Hello fellow nurses,
i will finish my training in about 2 years and i just met nurse who finished the 3-year-training i am going through right now.
you can find a job easily, there's maybe 100k open jobs right now. Over the last 30 years people got really sick of the conditions , striking/unions didnt work- so people quit or didn't even start the training.
Employers, like carehomes, just started to reduce quality of care and got used to running the floor with the legal minimum - while billing the health insurance for full care. So a nurse/nurse-assistant would sign off 15-20 hours worth of care after a 7 hour shift.
This leads to the really fucked-up Situation where LTC-homes make A LOT of money- while neglecting their customers and covering up every mistake that was made. (faking documents, lying and so on)
But there is good opportunity as well. All over germany , clinics and LTC-homes are reaching the absolute minimum of staffing. If they can't supply the minimum- the state puts a lid on the pot of gold.
Instead of commiting to a local employer, i am planing to follow the model of a nurse i met a few days, who finished his training last year.
he applied for a company that is doing temporary work. Everytime a house reaches minimum, they lose a shitton of money. like one nurse is missing - 10.000€ less money.
Instead, they rent a nurse for the time needed- which costs around 600-800€ per shift. And in temporary work- from this, you are being paid a fat income.
he was given a smartphone, recieving 1 or 2 mails a week for work oppotunities. Salary in the subject : 5800€ - 6700€ are the most common offers. Neurosurgery, LTC-homes, ICU's at Universities - you name it. Berlin? maybe Hamburg, Munich.
transport is being paid, as well as a "good" hotel (house cleaning and sauna) and 30€ / day for food.
I think this is what is going to "heal" our system - the german nursing "strike"( quitting and not coming back) lead to a situation where it is MORE economical to pay your workers a higher wage- because if you dont, you pay 10-fold.
For me, personally, it means i can judge every day if this is the right place for me.
Good money, sure, but what i want most is to be accountable for my work and the responsibilities i have- i can deliver that in this context. I will focus on the minimum (read files, supervise meds, seeing all patients, documenting everything) and i wont sign of anything i did'nt do.
If i need a break, i just tell my employer "next month i'm not gonna work" and thats it. Or i go to another place. maybe a 50% job with a few night shifts.
Want further qualification? Okay, we pay your training as psychiatric nurse , as well as your wage- and you stay with us for at least 2 years after that.
i am very excited that i finally found a job in nursing that i can commit to - by not commiting to the workplace
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Anything wrong with that? :)
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Sorry for the long story, i hope i wrote it well enough

I need advice and perspective on an incident I had with a coworker. I work on a neuro step down unit and due to desperation for staffing, an "experienced" LVN has been hired. A few shifts ago she gave me report on a patient who she claimed was basically a vegetable with a trach and peg tube. As I'm gathering my things to go into the room the RT comes out and says that he has decannulated. He was in fact not a vegetable and very much alert. No obturator on the wall, no spare cannula in sight. We stabilized him and I called her out on it and her only response was that I was making it sound like it was all her fault and that she wouldn't be spoken to like a child. Day shift charge said that when she got the patient, the CNA reported that it was at least an hour before she went into his room to do an assessment. He was moved to a room closer to the nurses station and she still did not see him. She also reported continuous feeding. There was no feeding supplies or equipment set up or in the room. When asked she said that the previous nurse from the ICU said that he had already been fed. wtf?!? A variance report was written. I wrote up an incident report and sent it to my clinical director who sucks. She allows bad employees to stay for way too long and has no backbone. She ended up getting after me for not doing a bedside report. No one does bedside report because we hand off to up to 4 different nurses and it takes forever. It's easier to give quick report outside of the room, pop in for a hello and move on to the next nurse. The next shift I am assigned one of the LVN's patients again. While I'm waiting for her to be available for report I skim through the chart and notice meds not given for 6 hours and an order for JP drain removal from 10 hours prior at the start of her shift. I went to see the patient and confirmed my suspicion that the JP drain was still in place. I bring it to the attention of the same day shift charge from the day before who is also our "team leader" and ask her how she wants for me to handle it. She says to see what she says and to tell her that she definitely needs to give the medications before she goes. Charge looks into her other patient's charts and a lot of medications have not been given. This time I insist on bedside shift report and when she gets to the JP drain she says that hopefully it will come out soon, confirming my theory that she had no idea there was even an order for it. The patient also complains that the drain has been in place going on 3 days with no output and I assure him that there is an order from 9am to remove it and I will gladly remove it as soon as possible. She looks shocked and says "yes. I failed to do that. I see. I failed to do that. Thank you for pointing that out. Thank you for your sarcasm." I was going to let it slide but couldn't so I tell her that it's not sarcasm and it's a plain fact. She says that it is sarcasm and it's the way I said it. I refute and press on with how it's a fact from the patient's chart. She then asks if I would like to continue reading the chart on my own and ignore her so she can be done and that she isn't going to do this again with me. Reference to the night before. I tell her that this conversation is no longer appropriate to have in front of a patient and I walked out. I reported this to both the day and night charge and again wrote it up in an email to my director and wrote a variance for delay in treatment for the medications.
So at this point I am torn if I should escalate this to HR or wait and see what my director is going to do. The team leader told me that she had told our director about how the LVN hadn't gone to see the trach patient and that she had a feeling that something bad was going to happen. When I spoke to my director the following morning she made excuses for how she is new to our floor and we are all still trying to figure out how to incorporate an LVN and blah blah blah. It isn't sitting well with me and I don't know what to do.

