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andhumanslovedstories · 5 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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weebsinstash · 1 year

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Alright bestie I’m on that shit again

So yandere Superman, right? Like obviously your fucked. The only other yandere in existence that might just be able to keep you from him is Batman, but even then he’d probably sooner work together just to ensure your safety- but that’s a prompt for another day.

Back to yan Superman, imagine you’re his darling and he is “keeping you safe”. But one day, you get snatched up by some organization that wants to use you as leverage or some shit, but you are just sobbing in relief at maybe being free- only to have Superman show up and do some not so super things to everyone who “stole” you

There are just so many casually horrifying things about Superman that people don't realize until you start like digging into his lore. "Oh he's super strong and a super fast flyer" actually he can do basically anything at those super speeds to the point he can literally even PROCESS THOUGHTS at near light-speed which means he has Absolutely Terrifying reaction times and can make plans and schemes on a dime, which, you know, can be even better utilized by him being intelligent. He has natural invulnerability so if you throw a punch at him too hard you could literally shatter the bones in your hand and he can't even control that, like you could literally hurt yourself with him on accident! He can see across INSANE DISTANCES and his x-ray vision doesn't have like a set range so he could do anything from, peep inside buildings to spy on you, to looking under your clothing for any bruises or injuries or even self harm marks, to peeking behind your hero disguise to learn your true identity, to seeing if there's anything inside your stomach and seeing if you're eating properly. Like jesus christ he literally found out Lois was pregnant from waking up one morning and suddenly hearing the heartbeat of the FETUS, there's literally nothing from him pulling that stereotypical "I know you're nervous or lying or afraid because I can literally hear your heartbeat increase" scary bullshit

And let's talk about Lois for a sec because my god her death was literally what kicked off the Injustice timeline? And there are other forms of Superman media where she just straight up dies naturally of cancer! Sure we could take the easy way and say "in this au Lois never existed or was just Clark's friend and he loved YOU" (which is my preferred default tbh bc, no competition for Reader lol) but I mean if you're going for that angst, that real whump, a yandere Clark Kent that just lost his wife/unborn child to either the Injustice incident or cancer, now overcome with grief? And in those cancer timelines they usually already have a son, Jonathan, and sometimes Jordan, and here's Clark thinking, well, his boy needs a mother, and he's got these weird feelings for you, and lil Jonny clearly has affection for you, maybe bring a bit of a platonic yan himself who sees you as either a big sister or even a secondary mom, so... be his wife maybe?

Like my god if Reader somehow helped him through the grief of losing Lois and managed to avoid "fully activating" Superman's anime villain arc, like he's going full fascist in the Injustice 2 Bad Ending, then some shit DEFINITELY goes down when Reader gets taken away. It just reactivates all his trauma. No! He can't lose anyone else! Jonathan can't lose anyone else! You're not just someone he loves, you're his FRIEND!

You're just huddled in whatever cell you've been kept in with your black eyes and bruises and knuckles bloodied from trying to fight back when you hear Clark's voice and you look up with excitement that just falls immediately off your face because holy shit did he just unlock that thumbprint scanner with a severed arm, and suddenly you're realizing there are other shades of red on his costume and dripping from his fingers

I can only imagine like, ngl I considered a sequel to my fic Doubt where Reader escapes the manor and runs into Supernan as the only other person who can protect you, so here we would have the inverse: you're the only one who knows about Clark's increasing instability and, while you still have your own freedom and autonomy, try to speak to Bruce about it, and now you have Batman Vs Superman: Competing For Your Heart Edition. I can only imagine what sort of unhinged reactions there would be if you think you've got Batman alone and you're beginning to cry all "Bruce I'm really worried about Clark, he isn't acting like himself, there's something wrong with him" and. Clark is like literally using his x-ray vision to read lips through the walls if he can't use his super hearing to outright eavesdrop.

Of course as you suggested, I'm always a slut for ideas with"oh shit I ran to this guy to help me and he's ALSO crazy, now they're teaming up and I'm in some weird shared/poly situation with TWO nutjobs". Lmao you go to Bruce concerned about Kal and Bruce goes to confront him and Clark just drops "did you know Y/N has been hiding self harm cuts under their hero suit also wow they smoke HELLA weed and im worried about their lungs and all the stuff they do when they're alone that no one else knows about 🥺" and suddenly here's Bruce " thanks i hate this actually :)" and there's a scheme concted to spy on you or move you elsewhere.

