[disComBobUlated86]

Hi, I've got one year left in nursing school and clinicals are starting to give more responsability, which is great but means more to organize. I'm also doing an internship this summer in which I get to see all that a nurse really does have to keep track of. What I am worried about, and have spoken to my professor about, is mainly disorganization. I have had ADD since I was little and I am on adderall for it. I have two things I'm worried about.

The biggest thing: organizing...keeping track of labs that need to be in, charting, and meds, and the biggest one TIME as well as getting assessments done in such a way that i don't forget to make a mental or written note of something, like iv placement. Does anyone have any helpful hints for organizing the day and keeping on task and on time?


also with report and getting verbal instructions...i'm the one who always says "what". sometimes i'm too involved in something else at the moment and need a minute (if it's not urgent of course) and sometimes i just need to repeat or clarify so i'll repeat back and ask what i worry may seem repatative questions that may make me seem spacey. does anyone else do this? and if so is it a problem or do people generally just get over it as long as you're effecient and a good nurse otherwise?

Thanks in advance :-) I'm getting so close to graduation and I'm just so nervous about getting a method set quick enough that I won't seem slow or like a bad nurse in orientating and starting the job. Everyone else seems to just remember and have things organized, and I feel so behind sometimes. The nurses I'm working with now say I'm doing great as an intern but there's so much more once you're out!

have a good day/night/whenever you're reading this :-)

[Skeetersmom119]

I have had my LPN license for 14 months, have ADD, going through menopause unable to take HRT, and I work on a long term care rehab/skilled unit which is constantly hopping. My advice to you is to keep a notebook. Make sure that you have a jot sheet with your patients on it, that is workable for you. I had to make my own. You will have to prioritize, know what things HAVE TO BE DONE AT THE PARTICULAR TIME STATED, and work out for yourself a method for completing the rest of your duties. Listen to all suggestions, then take whatever is doable for you. I cannot be near the desk during the day, too much noise and commotion. Things I need to follow up on, such as MD calls, I am fortunate that I can go into the staff development office down at the end of my hall, where it is quiet. I do not chart at the computer at the nurses station. Too much distraction. I had to have my psychiatrist change my dosage of Adderall, I found that I was bottoming out at 11:30-12 noon. That has helped. When you are getting report, you sometimes have to PULL IT OUT OF THE NURSE THAT YOU ARE RELIEVING. If you are going to be working in LTC, you will need to know 1) Their cognitive status (are they alert and oriented x 1, 2, 3) and if they have behaviors. Do they receive meds for the behaviors. 2) Are they independent,require assistance, etc.; 3) Are they on ABT or IV's, 4) Are they respiratory, do they have PRN or scheduled tx's, 5) Are they continent, do they have a foley? 6) Do they have pain management issues, and do they have meds for pain? Use your head, look at their dx, and preanticipate the pain, take care of the pain before they have to ring. Ringing for pain meds is a big distraction. Same with PRN sleeping meds, if they are asking nightly, remember it, give it to them, and see about getting an order for scheduled sleep meds. (for your notepad) Your respiratory folks, keep them close to the top for med pass. They have a tendency to be anxious, and hang on the call bell. Assess their oxygen sat, they may have PRN ativan if they get into an anxiety attack due to SOB. Use your judgement, but get to know your patients, their families, their quirks, and definately get a good working relationshipwith your aides. They are your eyes and ears. Make yourself approachable, listen to what they have to say. If they say that something isnt right, it is definately not right. Whatever they tell you, if it something that isnt causing any immediate danger, write it down, to follow up on after your main work is completed. (In a nice quiet place.) Feel free to email me . I am also a certfied dietary manager (ran kitchen in nursing home+ documented, kept weight rosters, careplans, etc) prior to becomeing a nurse. So I had to figure out how to make it all happen. I have a lot of tips and tools which could be of help to you. Don't be afraid, your ADD can be an asset, because we ADDer's thrive in chaos ! Look up Sari Solden on google, it will direct you to her website. She is a psychologist with ADD, and has written many books about women and ADD. I would like to hear from you. I graduated at the top of my class, by the way. LOL

[Bookworm14]

We have binders for our nursing notes on the patients (ICU). I stick post-it notes on the front of the binders. I use them to jot down when meds are due, special treatments, when labs are due, especially PTT's when on heparin drips. I also use one to write down what supplies I need to get before the next trip into the room (saves extra trips to supply room). I also jot down something that needs clarified or checked up on when I leave the room. I am the type of person that thoughts come quickly but then they are lost quickly so jotting thoughts down as they come has been a big help. (I even carry a notebook in my purse for this very reason).

Mornings are crazy and create anxiety that I have forgotten something so I put a quick checklist on the binder. (pt weight, charting completed, nurse shift check done in computer, etc,). Then when all the commotion of the morning hits I can just glance at the checklist and know that I have things done and haven't forgotten anything.

I take Concerta and found that my concentration and time management would really taper off after 8 hours or so. My doctor ordered Focalin (type of Ritalin) for me to take part way through my shift to help me concentrate through the whole thing.

My co-workers know that at times I have to put myself in "time out" to do my charting. This keeps me from being drawn into their conversations or issues with their patients. They know that I would rather help them than do my charting but sometimes you just have to isolate yourself and "get it done".

