New Grad RN with ADD - very difficult to manage multiple patients

[Lemon Bars]

I could use some advice from both newer and experienced nurses, please.

I just graduated from a BSN program. I have not taken the NCLEX-RN yet and I do not have my license or a nursing job yet. Based on my clinical rotations in school, and on other life experiences, I have some serious doubts about my ability to manage four or five patients at a time, such as on a typical hospital floor. In addition to being inexperienced, I think part of the issue is that I have non-hyperactive Attention Deficit Disorder. Multi-tasking, interruptions, working in loud or distracting environments is nearly impossible for me, even when I take my ADD medication and try my hardest to focus. It so bad that during nursing classes I often had to step out into the hallway to do in-class assignments due to the distraction of multiple conversations going on around me in the classroom.

There are many aspects of nursing that I do well in, such as patient education, thorough assessments and overall bedside manner. I'd like to find my niche in nursing right away, without going through the pain of being fired from a hospital for being too slow. Do I absolutely need a year or two of med-surg hospital experience before I can be hired into areas of the hospital that aren't so hectic? Or before I can be hired to do home health? Is home health a viable starting point for a new grad RN? Are there any new grad clinical residencies in home health?

Thanks so much for any help!

[NurseCard, ADN]

Home health really is great for a nurse who needs a quiet environment;

however I would never recommend intermittent HH to a brand new

nurse. That is, going to see 5-6 patients a day who are fresh out of the

hospital. It's a stressful as heck job that requires very keen assessment

skills and experience. I think. :)

PRIVATE DUTY may be an option. You are with one patient for 12 hours.

Some assignments are fairly complicated medically, some are not.

As far as an in-hospital job... maybe a small psych unit within the hospital?

No, you don't HAVE to have med surge experience, though it's

generally recommended for everyone. Some people never

work med surge and go on to long and illustrious careers.

[SmilingBluEyes]

I have ADHD, bad. No meds. Behavior modification and organization are all I have in my toolbox. I have learned to live with this, and even at times, it's helped me because even as old as I am getting, I still can keep up with 20-something nurses/techs; I am still a ball of energy at this age, a benefit to ADHD that works in my favor.

Write everything down. Have a "brain sheet" whereby you write down important things like vital signs, changes in patient condition, NPO status, IV status/how much is left to infuse, procedures scheduled and what times, and the like. I found that helpful.

I am a nurse manager now, and it's become even more critical I write things down. I keep a handy old fashioned calendar/appointment book in my computer bag. It's my bible. I write down anything I need to address with employees (not using names in case it's found) and important meetings, care plan interdisciplinary meetings, out of town trips, the many Skype calls I have to attend, monthly chart audits and reports due to administration, and deadlines for quality meetings with the Medical Director. I have a system and yes, I get myriad interruptions in my day, so having things in writing helps.

I use my email calendar for important meetings/events/ online learning due, etc and it reminds me in any variation of time from 15 minutes, to 1 hour---- or a day---- that something is coming up. When on the floor, I am there in the early morning for the initiation of 16 patients' treatments. I am the only nurse in the building for 4 hours. I have learned to have meds and supplements ready to go in advance of my patients coming in. I have a system that works and stay on top of things as they come up. Again, many interruptions threaten to throw me off. I use a brain sheet to write down important things like new medications, new admissions, changes in scheduling, etc so I can get back to what I need to do when I am ready.

Organization is so important in nursing. Anticipating what "may" come up, critical.

But if my hare-brained, perimenopausal-fogged ADHD self can do it, and I have for 21 years, you can do it too! You can overcome this and be a phenomenal nurse. ADD/ADHD will only limit your performance if you consider them a disability. I consider it a super-ability. Changing my thoughts about it has changed my attitude and I cope well.

[Serhilda, ADN, RN]

New grad here with ADHD. I'm not on any medications, never was in nursing school either. So far my plan is to write down as much as I can throughout my day (as the previous poster mentioned) and switch to night shift after orientation. I've heard there are fewer distractions on night shift with fewer calls, no family members to deal with, and fewer procedures. I felt like getting hospital experience prior to grad school was the right choice for me and may keep my options open for any other goals I may set in the future. You don't necessarily have to of course, but I do feel like it provides a good general foundation of nursing knowledge.

[Koalified]

Private duty is not hectic and may be a good fit. It's one to one. These jobs are usually through home health agencies. You could also look into Acute rehab (not nursing home). These pts tend to be less acute and stay longer in the facility so you get to know them better. The ratio isn't horrible either...maybe anywhere from 5 to 8 pts depending on shifts. I also think ICU could be a good fit. Although the pts are very sick and medically complex you only have 2 pts that you need to focus on. Many hospitals hire new grads into ICUs. They like fresh meat 😊. Good luck and whatever you choose, hang in there. Being a new grad isn't easy but we all went through it and survived.