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Plan of Care

Summary:

"At its core, nursing is nurturative, generative, and protective." Mosby's Dictionary of Medicine, Nursing, & Health Professions, 7th edition.

"You must use ingenuity, intuition, creativity, and past experience when tailoring a plan to meet [an individual's] needs." Lewis, Dirsen, Heitkemper, Bucher, & Camera, Medical-Surgical Nursing: Assessment and Management of Clinical Problems, 8th edition.

A nursing AU.

Notes:

There is a lot of jargon here. Because it's from the point of view of a nursing professor, the jargon's not explained within the text, but I've put a bunch of definitions and explanations in the notes for each chapter. Please let me know if there's anything I missed that y'all would like explained.

It's probably fairly obvious that I am, shall we say, very familiar with teaching community college nursing. This story comes from the heart.

Beta and encouragement for this came from Ainsley, Dine, Watersword, Lyrstzha, King Touchy, Hederahelix, and all the friends who have put up with me talking about it for the last year and a half. I also owe thanks to Wordbutler, whose Motion Practice series reminded me it was okay to write about something you know really well.

This story is dedicated to Hederahelix. She knows why.

Triggers: please heed the warnings, and if you need them, there are notes on specific trigger warnings on specific chapters.

(See the end of the work for more notes.)

Chapter 1: Assessment

Notes:

Definitions/explanations
a-fib: atrial fibrillation (heart dysrhythmia, relatively benign)
Careplan: detailed, written, individualized plan for implementation of nursing process for an individual patient/client. Hated by all nursing students (who have to write them) and nursing professors (who have to grade them).
Clinical: the hospital-based, practical experience of nursing school. Usually an instructor will have 6-10 students in a clinical group at one time.
Chux: the disposable pads placed under patients. They have a thin white absorbent pad on top of a blue plastic liner.
CNA: certified nursing assistant
DON: Director of Nursing
EMS: Emergency Medical Services, which in Chicago is run through the Fire Department
IV: Intravenous. The IV catheter (a plastic cannula guided in by a needle) is inserted into a patient's vein to enable delivery of IV fluids (through a pump to regulate the rate) and medications (through a syringe)
LPN: licensed practical nurse; less training & responsibility than a registered nurse. Can't do initial assessments, takes lower acuity patients. Scope of practice varies slightly by state. LVN/licensed vocational nurse in Texas and California.
Nursing degrees: ADN (associate's degree in nursing, from a community college), BSN (bachelors of science in nursing, from a 4 year college), MS or MSN: masters, usually some form of advanced practice nursing (nurse practitioner, nurse midwife, clinical nurse specialist, certified registered nurse anesthetist). Phil has his CNS in critical care with an additional focus on end of life care; he also has extra education and experience in cardiac telemetry.
The nursing process: assessment, diagnosis, planning, intervention, evaluation
OSD: Office for Students with Disabilities
prn: as needed
v-fib: ventricular fibrillation (heart dysrhythmia, requires defibrillation; extremely serious/life-threatening)

Chapter Text

Assessment: an identification…of the needs, preferences, and abilities of a patient. --Mosby's Dictionary of Medicine, Nursing, & Health Professions, 7th ed.

"Oh, you've got Clint Barton and Natasha Romanoff in your group," Selene Gallio drawled. Phil was careful not to let his distaste show, but sweet Jesus he hated her voice, all slow and nasal and so very persistent. If you weren't careful, Selene would trap you in a pointless conversation for hours, leaving you completely exhausted.

"You have to watch out for those two. I swear that Clint kid is the laziest student I've ever had. And his careplans, Phil, they were a disaster. He's lucky he did so well in theory; I was meeting with him every other week in clinical." She was looking at him with that overly serious expression she always had, her watery blue eyes widened dramatically.

Phil tried to think of something to say to cut her off, but he knew from experience that nothing ever worked. Selene was something you just had to endure. If only he'd gotten away before she'd seen him. If only the department chair would suddenly appear in the hallway, demanding his attention. If only another colleague would show up to get him out of this misery.

He looked up and down the hallway, but all the office doors remained stubbornly closed.

"He and that Natasha girl are very close," Selene went on, her finger pointing to Barton's name on the list. At least that kept her from reaching out to grab his arm.

