Nurses with ADD/ADHD?

acornp37 · Sep 13, 2011

This is my first semester into the nursing program! I'm excited, but at the same time really nervous... but who wouldn't be? There's a lot of material to cover and I'm a little in over my head about the amount of reading that's assigned and how am I ever going to remember all the procedures/ skills for clinicals?

But going back to the point of this thread (oh the irony!)... I've been diagnosed with ADD since I was 7 years old. I took Ritalin in elementary school and part of middle school. When high school rolled around, I stopped taking the medicine. I managed to be a part of my school's National Honor Society and also graduated top 10% of my class, but now that I am in college things changed after freshman year... boy was that a wake up call! My parents and I decided that I should get re-tested... and so my physician referred me to a neuropsychologist and did the whole 15 hour test and turned out that maybe meds. would help! It might just be the different learning environment or the fact that I had more "freedom" but eventually after changing my major I chose nursing. I have to take my tests in complete silence and now that most schools take their tests on a computer I won't be able to concentrate with all the tapping (maybe? I haven't taken a test in a room full of other people tapping away, but didn't want to risk it so I've been taking my tests in a quite room). I want to be an ACNP for various reasons. I like the more autonomy the NP position holds and in the future if I ever want to do research/ teach I can. I also like how it's not just conformed to a specific type of patients... it's more diverse. I'll have to work in an ICU or ER after getting my BSN and passing the NCLEX to be completely sure that I can handle those type of scenarios... but my question for you all is, is having ADD going to impact my job as a future NP? I'm not the kind of person to just do a task and then say "oh look there's a bird"... I think that when I'm focused I stay on track for the most part... not talking about studying because for that I have to be in a really quiet environment/ headphones/ and my medicine. It's more in the social context that that other side may appear more but not too often. I'm sure the "other side" could tell me that if you have to test in a quiet room how can you perform nursing duties when there's all sorts of noise going on? My answer to that is that that's a totally different scenario. The tests are part of a learning curriculum and for me to do well and succeed I have to be in quiet environment but when it comes to reality and working I think I can handle that. I think my ADD is more related to academia. Any suggestions, words from experience, advice, arguments, or opinions?

Robynruns · Sep 28, 2011

I am still in my first year of nursing and was just Dx ADD- taking Vyvanse, after my son was dx. I sat thru the sessions and related to everything the doctor spoke of. I struggled thru HS, quit Business school- due to boredom, went to FIT for Fashion design because it was hands on and I stood all day. My family needed me to recreate myself and found nursing. I struggled thru school. I would always fall asleep, while reading, during lectures. It was the worst. It took me so much more time than everyone else. I taped the lectures and listened to them while I did other things.... I made it thru. Now I struggle with remembering things. I am getting in trouble at work for overtime. Things take me longer than the other nurses. My coworkers say you are just thorough. My bosses only see the bottom line. I have to somehow speed it up. But I worry about being unsafe. I have never been worried for my job security before. I was always a hard worker and star. This is very upsetting. Any suggestions? BTW. I work in LTC, med pass nurse. The med seems to be making a difference. I am up to 40mg. Thinking that is my max.

Just taking it one day at a time.

SarahSez · Nov 8, 2011

Hi! I am so glad you started this thread, and I think that there should be a web site DEVOTED to nurses with A.D.H.D.!

So, I was diagnosed back when it was A.D.D. or A.D.H.D. I was diagnosed and put on medication when I was younger, like in 4th or 5th grade I think. Back then, I used Ritalin, then Adderal until middle school when I decided I was tired of being treated like a freak and that something was wrong with me and taking medication was my punishment. So, this is something I've dealt with for a LONG time.

I have compensated for all that time in between with massive amounts of caffeine, and nicotine, and settling on never feeling like I could do anything right. As a result, I still deal with some issues of insecurity, low self esteem, anxiety, and bouts of depression.

Nursing school REALLY brought to my attention that, while I have successfully managed my A.D.D. symptoms well enough to get into a nursing program, there was still room for improvement in a BIG WAY. So, finally I broke down and got back on medication after being tired of feeling inadequate as my fellow nursing students could cover 4X more material than I could in the same amount of time, and that I was always feeling rushed and frustrated in clinicals.

