… ignore some of the weird anatomy thz #also shoutouts to all those teeth studies i did only for them to be so distorted you can barely tell what it is

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newvision · 7 months

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Just watched Hannibal put on Will’s jacket in Mizumono and sobbed so hard I gagged! What kills me about it is that Hannibal is so clearly heartbroken over Will’s betrayal. It must have been so difficult and terrifying for him to reveal more and more of what was underneath his carefully construed mask to Will throughout the episodes, something he hasn’t done for anyone but his victims since he lost his sister. Throughout S2b we see him warm up to the idea of a companion. He tests Will and Will passes the tests, until Hannibal smells Freddie on him and knows she’s not actually dead. He could have left, then, with Abigail and they couldn’t have proven anything, he could have had a comfortable life somewhere else, but instead he chose to give Will the benefit of the doubt, presumably against his better judgement. Will did what I imagine must have been the very worst thing anyone could have done to Hannibal. He didn’t not understand him, he pretended to understand him to serve his own agenda. He sensed Hannibal craved understanding and gave him just enough to be able to turn on him. I think that’s why Hannibal gutted Will and killed Abigail, Will is the only one with the ability to truly hurt Hannibal and he does, so Hannibal hurts him in the way only he can — and by doing so imagines he will be able to leave Will behind, start a new life, just as alone as he has always been, as the promise of companionship was a hoax — but again, he’s doing it half-heartedly. He could have watched the life drain out of Will, but he leaves instead of really killing him, so Will isn’t truly gone from him. He leaves, yes, but he takes Will’s jacket and wears it — so Will isn’t truly gone from him. And that begs the question — would he have done that for anyone before meeting Will? I do not think so and neither did Will. When Hannibal asks him “Do you believe you could change me, the way I’ve changed you?” it seems like he wants Will to say no, but Will doesn’t, he say’s he has already altered him, that he is just as much a part of Hannibal as Hannibal is a part of him. They are both so so torn - Will, who betrays Hannibal, but says he did want the gift Hannibal gave him, Hannibal, who guts him but in a way that won’t allow him to die. Will, who wants to catch Hannibal, but seems so accusatory and hurt when he says “you were supposed to leave”. He’s a good fisherman, but begs the fish to swim away, and Hannibal swims towards him although he can see the fishing rod. Everyone talks about Will running towards his own destruction for him, but so does Hannibal. They’re crashing into each other. I cannot get over it, ever

#the way mads delivers the lines ‘I let you know me - see me’ is one of the best performances in all of cinema #the pain in his voice dear GOD #also will moving closer when Hannibal pushes the knife into his stomach #he takes what he can get from Hannibal!!! whatever it is #thank god I don’t relate to either of them 🤣🤣🤣🤣😂😂😂😂😂😂😂🤣😂🤣🤣🤣🤣 feeling normal and fine #its the most heartbreaking love story of all time perhaps #Hannibal #emmys thoughts on Hannibal #nbc Hannibal #will Graham #hannibal lecter #Mads mikkelsen #hugh dancy #hannigram

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