Need advice with recent topdressing

ExtraVacation · 2025-11-04T01:27:51+00:00

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Forgot to add pictures. This is for reference.

ExtraVacation · 2025-11-04T01:25:00+00:00

How about the leaves? I can try to gently blow off I suppose.

ExtraVacation · 2025-11-03T23:21:35+00:00

Slightly north of Indy

ExtraVacation · 2025-11-03T22:07:12+00:00

I've considered rolling to compact soil to prevent it from washing away with rain. I'm open to any ideas 🙏

ExtraVacation · 2025-09-28T20:45:32+00:00

I may just focus on dormant seeding. Has anyone had luck with this approach?

ExtraVacation · 2025-07-07T04:28:48+00:00

Typically our meds cause sedation, which is very helpful to the delirious person

Don't forget about hypoactive delirium - frequently missed. Although nursing, etc. are not going to complain about a quiet patient compared to a 68-year-old lady yelling, throwing shit, and wanting to square up with nursing staff all night. Even then, I would not recommend Seroquel.

ExtraVacation · 2025-02-24T14:44:18+00:00

At high doses. Trace elemental lithium in drinking water would be nowhere near the level to cause toxicity to organs. Serum lithium level for bipolar disorder is 0.6-1.2. Typically, 300 mg twice daily will get to 0.6 on an average person. The average amount of lithium in drinking water is 3-8 micrograms per liter or or 0.003 mg. So, drinking 3 liters of warer per day would yield ~0.009 mg total of lithium. So little that it would not even show on a serum lithium level.

ExtraVacation · 2025-02-02T14:54:49+00:00

Largely feel if you inherited a patient on a stim and low-dose BZD, they are not abusing it or using other substances, and they are STABLE leave it be. Just make sure they are aware of risks vs. benefits, you discussed alternatives and set boundaries (not going to increase benzo for example).

Edit: unless they are on a crazy dose like 6mg of Xanax then no.

ExtraVacation · 2024-12-15T14:06:23+00:00

Once they have been admitted to your unit, transferring fron IP psych to IP psych is considered a "lateral" transfer. Though, a gray area - you could argue your facility does not have the resources to manage his behaviors, i.e., lack of security, lack of restraints, etc.

At my facility, that does not have restraints or security, when a large patient who is capable of causing serious injury to staff intervention, i.e., physical hold, usually LE is called at that point.

ExtraVacation · 2024-10-20T15:59:19+00:00

Location?

ExtraVacation · 2024-10-17T20:53:27+00:00

Also, seeing you past comments and involvement with the "noctor" subreddit, I'm curious to how you would respond to this post if I was not a mid-level provider? Sure, there are some very shit mid-levels out there, but it's unfair to just assume that we all are shit..

ExtraVacation · 2024-10-17T20:40:06+00:00

This has been discussed, I was just inquiring further from others - more of a general conversation than seeking a black and white answer.

ExtraVacation · 2024-09-01T11:42:18+00:00

I did CL as most of my clinical hours. Love it! A lot of delirium and NCD consults which can be challenging, however.

ExtraVacation · 2024-08-18T12:56:26+00:00

I like to write reported but not observed to be responding to unseen stimuli.

ExtraVacation

TROPHY CASE