I am now on Vyvanse, and I love it! It lasts me all shift long and gradually wears off.

ANYWAY, my first job as a nurse was in long term care, and even that took some time to get used to organization of tasks and times, but what helped me was a good one page cheat sheet to tell me at a glance, what tasks I needed to complete for the day beyond the normal times and tasks, and check them off as I went. This worked fairly well to complete the tasks but I was still working on creating the time to do proper charting.

I just started my first hospital staff nurse job a few weeks ago, and I love the pace, all the new things to learn, and really putting myself to the test r/t critical thinking.

The system I used in long term care is not applicable in this new situation, because there are few real "norms" as far as planning my day and tasks is concerned because things can change on the drop of a hat! I am having a hard time finding a new system to organize myself, and time management is still a big issue. Everything takes more time than anticipated (especially since I am just learning where things are, proper contacts for each specific problem, learning computer charting and what is in my scope of practice at the hospital vs. long term care scope of care, and balancing the time it takes to provide the skillful care and unexpected time for patient education.) I also tend to get over whelmed when I do not succeed at a task, such as drawing blood or placing an I.V. cath, which ends up adding more minor tension through out the day.

Have any other A.D.D. nurses had this problem when changing nursing specialties? Hints, tips?

SarahSez · Nov 8, 2011

Blue Lou! I know your post was a while ago (years!) I really hope you found the swing of things and didn't give up on nursing completely! I think we as A.D.D.ers are unique and indispensable to the field of nursing, because we bring a very human, empathetic quality, and energy to the group.

There are a few magazines out that cater to A.D.H.D. issues, and one blurb caught my attention and really made me feel better about my choice to get into nursing. They listed the top 10 jobs for people w/ ADD, and guess what? Nursing was number 1 or 2! Because we like the pressure, the multiple facets and roles we need to take on in a single day, being on our feet and in movement all shift, and using the asset that sometimes feels like a curse, of our brains running a million miles a second. That's my theory anyway. I think the way our minds work is like a brand new super hero, just learning how to use their powers! Haha! I think the management of it on the job just involves a lot of conscious self-talk, and sometimes FORCING yourself to STOP. BREATH. Then RE-PRIORITIZE. The self talk we need to say to ourselves, take a breath, take one thing at a time, what's most important RIGHT NOW, I AM a good nurse, I AM smart, I CAN HANDLE THIS. Also, not being afraid to look stupid and asking for the help we need, and the questions we need to ask. Nobody is perfect, in fact everyone is IMPERFECT in their own ways, right? :) I hope everything worked out for you.

Also, Anyone who is having trouble with their ritalin or adderal doses feeling adequate over time, I believe it is a tolerance thing for sure. I never liked either drug because it felt like it grabbed hold of me when it started working, and i did NOT feel like myself. I felt trapped in my body on that junk! I love my new medication, Vyvanse, but unfortunately its not covered by most insurance yet and there is no generic for it. But even on the lowest dose, I feel it gradually give me the mental boost and alertness I need, and then gradually wear off as the day progresses. I still feel like my self, just sharper.

And never be fooled that medication alone is the answer to our problems! The medication is a great first step to show us the tip of the ice burg of what we are capable of, but organization skills, both physical and mental, are the core of our problems, and nothing can fix that but hard work and consistent practice of things that work for each of us as individuals. Happy journey and please, share things that work for you with the rest of us!

etaoinshrdluRN · Nov 14, 2011

The system I used in long term care is not applicable in this new situation, because there are few real "norms" as far as planning my day and tasks is concerned because things can change on the drop of a hat! I am having a hard time finding a new system to organize myself, and time management is still a big issue. Everything takes more time than anticipated (especially since I am just learning where things are, proper contacts for each specific problem, learning computer charting and what is in my scope of practice at the hospital vs. long term care scope of care, and balancing the time it takes to provide the skillful care and unexpected time for patient education.) I also tend to get over whelmed when I do not succeed at a task, such as drawing blood or placing an I.V. cath, which ends up adding more minor tension through out the day.
Have any other A.D.D. nurses had this problem when changing nursing specialties? Hints, tips?

