tool the patient

4

rumblesnore said: Perhaps a Enoch imagine? You could do whatever you’d like as to plot xx

Sure thing Darling!

Imagine being a Peculiar child who is an amazing craftsman and you make little dolls and creatures for Enoch to bring to life.

With a small amount of blood running down your fingers you fiddled with a long length of thin wire, twisting and bending every which way to determine the best shape.

Your tools sat patiently around you like a sort of ceremonial ritual as you glanced over the pile of cast away toys parts and odds’n’ends you had gathered for this specific purpose.

Enoch had been running through a lot of dolls lately, their little battles becoming more brutal and each doll being dispatched at amazing rates.

“I’m almost done I think” You crossed your legs and twisted the wire around the neck of a cast away doll head and a Frankenstein-esque body to secure it firmly before taking up the cast iron fire poker which had been sitting in the glowing red cinders of a fire, waiting.

“You’ve been sitting there for three hours.”

“You can’t rush these things, Enoch.” you reminded him as you slid down your goggles and began to weld the wire rings together into a solid metal brace.

“I can’t just churn them out like I used to, I want these ones to last so I don’t have to make new ones every week.”

Enoch smirked a little and glanced at you from the side of his eyes. “you know you love it.”

“I love a challenge, this isn’t a challenge.” You muttered as you pulled your goggled off your face and inspected the work carefully. “this is repetitive.”

Below you both there was a disturbing rattle followed by a deathly groan in the pipes, making you roll your eyes.

“The boiler again.” you muttered, knowing you would be the one to fix it again after dinner.

“Every single day” Enoch sighed and glanced at your hands which were stained red and raw.

“Come here.” He smiled a little and pulled a makeshift first aid kit from under his work bench.

“Not now.” You growled and began to fiddle with the doll again, determined to make it perfect.

Enoch sighed and pulled out a roll of gauze bandages, fabric tape, disinfectant, and a pair of small silver scissors.

Setting everything out he crawled over to you and gently pried the gadget out of your grip, despite your adamant protests.

“No, no, no, no, no! I’m just getting started! I’m on a roll here!” You whined as He set the doll aside and took your ragged hands, thick with callouses and scars.

“You’re going to get tetanus, that’s what you’re doing.” He scolded and took a cotton ball and poured a small amount of alcohol on it.

He wrapped a hand towel around the handle of your screwdriver and pressed it to your lips. “Bite down.”

You obeyed and began to hiss and whimper when he dabbed the stinging liquid on the open wounds.

“Ow, ow, ow, ow, OW.” You cried out until he stopped and wrapped clean gauze around the wounds and taped the bandages securely.

“You’re such a baby.” He snickered as you pouted.

He picked up the doll and turned it over in his hands, impressed with the workmanship.

“This is perfect.” he nodded but you snatched it away from him.

“No it’s not” You protested and He took it back.

“Yes.” he smiled. “it is. You’ve done a marvelous job Y/N” 

You blushed and muttered under your breath about it’s imperfection as Enoch ruffled your hair gently and set the gruesome thing on his work bench next to it’s opponent.

Time for the next battle.

youtube

Chucky will return in Cult of Chucky! The seventh entry in the Child’s Play series begins shooting this coming Monday in Winnipeg, Manitoba, Canada. Watch the announcement video (revealed by EW) above.

Series creator Don Mancini - who has written every installment in the franchise and directed the last two - is once again at the helm as writer and director, and he’s bringing back several key cast members.

Brad Dourif will provide the voice of Chucky, as he’s done in all six films. He’ll be joined by Jennifer Tilly (Bride of Chucky, Seed of Chucky) as Tiffany, along with Alex Vincent (Child’s Play, Child’s Play 2), Fiona Dourif (Curse of Chucky), and Summer H. Howell (Curse of Chucky).