33 F Highest 229.lbs Currently 219.lbs 5-28-2023 Goal 149.lbs I need to lose -70lbs I've lost 55ish lbs twice before & then 20lbs another time. 1 child 4 yrs, I nursed her. I'm on these meds right now: 5 mg of Lexapro 300 mg of bupropion XL 50 mg of naltrexone 30 mg of buspar & Hydroxyzine as needed. I smoke medical marijuana, sporadically I don't smoke cigarettes( well maybe a puff if I'm super buzzed) I drink maybe 1 or 2x a month anywhere from 2-6 drinks each time
I will do a weekly update, if you're interested I will be posting it in a couple subs. I accidentally sent my order under "friends and family" instead of "goods and services" so hopefully that doesn't delay my shipment. Next update will be about my order mishap & how it was resolved. I ordered 1-12 week supply with starter kit. I took the plung because I highly doubt that my insurance is going to cover it. I'm an open book, ask me anything. Attached is my weight chart from the dates of 12-16-2013 through 5-28-2023 As far as support my boyfriend/daughter dad is supportive but mad that it costs so much but I need to do this. He said "you just need to try and work out" 😔 but I truly believe this will work out for me. I shouldn't care but I feel like people are going to think I'm on drugs or something because I lose the weight so fast but I'm trying to convince myself that I don't care about what others think. I'm gonna keep it to myself for a while. Except from you guys. Thank you for listening.

For anyone that’s taken 1-2 months or more of Lupron Depot for endometriosis suppression, did you have symptoms right away (first few days or first week) taking it?
We ended up doing the injection at home, which was so stressful because we realized there are like no instructions online like we used for all the stim meds, so we called CVS Specialty and they walked us through it. I thiiiink we did it correctly, but I am not 100% sure if I should be feeling symptoms this early? It’s Saturday night and we did the shot Tuesday night.
I did have some period like light cramping this week and I think my period? I’m not 100% sure because tonight is the last night I take bc (I’ve been on it over 28-days), then it’s Lupron Depot again next month. My nurse said the brown/period like stuff was totally normal but I’m not sure if it’s related to LD or just was gonna happen anyway.

May 25 update – the verification process in their Discord is broken, so we are unable to check for any updates / changes. The presale will begin at 1pm May 26 on their site.
May 20 update – the May 19 public presale was stopped, the team says their server was attacked by bots. Those who contributed to the presale will be refunded, and a new presale will begin on May 26.
Token presale for a launchpad on Sui.
DETAILS Presale Details Presale will be held on Meadow launchpad Duration: 2 day(s) Purchase token: SUI Sale format: Overflow; final allocation received will be proportional to total committed amount Presale rate: 1 MED = $0.11 SUI Listing price: 1 MED = $0.11 SUI Hard cap: 795,970 SUI Minimum contribution: 80 SUI No maximum contribution Presale vesting: 20% at launch, 20% weekly Whitelist will receive a share of 1,130,000 bonus tokens Initial circulating market cap: $250,000 Taxes: 0% DEX listing: May 26 Mechanics & Features Multi-tier staking model — 4 tiers available Users stake $MED tokens to have access to IDO allocations based on their tier 10% of the total amount raised will go towards the Meadow Insurance fund Top 2 tiers will benefit from the Meadow Insurance, where if the token price falls below the IDO price within 3 months; throughout 2 vesting periods, you receive a % of your principal capital back Tokenomics Token symbol: MED Total supply: 100,000,000 4.4% — Seed sale (5% TGE, 2 months cliff, 3.95% monthly) 3.83% — Private sale (5% TGE, 10% month 2 and 3, then 5.35% monthly) 7% — Public sale (20% TGE, 20% weekly) 2.85% — Bonus airdrop (1 week cliff, then 25% weekly) 24.75% — Team & Advisors (6 months cliff; 2.5% unlock, 3% unlocks on 8th month, then 2.5% every 6 months for 4 years) 35% — Funded pool (5% every 6 months) 7% — Marketing & Development (6 months cliff, 0.5% every 2 months) 7% — Campaign Pool (4% unlocks in first month, then monthly unlock for 6 months) 0.42% — Liquidity

Hej med jer kloge hoveder. Jeg har nogle spørgsmål om starten af min investeringer. Har nemlig aldrig invisteret før og det er lidt rodet at finde rundt i med alle de regler. Mine spørgsmål omhandler mest profit til lang tidshorisont til fremtidig køb af hus, fornøjelser mm.
• Hvilke nogle fonde ville være super gode at bruge til en lang tidshorisont? Ved brug af månedsopsparing, ville Nordnet one være en god mulighed?
• Ville det være en god ide at have enkelte sikre aktier på aktiesparekontoen i stedet for på et normalt depot? Såsom novo osv

Hello all,
I am remodeling my house and was wondering if there was a supply store other than Home Depot/Menards/Lowe’s that locals shop at for materials. From plywood, to vinyl siding, to screws, etc? Somewhere competitive pricing. I’m able to go most places in metro area if it’s worth it
Also, if you have any decent recommendations for carpet places, and kitchen cabinet I’d appreciate it. I’m on somewhere of a budget but would still like decent quality.
Thank you all so much!

