Should I tell my nursing school about my disorder? - page 2

by Harmony4All | 5,473 Views | 34 Comments

Hi, I am currently in nursing school with two semesters left (not counting the one I am currently in). I have been diagnosed with Narcolepsy about 4 years ago (before I even started nursing school). I have noticed that due to... Read More


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    the early mornings aren't hard for me in the morning, but when I get home at 4 or 5 i'm usually staggering around like a drunk. I just try to keep myself awake, clean my apartment - anything to put off bedtime til at least 9 or 10. the best i can do is at least keep my bedtimes early so the few early mornings aren't such a shock to the system.

    i've known i was narcoleptic since high school but only got official diagnosis/sleep testing/provigil about 3 years ago. going to a neurologist and going through that process was a total lifesaver for me !

    I'm surprised to hear about your provigil regimen. From my understanding it's not supposed to be a short-acting drug (like ritalin or caffeine). it definitely gives me a little boost in the morning (at 100mg) . it doesn't feel like a buzz or a high but it does wake me up. after that, i'm up all day without experiencing sleep attacks.

    I think the greatest benefit of the provigil has been regulating my night-time sleep - since taking it, i feel much better when i wake up in the morning and have an easier time getting up. i have to take it every single day to get this effect though - if i skip one or two days i'm back to falling asleep without warning and sleeping through alarms.

    it definitely makes me metabolize other things faster. like alcohol. oh boy was that a surprise, the first time i ended up reeling drunk at a work function at 5 pm because i'd had half a bud light.

    caffeine has never done anything to fend off my sleep attacks ... i once burned myself cause i fell asleep holding a cup of coffee. lesson learned

    i would say from the symptoms in your first post, your current regimen isn't adequate and it might be time to go back to the Dr. and tweak it a bit. obviously i can't give you advice about what to do, other than to say go back to the Dr. If your PCP has been managing this, go to a legitimate sleep doc (usually a neurologist). they are WAY more knowledgeable about narcolepsy management.

    Do a bit of googling about sleep hygiene. It really has made a huge difference for me and it requires no drugs and no docs.

    As for the school bit - I just don't think telling your school is going to solve the problems, and would probably create more. Right now it's a matter of managing your personal health, which the school can't do for you. All they can do is react when they see a student falling asleep in clinicals.

    Good luck !
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    Personally, and this is just me, but I would tell them if it's affecting your performance and you are getting in trouble for it. Like you said, your clinical instructor saw you closing your eyes and was noting it - it's possible that it might come up in your clinical evaluation.

    I have generalized anxiety, and have discussed the issue with clinical instructors in the past when it's been a problem. In med-surg, with 12 hour clinicals, I would get so overwhelmed and freaked out that sometimes I literally needed to leave the floor for a few minutes and splash some water on my face and calm down so I could provide safe patient care. My clinical instructor was a lot more understanding of my need to do this since she knew what was going on. However, I've had clinical sites where the anxiety hasn't been an issue, and there was no need to bring it up to my instructors because it wasn't affecting my performance.