Here is the official synopsis:

Confined to an asylum for the criminally insane for the past four years, Nica Pierce (Fiona Dourif) is erroneously convinced that she, not Chucky, murdered her entire family. But when her psychiatrist introduces a new therapeutic “tool” to facilitate his patients’ group sessions — an all-too-familiar “Good Guy” doll with an innocently smiling face — a string of grisly deaths begins to plague the asylum, and Nica starts to wonder if maybe she isn’t crazy after all. Andy Barclay (Alex Vincent), Chucky’s now-grown-up nemesis from the original Child’s Play, races to Nica’s aid. But to save her he’ll have to get past Tiffany (Oscar-nominee Jennifer Tilly), Chucky’s long-ago bride, who will do anything, no matter how deadly or depraved, to help her beloved devil doll.

A Day Like Today

a little bubble carries me to the surface i am glad not to be drowning but I know this ocean is not getting smaller and the distance to the shore is not getting shorter a muffin a coffee a cell phone playing music to distill emotion and let it float to the surface of the beaker trying to propel me like a ship stranded in a windless sea to write write write let some words sift through the screen of self-criticism to the page energy where are you my gas tank has no reading i do what i can to protect the adverse effects trying to think clearly through the hysteria of those moments when my walls collapse and i am claustrophobic a prisoner trapped under my own skin closing in inside yeah before that happens i mitigate all the incoming factors like a surgeon switching from tool to tool hoping the patient will not die before he gets it right strapped to the gurney my fate in his sterile-gloved hands the walls teeter I think if the table wiggles one more time my walls might crush me. 

anonymous asked:

Hi there!!! ❤💛If you were still doing the ships - I was interested in one! I'm 4' 11". Black pixie hair cut, covered in tattoos snake bite piercings(when I'm not at work!) I just finished my bachelors in psychology - I'm going for my doctorate in clinical psych in December (yay!) I've endured many years of of abuse and trauma but I use my experience as tools to help my patients where I work. (I work at a psychiatric hospital!)I love drawing, and I'm very quiet. Thank you again for this 💚💙

i ship you with…

MURDOC!

  • he loves your piercings and tattoos and wants to know all of the meanings of them, even if they don’t have one or you won’t tell him what they are. he’s going to make some up if you won’t tell him!
  • he’s super proud of your pursuit in your education. murdoc finds your psychology major interesting, especially when you tell him little facts you’ve learned
  • you can understand murdoc if you use your experience to understand patients. as someone who went through years of abuse and trauma as well, murdoc trusts you to help him and listen to him and he’ll do exactly the same for him
  • being quiet is fine with murdoc because despite being loud most of the time he has his moments where he needs the silence. he’ll climb into bed next to you just for a hug and some quiet, that being his favorite place at the end of the day
Extracurricular Activities + A CS One Shot

A/N: I swear I’m going to get better at posting things more frequently one of these days. Anyway, here’s a little smutty sequel to this one shot I wrote a while back because I promised it to @xpumpkindumplingx and @ilovemesomekillianjones and because there’s apparently nothing like reading Halloween-ish things in November, right? :] 4.5K and rated M for sure.


“Killian….stop-” Emma weakly warned, spinning to face him and his salacious smirk. “-doing that. You’re supposed to be supervising, remember?”

“True,” he laughed, letting his fingertips trail down her sides while tickling her ribs. “But these little events are supposed to be fun, you know. Depriving me of such privilege would be bad form.”

Emma couldn’t help but roll her eyes at his innuendo, his words hinting toward things she shouldn’t be pondering given their current location. The circumstances he was so teasingly reminding her of were those of a school fundraiser in the shape of the annual corn maze Principal Hopper insisted on each year. She’d avoided participating in the planning and proctoring of this long lived tradition for a few years now, always claiming she was busy with some other obligation.

She, of course, couldn’t use that line this year when she was propositioned - mostly because the offer came from the devilishly handsome gym teacher who would have definitely qualified as her other obligation if they were anywhere but standing a short distance from the evening’s adolescent event. She mused at the thought of him being her excuse for exclusion as she glared at his attempt to steal a kiss from her stubborn lips. Well, ‘steal’ was a loosely used word. It’s not like she wasn’t aching to give in to him - even if they were barely out of sight courtesy of some well placed bales of hay.