If there's only one word a Market partner gotta know how to spell...

Delivery to all patients with med cards tri state ..maine meets in Kittery amazing people and great service wondful supply of best growers in maine ...

Vet tells me that they do not give refills and only prescribe 2 months at a time "in case the pet dies because meds cannot be refunded". I openly stated twice that I would gladly pay for more refills and volunteered to sign a paper saying that I would not try to return unused pills. My cat has a severe case of hyperthyroidism. There is no cure and he will have to take the little methimazole pills for the rest of his life. He is stable and well on these but it is huge inconvenience to only have 2 month supply. Is this standard protocol?
More background: He is a rescue cat who is about 15 years old. He was the neighborhood's street cat and when he got sick we helped him and since then he refused to leave our house and became our cat. He displayed hyperactivity, excess hunger, panting, and I think what could only be described as cat anxiety on and off. 2 years and 5 veterinarians later, he is finally diagnosed with hyperthyroidism. I always thought he had this but no one listened to me and former docs would literally shrug and say "we don't know what is wrong". Now, he is finally diagnosed and treatable but it seems hard getting a refill for his meds now that he is finally stable 🤦‍♀️ I am not expecting any miracle cure, just want him to be comfortable and not suffer for whatever time is left in his life.

This is the best tl;dr I could make, original reduced by 63%. (I'm a bot)

Preliminary operations have already begun to pave the way for a counteroffensive against Russian occupying forces, a Ukrainian presidential adviser has said.
"It's an ongoing process of de-occupation, and certain processes are already happening, like destroying supply lines or blowing up depots behind the lines."The intensity is increasing, but it will take quite a long period of time," he added, predicting that as the counteroffensive gathered momentum, there would be more incursions into Russia by Russian rebel groups, such as the raid in Belgorod region earlier this week.
A long spell of dry weather has driven anticipation of the counteroffensive, as has the incursion by Ukrainian-backed Russian rebel groups into Belgorod, possibly intended to draw troops and equipment away from the frontline in Ukraine.
Podolyak denied the Russian groups - the Russian Volunteer Corps and the Freedom of Russia Legion - which include far-right extremists in their ranks, were acting on Kyiv's orders.
He said their contracts as part of Ukraine's foreign legion had ended and they therefore had the status of "citizens of the Russian Federation temporarily on the territory of Ukraine".
"The further Ukraine goes towards liberating its territory, the more such incidents we see within Russian Federation territory," Podolyak predicted.

Summary Source FAQ Feedback Top keywords: Russian^#1 Ukraine^#2 Russia^#3 enemies^#4 territory^#5
Post found in /worldnews, /AutoNewspaper and /GUARDIANauto.
NOTICE: This thread is for discussing the submission topic. Please do not discuss the concept of the autotldr bot here.

I have one of the smallest code-compliant showers in my space: 32"x32". (example on Home Depot)
I'm looking for a bomb-proof, fool-proof method of containing the water.
I have 3 feasible options:
***
Option#1: Basic Rod (just the usual)
Pros: - Simple and bomb-proof. - Fool proof ?
Cons: - Least amount of showering room.
Option#2: Curved Rod (a rod that bows outward, giving a few more inches of torso room. (example on Amazon)
Pros: - Bomb-proof. - Gives a little extra room.
Cons: - Not idiot-proof: I've seen people comment and others up-vote "but wouldn't your floor get soaked?"
Option#3: Retractable (often used in RV's, they are plastic and rolled up and squeegeed dry when opened. (example on YouTube)
Pros: - Best water-proof option. - Doesn't draft inward like a typical curtain.
Cons: - Latch may not be fool or bomb-proof. - Perhaps tacky. - Expensive and time-consuming if it needs replacing.
***
Additional Notes: - Shower curtains would be the "hookless / Pre-Hook" type (example from hotel supply) and have the rubberized weights on bottom (example on Amazon). - Swinging doors will not work for the space and neither would glass.
Please cast a vote and / or lemme know your opinion / experiences.
Thanks.
View Poll