I've even thought of "Reader oh nooOoooOo, that, giant monster or villain attack or whatever also coincidentally destroyed your shitty little apartment complex? You mean Clark 'accidently' got sent flying into your building or smacked some giant creature into it and now you don't have a place to live? And you're broke too? Oh no 🥺 Well, BATMAN has this nice big house with lots of room in for you to stay toooootally 'temporarily', we PROMISE uwu"

Batman is the one who can put a tracking chip injected into your skin or even disguised as a filling in one of your teeth, and Superman is the one who can zoom off to rescue you/retrieve you "faster than a speeding bullet". I think one of the only people who could bring them down together at that point would be like. Fucking DARKSEID and, Jesus no, you definitely don't want HIM treating you as a pet 😭 the evil Batman that was brainwashed by him in the Apokolips War movie was scary enough (and scary HOT, lmao, let him keep me as some sort of prize and the only luxury Darkseid will allow him as a reward for his obedience. Lord Batman goes from having a meeting talking about like enslaving people to returning to his quarters and railing tf outta you because he's still holding onto some slim vestiges of humanity where he cares about you but also using you as his personal anti stress fuck toy)

#yandere superman #yandere batman #yandere dc #i got a draft whee damian and jon like you and introduce you to their fathers #and suddenly stalking you becomes a family affair #the boys walk you home and jon lies about having to pee so damian can plant bugs while youre distracted #the boys going back to their fathers and telling them all of your personal business #'yeah dad when she was at work i used my xray vision and saw her creepy manager grope her in the walk in'#suddenly your small little privately owned cafe was just bought out by wayne enterprises and your boss is fired or goes missing #maybe Bruce gets you a job st Wayne tech bc hes been following you as batman and he doesnt like you working third ahift #lmao heres hoping i actually finish it wven though im not quite sure where to go w it yet #but like its literally over 8 pages at least so. obviously some sort of creative juices are flowing #yandere stuff #sinprompts #at this point i cant promise shit bc my emotions and motivation are waaaaaacky

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hailsatanacab · 1 year

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"give me a fandom and a prompt and i'll give you at least five sentences"

Ok then.

Jazz, Danny and Bruce are in the same age range, and Bruce has been harboring a massive crush on 7'foot tall Jazz since just after he began his training journey.

His kids know about and are mercyless. Danny thinks he's a bit of a fruit loop and 100% knows Bruce has a crush on his sister.

Into the future his coworkers find out that batman has been quietly pining after the Ghost Kings sister for years.

Chaos.

love that this reads as a challenge. Ok then. Write it. i will, let's goooo!

(sorry i kinda took it so that Jazz, Danny, and Bruce were all old friends but in that horrible adult way where you can only hang out with each other once in a blue moon when your work schedules miraculously align)

——

"Respectfully, Batman, you can take your "it's not necessary" and you can shove it up your arse. There's a demon the size of a skyscraper heading towards Metropolis and we need reinforcements."

"Superman can—"

"Superman can't. You do remember the part of the report I made telling you this, right? Or did your stubborn little bat brain just shut down when I mentioned magic?"

"Actually," Nightwing interrupts from the side, a shit-eating grin on his face, "I think his brain shut down when you mentioned the Ghost King."

"Nightwing." Batman growls in warning, his jaw clenching so hard Constantine can swear he hears the bones creaking.

Nightwing just snickers, and turns away to press a finger to his ear, no doubt letting the rest of the bat brood in on what's happening here... Whatever that is. All Constantine knows is that Batman is standing between him and fixing this mess for no God-forsaken reason.

Luckily, some of the more reasonable members of the League step in to try and talk some sense into Batman. It gives him some time to calm down.

"Batman. We need him. I know you dislike working with unknowns, but he's our best shot."

It actually looks like Wonder Woman might be getting through to him, Batman even opens his mouth to actually explain some things—a huge step forward for this incredibly emotionally constipated man.

Instead, Nightwing snorts and beats him to it. "Unknowns? More like—"

"Nightwing, please."

"Oh, for Pete's sake, get your head out of your arse and let me do this. The Ghost King is our only hope. I'm summoning him, no matter what you say."

For a long second, Constantine thinks that he'll refuse and he might have to resort to more violent methods of persuasion—which, honestly, Constantine has fantasised about many times during the more boring JL meetings—but eventually, Batman relents and steps out of the way.

"Fine. Nightwing, go check in with Red Robin."