“I’m pretty sure you’re referencing two very different types of fun, Jones,” she quipped, trying not to lean into his heated touch. “We’re supposed to be monitoring the area for deviant students - not teaching a very inappropriate behavior 'how-to’ course.”

“But teaching is what we do, love,” he returned as his hot gaze lingered on her lips. “You can’t warrant a man for utilizing his talents.”

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signs as relatable dentist things
  • Aries: One hand on the mirror, one hand on the scraper, itch on your nose.
  • Taurus: Accidentally dropping a tool in a patient's mouth.
  • Gemini: Making the patient wait while you figure out how to work the foot pedal controls for the chair.
  • Cancer: Getting distracted by the cool lite rock playing in your room.
  • Leo: When you secretly sharpen the plastic piece that your patient will have to bite on for their x-Ray.
  • Virgo: Falling into a deep depression about your ex-wife during a routine cleaning, and starting to cry in your patient's mouth.
  • Libra: Giving the kid the token for the capsule toy machine in the lobby.
  • Scorpio: The pure panic and terror in the patient's eyes when your electric saw approaches their vulnerable mouth.
  • Sagittarius: The sweet cathartic release of tearing a tooth out of a live human skull
  • Capricorn: Scraping small sigils into your metal tools so that they curse the patient with the feeling that their tongue is uncomfortably large for their mouth.
  • Aquarius: When you finally fuck up big time and carelessly cut a patient's throat during a procedure, get sued for malpractice, lose all your money, assets, your kids, and all your friends, and live out a lonely depressing life.
  • Pisces: When your patient hasn't flossed since he was last in your chair.
In response to "The View"

I have had a few days to mull over the ignorant words spoken by Joy Behar and the other women on that show.
I find I’m insulted, hurt and all together disappointed.
Insulted that they can degrade nursing to a “costume” and “doctor’s stethoscope”. My scrubs allow me to work. My work involves moving in all ways and getting covered in every fluid imaginable. I don’t think heels and fashion wear would be appropriate for CPR.
MY stethoscope is one of many tools I use to help patients. I can’t count how many times I have caught a murmur that several doctors have missed or how many times I’ve lent MY stethoscope to a doctor.
I am hurt that once again that nurses are degraded to stereotype. Nursing is a talent to be shared. We are not the idiots too often portrayed on TV.
I didn’t go to school for 6+ years to be a doctor’s eye candy, waitress or hospital servant. I am trained and educated to react to acute changes in patient conditions. It is my CAREER and my passion.
I am mostly disappointed a out how these women can degrade other women so casually. Women have so much to contend with socially and in the work place without these women adding their two cents.
But I am also proud about how the nursing community has come together. We have flooded social media with our response. We have shown the world our souls and compassion.

I am proud to be a nurse!

Now if you will excuse me, I have lives to save….

6

Coating Makes Steel Tougher, Keeps Microbes From Sticking

More and more objects are getting superhydrophobic coatings that make liquids bounce right off. Surfaces with complex nanoscopic structures that prevent wetting will soon be deployed on wind turbine blades and aircraft wings to prevent ice from sticking, and even concrete is being doped with superhydrophobic compounds to help it last decades longer.

Much still needs to be done, though, to strengthen these coatings because any damage can remove the ability to repel liquids. Such an advance is hugely important since there are potentially life-saving healthcare applications if this hurdle could be overcome with a stable, nontoxic coating for steel. Just imagine if implants, scalpels and other tools used on patients had a surface impossible for infection-causing microbes to cling to.

Now, Joanna Aizenberg and her colleagues at Harvard’s Wyss Institute for Biologically Inspired Engineering have demonstrated a possible solution. They’ve been able to coat stainless steel with nanoporous tungsten oxide, which repels all liquids. What’s more, the surface is extremely tough, maintaining superhydrophobicity even after being scratched with sharp steel objects and diamond.

