Planning to be a unit nurse

[wishingmary]

I am beginning my last year of ADN school. I've been getting a scholarship from the hospital that I'm partial. I found out tonight from one of the MICU nurses where I also work as a tech that if you are on scholarship, you won't have much say in where you end up. They put you in the area of most need; i.e. EGD under a doctor from Hell, any floor, whatever shift, or any of the units. She had gotten her scholarship from another hospital and that is what happened to her but she got lucky and landed a critical care placement and worked all 3 (ICCU, MICU, SICU). My only work option is weekend option because I have 2 school aged children and am divorced. My parents and visitation for my "X" help me with my kids on the weekends and I want to be free to help out at my children's school during the week and as they go to a private school, I must take them and pick them up. I've heard from various nurses and bullitens that if you end up on a med-surg floor for instance, you may get stuck there as they are in such need of nurses. I know I transferred from an aide position on a floor to the MICU simply because our floor manager had hired more aides than she had space and I took advantage of it. I've also heard that another hospital has an incredible critical care training department. She recommends that if I really want to be a good critical care nurse quickly, pay back the scholarship (half is still in a CD) and hire on at the other hospital. Work a couple years, take as many classes there as I can fit in (not all are required) and then come back. The reasons I want to work in critical care are the lower patient load, the respect they get from doctors, the turmoil of physical crisis - never a dull moment and God's creation of the human body is awesome and sometimes unpredictable. However, I have been recently diagnosed with ADHD and even on medication, I get tongue tied and I'm not the best in reading social idioms and understanding jokes which makes me look foolish. You could say I'm out of step. Get me on a physiological topic and I can look smart. Give me a recipe and I can go with it. I'm a "B" student in nursing school with all "A's" in my hard core science pre-requisites. My ADHD is manifested primarily in my ability to hyperfocus (I'm not hyperactive) but without my plan for the day, I can be forgetful. I'm picking up on some strategies I see a nurse use who has taken a special liking to me, maybe because I get so tongue tied. After assessing her patients, checking lines,etc she sits alot doing her charts and thinks about her patients before she does anything else not requiring immediate attention. Her actions are deliberate and she wastes little time in "running around" and being stressed. I know I'd have to write more notes than she does, i.e. things that would be pertinent to ask or get permission from family members when they call like can I shave that full beard. She's thinking that she anticipates an order for a tube feeding in dear old dad and knows the tape would never stick. Mundane trivial things like that. When problem solving she first rules out things that are simple solutions. Is that why she's so calm? I find her interesting to watch. Back to the ADHD thing, I don't stutter, but when I'm feeling unsure of myself which is often down there, my syntax isn't the best. The shear knowledge base and gagetry I need to learn is also overwhelming but I still want to learn and am not afraid of learning and performing new competencies as a student nurse. As a tech, things are a bit more safe and I can recognize when a patient is in trouble. Today while placing the leads for a 12-lead, I had to yell "V tach" and got everybody running (with the support of the monitor alarms). The ADHD thing does worry me; however, because I've only been on Concerta since being diagnosed 2 months ago and see a difference but I have years of not attaining what "I'm capable" with lots of failures due to brain farts. I just don't know how consistent I'll be. I've talked alot here any words of wisdom? Any ADHDers out there? From previous job experiences, I've found the greater the crisis, the more focused I am like when I was a unit secretary in the 80's calming families down, answering call lights, dispatching requests, ordering stuff, finding charts for doctors, answering the phone, manning the fort. I even survived an abusive husband with my head up and values upheld on right behavior. I've been told I would make a good psych nurse by a floor nurse I used to work with and whom I respect. She said I have a calm voice and have a nack for talking to confused people. Psych nurse? I'd be stuck forever! Forgetting my nursing skills and what would happen if I wanted a change, nursing home? Heaven forbid! I start my psych rotation in three weeks. Any thoughts?

[littleICURN]

Go for it! If you want to be in ICU and have an opportunity to start there then do it. If you want it bad enough, then you'll find a way to make it happen. I am a new nurse in the ICU. I started straight out of nursing school. I also have been diagnosed with ADD. I was diagnosed in high school and put on ritalin. I stopped taking ritalin after high school. I did not want to feel dependent on a med to function. I admit life would be a lot easier if I had stayed on it. I am not normally an organized person as anyone who saw my house would agree with. I find that being in such a critical environment where you are constantly assessing and charting forces me to stay organized and i find i function better than if i did not have to be so attentive. I have found many disadvantages to starting out in critical care as a new nurse. Some are just the lack of basic nursing knowledge that you have to develope at the same time you are trying to learn about swans and and temp. pacers and other things used only in critical care. I admit it would have been easier had I developed my basic skills in med surg before trying to learn the more critical care skills. I have had to learn them together which has been a challenge. I still have times when i think maybe i took on too much too soon. I have an extremely supportive team of nurses working with me which has made this task of starting in critical care a little less frightening. You'll definitely need to work in an environment of supportive people. And as i said before, like you mentioned in your post, the more intense the situation, the more focused you have to be at all times. People with ADD and ADHD need to be forced to stay focused, the more focused we are, the better we can function.

Good luck with whatever you decide to do!

[wishingmary]

Thanks. Being in nursing school and just starting in the MICU has probably overwhelmed me a bit with the wealth of knowledge one must possess but I am a good student and Concerta really does help me focus; although just being diagnosed and already having one associate degree and a bunch of 3000 level courses with a GPA of 2.98 says I can focus anyway. The difference is the amount of time I have to put in. Over the next year, I'll probably get to know how I'll do on the medication so maybe I'll trust myself a bit more. Those around me are wonderful nurses. I think critical care is awesome. Got orientation tomorrow morning and I've got 3 chapters + 4 units of chapters in one course and I don't know how much for my other course that is suppose to be read by Monday. And I have to work all weekend

Got to go and thanks for replying. Do people really read all that in just a matter of days? Today was the first time we could buy our syllabi. Should I complain?