"She never did anything I had to meet with her about, and her careplans were decent, but there's something about her that just rubs me the wrong way," Selene continued. "She gets way too much attention from the guys, Phil, and the way she responds when one of them smiles at her is seriously creepy. The only guy she can even tolerate is Clint; I have no idea how she's going to respond to having a male instructor. You want my advice, you'll keep those two separate, and you'd better watch Clint like a hawk."

Selene was the worst instructor at his campus; no one with a brain would trust anything she said. Phil would wait until he met his students before forming an impression, thank you. He glanced at his watch and hid a smile. There was a way out of this after all.

"I'll keep that in mind," he said blandly. "If you'll excuse me, I have to go set up for IV lab." He walked rapidly towards the stairs, sighing in relief as soon as he turned the corner.

He mulled over his plans for the semester while checking that the lab personnel had set up everything the way they had requested. Beth had probably already been there--it was her lab--but she wasn't as thorough as he was. Both she and Lorraine would appreciate his last-minute check, even if they never said anything.

The cannulas, the tubing, and the IV bags were arranged at the front of the room, but the only IV pump present was the one that did nothing but alarm the moment you turned it on. He searched through the other lab and rolled the pump he found there across the hall and into their lab. He checked that all the dummies had at least one arm where the students could stick them, complete with red food dye "blood," made sure the arms had blue chux pads underneath them to protect the linens, and walked through the lab one more time before letting the students in.

This was only his third semester teaching full time, but he knew what to expect from a typical clinical group. There would be at least one student who made him want to pull out what remained of his hair in frustration, one who tried really hard but just didn't have what it took to become a nurse, and one who made it worth missing dinner with Henry and Ava once a week for his evening shift clinical. He wondered which categories Clint Barton and Natasha Romanoff would fall into.

The spring semester had, to put it bluntly, sucked. He'd lost three students before spring break: one from repeated clinical safety issues, one who had to withdraw for personal reasons, and a third who'd seen the writing on the wall after she failed the midterm. Two more had failed the class, despite meeting with both Phil and the tutor weekly. Those two were back to try again this semester, along with the one who'd withdrawn when her grandmother got sick, but they'd be with a different clinical instructor. He'd have a new group of ten to work with, and he'd get his first look at them in lab that morning.

Beth was doing the lecture and demonstration, but she left some time before she started for Phil and Lorraine to introduce themselves to the class. He went through his usual deliberately vague spiel about going to UIC for his BSN, getting his masters in California, and coming back to help a family member who was ill. He appreciated that Beth and Lorraine felt comfortable discussing their kids, but that didn't mean the students needed to learn anything about his personal life. If a few astute students picked up on the subtext behind the years he'd worked at San Francisco General, that was fine, but there was no need to broadcast it.

Beth would lecture for at least an hour, and the lab was set up; he could use the lecture time to put together packets for his clinical orientation. He was in his office stuffing folders, copies carefully organized in piles all over the desk, when his beeper went off. He didn't recognize the number.

When he dialed, the phone was answered on the first ring. "This is Natasha," a woman said, speaking loudly over the sound of a siren.

"Hello, Natasha, this is Phil Coulson; you paged me," Phil answered. If this was Natasha Romanoff, she should have been in class with the other students.

"Yes, hello, Professor Coulson," Natasha said. "Clint and I are in your clinical group, and we got stuck when our relief didn't show up on time. We're heading to a call right now. I apologize, but we're going to be late for lab. We'll get there as soon as we can."

"Thanks for letting me know," Phil said. Selene hadn't mentioned that her problem students were paramedics. Knowing her, she'd never bothered to find out. "I'll need to meet with you and Clint to arrange for some make-up time."

"We'll do that, sir," Natasha said. "Sorry, I've got to go."

Missing any lab could set a student back, more than they ever realized, but if Clint and Natasha were medics, they already knew how to start an IV. They'd just need some tutoring in how to do it with aseptic technique, and maybe some help with how to run the IV pumps. And how to push meds correctly; medics were used to doing everything too fast.

At least he wouldn't need to worry about putting them with telemetry patients once they got to the hospital. It was always a relief to find a student who actually knew something about dysrhythmias and cardiac meds. Having two in his clinical group was a lucky break, no matter what Selene thought.