Information coming from the grapevine and is subject to change. I will keep the list updated if people comment with updated information. Stay safe out there.
GWA Water Update as of May 28th. Boil notice & water tank locations.
Airport Update: earliest operational date May 30th
Shell gas stations: information update
YIGO - Shell gas station CLOSED - Payless - Joanns bakery - Cafe Pandero - KFC - PS Mart - is giving FREE water to those who need it at the back of their store, just bring your containers - Imma Market - One Plus One Mart - Hello Mart - JCK - Prime Mart - Island Pantry - Hills Mart
DEDEDO - 76 Gas Station - cash/card - has gas as of 5/28 3am - Shell gas (Micronesia Mall intersection) - cash/card - Shell gas (NCS) - cash/card - Dededo Payless - Micronesia Mall Payless - American Bakery - cash only - Kings - sit down - KFC - cash/card - NCS market - Fine Store - Onedera - cash/card, has ice limit 2 per customer - Prime Mart @ Wusstig Palm Market - White Market - UR Market - John B’s Mart
TUMON/TAMUNING - Shell Gas by GPO (?) saw people pumping gas at 2pm May 28th after Shell announced that location was closed May 27th - Shell Gas Tumon - for first responders only - ATM - next to Tumon Burger King - First Hawaiian Bank ATM - next to Lonestar - ⚡️Mactech⚡️ free phone charging - ⚡️Smart town⚡️free 30mins of charging - Hilton & Hyatt lobbies have AC & power outlets ⚡️ - Home Depot - Kmart - Elite Bakery - Denny’s - Ban Thai - to go orders - cash/card - Mi Sazon’s - King’s - next to GPO, cash only - Hilton - breakfast buffet - cash only - Maxi Mart - card/cash, out of ice until next week - Joy market - Seoul Mart - Lucky Spring
BARRIGADA / MONGMONG-TOTO-MAITE - Shell gas station CLOSED - New MTM Market - San Jose Supermarket - Os 7 Store - Ebenezer Mart - cash only, no ice - Wendy’s - Happy Mart - Su Mart - Kanada Mart
MANGILAO - Shell gas station CLOSED - KFC - cash only - Wendy’s - Pagat Market Payless: has ice - Uncle Cho - New Zuni Mart - New Campus Mart - cash only - Dairy Mart - K2 Market - GCC Mart - Eagles Mart
HARMON - Shell gas station - cash/card - Eternal Water (@ Bank of Guam building) - for water - WSTCO (feed store/pet supplies) - Kings - cash only - SJ Market
CHALAN PAGO-ORDOT - Shell Gas Station - Diesel Only, cash/card - Shine Market: cash/card, water machine works
HAGATNA / AGANA HEIGHTS - Shell gas station - cash/card - Dr. Kabob @ Agana Shopping Center - cash/credit - McDonald’s - cash only - Mosa’s - sit down
YPAO - 76 Gas Station - cash only - New Ypao Mart
TALOFOFO - Jeff’s Pirates Cove - cash/card - Paulino Store
AGAT - 76 Gas Station - cash only - Bay Dollar
OTHER - SINJANA Payless - cash only - PITI Day Buy Day - cash only - SUMAY Payless - MALESSO Tomoge Beach Mart - TIYAN Shell gas station - cash/card - MAITE San Jose Mart - cash only - LATTE HEIGHTS Village Pantry - cash/card

I had an idea earlier when tinkering with my model trains. It’s just you, a gun, and a little tank engine. You plan your routes to supply depots, where you shoot sosigs, gain new weapons, and upgrade your train with other cars and other locomotives, such as an old 4-4-0, armored artillery cars, huge 4-8-4s, ect.

