I'm Making Horrible Mistakes At The Bedside, Help

Advice Column

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Feeling Like An Imposter

Dear Nurse Beth,

I have ADHD and have been an RN for 24 yrs. I have worked in practically every aspect of nursing, trying to find a niche where I actually like a job, Drs and nurses I relate to, and feel competent.

I have never felt like I belong (like a nurse imposter), and have struggled with things that most nurses don't even give mind to.

Recently my symptoms have become so severe that I am unable to multitask, prioritize and manage time.

I'm making horrible mistakes at the bedside and desperately need to find a job where I can function safely and not dread every single workday. Yes, I've had therapy and medication, but it is clear that my place at the bedside is over. My strengths are more qualitative in nature, not task-oriented or quantitative.

I'm great with relating to and helping people, communication and analysis. I don't want to give up on nursing, but I don't know where to go from here. Any advice would be much appreciated.

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Nurse Beth, MSN

159 Articles; 2,855 Posts

Specializes in Tele, ICU, Staff Development, Freelance Writer. Has 30 years experience.

Dear Desperate,

You say you have been treated for your ADHD, does that mean in the past?  I hope you and your provider are working together to get on top of your symptoms. Sometimes medications lose their efficacy. 

Is it possible for you to take a break, maybe a medical leave of absence?

Bedside nursing is very stressful, especially with the high patient loads that are so prevalent.

Having one patient at a time helps to reduce multitasking. Which is better described as cognitive stacking 🙂  IMHO.

With your communication and people skills, consider:

  • hospice
  • private duty nursing (although jobs are few for RNs)
  • home health
  • IV infusion

These are all a potentially good fit for you.

Analytic skills are good for:

  • documentation specialist
  • infection prevention
  • quality
  • case management
  • legal nurse consultant

Register on Indeed.com or other Job Search site and you will see a large variety of jobs for RNs. This will help stimulate your mind and broaden your search.

I hope your health improves and you find another job soon.

Best wishes,

Nurse Beth 

NRSKarenRN, BSN, RN

11 Articles; 17,563 Posts

Specializes in Vents, Telemetry, Home Care, Home infusion. Has 46 years experience.

My colleagues have offered great advice.  I suggest contacting your employers Employee Assistance Program for advice and support before throwing in the towel and leaving current position.  Having outside ears can offer you advice regarding work situation along with employers policies regarding FMLA benefits, medical leave, short term counseling for anxiety/depression/ADHD etc; some offer career counseling even retirement planning. 

Since I've done Hospice, Private Duty (often pediatric patients as a covered by Medicaid), Home Health and IV Infusion --provide one on one care opportunities with decreased stress compared to hospital nursing. Wishing you success in landing best position. 

JKL33

6,469 Posts

Consider visiting your PCP and kind of review/start from the beginning. For example, there could be other conditions impacting your performance besides or in addition to ADHD. Specifically anxiety comes to mind but there are other medical and psychiatric conditions that could contribute. BTW, I'm not trying to imply that you don't know yourself or your own struggles, just that sometimes it is worth re-analyzing old premises.

I would add Community Health to the above list.

Good luck ~

Peachpit

128 Posts

Has 33 years experience.

I have struggled with depression and anxiety for decades. I understand completely what the OP is saying about feeling like am imposter, not finding the nursing niche so many do.

I left bedside about 5 yrs ago. The stress is better but the lack of belonging persists and I have just accepted that with the mental health issues I have had virtually all my life, that is just how its going to be for me but I am still an effective and productive nurse - even if my job isn't bedside nursing. 

Wishing you the best OP. 

nursel56

7,046 Posts

Specializes in Peds/outpatient FP,derm,allergy/private duty. Has 47 years experience.

Excellent advice so far!

I've been through all of that before.  It sounds like there is a certain level of grief associated with a decision like this, despite how we know it's the right thing to do.

I went from high stress hospital to clinic nursing, which alleviated my anxiety in the sense that you are required to multi-task, but I didn't wake up in the middle of the night thinking about things I may have missed because my memory of the shift was a blur.

I would just mention another very important factor for me was the supportiveness or lack thereof from managers and co-workers.  I was very fortunate (mostly) in that regard.  I was really struggling with panic attacks over assisting with minor surgeries at one point.  I decided to disclose that, and my team leader and MD boss were like why didn't you tell us sooner? Just let us know and you can switch with another nurse.  Fortunately things got better but I'll never forget their kindness.

mdsRN2005

23 Posts

You've already gotten several great suggestions but I'd like to add a couple more.  Occupational health is an option that provides patient interaction but less patient acuity and technical skills.  Also you might look into remote work from home options. This could vary from remote triage to telehealth or case management.  Good luck!  

Nurse Beth, MSN

159 Articles; 2,855 Posts

Specializes in Tele, ICU, Staff Development, Freelance Writer. Has 30 years experience.
NRSKarenRN said:

My colleagues have offered great advice.  I suggest contacting your employers Employee Assistance Program for advice and support before throwing in the towel and leaving current position.  Having outside ears can offer you advice regarding work situation along with employers policies regarding FMLA benefits, medical leave, short term counseling for anxiety/depression/ADHD etc; some offer career counseling even retirement planning. 

Since I've done Hospice, Private Duty (often pediatric patients as a covered by Medicaid), Home Health and IV Infusion --provide one on one care opportunities with decreased stress compared to hospital nursing. Wishing you success in landing best position. 

Thank you, @NRSKarenRN, for the excellent and helpful advice.