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ADHD and nursing school please help

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So I am a first year student in nursing school and prior to Nursing School I was a solid A/B student. I have been successful in college completing core classes and prerequesites with out a hitch, when I say with out a hitch I mean my learning disability has not been a hinderance. I've been sturggling on the tests and at times in clinical in staying on task and having my care plans not be pedantic or long winded. My grades on the exams have ranged from 78-70%. My clinical instructor pulled me aside and inquired if I had ever been tested for a learning disability, not knowing about my diagnosis. I want nothing more than to be a proficient nursing student not just skating by on C's and nerves. I am trying every tactic I know of to be successful; reading, NCLEX prep (relevant to test material), flash cards, listening to lectures on my Ipod, study groups.

My concerns and questions are these: Making it through nursing school with ADHD and avoiding taking medication for it? What else I could possibly do for studying purposes? Has anyone had a similar experience with a learning disability and coped succesfully? I was warned at my school not to disclose my diagnosis to any faculty for fear of being judged and veiwed as inferior/incompetent, now the cats out of the bag what can I do?

Please help, I dont care if it's just mere reassurance or a similar story. I have never felt more fufilled since being in nursing school it is heart breaking to think I can't do this.

IrishMurse

I'm sorry u have not gotten a reply....i dont know very much about ADHD and just wanted to offer words of encourgament...all u can do is work hard and do the best you can, if the medication helps u better then take it...but there is only so much u can do...have a lovely one and good luck in nursing school :)

I was just accepted into the nursing program for spring 2010 so I can't say too much on that yet. But I have adult ADHD. I struggled for years before I went to my doctor. I tried all the self help methods but had too many focusing problems. I would do fine in college without the meds but during tests it was hard to keep my focus. I decided to take meds for my ADHD and I've been a lot happier. It took me 10 years to get my AA (I now carry 110 credit hours) but that wasn't because of my ADHD, I have 4 children and a husband who is in the Navy. I don't intend on telling anyone about my condition but if they ask I'll tell. What I'm worried about the most is the drug test you have to take. I'm worried about popping positive because I take dexedrine. I'm not sure if I should bring my medical record with me when I go or what I'm supposed to do. I've worked hard to get where I am today dispite my ADHD and I'm proud of myself. It can be a struggle at times but you can do it. With the cat being out of the bag, hold your head high and don't worry about it. Good luck!

DolceVita, BSN, RN

Specializes in IMCU. Has 10 years experience.

I don't think faculty need to know. You can go to the disability resource advisor and they write up what your accommodations should be. No disclosure is made regarding diagnosis.

As for non-pharmacological measures...you should still consult someone qualified to give you more than anecdotal advice. Suggestions from those on allnurses is fine but not a replacement for a proper consultation.

Drug test results should only be transmitted pass/fail. My understanding is that if "something" comes up you will be asked for more information by the party doing the testing.

i have adhd and i am a non-traditional student.....my first year of nsg school i did fine, but when the testing environment changed the next year, i couldn't perform as well.....an instructor pulled me aside and said i should look into getting some accomodations, which i did, and life is much better now as far as testing.........the reason nsg school is hard for my brain is the sheer overload of material which takes me time to sort through mentally----once i get it, i got it, but i always have a zillion other things coming in besides nsg work too!

i go to a large school, and all instructors have been great......btw, they have to bc it's the law, but i think they would have been fine anyway.......

i dont see what the problem is telling people you have adhd! i take meds, but i am also very much me, and me has adhd!

i was warned at my school not to disclose my diagnosis to any faculty for fear of being judged and veiwed as inferior/incompetent, now the cats out of the bag what can i do?

what does that mean, that you were warned ? do you go to a school in america that receives any government funds?

DolceVita, BSN, RN

Specializes in IMCU. Has 10 years experience.

staeces makes a good point

Still it really isn't their business. I don't know enough about it but is their any extra safety risk during clinical? That might be the ONLY reason they need know.

Who in the world would tell someone not to get help if help is available!

Go to your MD get documentation give this to your school's disability resource department /advisor. You will be allowed accomodations. My advisor was a source of great emotional support through school.

Nursing school is tough and a C grade won't cut it in nursing school.

I used extended testing time in the testing center. The testing center was quiet with minimal distractions.

I did hand my instructors accomodation documentation at the beginning of each semester. This paperwork does not list the diagnosis.

I did not always use these resources but it is a good idea to have this option if needed. All of the instructors respected my needs - yup it is the law.

Some instructors were resistant (more so because they saw it as a hassle) I found that if I had suggestions and information as how to accomodate my needs they came around.

There are so many judgemental people out there - don't let them or concerns about being judged stop you...easier said than done - I know

Good Luck!

Yes and accredited by the AACN, it is a public community college

llg, PhD, RN

Specializes in Nursing Professional Development. Has 44 years experience.

Who told you not to tell the faculty? Was it a school official?

Thanks for the support my last exam I got an 86, things are improving.

:wink2: Thanks for breaking the ice!

Who told you not to tell the faculty? Was it a school official?