Nightwing has the kind of devious smile that makes John glad he doesn't have kids.

"Oh, don't worry about it, B. Red Robin's coming here. So's Red Hood, I don't need to go anywhere."

"Nightwing—"

"Sh, it's starting." So saying, Nightwing then very obviously ignores Batman's protests with a poker face that even Constantine envies. What he wouldn't give to be able to shut the bat out like that.

The summoning goes quickly, thankfully. The lights flicker, the temperature drops, and the chalk circle erupts in green flames. Standard summoning practices, sure. Even the impromptu appearance of Red Hood and Red Robin—"Did we miss him?", "No, not yet! I got 2:37, what about you guys?"—doesn't throw him off.

It does pique his interest, though. Just what the hell is going on with them? Constantine's weighing up the pros and cons of asking them once all of this is over when the ground splits open and the clawed hand of the Ghost King begins to pull himself out of the ground.

John's a seasoned summoner. It's practically his job, he's done it countless times.

The icey fear that grips his heart, that freezes his breath in his chest, is new.

Pure, unadulterated power floods the area and he feels small, so, so small, like a child playing with things he doesn't understand. When he finally tears his eyes away from the portal, he catches a glimpse of the other magic users in the room, the same horror he feels clear in their faces. Even Captain Marvel stares slackjawed.

The pressure rises, death magic screaming in his ears, almost forcing him to his knees, and suddenly he's not so sure this is a good idea.

Too late to back out now, though.

Sickly green light pours from the crack in the ground, growing brighter and brighter as the giant figure rises, until Constantine has to close his eyes and look away. The last thing he sees are eyes, teeth, horns, a crown so bright that it burns an afterimage into his retinas.

When the light dies down and he opens his eyes again, a humanoid man floats in the centre of the circle. The ground is whole, nothing is burning, the man doesn't even have a crown. Instead, other than the wispy white hair, slightly green skin, and the—you know—floating, the Ghost King appears pretty normal. Huh.

Constantine blinks, rubbing his bleary eyes, and checks around to make sure everyone's okay. Most of the League are doing the same as him, taking fortifying breaths and trying to appear as if they've not just been completely blinded.

Most of them, that is, aside from the Gotham vigilantes.

Batman himself stands upright, arms crossed, looking completely unbothered by the whole thing and John's got to admit, he wishes he could do that, too. That was... a hell of a show.

The others, however, are waving frantically with huge smiles on their faces.

What?

There's a brief, taut silence, as everyone else tries to catch their breath.

As much as he would rather take a bit of a breather, John should probably start making introductions. Unfortunately, he only gets as far as opening his mouth before the Ghost King beats him to it.

"Oh, Ancients, hey guys! It's been forever, how are you? Look at you all, so grown up, wow—Nightwing, buddy, do a flip!"

It doesn't take much to get Nightwing going, and he certainly doesn't leave it at one flip. The whole of the Justice League and Justice League Dark watch with open mouths as Nightwing performs for the Ghost King.

What, and John can't stress this enough, the fuck?

As soon as Nightwing rights himself, Red Hood swats him across the back of the head and calls him a show off.

The Ghost King just laughs as he claps. "There's my little monkey, look at you go! And I'm loving that leather jacket, Hood, is that new? Looks good on you, really your colour. Brings out the red in your helmet."

"Thanks, Uncle D. At least someone around here appreciates fashion."

"Are you kidding me, you know I breathe fashion, need I remind—"

"Need I remind you of the Discowing incident?"

"That was era-appropriate and you know it! Uncle D, tell him it was era-appropriate!"

"It was era-appropriate, but so are crocs and it doesn't make them fashionable." The Ghost King—and holy shit, is this actually the Ghost King? Or did Constantine just accidentally summon a deceased family member, what the fuck is happening here?—turns to look at Red Robin with a smile, resolutely ignorning the argument he created. "How you doing, Double R? You get that tablet Tucker made for you?"

"Yes, thank you! It's so cool, how did he—"

"How's Tucker doing?" Batman interrupts, his hands now hidden underneath his cape.

As soon as the question leaves his lips, everyone groans. Red Robin makes a show of lifting up his wrist and staring at it intently.

"Incredible," Red Hood mutters with a shake of his head.

Even the Ghost King seems put out, rolling his eyes and answering in a flat tone as if he knows Batman isn't interested in what he has to say.

Not for the first time, Constantine feels like he's missing something.

"Tucker's doing very well, thank you for asking."