Err “and stuck dealing with her daughter” is what I mean.
Forgive me; I’m new here and don’t really know where else to ask for help, but I recently moved back home to my parents house two years after my stepdad’s death because my mom was practically too deaf to hear the phone ring or anyone knock on the door or the doorbell, living upstairs alone a majority of the time with around a half dozen indoor cats and even more cats outdoors, dried up cat urine and cat feces in every room that wasn’t closed off. Meanwhile, her oldest daughter from her first marriage has been living here the entire time in my parents’ basement, ever since January or February of 2016, a majority of the time not working, no income, and sitting around playing games on the computer with her friends.
A friend of the family sent me a text around August of last year telling me the condition the house was in when she dropped my mom off at the house; mom had stayed with her parents for a couple of days because mom was spending around $70 a month on cat food and wouldn’t have much to eat by the end of the month and couldn’t afford to pay for any of her meds except her blood pressure pills.
I was in a group home at the time because I had a nervous breakdown when my sister, my stepdad’s oldest son, my Aunt who was in early stages of dementia at the time, and my aunt’s daughter basically all ganged up on me and told me that they would take care of mom but they wanted me to leave. This was about a week before my stepdad died (he was still in the hospital at the time) when I told my therapist I was afraid I might hurt myself if I had to go back home after everything that happened. It was a pretty good group home and I got a lot of help mentally while I was there.
Basically, in the two years I was gone, my dad’s oldest son from his previous marriage sold off anything of value that he could before leaving because of how bad the house smelled because of all the cats’ urine. He still came by every now and again to mow the yard because my mom wasn’t able to do it and my sister was “allergic” so she never even offered to mow the yard the entire 6-8 months my sister claimed it was only my mom and her left living there. My sister lived in the same basement as my stepbrother while all this happened and didn’t seem to do anything to stop it. Mind you, no walls separating them from each other, only a thick, black curtain and the only slept maybe 30 or so feet away from each other.
I was foolish enough to come back here, even though I would be doing a major majority of the cleaning, all of the mowing of the yard, and using most of my own money to replace a lot of mom’s stuff. I also lacked the hindsight to take pictures of the upstairs before helping my sister clean up a majority of the cat feces and cat urine off the floors and baseboards. All cleaning supplies came out of my own income and there were even nights I would stay up all night cleaning when she was “too tired” and “had a headache” while I could hear her laughing and talking with her online friends later. I ended up losing 15 pounds in less than two weeks because I had no appetite from the smell and can’t rest in a filthy house.
So here I am, trying to work with her half a year later for mom’s sake, doing a majority of the cleaning, all of the mowing, and spending my own money voluntarily to buy food and household supplies: paper towels, toilet paper, sanitary pads(?) and such mostly for mom but for her, too. Cat food, cat litter, etc for the original two cats dad had before I left, you get the idea.
I told my sister I’ll do the majority of the cleaning, all of the mowing, and clean mom’s car if she takes care of mom and keeps a close eye on her, handles cooking breakfast for mom and gives her the morning meds and helps mom bathe since mom’s gotten so weak that she can’t even open a bottle of water without help cracking it open first. Right now, I got mom’s insurance to pay for hearing aids for both ears, found her a primary care physician thanks to the nice lady at Adult Protective Services (because I asked my sister to help me call around but she didn’t because she was too busy playing on the computer at the time), made her daughter get a new driver’s license because she was driving mom’s car when her license had expired two years ago but she was “too busy” to renew it. I finally had to pause her internet access till she passed it; she failed the written test 3 times then passed it the 4th time after I cut off her internet access (which I’ve had to do often, even before leaving).
I love my mom to death, and would only do this for her, but I honestly had no plans to stay this long; I just can’t get anyone from her family to come here to take care of her (and my sister) so I can cut all ties with her oldest daughter entirely and go back to being healthy and happy again because mom’s family are more familiar with her than they are with me and has basically gaslighted me buy bringing up my bipolar diagnosis and all the emotional outbursts I had when mom and dad’s kids had stressed me out from when I was the only one constantly checking in on dad, helping bathe him, etc before he got hospitalized for the last time.
TLDR feel like I’m going crazy because I made the mistake of coming back home to HELP take care of Mom and now I feel like I’m stuck here because I know if I leave now that this will only happen again. What can I do legally to help mom, help myself, and is there anyway I can prevent her oldest daughter from using (and neglecting) mom any further?
PS. Not much money left, no friends, and I am unable to drive due to disability. PPS. Half of my stuff (over $1000 worth of gaming stuff and electronics) is still at the group home I came from and haven’t been able to get it. Just hope I can get all of it back after this long. Maybe I can sell it to help pay for a lawyer should I need one.

Hi! March 2020 longhauler still here, still queer, still very much not okay, and, after a long posting hiatus, I thought I would crawl out of my humid cave for a sec to offer a firsthand account from the NYU Langone Post-Covid clinic in case anyone is wondering.
Tl;dr: While your mileage may vary, I just went and was pleasantly surprised. Based on the care I've gotten in my long haul tenure, my expectations were in the toilet and I fully anticipated this being a total waste of time, but was glad I went. I'm still managing my expectations; it remains to be seen whether I can endure repeated trips into the city and whether anything actionable will come of them. But so far I'm experiencing a higher quality of care than what I was getting including feeling heard and validated and having my care considered holistically (in the sense of the whole person and all body systems and medical issues informing each other) and coordinated in a way that relieves of some of the burden on my end and thus would recommend them to anyone.
I landed on NYU Post-Covid after hearing good things, hearing disappointing things about OTHER post-covid clinics from other longhauler friends, and having NYU recommended to me by my dentist. They accepted my insurance and my copay was same as a specialist visit. I took their soonest appointment which was several months out but, unprompted, they actually called me to let me know they had a cancellation and offered sooner availability (kind of unheard of.) As is often the case, they send you emails beforehand inviting you to get set up in the patient portal and fill out an extensive pre-visit questionnaire. The first appointment was an in-person intake with a Nurse Practitioner. The building seemed new and upscale, and I was surprised to be one of very few people in the waiting area. The receptionist was kind and accommodating when I needed to sit and use an iPad rather than standing to sign the forms they were asking for. The NP spent an hour with me, took vitals and a thorough medical history (including symptoms during acute infection vs. persisting issues), answered all my questions, made several referrals (cardiology, neurology, rheumatology, ob/gyn, psychology, pulmonology, and rehab/PT), and ran bloodwork at the end (including labs I asked about/requested) right down the hall. They asked if I drove myself there (I couldn't) and, knowing that I don't live in the city and the travel was taxing on my system, without my asking, they offered to try to minimize in-person demands (trying to make specialist appointments virtual or at locations closer to me when humanly possible.) They said they would try to maximize efficiency for the times I did need to come in, so for example, helped coordinate two in-person appts on the same day when I need to return in July for a Pulmonary Function Test and to see a resident doc.
They set expectations at the beginning of the appointment by communicating that long covid is still something they're learning about, but went out of their way to tell me, "you're not crazy" and that they are seeing other OG long haulers with issues similar to mine. After what we've been through, a little validation goes a long way. I asked about a wheelchair fully expecting they would refer me back to my primary about this, and when they asked very matter-of-factly why I needed one, I felt myself tense up a bit - the PTSD from the medical gaslighting is real - but she listened thoughtfully to my explanation and without hesitation responded, "we'll order one to your house." I could have cried. She worked with me to decide which type of chair would be best and put the order in on the spot. The med supply company contacted me same day (though my insurance found a way to ruin it, but that is a story for another day.)
My NP patiently answered all my questions and added some labs I brought up to the standard bloodwork, which was done down the hall by a lovely phlebotomist who was good at her job and expressed compassion for what we go through. I got the results within hours in the patient portal, which is mercifully clear and, save for a minor snag, easy to use, unlike my usual medical group's patient portal, which was apparently designed by deranged chimpanzees. Today I had to follow up because the handful of specialists they referred me to were supposed to reach out to me within the week, but I hadn't heard yet. Once I did that, the person I spoke to said she just messaged every single one reminding them to reach out, and I got a call from one within a couple hours.
The last piece of this that excites me is - they said when I return in person for my appointment with one of the residents, they will likely invite me to participate in research studies if I'm interested.
To sum it up: I found them overall to be helpful, responsive, and compassionate, and I'm cautiously optimistic. They are busy and human and this is not a panacea; you may run into some of the same bureaucratic issues and inconveniences that arise at other practices (ie. long wait times for appointments, having to follow up on things) but you also may experience a higher quality of care and/or the revelation of being truly heard by people who believe you, have seen others like you, and who've chosen to devote themselves to this cursed disease. They seem to get that bedside manner and care coordination are important parts of the equation for us, and that meant a lot to me. The rest remains to be seen! I'll do my best to provide some updates when I can. Love to you all. *slithers back into bottomless abyss*