Yes the director of the Learing Resource Center and a few other Faculty members outside of nursing. My school reputation is that of great rigor and at times arbitrary scrutinization. My logic is this; telling a medical professional ( Clinical Instructor) you have a disability synomous with disorginization or lack of attention you put a bug in thier ear and thats something that might start looking for and project onto you. It seems to be a common flaw in stressful situations. The instructors job is not only to teach us but to deem us competent to have a person's well being rest in our hands as students.

SheaTab

Specializes in RN Education, OB, ED, Administration. Has 6 years experience.

This is a great discussion! I am so glad you opened up some much needed dialogue about ADHD. There are a number of misconceptions about this disorder. I STRONGLY recommend that you purchase the book: Driven To Distraction : Recognizing and Coping with Attention Deficit Disorder from Childhood Through Adulthood; Hallowell. This book has really helped me to understand a lot of the issues that I've had as a student and in my personal life.

I was untreated up until recently and school was always a significant challenge. Since treatment, it has literally been like having a light switch flipped on in terms of my ability to comprehend and retain complex material. I remember struggling to a debilitating degree with reading and found myself self-medicating with another stimulant -- Caffeine. It worked well, actually. Are you being treated?

So, as an aside, I was a 4.0 nursing student all the way through my ADN, BSN, and MSN (except for one graduate-level nursing theory course)! I figured out how to learn in spite of my excessive distractibility and you can do the same. I'd love to give you some advice if I may. This strongly applies to all nursing students as well.

1. Always read for comprehension!! At the end of each paragraph you read, stop, cover your book and explain aloud/silently what you just read. If you can't, go back and reread. If you can't explain it, you probably don't really get it. Yes, this takes a lot of additional study time, but studying this way is worth its weight in gold. The time you do spend reading infinitely more productive. And, you have an obligation to your patients to really understand the pathophysiologic basis of all the nursing care you give.

2. Always read the chapters. You may distract more easily in class and will get less out of lectures than some of your peers. With this in mind, lecture only hits the highlights and there is SO MUCH MORE to know than the highlights. Also, you will have an easier time picking up on the important points during lecture if you have pre-read the chapters.

3. Remember, no cell is an island. One thing goes awry and the other systems will likely be affected. Understand the pathophysiology and you will have infinitely less to memorize! Here is an example I gave one of my students:

"Remember the examples I helped you work through with regard to the negative feedback mechanism of TSH & T3/T4. Also, how about the one where we talked about Aldosterone and the effects on the BP? This was an essential concept that all of you should have grasped from the renal lecture and also in fluid & electrolytes. Remember, if you can’t explain it, then you probably don’t really get it. Also, what happens when your patient asks you about their condition? I know you don’t want to be one of those nurses who tells them to wait until their physician rounds in the morning or one who gives the wrong information. The problem with memorizing is that you will do your best to get it for the test and then when it comes up in another system, you have no idea how to apply it. Remember, that any broken body system will have effects on all the others. Answering questions and taking care of these complex patients requires you to apply not just endo patients but also cardiac, renal, neuro,, pulmonary, etc. because one problem will affect other systems. Does that make sense? Take Hyperaldosteronism, for example. You have to understand that the aldosterone will cause you to retain sodium and excrete potassium. Now, if you don’t understand how this hormone is activated, you might get confused and think that this is just an endo problem. Aldosterone can be activated by anything that affects blood flow to the kidneys. So, consider the patient who is bleeding to death and has low flow to the kidneys. This will activate renin (needs conversion help from angiotensinogen from the liver!), then angiotensin I (AT I) (which requires angiotensin converting enzyme from the LUNGS & Kidneys) to convert to angiotensin II (AT II) which will ultimately result in renal tubular reabsorption of sodium, chloride, water and elimination of potassium. It will also activate Aldosterone which will also result in renal tubular reabsorption of sodium, chloride, water and elimination of potassium! Guess what else AT II does? It causes arterial constriction and stimulation of Antidiuretic Hormone (ADH) release from the posterior pituitary. This will result in increased BP from water reabsorption in the kidneys. All of these things result in increased blood flow to the kidneys which is why this started in the first place! In the case of hemorrhage, Aldosterone will help matters by causing sodium reabsorption, water will follow the sodium and result in increased blood volume! This is a good thing in this case. Imagine however that the kidneys were receiving low blood flow because the pump (heart) is diseased and not working properly as is the case with heart failure. This will also cause activation of RAAS cascade will further exacerbate the problem by causing increased fluid retention. Also, consider that AT II causes vasoconstriction (increased systemic vascular resistance) which will make the heart work harder to pump through constricted vessels. Aldosterone can cause potassium depletion which will put this patient at risk for a host of other problems related to hypokalemia. How about the patient who has diabetes and thus arteriosclerosis and thickening of the basement membrane of the renal vessels. Their kidneys will perceive that there is a low-output state and activate Renin Angiotensin Angiotensin II Aldosterone. Do these patients need increased blood volume? Not usually, but they will get it and it can have a devastating effect on the body. You will often see these patients on an Ace inhibitor because of this. Make sense? Aldosterone can also be activated by elevated levels of potassium which makes sense now that you understand the system. Activation will result in dumping of the potassium. Dig?