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 - serpentine - 
a locus / felix playlist
for Red Vs Blue s13e19

1. Psycho - Muse | Are you a human drone? (Aye, sir!) Are you a killing machine? (Aye, sir!) I’m in control, motherfucker, do you understand? (Aye, sir!)

2. Change (in the house of flies) - Deftones | I’ve watched a change in you/It’s like you never had wings/ Now you feel so alive

3. Counting Bodies Like Sheep To The Rhythm Of The War Drums - A Perfect Circle | Don’t fret precious I’m here, step away from the window/Go back to sleep/Safe from pain and truth and choice and other poison devils, See, they don’t give a fuck about you, like I do.

4. The Patient - Tool | Be patient. I must keep reminding myself of this. I must keep reminding myself of this. I must keep reminding myself of this.

5. Karma Police - Radiohead | I’ve given all I can/But we’re still on the payroll

6. Phase 1: Fortification - 30 Seconds to Mars | He swallowed his heroes/They fell out of context/He opened his windows/To decadent interest/He polished his image/Like that of a human/He battled the planets and won

7. Serpentine - Disturbed | Even though I felt cold inside/When you told me it would be alright/I had given up control and/I didn’t focus hard enough to see/The warning signs/Your heart is serpentine

8. From the Inside - Linkin Park | I’ll take everything from the inside and throw it all away/Cause I swear for the last time I won’t trust myself with you/I won’t waste myself on you

Hysteria

Drabble Prompt:  Anonymous requested: A historical AU where new Dr. Mellark has to treat Katniss for “hysteria”. She’s trapped in an unconsummated/sexless arranged marriage. Peeta is shocked at how his mentor Dr. Abernathy tends to his patients, but changes his mind when he meets Katniss. 

Author:  fuckingplebe (atetheredmind)

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IV Tips and Tricks

Dear followers-I’m sorry for the lack of posts recently! I just got back Saturday from a fun filled 2 week adventure in Jamaica doing public health nursing(standby for a post as soon as I get pictures working).

Today we hit the ground running with med surg and FINALLY ‘learned’ how to insert IVs. Oh boy. Let me preface by saying that my school is actually pretty progressive-many nursing schools don’t teach IVs at all and assume that once you start working that you’ll get ‘on the job training’. This being said, I’m sad to say, I realize now why we have IV teams. Nurses just aren’t getting the education on IVs that they need! Not only was today taught by someone who has been out of clinical practice for years, but it very well could have been titled ‘Ways to attempt and then lose a perfectly good vein with poor practice.’. 

In my EMS life I’ve been doing IVs for a solid…3.5-4 years now and consider myself a pretty decent stick so I figured I’d put together a list of tips to hopefully help other nursing/med students out there! :)

Finding a Vein

1. Don’t hit the arm! Seriously. Not only does your patient not want to get beat up, but if you’re going to be drawing labs off your line, you can skew some lab values by causing venous trauma. I like to be a lot more gentle with my search. 

2.  Feeling is more important than seeing. A good vein should feel ‘spongy’-if you compress it, it should rebound with ease. It shouldn’t feel hard or have bumps in it. It is super important to have a knowledge of your anatomical landmarks. Everyone’s bodies are little different but we all have the same basic veins in the same basic positions. I start feeling before i put my tourniquet or gloves on. Take your finger and rub it gently over their skin. Feel for areas that are more compressible than others, or that ‘dip down’ slightly. If you’re really having a tough time, heat packs, dropping the arm over the side of the bed(let gravity  be your friend), or even take an alcohol prep and rub the area well. Sometimes the gleam of the alcohol will help you see curves in the skin that you would have otherwise missed. Once you’ve found a vein you think you like-try to figure out what direction it goes in. Is it straight(good!) or is it crooked or lumpy(bad!)?