He went back down to the lab once he'd finished with the folders. Beth was just wrapping up. After the break, he wandered around while the students practiced, introducing himself and getting the sense of the class and his clinical group. They'd been practicing for about twenty minutes when a woman with fiery red hair walked in, accompanied by a man with truly impressive arms.

Both of them were wearing their uniforms. Their cargo pants fit closely enough that Phil could see the man's ass was as spectacular as his arms. The woman was stunning, her curves in no way hidden by her uniform. He could see how she'd attract a lot of attention, despite exuding a don't fuck with me attitude nearly as impressive as her partner's muscles.

Phil swallowed, reminded himself that he was here to teach, nothing else, and walked up to the students. "You must be Clint and Natasha," he said, his professorial mask firmly in place.

"Professor Coulson?" Natasha said, one perfectly groomed eyebrow raised. Clint was watching him closely but didn't say anything.

"Phil is fine," he said.

"We've got our scrubs in our packs, but we thought we'd better come here before we changed," Clint said. He was wearing hearing aids in both ears, but nothing about his voice suggested long-term, severe hearing loss.

"That's all right," Phil said. "As far as I'm concerned, a uniform is a uniform. You'll find we aren't as strict as the first semester faculty."

"That's not what I hear, sir," Clint said, grinning at him. "Word is you're a bit of a hard-ass. It's okay, though; me and Nat like a challenge."

"I'll keep that in mind, Mr. Barton," Phil said. It took more effort than it usually did to keep his expression flat. He explained the purpose of the lab--Clint hadn't remembered to print his assignment out, but Natasha handed him a second copy without a word--and let them join their classmates.

By the end of the lab he'd already tentatively identified four students he didn't think would make it (only one of them in his clinical group), three who thought they knew everything already (including another paramedic), two who had heard about his reputation and were terrified every time he came close to them, and one he thought might have ADHD.

Not too bad, in other words.

When he talked to Beth and Lorraine, they all agreed it was a much stronger group this time.

"Who was that who came in late, Phil?" Beth asked him. She leaned towards her desk to peer at the enrollment list, nearly tipping out of her chair. They were already down to twenty-nine; one student had withdrawn that day.

"Natasha Romanoff and Clint Barton," he answered. "They let me know they were running late; I'll grab them before class and set up some make-up lab time for them."

"Did you catch a load of that gun show?" Lorraine asked, pointing at her bicep and grinning. "Hope the kid spends more time on his studies than he does at the gym."

"Remember that guy from a few years ago, the one who dropped?" Beth asked her. "Phil, that was before your time, I think, but this guy made your student look like a weakling; we all figured he was using steroids."

"The redhead looked pretty tough, too," Lorraine said, ignoring Beth. "I bet you'll have your hands full with those two, Phil."

"At least they'll know the difference between a-fib and v-fib," Phil pointed out. "Did either of you get anything from OSD on Clint Barton? He's wearing hearing aids."

"Yeah, I noticed that, too," Lorraine said. "I asked the first semester faculty and they said he never asked for any accommodation, but he's got an amplified stethoscope. I guess just keep an eye on him."

Phil nodded, unsurprised. Clint didn't strike him as the type to ask for help unless he absolutely had to. Most paramedics didn't.

***
Phil ate at his desk, as usual, flipping between lecture notes and his email in between bites. The phone rang just after he'd taken a bite, but he managed to swallow it quickly enough to catch the call before it went to voice mail. "Phil Coulson," he said.

"Hey, Florence, when are you orienting your candy stripers?"

"I fail to see why that's any concern of yours, Tony," Phil said, wishing he'd let the call go to voice mail after all.

"Didn't you hear? I'm meeting all the clinical groups in the first and second semesters," Tony said. "It's part of the scholarship program."

Right. There'd been something in the minutes of the last board meeting about the Stark Foundation endowing some new scholarship fund for nursing students. "I wasn't aware meeting you was a requirement for the SHIELD scholarship," he said.

Phil wasn't sure what was going on; Tony usually blew off whatever official duties he could. Phil tried not to feel flattered by the fact that he'd flown to Chicago for this. He wasn't entirely successful.

