Nursing student with ADHD, struggling in clinical! - page 4

Hi everybody, I am struggling in my advanced med-surge clnical rotation. Although I am a really compassionate and meticulous person, I don't do well under pressure and with lots of things to balance at once on my plate. Under... Read More

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    Some clinical environments will always be more 'chaotic' than others - it's just the nature of the beast. In order to cope with a busy MedSurg/tele unit, you have to master the art of dealing with a constant bombardment of new information & tasks. This may be a deal-breaker for you. It may be a good idea to begin exploring working environments that can provide much more structure and stability with longer lengths of stay - admits & discharges add to the problem. Although they are not easy to find on the 'acute' side, there are some types of ORs that may fill the bill for you if periop nursing is an area you would consider.

    You're obviously working very hard to overcome your difficulties. I just wanted to applaud your efforts & wish you tons of luck.

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  2. 1
    Quote from milksgalore
    HAHA, that is such a great point. I really appreciate that you are giving me a response from the instructor's perspective. It really gives me a different set of eyes rather compared to another student's response. Ok, so it is all fairly simple, but I am perhaps making it to be much crazier than it really is. So just get the basics! To think it through and apply what you know...yeah, that's my problem in the clnical setting! For some reason i freeze and I /don't/ know...but perhaps I do, I just need to learn to think in stressful situation. I will try to remember this post during those times. Thanks!
    I would never steer you wrong. I am working with a student I had a couple of semesters ago right now. She gets herself so overwhelmed because of the volume of the information. I told her dumb it down. For instance cardiogenic shock!!! Who wouldn't say OMG! So think about what is one of the common reasons for cardiogenic shock? MI- why can it cause shock? A serious injury to the myocardium. So what happens well the heart can't pump as effectively due to injury. so what does the patient experience, Decreased cardiac output, low urine output, decreased vital signs, increase in the pressures of the heart. Ok now how do you treat that. Well can be a combo of things. Vasopressors maybe be needed for hypotension, inotropes to increase cardiac output, diuretics for volume overload and in real bad cases intra aortic balloon pump. So as a nurse what do you do besides implementing the medications if ordered. So nursing considerations physical assessment, monitoring of vital signs, intake and output, monitoring oxygenation, etc. Nursing school gives tons of information. Yes you need it to a point but when you are at the bedside you need to have basic understanding and the advanced knowledge comes with experience.
    Also while we all love to have "A's". If you can't apply it the A's don't matter. A patient never asks for the A nurse but the nurse who can care for them which requires common sense. Hang in there!
    TallSN likes this.
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    Quote from milksgalore

    THank you so much! I will take a look at all of them! Although a brainsheet (I've been working with one) will help me organize my day, the problem is that everything including the day's shift and everything within is a whirlwind for me. So do you have any advice on how to calm the whirlwind in my mind DURING a time of chaos, like say...if an acute situation were to occur. WITHIN that situation, I am running around like a headless chicken, and even if I write things down, I just can't get myself to THINK CLEARLY. D: Any advice for then?
    Crap can happen during any shift. So you need to then prioritize at that time. It would be helpful with something that has happened and I would be glad to give you some suggestions. Always emergency type things like respiratory distress takes priority. Patient who needs a bedpan delegate to a nursing assistant if you are doing medications or say doing a dressing change. As nurses we are always working it and shuffling it. This truly takes time to perfect. I remember my instructor told me at least 6 months after graduating. She was right. If noise is a distracted for you then you may need to remove yourself and think it through. Have you talked to your instructor for some suggestions based upon her observation?
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    Quite honestly adderall and such medications are intended for hyper focusing thus maybe it's causing more trouble in time oriented tasks. Dividing up tasks into days helps me tremendously! An example is if I have to read a chapter in four days then I'll divide it by 4. I have to divide all my tasks up including flash cards, everything or say I have one day for a chapter than I'll read one half in the morning and other after dinner. It makes studying manageable.
  5. 0
    Quote from HouTx
    Some clinical environments will always be more 'chaotic' than others - it's just the nature of the beast. In order to cope with a busy MedSurg/tele unit, you have to master the art of dealing with a constant bombardment of new information & tasks. This may be a deal-breaker for you. It may be a good idea to begin exploring working environments that can provide much more structure and stability with longer lengths of stay - admits & discharges add to the problem. Although they are not easy to find on the 'acute' side, there are some types of ORs that may fill the bill for you if periop nursing is an area you would consider.