3. Consider what your patient is going to need-both now, and in the near future. Nothing pisses me off more than going to pick up a transfer from the doctor’s office and finding that the nurse has started a tiny 24 gauge IV in the arm of a 240lb man with hypotension. When you’re looking for a good vein-you want to consider what size IV that the patient needs. Bigger is not always better and you certainly should always try the smallest gauge you can-but if the patient is going to surgery(usually 18), needing blood(at least a 20), ect., you need to make sure that the vein you pick is going to accommodate the size needle you need to place. Scattering the patient’s arms with 24 gauges when they needed one good 18 isn’t going to help anyone. 

4. Start low, but the AC is not the end all, be all no no spot that people think it is. If your patient is incredibly sick, needs fluid/medications quickly,they have the worst possible veins elsewhere and generally isn’t going to be waving their arm around-its totally fine to start an AC line initially with the thought that once the situation calms down, another IV site can and will be attempted. I forgot who said it but…act with purpose. If you’re going to have to stick the patient 4 times to get a hand vein when there is a good forearm, you’ve exposed the patient to infection 4 times instead of one. Use good judgement. 

Sticking and Flushing-Troubleshooting

1. When I take my needle out of the package, I like to make sure that the angiocath will glide smoothly over the needle. You NEVER want to pull a catheter back over a needle however(sheared catheters are a deadly no no), so you can do this by gently twisting at the base of the catheter. This prevents the sticky situation of trying to advance the catheter over the needle and finding out that its particularly stuck on there. 

2. Bevel up!(usually. Some will advocate otherwise with specific types of veins but its exceptionally painful and a good rule of thumb to just always think up) Stick with purpose but don’t jam it in there. Real arms are much different than the plastic kool-aid mannequins. 

3. There is no ‘rule’ for the angle of insertion. It all depends on the vein. If you’ve got a very superficial vein, I might enter virtually parallel to the skin. If its deeper-you adjust. Gauging the depth is something that comes with time-but once you puncture through enough good veins, you’ll come to realize which veins can’t tolerate a 15-45 degree approach. 

4. Veins don’t run away from needles. Period. The #1 reason that IV sticks are lost is failure to properly anchor. Particularly in elderly patients with saggy skin, you need to pull the area around your prospective vein taut. 

5. Know that some veins won’t tolerate being stuck with a tourniquet on. I’ve found sometimes that very fragile elderly patients, as well as big muscle men guys with bulging veins, just can’t handle you trying to stick the vein with that additional pressure. If others have tried and failed-find your site with the tourniquet, then pop it and attempt. 

6.  Flash. YAY! Depending on the size of the catheter, you may not always get flash immediately back in the catheter. Look at the chamber as well-I tend to find that with 18 and larger, I don’t get flash first in the catheter but will have blood in the chamber. Once you get flash, don’t stop. Lower your angle and advance it gentle just a ‘tiny’ bit further. You may have just knicked the vein. Advancing further a fraction of a mm further ensures that you’re in the vein. 

7.  Pop the tourniquet ASAP. Its not comfortable and can cause damage, particularly if you’re trying to flush against it.  

7. Help! I’ve got flash but it won’t advance! Remember that veins have valves. If you’re up against a valve, you may be in the vein(you’ve got blood return!) but the catheter won’t budge. Before giving up and pulling the line-try attaching your flush. This takes a bit of practice and won’t work everytime, but try pulling back a little bit of blood and then pushing a little bit of fluid as you try to advance the catheter further in. Continue in brief little pull, push. stop. pull push stop. until your catheter has advanced or you give up(i.e. the vein infiltrates or you stop being able to push/get blood return)

8.  If it doesn’t flush easily but the catheter is fully advanced-first-is the clamp unlocked? Is my flush screwed on right? If it is-try pulling back on the catheter a bit. This may be what is is commonly called a ‘positional’ IV and the end of the catheter may very well just be up against the wall of the vein. If it is still hard to flush-don’t force it! Take the line out. 