"Oh, it's not the SHIELD scholarship," Tony said. "That's for students who want to advance their degrees, ADN to BSN, BSN to Masters, that sort of thing. You could take advantage of it if you went ahead and got your doctorate. I'd fund your tuition myself."

"That's not necessary," Phil said, knowing he'd be ignored.

"You know, Nurse Coulson sounds weird--does anyone really call nurses that outside of movies? If you let me fund your education, you wouldn't be the only one on the board without a doctorate, and I could call you Dr. Coulson. That sounds way better than Professor Coulson. Let's not even discuss Nurse Coulson, because that just sounds wrong. I mean, I know it's your profession, Professor, but still."

He really shouldn't have picked up the phone. "As I've told you," multiple times, "I have no interest in pursuing a doctorate," Phil said. "Besides, you don't have one either."

"Totally beside the point I'm trying to make here, Nurse Ratched. I don't need a doctorate; everyone already knows I'm a genius."

"What do you want, Tony?" Phil asked wearily.

"Half the entering students and several in your class qualified for the Coulson Scholarship, and I want to meet them," Tony said.

"The Coulson Scholarship? Please tell me you're joking," Phil said. He rubbed at his forehead, envisioning countless banquets where his presence would be required.

"Nope, no joke. The Eleanor Coulson Memorial Scholarship is a real thing, which you would already know if you'd bothered to show up at the last board meeting. How was Henry's Little League game, anyway?"

"You named a scholarship fund after Ellie?" Phil asked, sitting up quickly. "Why?"

"I wanted to name it after you, but Potts said no," Tony answered. "She said you'd appreciate this more. I could change it back, though--"

"No," Phil said. "Tony…I don't know what to say. Thank you." He'd attend as many banquets as Pepper could arrange if it meant an opportunity to honor Ellie.

"It's the least I could do," Tony said. "You're holding the line out there, Hot Lips; don't think I don't know that."

Phil had met Tony Stark when the defibrillator he'd jury-rigged in a cave in Afghanistan malfunctioned at a Chicago benefit. He'd been brought to Mt. Sinai, because it was close and it had the best cardiac team in the city.

The DON had informed Phil that being assigned to Stark as his primary nurse was an honor. That hadn't really helped. He'd done his job, though, and while he'd been caring for Tony, he'd stopped a student from making a major medication error that could have killed him.

It hadn't been the student's fault; her instructor hadn't checked the medication with her. Thanks to Phil, Loki Laufeyson had been fired; he'd had it out for Phil ever since. Tony, on the other hand, had become an instant advocate of advancing nursing education. Phil had been affected as well; he'd finally taken Nick up on his offer to teach full time. The next semester Nick had resigned as department chair to work for the Initiative, but by then Phil was as in love with teaching as he was with nursing.

"I'll tell Henry and Ava tonight," Phil said.

Tony was one of the most arrogant, irritating, self-absorbed men he'd ever met, but he was also brilliant, dedicated, and generous to a fault. His company's commitment to health care continued to expand, his foundation donated substantially to the Initiative, and he seemed strangely determined to pursue some sort of friendship with Phil.

It didn't hurt that he shared Phil's feelings about his sister's ex-husband. That had been an interesting conversation.

Tony had tried to get Phil to accept some sort of gift ever since his hospitalization, but Phil had always turned him down. This, however, was a gift he couldn't possibly refuse. "They're a bit young to understand, but they'll appreciate it when they're older. I certainly do."

"Great, so that's settled. You still need to tell me when your orientation is; two of the recipients are in your group."

"Thursday. We've got the conference room on the third floor," Phil said, succumbing to the inevitable.

"You're probably making them show up early, aren't you?" Tony said. "You nurses are evil when it comes to mornings. Do you have a lunch break planned?"

"From 11:30 to 12:30," Phil confirmed.

"Great. I'll have food sent in. See you then," Tony said, hanging up.

Phil picked up the framed photo of Ellie and the kids taken just after her diagnosis. She'd died two years later, the day after her forty-second birthday, when Ava was only three. She didn't really remember her mother, and Phil wasn't sure how much Henry did, either, although he was four years older than his sister. Thanks to Tony Stark, the Eleanor Coulson Memorial Scholarship Fund would keep her name alive.

