ADHD, Anxiety and PTSD

[midnightlpn]

Hello, this is my first time posting. Figured it would be beneficial to see how others nurses with mental issues cope at work and home. I've been a LPN for 3 years now. Before becoming a nurse I was a PCT/CNA for 5 years. Recently, I was diagnosed with ADHD, anxiety disorder and PTSD. No, I am not military. I am a spouse of a veteran. I have 5 kids ages 1-14. My husband stays home with the kids. I took a night position at a rehab facility in July. I have the most acute set of patients in the facility, most are not too stable when the hospital discharges them to our unit. Since I've started I feel inadequate. I complete my work, help my team of nurses and aides, and thought I was doing a good job. But lately management has been getting on me about just about everything. I have no patient complaints, no med errors, or write ups. Average day I have 22-24 patients, post surgical, IV/PICCs on 4 patients, 2 PEGS, 6-8 accuchecks. I do treatments at night, order labs, and also responsible for 24 hour chart checks. Whatever orders or charting day shift did not complete I am responsible for. Well, if I stay past my shift to complete charts I get in trouble, then if I leave on time and leave day shift to follow up it doesn't get done and I still get it trouble. We have paper mars/tars and charts. Labs orders are handwritten. It's extremely difficult to manage the post surgical/subacute patients and complete all my charting but I get it done. Well, two weeks ago my unit manager stayed overnight with me to supposedly give me more training but instead I got monitored like a incompetent nurse the whole shift. She didn't offer any recommendations or assistance just watched me. At the end of the shift she said I performed flawlessly. So to me their issue is with their own insufficencies. I got in trouble once for picking up needed supplies from central supply because they were not stocking our unit. Some days day shift gets 6 admits and when I come in a lot of the admission paperwork isn't complete which adds to my load of tasks. I continue to show up, always smiling and positive and being the best team player I can be. Always the last to leave and get teased about it. Supervisors stand around and joke while I struggling to finish not only my work, but work other nurses failed to follow up on. I feel discouraged alienated. Am I being unreasonable or are their expectations unreasonable? I know I have ADHD and anxiety but overall it is well managed with therapy and meds. I just feel inadequate.I'm so tired when I get home I feel absent with the family. Any suggestions?

[cateye112]

Hi Midnightlpn,

First, they are likely giving you more work than should be allowed as that has become the norm in nursing these days, unfortunately.

As an RN with ADHD, I can relate. For the first several months I was attempting to do my job without my medication for ADHD and I too would feel inept/get in trouble for staying late to get the mandated work finished. In my case, my preceptor had been overcontrolling with her last newbie (who then greatly struggled on her own), therefore went to the complete opposite end of the spectrum and pretty much left me to fend for myself.

After getting back on my properly dosed medication and getting some prioritizing advice from a helpful co-worker things finally fell into place.

To make a long story short, my suggestions are to ask co-workers what works for them. Find someone that you can trust and that does a great job. Also, make sure you are well prepared before the start of your shift and have a routine, we thrive in that. Lastly, make sure that your medications are working properly. If you don't feel like they are talk to your doctor.

Also, has something changed recently that you are suddenly having problems? You are 3 years in right? So why now? Just something to consider.

I hope all gets better for you soon.

[midnightlpn]

Thanks for the reply and suggestions. Nothing has really changed, I guess this is the first time I have worked somewhere that was so inefficient in their processes. I find myself frequently trying to reinvent ways of doing things so that productivity increases. My meds seem to be working well and I'm still going to therapy on a regular basis. I think I just need to be more confident in my skills and ideas and learn to be more assertive . Using a brain sheet helps a lot because I canchek off tasks as they are completed and hopefully not get fixated on all the distractions.