    I disagree with not allowing a lunch during a long clinical, so if your clinicals are over 6 hours and you're not getting even a break, that seems very unfair to me. Even with my 5 hour clinicals my first semester, we were given a short break in order to get a snack and rest our feet. And even if people say "Oh in the real world blah blah blah"...I really feel like it's just not a good comparison. We're still students. We're still learning. And when it comes down to it, there should still be a nurse responsible for your patient while you're in school, and they shouldn't be dropping the ball completely just because you are there. If you are letting him/her know when you leave the floor, there shouldn't be a problem at all with you taking a short break for yourself. Naps are probably out of the question, but 15 minutes to pee, eat a banana, and check your phone is allowed on every floor I've ever seen even in the real world.
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    I would say it would be in your best interest to disclose this information. Since they are unaware, all they will see is some lazy student falling asleep in meetings, instead of someone with a real disorder. They need to know so they can do what they need to help you, and if that means you take a break(which you should be allowed to do whether or not you have a disorder ), then so be it.
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    I remember I told my instructor I have hypothyroidism and have to take medication for it. I don't know if it made any difference, but it just came up. Explained why I'm so tired all the time, as well.
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    I wonder if I could have narcolepsy. I have always had trouble staying awake, especially during classes. I have tried everything, but I am always falling asleep during lectures, especially long ones. I even did this as a high schooler. One of my instructors even joked about me nodding off in class, so now I am worried because I don't want them to think I am being rude.
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    By all means tell your program. And continue to work with your physician (hopefully a sleep specialist -- mine is also a neurologist) to assure you're trying all of the combinations of medication and sleep hygiene to maintain daytime wakefulness. I don't know what the difference is between the formula for Provigil and the new drug from the same company (I think) that is called something like Nuvigil but that may be worth exploring. I suffered with excessive daytime sleepiness for decades before I was diagnosed -- but Provigil works well for me. I do recommend that you try taking it every day for a few weeks -- and I mean, 7 days a week -- unless your physician and you have determined that this is not advantageous for you. I think that taking it every day on a schedule that keeps you awake and alert for an appropriate number of hours may improve your sleep quality and therefore make it easier for you to stay awake when you really need to, like during conferences and classes. I'm going to assume that you've had a formal sleep study done. If you haven't, by all means have one done. If you have undiagnosed sleep apnea you need treatment for that too. Good luck with it all.
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    In my opinion based on long experience, NO. You have so little left, do what you have to to finish. That ls all you have to do. At this point you are not looking for stellar, excellence, etc You want to finsh. You have already proven yourself as far as quality of your work. Finish this and then fine tune what you have to do be able to practice like you want. Don't let other's discourage you at all. Nursing is very broad in what you can do with it. Nursing school is very different from the typical schools and can be very political and very unforgiving. I would not at all divulge this unless you can go to disability services, go through their entire process and get their protection. Even then you are not fully protected. The commitee that will meet to put their thumb print on those graduating may not feel comfortable graduating you as you will represent them. Too much in nursing is subjective and requires no proof. We have to change that but not in your two semesters. They definitely will not understand it as fully as they should for your sake. Think long and hard before you divulge this with so little left. Barinbass
  8. 0
    Ditto for Provigil. I wouldn't mention it unless there was a compelling reason to, i.e. program policy or a potential affect on your performance issue. While the is an issue of "reasonable accommodation" for those with disabilities, you have an obligation to minimize the potential problems with lifestyle modification, meds, etc.
  9. 0
    Absolutely not. Do not mention it to your institution unless you want to open up the *possibility* of you being under the mercy of an administration and possibly screw up future opportunities that might have otherwise been open to you if you'd have kept your mouth shut. I am only recommending this to you if you know how to use your common sense.

    The problem is that you want to get a piece of paper stating that you are an RN. End of story. After that, you have options even if you fall out unexpectedly like a fainting goat on occasion. Obviously your common sense would tell you not to apply for a job where your condition would even possibly put someone at risk.

    Options- Research jobs, jobs in education, non clinical jobs, legal consulting, etc., which require that you be an RN. The bottom line is that once you have or have had a license- that puts you in a different situation than if you (because of your condition) were denied the opportunity to become an RN in the first place.

    Example: should a private pilot with failing vision go on to become a flight instructor or test pilot? You bet! He or she could still be a ground school instructor, teach aerospace/aeronautical engineering concepts even if he or she is blind as a bat! ... especially in those jobs that have a requirement that one must be or have been an FAA licensed pilot.

    Be smart and keep others save, but at the same time, understand how the real-world works and don't shoot yourself in the foot in the name of "doing the right thing". You can "do the right thing" on your own without screwing yourself in the long run.
  10. 0
    I have mixed feeling. I believe in your right to privacy, but I've also seen what happens when Narcolepsy is not revealed to an employer.


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