He'd have to call his parents; they'd want to know. He'd call in the morning, when his father would be on the golf course.

He put the picture back on his desk when someone knocked on his door. "Come in," he called.

Natasha and Clint entered, both clutching large travel mugs like they were rare and precious objects. The mugs had the Chicago EMS logo on them, and Clint's had a sizeable dent in it.

"Coming to class without sleep isn't the best idea," Phil told them. The standard shifts for paramedics included at least one overnight.

"It won't happen again, sir," Natasha said. "We're both cutting back to one weekend a month."

They're the two who got the scholarship, Phil thought, even though he had no real basis for it.

"We got a few hours between calls," Clint added. "We'll be fine." He took a sip from his mug, grimacing slightly.

Phil went over the basics of the lecture they'd missed and told them to put in some extra time in open lab, then sent them off to class. Clint didn't say anything about his hearing, and Phil didn't ask, although he noticed the way Clint focused on Phil's mouth when he talked. He made sure to face Clint directly and keep his speech clear.

***
Phil was tied up in meetings and didn't see any of his students again until Thursday morning. Clint and Natasha, he was pleased to see, showed up early. They had their travel mugs again, but they looked more rested. He passed them their folders and settled in to wait for the rest of the group.

"I heard you work here, Professor," Clint said.

Phil looked up from his notes. The neckline of the white scrub top Clint was wearing exposed his neck and a little bit of his chest, which was as well muscled as the rest of him. Despite the overly aggressive air conditioning, he'd draped his lab coat over the back of the chair rather than wear it. The short sleeves of his scrubs showed even more of his arms than his paramedic uniform had.

"That's right," Phil said, telling himself to focus. "I still do some shifts prn, mostly telemetry, sometimes house supervisor."

"Will we have clinical on the telemetry floor, sir?" Natasha asked.

Phil nodded. It was a little odd to be addressed as "sir" all the time, but he'd already figured the two of them for ex-military. "I share telemetry and orthopedics with the fourth semester faculty. Since you two have cardiac experience, I'll probably start you there."

"Great," Clint said, satisfaction evident in his face.

The rest of the group started trickling in: a forty-ish white woman with a nose piercing and an MFA who wanted to become a midwife. An emotional blonde in her twenties who'd decided on nursing as a career after her father died. An African American woman who'd been a CNA for three years; she exuded a no-nonsense attitude that Phil immediately appreciated. Two LPNs from Nigeria who seemed even more joined at the hip than Clint and Natasha; it turned out they were sisters. A bearded red-head who alternated a bright smile with a confused expression (he was one of the students Phil and his co-workers were worried about). The last student, a white woman in her late twenties or early thirties, rushed in twenty minutes late, saying that she'd overslept; he'd have to watch her closely as well.

He used his usual icebreakers, passed out his usual paperwork, talked over the charting system, and went over his general expectations before lunch. He had to repeat himself more than usual; between the emotional blonde (Ginny), the sisters (Joy and Grace; they had some ESL issues) and the befuddled red-head (Rick), he was getting a lot of blank looks. Clint, Natasha, LaRhonda (the CNA), Constance (the MFA), and the latecomer (Marie) seemed to be getting it, at least. Phil caught Clint giving Natasha annoyed glances a few times, usually when one of the other students was asking a question Phil had already answered two or three times.

Phil tried to spread his attention evenly between the students, but his eye was drawn again and again to Clint. His expression didn't display much interest, but Phil caught him nodding frequently enough that he knew Clint was taking in everything he said, and he was watching Phil closely enough that Phil figured he was lip-reading. He responded to Phil's occasional attempts at dry humor with smirks, once going so far as to smile broadly. The smile transformed Clint's face from oddly attractive to breathtaking; when he met Phil's eyes, Phil felt the corner of his mouth go up involuntarily. After that, he redoubled his efforts to pay equal attention to the entire group.

Three people in Stark Industries t-shirts arrived at 11:15 and started setting up the food: several varieties of pizza, salad, drinks, cookies. There was enough food to feed everyone three times over, as usual, and a pile of t-shirts of varying sizes. Phil knew Stark would have provided a similar, even larger, set-up in the nurses' break room. Some of his colleagues joked that they'd gained ten pounds since the day Tony Stark first showed up on their floor; there were regular deliveries whether or not he was in town.