    You're obviously working very hard to overcome your difficulties. I just wanted to applaud your efforts & wish you tons of luck.
    Thank you so much!
    I wholeheartedly agree about the chaos of certain floors. That's why if I could be a nurse, it would be be in a more structured and stable setting. Unfortunately, I must surpass this current obstacle in order to become one in a less acute setting! D:
  6. 0
    Quote from lmccrn62
    I would never steer you wrong. I am working with a student I had a couple of semesters ago right now. She gets herself so overwhelmed because of the volume of the information. I told her dumb it down. For instance cardiogenic shock!!! Who wouldn't say OMG! So think about what is one of the common reasons for cardiogenic shock? MI- why can it cause shock? A serious injury to the myocardium. So what happens well the heart can't pump as effectively due to injury. so what does the patient experience, Decreased cardiac output, low urine output, decreased vital signs, increase in the pressures of the heart. Ok now how do you treat that. Well can be a combo of things. Vasopressors maybe be needed for hypotension, inotropes to increase cardiac output, diuretics for volume overload and in real bad cases intra aortic balloon pump. So as a nurse what do you do besides implementing the medications if ordered. So nursing considerations physical assessment, monitoring of vital signs, intake and output, monitoring oxygenation, etc. Nursing school gives tons of information. Yes you need it to a point but when you are at the bedside you need to have basic understanding and the advanced knowledge comes with experience.
    Also while we all love to have "A's". If you can't apply it the A's don't matter. A patient never asks for the A nurse but the nurse who can care for them which requires common sense. Hang in there!
    Haha, as soon as you mentioned cardiogenic shock, I began to panic. But as soon as you broke it down--you are right, I realized how basic it can really be. I'll practice remembering that in times of anxiety!
  7. 0
    Quote from lmccrn62
    Crap can happen during any shift. So you need to then prioritize at that time. It would be helpful with something that has happened and I would be glad to give you some suggestions. Always emergency type things like respiratory distress takes priority. Patient who needs a bedpan delegate to a nursing assistant if you are doing medications or say doing a dressing change. As nurses we are always working it and shuffling it. This truly takes time to perfect. I remember my instructor told me at least 6 months after graduating. She was right. If noise is a distracted for you then you may need to remove yourself and think it through. Have you talked to your instructor for some suggestions based upon her observation?
    Yes, yes, it does take time to get better at it. And I have certainly gotten better at this overtime. Unfortunately, I am taking longer than other students and in the allotted amount of hours of the curriculum to learn in time in order to pass the course. But I will still do the best I can. *Le sigh*
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    Quote from Carley77
    Quite honestly adderall and such medications are intended for hyper focusing thus maybe it's causing more trouble in time oriented tasks. Dividing up tasks into days helps me tremendously! An example is if I have to read a chapter in four days then I'll divide it by 4. I have to divide all my tasks up including flash cards, everything or say I have one day for a chapter than I'll read one half in the morning and other after dinner. It makes studying manageable.
    I used to have the problem of trying to do EVERYTHING. But then I learned that that just makes me anxious, so I learned to break things down too. It was a good habit to pick up haha. I'm glad that it has worked for you .
  9. 0
    Quote from lmccrn62
    Crap can happen during any shift. So you need to then prioritize at that time. It would be helpful with something that has happened and I would be glad to give you some suggestions. Always emergency type things like respiratory distress takes priority. Patient who needs a bedpan delegate to a nursing assistant if you are doing medications or say doing a dressing change. As nurses we are always working it and shuffling it. This truly takes time to perfect. I remember my instructor told me at least 6 months after graduating. She was right. If noise is a distracted for you then you may need to remove yourself and think it through. Have you talked to your instructor for some suggestions based upon her observation?
    Yes, my instructor has noticed, and she doesn't know what to do either. I use a timesheet, she reminds me about things, etc. But still, in the moment, my mind is just a whirlwind, and she, nor I, know what to do. I really think that I just need more practice...but there is only a limited amount of practice that I could have in this specific type of setting, unless I become a CNA. But that's too late for now to pass this course in time.
  10. 0
    I tried PMing you again but was denied! Not sure why! Here is the important part of the PM:

    I was never consistent with herbals I bought so I am not sure what really works. I would research what are the good herbals to deal with anxiety on reputable sites. Use your pharm text book and drug guide too! Check out some forums that help people with anxiety and see what are some common ones that seem to really help.

    Good luck!!! Keep me posted!!!!


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