My challenge is with time. I have no concept of time and this is even worse when we are slower. I am much better with a critical patient that forces me to chart immediately and stay on task.

Hope some of this helps!

[Skeetersmom119]

Originally Posted by Bookworm14

We have binders for our nursing notes on the patients (ICU). I stick post-it notes on the front of the binders. I use them to jot down when meds are due, special treatments, when labs are due, especially PTT's when on heparin drips. I also use one to write down what supplies I need to get before the next trip into the room (saves extra trips to supply room). I also jot down something that needs clarified or checked up on when I leave the room. I am the type of person that thoughts come quickly but then they are lost quickly so jotting thoughts down as they come has been a big help. (I even carry a notebook in my purse for this very reason).

Mornings are crazy and create anxiety that I have forgotten something so I put a quick checklist on the binder. (pt weight, charting completed, nurse shift check done in computer, etc,). Then when all the commotion of the morning hits I can just glance at the checklist and know that I have things done and haven't forgotten anything.

I take Concerta and found that my concentration and time management would really taper off after 8 hours or so. My doctor ordered Focalin (type of Ritalin) for me to take part way through my shift to help me concentrate through the whole thing.

My co-workers know that at times I have to put myself in "time out" to do my charting. This keeps me from being drawn into their conversations or issues with their patients. They know that I would rather help them than do my charting but sometimes you just have to isolate yourself and "get it done".

My challenge is with time. I have no concept of time and this is even worse when we are slower. I am much better with a critical patient that forces me to chart immediately and stay on task.

Hope some of this helps!

Sticky notes are a wonderful thing ! The desk is chaotic on my unit, with orders changing daily, charts lined up for transcription, the phones ringing CONSTANTLY because we have a party line system, and family members are usually on the other end wanting to talk to their loved one. I do not work the desk, for that reason. LOL. I have to go to the end of the other hall, in the dayroom to chart on the computer, in order to avoid distractions. I had my Adderall dosage adjusted to where I take 1.5 tabs at 11:30am, where I bottom out. My doctor told me that when someone with ADD is in a hectic environment, the medication is used by the body at a faster rate. Glad to see that you are managing well. My motto is "I thrive in chaos."

[lisat380]

I'm on Adderall too but I've asked my MD if he could diagnose me cuz when I was in nursing school I was struggling big time. I'm thinking I have ADD but I'm not diagnosed with it cuz the Dr told me there is no test for me to take since I'm in my late 20s and all he can do is medicate me. I started to take Wellbutrin and it didnt really help with my concentration and I usually get disorganized. Then he prescribed me Adderall. I did a lot of research before on Ritalin and Adderall and I've been taking Adderall for a couple months now and it has helped with my concentration and I'm more motivated to actually study its like I have to DO something. And btw, I work noc shifts and if my patients are asleep I take the time to study. It's like I can't waste anytime or if my patients awake I talk to them about anything and I talk a lot till they get bored and go back to sleep. hahaha Anyways, I'm glad im not the only 1 on Adderall BUT I hope I'll be ok since i'm not diagnosed and I'm really not addicted to it, well maybe, I just want sumthing to help me focus.

Are any of you in the process of taking your NCLEX-PN/RN anytime soon? If you're on Adderall were you diagnosed with it or you're just taking it as prescribed but you don't know if you have Adderall or not?

I'm just worried that some ppl might make it a big deal that I'm NOT diagnosed with ADD but I'm taking sumthing for it anyway, and the DR prescribed it to me, so wat? Maybe Im getting irritable bout that. In nursing school a lot of my classmates took Ginko Biloba or Focus Smart where you have to take 8 pills at once! I was overwhelmed and I seeked help myself instead of ODing my self on "smart" pills that won't work. Yup nursing school was a cry for help on the last semester.

[disComBobUlated86]

Lisat: Yeah, I was diagnosed at age 5. Then I retested at 17 or 18 I think. You should be able to find a test if you wanted, but it'd probably be through a psychologist/psychiatrist. My meds are all handled by a psychatrist. But if your MD is working for you, that's great :-) They can just perscribe off label. My brother gets his through the pediatrician. And I'm glad you went to talk to an MD about it, a lot of people are afraid to or think it'd be silly and people would think they were being ridiculous.

[lisat380]

disComBobUlated86

I was afraid to be taking Adderall at first cuz I was'nt sure if they were gona disqualify me when I applied for jobs at hospitals. When i took a drug test the doctor asked me if I have ADD and I said no I'm just taking it to help me focus and she said "so your doctor just handed it to you?" I was like yeah. I feared that they won't let me work cuz its a "controlled substance" and again Im not diagnosed with ADD but the hospitals didnt tell me anything and I now work per diem as a cna at two hospitals.

So now I'm good I'm not paranoid i can study for my NCLEX-PN and hope to pass with my 2nd attempt and using Suzannes plan and to any1 thats in the process of taking your NCLEX you should give her program a try, no cost, heard a lot about people passing after 3xs or if you lagged for over a year or so you'll pass if u follow exactly the way she wants you to do it.

Wow, by reading all the good stories that ppl had been through, I find it inspiring and motivational AND educational, if i only knew about this website before i wud've been a nurse already. An LVN or RN that is