Ginny was breathless with excitement when Tony walked in the room and greeted Phil. Fortunately, Tony was on his best behavior, although he tried to flirt with Natasha. She whispered something to him that made him step back, his face a little pale beneath the ever-present tan. Natasha met Phil's eyes with a tiny smirk, and he nodded at her approvingly. Clint stayed back and watched, a proud look on his face.

That was the moment when it hit Phil. He'd obviously been even more affected by Clint than he'd realized if he'd managed to miss that Clint and Natasha were a couple. Well, now he knew; that should help him move past his ridiculous attraction to the man. Not that he should need any help; the entire situation was unprofessional and embarrassing, even if no one would ever know about it.

Tony pulled Clint and Natasha aside after lunch, handing them folders embossed with the logo of his foundation. Phil had been right about who the scholarship recipients were.

Thor showed up while Tony was still telling the students how his captivity and its consequences had led to Stark Industries switching focus from weapons to medical technology. Phil wasn't paying much attention; he'd heard the story several times before.

"Philip!" Thor said, pulled Phil into a hug, and talked quietly with him about plans for their next board meeting.

After Tony finished, Phil introduced his students. Joy and Grace put their heads together and giggled behind their hands, more appreciative of Thor's appearance than they were of Tony's. Even though Thor wasn't really Phil's type, he could certainly understand where they were coming from; he'd heard people referring to Dr. Odinson as a god more than once. Eventually Pepper showed up and ushered Tony out the door with a wave at Phil. Thor left with them after another hug.

"How do you know Tony Stark, Professor?" Ginny asked once the door had closed.

"I work with him on the Strategic Healthcare Initiative for Evaluation, Leadership and Diagnosis," Phil said. "Dr. Odinson is part of SHIELD as well."

"Isn't that the group that Steven Rogers started?" Constance asked.

"Dr. Rogers and Nick Fury," Phil confirmed, leaving out the part that he'd played. "Now, let's get back to the agenda. I'd like to talk to you about my expectations for homework."

***
They finished up orientation with a tour and a scavenger hunt, and the semester moved on from there. Clint asked to move up to two patients the second day of clinical, confessing that he'd been a bit bored the previous semester. Phil gave Natasha two as well, playing a hunch. She didn't say a word until after post-conference. Then she thanked him.

Clint and Natasha remained Phil's strongest students in the hospital setting, but Clint was one of several who were struggling with careplans, even with Natasha's help. The first time he made an appointment to meet with Phil, Natasha accompanied him. "I'd like it if she stayed, sir," Clint said. "That way she can remind me of anything I forget."

"If you're both comfortable with it, that's fine with me," Phil answered. From the look Clint and Natasha shared, he felt like he'd passed some sort of test.

The second time Phil sat down with him to go over things in his office, this time without Natasha, Clint admitted that he'd left school at an early age. He'd only gotten his GED the year before he started his medic training in the Army. His spelling, grammar, and general writing abilities were atrocious; Phil was surprised he'd done as well as he had up to that point.

"I know it's a problem," Clint said, looking down. "I'd really like to get my BSN, maybe even a masters some day, but I don't know if that's even possible."

Phil waited until he looked up again. "It's definitely possible," he said, making sure Clint understood. "You'll have to work hard, though."

"I can work hard," Clint said, his shoulders set. "I just don't know where to start."

Phil sent Clint to the writing center. The tutor there emailed him to let him know Clint was meeting with him weekly and making progress. Phil met with him weekly as well, and he saw steady improvement in Clint's careplans. His charting improved as well.

After another few weeks, Clint mentioned that he'd had a hard time following Selene's lectures. Her drawl was hard to read, and she tended to look at the screen projecting her slides rather than at the class.

"I appreciate that you don't do that, sir," he told Phil.

Phil shrugged, hiding how pleased he was at the compliment. "I've never liked PowerPoint."

***
Phil was in his office one Monday afternoon, editing his questions for the next exam. The nursing school's server was not cooperating that day, and eventually Phil gave up, shutting the computer down with a click of the mouse that was distinctly unsatisfying. Clint was waiting on the bench in the hallway outside, and Phil guiltily realized he was already running late for their appointment. He was just about to call Clint in when Ava burst through the door, Darcy and Henry right behind her.