A Wishlist

Naturally, there are a lot of simple changes that they could make to improve the war system without much development. I'd love to see a tooltip detailing what new war objectives any particular war goal would add, for example, or to be able to assign generals to defend an HQ that doesn't have a front yet, but is totally going to get navally invaded. But, I've been thinking a lot about what the Victoria 3 devs seemed to be trying to achieve, and how to make significant alterations to get closer to achieving it.
My goal here is to present some ideas I've had kicking around in my head on how to get closer to what they had intended. Specifically, that is, for general personalities to handle micro while the player focuses on promoting and assigning the right generals, and for there to be an incentive to run more lightly-equipped forces in Colonial regions (which was discussed in an early dev diary).

Headquarters Replace Fronts, Gain Orders

With that in mind, I think that the key to fixing this is to rework Headquarters, and make them actually behave like HQs, instead of like folders for your generals to draw troops from. They should be buildings with work modes, one per HQ region.
Each HQ should have a set of theater-wide orders that it can implement. These can include simple orders, like advancing into a neighboring HQ, or more complicated orders, such as preparing a naval invasion. Generals assigned to the HQ will then be divided between those orders.
So, for example, if you're engaged in a colonial war, you might set the Niger HQ to Secure the Niger HQ (attacking overland into any enemy territory in the local HQ), Attack the Congo HQ (attacking overland into any enemy territory in the Congo HQ, when they feel they have an advantage), and Naval Invasion [Dahomey] (which in this example would be an enemy territory inaccessibly by land). With that priority order, the HQ would then assign generals to Secure the Niger HQ until there was a green advantage, then to Attack the Congo, and then finally to the naval invasion, if there are any left. It would also seek to assign people with the right traits - eg, if a battle is taking place in the forest, it will be more likely to roll a general with forest-related traits assigned to that action, if there's one in the HQ.
The traits of the highest ranking general in the HQ should influence these decisions, such as how large an advantage is needed before they'll attack (or how large a disadvantage is needed to stop them from attacking, if they're reckless). Rather than assigning generals from other HQs to orders, instead, when they are Mobilized, you select an HQ to Mobilize them to. Unmobilized generals and troops will still participate in defensive battles as usual, and local generals would Mobilize to their own HQ to attack.
Different or more advanced orders may apply modifiers. For example, after researching Field Works, they may gain a Dig In order, which is a Secure HQ order, but with a malus to provinces captured and a bonus to defense (which would be upgraded after Trench Works). After researching Stormtroopers, they may gain a Blitzkrieg order, which will pull units off the front line for 50 days, then launch an attack with a big bonus to the roll for how many units become involved.
Generals mobilized to a new HQ will take a debuff similar to the new equipment malus, which decays over a year as they familiarize themselves with an unfamiliar place. This should be less severe - something like -20%, decaying 0.2/week. Once it decays, a general should gain a 'Veterancy' trait. There should be a unique one for each HQ - for example, Congo Veterancy would prevent a future penalty for being assigned in the Congo, provide a small buff to jungle combat or low supply, and maybe when it's gained, there's a chance of an event that could change the general's ideology based on their wartime experience. Some HQ veterancies might have debuffs, or have on-gain events that can give debuffs like Malaria. It should be possible to re-assign generals, but doing so should always promote them. Similarly, events that give a promotion should have an option to select an HQ with unassigned troops to reassign them to as well.