Understanding the effects of Aldosterone, will also help you understand how and why ACE inhibitors work. They prevent the conversion of Angiotensin I to Angiotensin II which will result in preventing the stimulation of the adrenal cortex which will release aldosterone. You can also see then how Angiotensin Receptor Blockers (ARBs) and Renin Blockers (RBs) work to help patients with hypertension. They ultimately prevent the release of Aldosterone!  Anything that results in increased circulating blood volume will raise the BP. Sometimes this is a good thing, like in the case that you are severely dehydrated or hemorrhaging. It can be a terrible thing for the patient who has heart failure, is already hypertensive, or who is in renal failure!"

Do you see how understanding a very important "little" thing like the function of aldosterone helps you to grasp endo, cardiac, and renal issues?

4. Sit at the front of the class during lecture and tests. This will help with distractibility. Also, wear ear plugs during tests. No exceptions.

5. Read up on the stress response as well. Understanding cortisol will help you immensely in terms of anticipating the effects of nearly every disease process and its effects on the body. Additionally, psychological stressors have the same effect!

I'm proud of you for coming forward and talking about your ADHD. You have nothing to be ashamed of. This is a very real condition that improves dramatically with treatment and lifestyle modifications. Many nurses and doctors have ADHD and thrive very well in the profession. Many also choose high-intensity areas like Emergency Medicine/Nursing because the environment is very stimulating. No shame! We are humans just like our patients; and as such, we will experience alterations in our physical and mental health from time-to-time.

Keep Rocking!

Tabitha

ashleyisawesome, BSN, RN

Specializes in LDRP.

my clinical instructor is a clinical psych mental health specialist, so she picked up that i had ADD right away. she asked me about it and i admitted that i used to take aderall, but its adverse effects outweigh the benefits for me and i prefer not to take medications..

well ever since then, i feel as though i have become the joke of our clinical group. shes constantly making jokes about me and my ADD, and its embarassing... she even critiques my papers in front of the whole group and says things like "we can clearly see Ashley's ADD shining through here, she starts out great and then takes a sharp left turn and i dont know what shes talking about!" then everyone laughs.. except me..

SheaTab

Specializes in RN Education, OB, ED, Administration. Has 6 years experience.

my clinical instructor is a clinical psych mental health specialist, so she picked up that i had ADD right away. she asked me about it and i admitted that i used to take aderall, but its adverse effects outweigh the benefits for me and i prefer not to take medications..

well ever since then, i feel as though i have become the joke of our clinical group. shes constantly making jokes about me and my ADD, and its embarassing... she even critiques my papers in front of the whole group and says things like "we can clearly see Ashley's ADD shining through here, she starts out great and then takes a sharp left turn and i dont know what shes talking about!" then everyone laughs.. except me..

Houston, we have a problem!

Ashley, I am horrified that you have felt made fun of and publicly critiqued. This is absolutely unacceptable in my estimation. I'd like to make a suggestion to you, if I may.

I'd suggest that you request a formal meeting with this instructor during non-class/clinical time. This will provide for limited distractions and also indicate to her that you care strongly about your concerns. You might have a conversation that goes something like this ...

"Dr./Ms. Doe, I wanted to discuss something with you that has concerned me with regard to my mental health clinical experience. There have been a few times when my diagnosis was referenced publicly that have resulted in a great deal of embarrassment to me. I am hoping that we can talk about this and perhaps come to a better understanding."

Just like our vulnerable patients, students are also very vulnerable. Ashley, try to stick to "I" statements to keep the conversation heading in a productive direction. Try to organize your thoughts beforehand and make sure you are able to give a few examples of specific incidences where these things have occurred. You don't want to attack your instructor, but you are actually doing her a favor by letting her know how inappropriate her actions are. She might easily make this mistake again. Also, there might be a possibility that you have laughed along with the group at times which may have resulted in her and the class thinking it doesn't bother you much. I can easily see how this might happen as a way to protect yourself from feeling made fun of. You know the old saying, "I'm not laughing at you, I'm laughing with you." Or, "if you can't beat them, join them?" Certainly a nursing student wouldn't try "beating" her professor, so it is better to join in the fun, even if it is aimed at you. Hopefully, just by telling her that your feelings have been hurt will result in a heartfelt apology. I suspect they will. However, if that isn't her response, I'd suggest you take your concerns to your course coordinator and then follow the command all the way up. Be kind, informed, and assertive. Your health history is not up for public discussion unless you choose to make it so. Even if you have discussed your diagnosis among your peers and instructors, you may reserve the right to take it off the table as available to discuss in the future. If this has something to do with it, then perhaps you simply need to tell the instructor that moving forward, you'd prefer it if your diagnosis not be discussed publicly.

Please let me know if I can help.

Keep Rocking!

Tabitha