"I'm sorry, boss," Darcy said. She was wearing one of her many knitted monstrosities on her head and another around her neck, despite the unseasonably warm weather. "I know I said I could keep them another hour, but Jane called, and this is the only time she has free to help me with that stupid biochemistry class she made me take."

"It's okay," Phil said, pulling Ava into a hug. "Hey, guys, how was school?"

"We learned some more about anatomy today in science, but Ms. Walsh doesn't understand it as well as you do," Ava said, squirming a little. "I think she was mad when I told her about the duodenum, jejunum, and ischium."

"Ileum," Phil corrected absently, letting her go. "The ischium's part of the hip. How about you, kiddo?" he asked Henry, who these days thought of himself as too old for automatic hugs.

"It was fine," Henry said, looking at his shoe.

Phil looked up at Darcy, raising an eyebrow. "Your demon child broke my iPod," she said. "Again."

"Henry, what did I tell you about leaving Darcy's things alone?" Phil said, frowning at him. "We'll have to discuss an appropriate punishment later; for now, get started on your homework. Darcy, let me know how much to replace it and I'll add it to your next check, if that's all right."

"That'll work," she said. "I'll pick one up after I finish studying with Jane. She and Thor are headed out for some sort of conference tomorrow morning."

There was a knock on the door. "Come in," Phil called.

"I'm sorry, sir. I can come back tomorrow after clinical," Clint said hesitantly, sticking his head through the door.

"I think if you can just give me a minute, I can get these two settled down," Phil said, grateful that he'd managed to garner himself one of the largest offices in the building. Sometimes knowing Tony came in handy. "Ava, Henry, this is Mr. Barton; he's one of my students."

"Hello there, Mr. Barton," Darcy said, holding out her hand and looking him up and down. "I'm Darcy. I look after these two in exchange for room, board, and a small pittance."

It wasn't really a pittance. Phil took a moment to be grateful for the combination of circumstances that left him able to provide for the kids. Ellie's ex-husband's wealth didn't make up for what he'd put her through during their marriage, but that didn't mean it didn't come in handy.

"Uh, hi, Darcy," Clint said, shaking her hand. "I'm Clint."

"Darcy, you said Jane was waiting," Phil said pointedly. Clint already had a girlfriend; he didn't need Darcy giving him the eye.

"Right," she answered. "I'll see you at home. I might not be in until late, though."

"I've got clinical tomorrow, so you'll need to take the kids to school," Phil reminded her.

"Will do, boss," she said, giving him a sloppy salute. "Clint, it was a pleasure to meet you."

"Likewise," Clint answered.

It was awkward until Phil set them up to work on homework in the far corner of the office, but the kids behaved well. Clint barely needed any tutoring.

"You're on the right track here," Phil said, genuinely pleased at his progress. "Just make sure all your interventions have appropriate rationales, and you'll be fine."

"Good, thanks," Clint said, smiling. Jesus, the man was ridiculously attractive already; it was completely unfair how he looked when he smiled.

"You're really doing well," Phil said, because he was a firm believer in positive reinforcement. "Let me know if there's anything else I can do to help, okay?"

"You've done a lot already," Clint said. "Seriously, sir, I really appreciate everything you've done. You've been great."

Phil couldn't stop his smile from broadening. "You're welcome. I'll see you in the morning, okay?"

Clint nodded. "Bye, Mr. Barton," Ava said, looking very like her mother had at that age.

Clint ruffled her hair and said goodbye to both kids, and Phil shoved how adorable it was to the back of his mind.

***
Phil met with Clint once more towards the end of the semester, mostly to go over his overall progress in clinical. "You've done an excellent job this fall, Clint," he said.

"Thank you, sir," Clint said, and it looked like he was blushing. He looked over at the picture of Ellie and the kids. "Is that their mom?" he asked.

Phil paused for a moment. "You don't have to answer," Clint added. "I was just wondering if she's the person my scholarship's named after."

Phil nodded slowly. "Yes, to both questions. She died five years ago. Ovarian cancer."

"I'm sorry for your loss," Clint said. "Were you married long?"