Regional Buildings and HQ Work Modes

To help with regionalism, certain buildings should attach to their HQ.
Airfields come to mind as an immediate example. Planes of this era don't have a lot of range (see Hearts of Iron's WW1 era planes). They need a local airbase to be supplied. Instead of replacing ground vehicles for capture speed, an Airbase should be a building that provides an HQ a Squadron per level, which should use planes and oil, and have a work mode to use ammunition. Squadrons should be assigned to Orders like generals are, and should provide Air Recon, increasing the percentage of units assigned to that order that appear in any given battle. When assigned to use Ammunition, these planes should also reduce enemy Air Recon, by attacking other planes.
Fortifications might apply after certain research, which may house units which cannot be assigned to a general, but gain an additional defensive bonus.
Depots are a second example. Depots should be unlocked by having any Army Model except Peasant Levies. They should be capped to level 5 with National Militia, and otherwise have a cap based on technology. More on these below.
Whenever a General arrives in a new HQ, a 5 year cooldown period should begin. At the outset, their forces should have -20%, similar to new equipment adjustment, but for New Front Adjustment. Once it's decayed, the General should gain a new unique Veterancy trait for that HQ. An event should pop up, describing how they've adjusted to this kind of assignment, and they should gain a small permanent buff - as well as having no penalty when returning to this HQ in the future.
HQs should have some unique content surrounding this process - eg, a general without Congo Veterancy should have a chance to gain Malaria while in the Congo, and when a general with the Occitanian Veterancy might gain a unique maneuver to use while fighting in the Alps and Pyrenese. A few such local events could provide a lot of flavor to colonial wars.
It should be possible to reassign Generals permanently, but it should automatically promote them. A general should be limited to gaining 1 veterancy per promotion level, to encourage you to promote more experienced generals. When they gain a veterancy, there should be a pop-up alert with some flavor, so that you can consider promoting and re-assigning them.
There should also be a chance to convert to a higher ranking general's ideology, and emergent ideologies can have a greatly increased chance (eg the fascist and communist ideologies), and different HQs conditions may spawn different ideologies (eg, ethno-nationalist and humanitarian being more likely in HQs with a lot of discriminated pops, Jingoist in HQs with decentralized nations, etc).

Strategic Region/HQ Based Markets

It was difficult and expensive to acquire ammunition in colonial India, even though it was cheap in England. The expense of moving things is significant, and the price of groceries in one part of the British Empire could be vastly different from another. There was a lot of profit to be made in moving goods.
Goods, by default, should only be bought and sold in their HQ Market. Grain grown in the Dnieper region can only be purchased by buildings and pops in the Dnieper region. Instead of a national market, how price differences are handled between regions depends on your laws and technology.
For consumer goods, Under Traditionalism or Industry Banned, Trade Centers will dynamically appear to trade in luxury goods between domestic markets, with work modes to use convoys and/or transportation to reach more distant markets and use fewer laborers. Under Agrarianism, they'll also seek to export non-perishable agricultural goods and groceries to profitable destinations, and import agricultural inputs such as fertilizer and tools. Under the others, they'd move any kind of goods. Technology will affect what resources can be traded - for example, Transportation can never be Traded between regions, Meat can only be Traded outside of its regional market after Refrigeration is discovered, and Fruit only after Screw Frigates. These will focus exclusively on profitability, depending on your laws, you may have more or less control over work modes that consume transportation and convoys.
Military goods would be acquired by Depots. A Depot takes very little construction to build, and each type of depot holds and trades in different types of goods - for example, a Munitions Depot holds Ammunition. Based on its work mode, it will import Ammunition from other parts of your market or (if available) overseas markets, selecting the cheapest available price. It will sell to the local market, based on work mode (buying to full and selling when the price is above +70% on Emergency Stockpile, buying to full and selling when the price is above +10% on Supply Depot, and buying at -0% of less and selling at +20% on Reserve Supply. This should help laissez faire economies to go a little longer between wars without affecting the resources industry. Naturally, Depots only sell to allies - but your arms industries might sell to anyone's depots. Depending on your econ laws, your arms industries may find other buyers abroad.
Troops would buy from the HQ they're assigned to, even if they're attacking a neighboring HQ. Troops on naval invasions wouldn't be able to attack non-coastal provinces this way - you'd want to develop some treaty ports or take some coastline like in French Algeria before proceeding inland, and coastal troops would suffer from the insufficient support penalty like they do when first landing if there aren't enough fleets assigned to the naval invasion. Better technology may unlock advanced naval landing Orders which can press in farther from the coast, but not drastically - lack of local supply lines would still be crippling.
Additionally, Interventionism and Command Economy should be able to build depots that trade in consumer goods, 'competing' with Trade Centers. Both Trade Centers and Depots should count against the Depot Limit, a figure that's similar to Arable Terrain, but is increased by local infrastructure buildings and by some laws and technologies. Command Economies should lose all of their Trade Centers, but gain a bonus to Depot construction.
This way, the free market will generate regional inequality in a colonial empire. The Depot Limit should be reduced for Subjects and Unincorporated Territories, and further reduced in those areas by Colonial Exploitation laws of the Overlord. On Colonial Resettlement, Depots and Trade Centers in subjects and unincorporated territories should only be able to hire pops from the Overlord's Primary Cultures for share-owning positions - potentially limiting their growth.

