With my ranger in DKS I had the main skills assigned to the 4 buttons, and Healing / summon creature / dragon stone / dragon morph stone assigned to the D-pad directions. Eventually I changed the summon creature hotkey to something else, and just used the crystal skull from the pause item menu (and also paused the game to cast Way of the Ranger, which I tried for the first time on level 40, after buying a bow with that bonus).