Securing the Line

1. I don’t care what anyone says-there are a million and one ways to tape down an IV and it all depends on your hospital policy and how you were taught. Some people I know like to make ‘bridges’ with some tape and gauze to slide between where the catheter will meet the skin. This is a good tool with older patients and other people at higher risk for breakdown. I prefer tegaderm first, then a piece of clear tape over the insertion site on top of the tegaderm, then a loop around the hub, and finally an additional piece of tape to loop and secure the lock.  Regardless of your method-it must be fairly sturdy, secure and most importantly-you must still be able to visualize your site for regular assessment.

When Should I Pull the Line?  

Warning signs of a bad IV include infiltration(puffy, cool, possibly damp skin), extravasation(infiltration of a vesicant leading to tissue necrosis-bad bad bad!), thrombophelbitis(warm to touch, red, possible pus, red streaking up arm, palpable ‘cord’/hard vein), and intense pain when administering fluids(you may not be able to see a small infiltration initially but the patient should not be screaming as you’re pushing the flush). 

In all cases-pull the line, call somebody to start treatment(ranging from elevation and heat/cold to administration of specific medications).  and get a new IV restarted in the opposite limb asap. 

Hope this helped some! If anyone has anything to add-feel free!!! :) 

3 ways repealing Obamacare affects millennial health care

What will replace Obamacare?

  • The Urban Institute released a study showing that if parts of the ACA are pulled apart — as was proposed in the vetoed January 2016 bill — without a replacement, nearly 30 million Americans will become uninsured, including 4.4 million children.
  • Republicans are now floating replacement plans, including House Speaker Paul Ryan’s “A Better Way” plan and a proposal devised by Trump’s pick for secretary of Department of Health and Human Services, Georgia Republican Senator Tom Price.
  • Price’s approach is to replace insurance exchanges and individual mandates with tax credits based on age to help people buy insurance themselves. 
  • The government could give grants to states to establish pools for those with high health care costs who cannot find insurance on their own.

Women’s birth control may no longer be covered.

  • Mandating that insurance companies pay for female contraceptives was a hornets’ nest of contention during the design of the ACA.
  •  The issue brought the eventual law before the Supreme Court, which, hampered by a vacant seat, sent the case back to a lower court.
  • Under the ACA, 18 types of federally approved birth control must be covered by health insurance plans offered in the exchange — with no copay and no out-of-pocket expenses.
  • While insurers, under the ACA, are required to cover a type of each of the 18 kinds of contraception for free, they are still allowed to charge women for name brand or more expensive versions.
  • Removing the provision could result in a shift back to private providers for contraceptive care.

Women’s costs may be higher.

  • Women may pay more for the same health insurance if the ACA is repealed. 
  • The ACA issued a final ruling in May highlighting its regulations that prohibit the discrimination of coverage based on race, color, national origin, sex, age or disability.
  • These protections have been in place for many years, but for women the ACA has made a big difference. 
  • Prior to the ACA, women were routinely charged up to 50% more for the same health coverage — and for some women it was as high as 81%. Even after the ACA was enacted, a gender gap sill persisted.
  • But with the final ruling this year, the practice of “gender rating,” or charging women more because they are considered to be a higher risk (i.e., they visit the doctor more, live longer and have babies), is illegal.
  • Still, some health care industry analysts believe that insurance companies should be able to use gender rating as a tool in charging patients more.
  • This suggests that without a mandate to keep insurance companies from charging women more, they may revert to a policy similar to car insurance, in which teenagers can be charged more because of their higher risk.
  • This would leave women without the protection of gender parity.

The return of rescission.

  • One of the things the ACA brought you was the peace of mind that should you — healthy, active and young, the kind of person health insurance companies love — get sick, the company cannot cancel your policy.
  • The practice is called rescission. The ACA outlaws it. With the Republicans’ interest in fewer federal regulations and lower costs, there are no assurances that replacement legislation would have such patient protections in place. Read more