Summary

By creating Strategic Markets, we create local inequality, and the conditions that make it so that goods and services may be cheaper or more expensive in their regions of origin. It may be harder to supply troops in colonial regions, and those regions actually suffer reduced opportunity, and are harder to garrison with the best military technology. We create regional inequality, where focused cash crop economies might have cheap sugar and fruit, but people might have to pay high prices for wheat, meat, or furniture, and where the wealth of trade flows towards market leaders.
We also fix the issue of micromanaging fronts, while working towards achieving the intended logistics-based war system, where the personalities and politics of generals impacts how wars are prosecuted, where the player makes grand strategic decisions about the type of orders being issued over sweeping regions, instead.
By employing depots, we limit a region's ability to support military forces, so that you don't see massive WW1 style fronts in the Sahara Desert. We make colonial empires less effective at fighting in territories where their presences are small, and made Treaty Ports a bigger deal for colonial power projection and trade, siphoning off a lot of local Depot Limit. We make it make sense to have more remote regions run more lightly-equipped troops, where you're better using the throughput of 5 depots to run 20 units without artillery than 5 units with artillery and trucks.
Together, they create a player management interaction for war that keeps the grand strategic perspective, and eliminates war micro, while adding a lot of flavor to each HQ, and a real feeling that nations are more or less present in different theaters.

We’ve been together almost 4 years. For the last 6 months or so, every month I pick up my fiancés prescription for him. He has an injectable medication that he takes once a week. Every month I ask the pharmacist for the exact needles he needs. I say exactly what I need, I’ve shown them pictures. I’ve said it as many ways as I can. I’ve explained exactly what meds he takes and how he takes them and the exact type of needles he needs. Every month they tell me that due to covid supply issues they don’t have those needles but this other kind will work. I make sure to ask again that it will for sure work with his meds and they assure me. I have literally spent 15 minutes with a pharmacist looking through their boxes of needles one by one and him telling me that the needles he’s giving me are right. Every month I go home and they’re the wrong needles. He yells. I apologize. I try to explain what the pharmacist tells me. He yells some more. Thinks I should be double checking. I am. He won’t hear it. He yells some more about that I’m just making excuses. This last time I blew up and told him that I’m never buying him needles again. He says “clearly.” We don’t talk until the next day.
This month he buys his own needles while I’m in the car. He walks in and comes out, checks the bag and it’s the wrong needles. He goes back in and gets more and they’re still wrong. He tries to go back in but it’s closed. The lady sees him and has sympathy and they try for the 3rd time to get the right needles. We get home and it’s wrong. He’s pissed. I’m thinking I told you so but I know if I say it he’ll by mad at me instead of the giant bag of needles. As he’s complaining about how he explained everything right he can’t believe they still got it wrong, I finally say yeah I feel like no matter what I say they’re giving us crazy things. He kinda ignores what I said and keeps ranting about the pharmacy. I think eventually he’ll realize that everything he’s saying is exactly the things I’ve been saying to him for months that he calls “excuses.” He never does, just goes to another pharmacy to get the right needles.
I feel so many emotions about it. I feel like I should feel sympathy for him that it’s always this huge struggle just to be able to take his meds but I don’t. I feel vindicated but not in a way that makes me feel right. I’m so angry that he can’t see how hard I fucking tried every single month to get it right. I thought once he knew that it was always like this he’d realize I’ve been trying. When would fight about it he would say that it felt like I didn’t know how big of deal this was and I didn’t care enough to get it right. But I would try to explain that I did care. I would go to 3 pharmacies fully crying trying to get the right needles just to get yelled at when I got home anyway. I really thought that when it happened to him he would understand that nothing I was saying was excuses, but he didn’t.
A fight that we have fairly regularly recently is that I feel like he’s interpreting everything I do maliciously and never making an effort to see where I’m coming from. This is probably the straw for me with it though. If you can’t go through the same exact scenario you’ve yelled at me for and not seen the problem then I don’t know what ever will.
Is there any saving this ? I mean clearly our communication together is not great but it’s something we’ve been working on. Is there any way for him to ever see where I’m coming from? Every time I try to talk about my side of things he’ll say I’m just making excuses for myself. Any apology I give is me “just telling him what he want to hear”. He doesn’t believe my apologies and he makes no effort to understand where I’m coming from. I genuinely thought that him fully living the “excuses” would make him realize that sometimes I give my best and shit still doesn’t work out. How can I make him see that? We’ve talked about couples counseling but we can’t financially swing it right now and his insurance only covers solo therapy. We both have been needing to get back into individual therapy and have been looking. I know that will help as we’re both much better at coping and communicating when we’re seeing someone but I can’t help but feel like that’s just grasping at straws at this point. I truly do love him but I don’t know if I can live like this forever and I feel like I can’t plan a life with a guy he plans to be but not the guy he actually is.