New Graduate- ADHD and working as a nurse

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 Hi guys! 

So- I'm a new nurse working on a Med/Surg unit with newly diagnosed ADHD (combined). I'm on meds, and I really like my job. My preceptor is really nice, but I still get feedback to focus more and avoid moving on to other task in the middle of one. 

That being said- I've only been there for 7 days! I know that I will improve, but I wanted to ask for some tips to help. I made my own nurse's brain, which helps with report but here are some issues I'm personally having-

1) Notes, notes, notes! Reading doctor notes and finding the most important information, since there's so much to read, who should I look for, what should look for, what is most important? This goes for looking at the patient's chart in general. After getting report, I normally do my progress note, look at notes from doctors and any recent labs and my meds. Is there anything else that would be important? 

2)  Forgetfulness and working memory- I understand that that's just apart of having this condition, but sometimes I catch myself being a bit forgetful when being asked a question about a patient, but then remember the answer later. 

I know that some of these things will take time, and I've already learned so much at work. I know medication will not solve everything- so I just would appreciate some tips ?

Thank you!

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Specializes in GI/ENT/Urology post-op.

Hello! I'm a fellow nurse with ADHD, but I just started my first job in September so I'm still figuring these things out myself. I got a lot of the same feedback during orientation - finishing one task before moving onto another, etc. Here are some little things that help me during start of shift setup:

1. I arrive EARLY, about 6:20 ideally! My things have to all be in their correct pockets for me to feel in control of my day, and I get as much of my mental setup as I can done before report - usually, at least on my unit, assignments are finished by about 6:40, and I take full advantage of that. I expect that as I move through my first year I'll need less setup time, but right now it's essential.

2. Looking up patients. I take a quick glance through all the vitals, orders, most recent labs. I then do a slightly deeper dive on each patient starting with the most recent resident/fellow's progress note and take my notes, starting with the least stable seeming patient. I try to do the quick glance through before report and then the deeper dive and note taking after.

3. Making full use of tools available. We're on Epic, and there's a "Brain" screen that shows everything due for your patients each hour, from incentive spirometry to meds to pain reassessments, and also allows you to add "to do" items. There's also a "work list" screen for each patient listing all med and task due times. I print the work lists and update them throughout the shift. I bring them with me when I pull meds - I check off meds as I pull them, and cross them off when they're given. These tools really help avoid feeling "scattered".

4. SLOW DOWN. I still struggle with this daily. Realize when you're feeling scattered and frazzled and take a pause for a deep breath. The due time for your patient's eyedrops will never be as important as their safety. Don't skip steps if you can possibly help it - stick to your process once you find it.

All these things are very much works in progress for me and still a daily struggle! I'd be interested in sharing notes as we both move forward through this year of firehose learning.

::Edit:: I forgot! I've recently started charting my assessments in the room right after doing them, when time pressures allow. It eliminates the need to take extra notes/ hold my findings in my very fallible working memory, and it also eliminates a big documentation task from my to do list later in the shift. Plus, if I missed something in my assessment, then I'm still in there chatting with my patient when I discover it and don't have to make an extra trip to the room. It's not always possible but when it is, even just for some of my patients (especially the most complex), it's really helpful

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