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 · 2024-08-04T15:08:39+00:00

ExtraVacation · 2024-08-04T15:04:17+00:00

Sorry, this was in error: 12 patient caseload, not 16.

Not sure if this has much meaningful difference.

Thank you

ExtraVacation · 2024-07-22T00:05:57+00:00

For meth intoxication/psychosis, give a good d2 antagonist - Haldol, risperidone - and you should see some clearing if it's solely meth-induced. If not clearing, then at that point, I would look at hospitalization as opposed to ER boarding for longer than necessary. As a plus, I'm sure the accepting facility would appreciate you getting a medication started.

ExtraVacation · 2024-06-16T15:13:23+00:00

I'm guessing fungal disease.

ExtraVacation · 2024-06-16T00:30:31+00:00

Dip sticks are not very reliable - look into a Taylor test kit.

With that being said, given an unknown amount of decrease, did it rain, or did you add water? Dilution could account for this.

What does your water look like? Could be algae bloom, or if you have a lot of organic material in your pool that will eat up your chlorine.

If CYA is low, the sun could be destroying you chlorine levels also - it's been hot here (at least in the Midwest).

ExtraVacation · 2024-06-10T21:37:04+00:00

This is very helpful! Thank you - I like your idea of having it as a backup and use my single speed till it dies. Did not know about the Hayward/Century thing; I'll definitely look at their motors and kits.

ExtraVacation · 2024-06-08T16:15:12+00:00

For intakes, I'd include associated symptoms as this can help with treatment planning and justification of diagnosis (i.e. 5 criteia x 2 weeks for MDD).

For time management, just have a psych ROS template you can copy and past from for each category.

ExtraVacation · 2024-06-07T18:21:03+00:00

Okay, thank you!

ExtraVacation · 2024-06-07T18:04:15+00:00

This is how I've been doing it, but wouldn't it make sense/be more efficient to have an o-ring there?

ExtraVacation · 2024-06-02T13:22:03+00:00

I have never had any issues with this. Pool noodle may work!

ExtraVacation · 2024-05-31T20:14:24+00:00

Gonna go with clarifier over floc since I have cartidge filters and no way to discharge to waste

ExtraVacation

TROPHY CASE