Phil shook his head. "No, Ellie was my sister," he said.

"Oh," Clint said, his eyes wide. "I didn't realize; I'm sorry if I offended you."

"No offense taken," Phil reassured him. "It's an easy mistake to make, I suppose."

He could see Clint wondering, so he went ahead and answered the question he hadn't asked. "Their father's not in the picture. Which is fortunate, because he's…let's just say he's not exactly a good person." There was no reason to tell Clint about Justin Hammer, even if Phil wanted to.

"Did your sister know Mr. Stark?" Clint asked.

"No," Phil said. "He knows about her, and he thought the scholarship would be a nice gesture. Despite the self-absorption and remarkably short attention span, he's got a good heart." God, had he really just said that to a student? Clint laughed, though, and it wasn't as if Tony would mind.

Phil thought for a moment, leaning back in his chair. "It would have been entertaining if they had met. Ellie would have shut him down with a look. Once she got rid of Justin, she didn't tolerate any of that shit; Natasha reminds me a little of her. Uh, sorry for the language," he added; he made it a point not to swear in front of his students. Of course, he also made it a point not to talk about his personal life, not to complain about Tony Stark, and not to pay attention to his students' looks. It looked like he was four for four with Clint.

Clint laughed. "I'm a medic, Phil, and I was in the Army. You'd have to do a lot worse than that to offend me."

There was a knock on his door: the next student. "I'll be with you in a minute," Phil called through the door.

"That'll be Nat," Clint said. "Come in," he called out, grinning at Phil.

The reason for the grin had to be the brightly colored gift bag that Natasha brought in to the office and handed to Phil. "This isn't necessary," he said. His clinical group had given him a gift on their last day at the hospital, and Phil knew everyone had contributed to it.

"We wanted to get you something just from us," Clint said, looking at Natasha.

"We both really appreciate everything you've done for us this semester," Natasha said.

Phil's eyebrows went up, because Natasha had come to his office for Clint's first appointment, but she hadn't needed any other help. He'd talked to her at clinical now and again about her time in the army, or what it was like being one of the few women paramedics in the city, but that was it.

"You treated me the same as everyone else," Natasha explained. When he kept looking at her, confused, she added, "Other people--men, mostly--they don't do that."

"That's a shame," Phil said after a moment.

Her smile was small, but it lit up her face the same way Clint's grin lit up his.

"Go ahead, open it," Clint said, nudging Phil with his elbow.

"All right," Phil said. He took out the coffee first: dark roast, Sumatran, from a local roaster. "This looks great," he said.

"That's from me," Natasha said. "The mug's from both of us."

Phil laughed out loud when he took the mug out of its box. It had Superman flying and was emblazoned "Fighting Villains and Mornings!"

"They didn't have one that said 'Fighting Idiots and Mornings,' but we figured this one was close enough," Natasha said, with another smile.

"It's perfect," Phil said. "Thank you."

"There's something from me at the bottom," Clint said, shifting in his chair.

Phil looked curiously at the plastic container, which was lined with foil. When Phil opened it, he smelled cinnamon, nutmeg, and pumpkin. He pulled back the foil. "Are these scones?" he asked, taking one out of the container. It was still warm. "Did you make these?"

"Yeah," Clint said, glancing at him before looking back down. "I figured you might like them--you brought scones to post-conference that one time."

"I do," Phil said. He took a careful bite, trying to keep from getting crumbs everywhere, but it was impossible to maintain any dignity once the flavor hit his taste buds. "Oh my God, this is incredible," he said, his eyes closing with pleasure.

"I'm glad you like them, sir," Clint said. When Phil opened his eyes, he could see a flush of pink across the top of Clint's cheeks.

"Yes, well, thank you," Phil said, feeling awkward. "Clint, Natasha, it was a pleasure working with you this semester. My door's always open, even after you move on to other classes. Please don't hesitate to drop by if there's anything you need, or just to let me know how you're doing." He said it to every student, but he'd rarely meant it this much.

"I'll do that," Clint said, shaking his hand, holding on for a moment before dropping it. "Thanks again, Phil."

"I'll see you at the final," Phil said. Natasha gave him a quick, wordless hug, and walked out. Clint smiled at Phil again and followed her.