What follows is the most awkward silence Constantine has ever had the pleasure to be a part of.

All three of the Gotham vigilantes, including the Ghost King, are staring at Batman, waiting for something. Batman's cloak shifts as if he's moving his hands, fidgeting. If Constantine didn't know any better, he'd say he was nervous.

"Good. That's good, I'm glad to hear it."

Instead of saying anything else, the Ghost King just raises his eyebrows and continues to stare at Batman. Has he offended him in some way? Are they all going to die because of this?

After what seems like an agonising few minutes but could only really be a few seconds, Batman's shoulders dip and he takes a breath. "And Jazz?"

They all erupt into shouts, the Ghost King being the loudest. The only thing John can make out is when the Ghost King throws his hand in the air to point at Red Robin with a shout of "Time!"

"1:30.91, we got 1:30.91 on the clock, who's closest?"

"Did you even try to hold it in at all, old man? I'm so disappointed in you. People think you're cool. People think you're suave, I don't understand how they could be so wrong."

"Thank you for that, Hood."

"No, thank you, I won. Again. Because you're so predictable. Actually, I had one minute seventeen, so you held out longer than I thought you would."

Batman pinches the bridge of his nose and sighs loudly.

Constantine feels like doing the same thing.

Whatever. He's going to have to interrupt... whatever this is. There's still a rampaging demon heading their way that they've got to bargain for. He can untangle Batman's personal connection to the Ghost King later. Or he could leave it alone and forget everything about it.

Yeah, he'll do that one.

But before he can actually open his mouth to say anything, the Ghost King, again, beats him to it.

"So, B-Man, did you summon me here for a particular reason, or was it really just so you could ask about Jazz?"

There's a beat of silence before Batman mutters, "I asked about Tucker, too. We've not seen each other in so long, it's only polite."

"And I'm sure you meant it, you're the paragon of manners." The Ghost King nods slow and wide-eyed as if he doesn't believe him at all.

At this point, even Constantine doesn't believe him.

"It has been forever, though." The Ghost King muses, bringing his hand to his chin and folding his legs underneath him. "We should all get together sometime! If you get Alfie to make some of his cookies again, I'll get Clockwork to lend us a pocket dimension where we can spend as much time as we want, deal?"

"It's a deal."

No hesitation at all, incredible.

Hold on. Wait. John has to fight the urge to pinch himself, because this has to be a dream, right? Is Batman actually smiling? He didn't even know he could do that.

An itch niggles at the back of John's mind. He's starting to get an inkling of what's going on here and it's... weird, to say the least.

"Oooh," Nightwing singsongs, like a child in a playground tickled by the very idea of romance.

But then, who's he to judge? John's no stranger to strange bedfellows, that's for sure. Whoever this Jazz is, she must be something incredible—she'd have to be, if Batman can't even go two minutes without asking about her.

"Batman and Jasmine sitting in a tree," Nightwing continues, with both Red Hood and Red Robin joining in for the rest. "K—I—S—S—I—"

"Stop," Batman growls, completely drowned out by the Ghost King's laughter, but...

But.

It all suddenly clicks for John.

The Ghost King Phantom.

Her Royal Highness, Princess Jasmine Phantom.

Jazz.

"Holy shit, mate," John breathes, unable to stop himself as everyone looks his way. "You have the hots for the Princess of the Infinite Realms?"

The Justice League meeting room has never descended into chaos quicker.

#dpxdc #danny phantom crossover #danny phantom x batman #hoooolllyyy mackeral #it was hubris thinking i could keep anything to five sentences really wasn't it?#fucking played myself with that didn't i???#anyway here's even more words on this i hope you enjoy!!#some things that didn't make it in:#duke doesn't come to see danny because he's too bright when he's in his ghost form and it gives him a migraine - he still plays the game #though and is second closest!#damian is there he's just biding his time. it's become a tradition for damian to try and stab danny whenever he turns up #he hasn't managed it yet but danny keeps encouraging him to try again! you'll get me next time champ!#it infuriates damian to no end - no he's not doing it because he's having fun he legitimately wants to kill him shut up!#danny loves cass so much and when they do all get together they always sit together - it often ends up with cass curling up around danny #ellie turns up every now and then! she's like an honourary wayne at this point #she's always down for any pranks and shenanigans #thank you for the prompt!! it was very fun. as you can see i got rather carried away haha #thank you i hope you enjoyed it!!!#my writing #cab writes

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