I went from LTC to acute care. Found myself faced with much of what you seem to be faced with. A couple things helped in my case:

1) got a diagnosis and stimulant meds, because there was a "ditz" factor that scared me, when I would do something careless, despite efforts. Meds really helped me focus, as well as tune out interpersonal chit-chat that tended to distract me from my job

2) approached unit nurse educator for specific time management tips. She spent 3 shifts with me, came up with more suggestions and lots of encouragement

3) Learned to delegate as needed.

4) Made it a point to learn and know what resources were available to me. After being the sole nurse in the LTC facility to being one of hundreds in a large hospital, it required effort to identify what I could and should do, and what could and should be farmed out to the team. Diabetes education, for example, which is so comprehensive it could take all day, even with a motivated patient.

5) Really internalizing the difference between a charge nurse LTC role and that of a staff RN in acute care. ADHD people are often great at getting the big picture and properly advocating for patients. In LTC, that role is so much more limited. Task-orientation should not obscure the big picture, or patient advocacy.

HTH

LV08 · Nov 23, 2011

Hello everyone. :) I was looking up nurses with ADD and I ame across this post. I am pleases to say I feel better reading this. I am not a nurse yet,but I am in my first quarter of school. I am having a really hard time. I was classified when I was really young. I took meds through high school. Now I am 30 and the symptoms are so bad. I feel like I did when I was first diagnosed. Can't complete tasks,can't sit still,can't manage time at all! Its very frustrating. I have been crying and angry. From there depressed,anxious,hopeless. Wondering if this was the right choice for me. it took me so long to realize its my ADD thats keeping me from doing better. I came to fhe conclusion I need to get a re eval and go back on meds. But I dont have insurance and I don't have a job. My family is nice enough to help me out. Does anyome have suggestions about a good doc in Bergen County,NJ area? I think I might need a coach for dealing with the time management and other issues. I cant stop crying over thisbc I am fearful of failing this quarter. I know its not bc of me being lazy or not studying... any suggestions???? Thanks it would be so much appreciated if anyone answers. :)

erinberrin, CNA · Nov 23, 2011

I went from LTC to acute care. Found myself faced with much of what you seem to be faced with. A couple things helped in my case:
1) got a diagnosis and stimulant meds, because there was a "ditz" factor that scared me, when I would do something careless, despite efforts. Meds really helped me focus, as well as tune out interpersonal chit-chat that tended to distract me from my job
2) approached unit nurse educator for specific time management tips. She spent 3 shifts with me, came up with more suggestions and lots of encouragement
3) Learned to delegate as needed.
4) Made it a point to learn and know what resources were available to me. After being the sole nurse in the LTC facility to being one of hundreds in a large hospital, it required effort to identify what I could and should do, and what could and should be farmed out to the team. Diabetes education, for example, which is so comprehensive it could take all day, even with a motivated patient.
5) Really internalizing the difference between a charge nurse LTC role and that of a staff RN in acute care. ADHD people are often great at getting the big picture and properly advocating for patients. In LTC, that role is so much more limited. Task-orientation should not obscure the big picture, or patient advocacy.
HTH

:cool: I am so conflicted with the ADD subject. I think if you grew up with it as a child..or you have a child who has been diagnosed with it ..and more and more children are diagnosed with it everyday..I often wonder..if its a dicipline thing..or a constant redirection of yourself to deal with the task at hand..just discipline of yourself more than they adverage person..you know..When I was in college and at the ripe old age of 37 still in college..I found that because the bar was set so high in my classes..it was a challenge..and a constant discipline of myself..I dont think there is a perfect balance for anyone..I can say that meds in modification for this disease are the best bet but god is it something you have to be on for the rest of your life? Your body chemisty gets used to them..so I still get very conflicted on the ADD ADHD subject..I still feel just because someone does not learn or articulate the same as to be expected as "THE NORM"..does that necessarily mean that they are adhd..or add..or just built diff than they adv. bear..that add adhd subject hits a sore spot for me..I tell you I find at work..for me its best to follow someone or learn from someone who understands or just fits for whatever reason..chemsitry..dna..who the heck knows..nature..sometimes a we roll well other times..ay oooocch ouch..oh studder..lol..

LV08 · Nov 25, 2011

Thanks for your response. I understand what you mean. I have to come to terms with the fact that I will be on meds for the rest of my life for this. When I was diagnosed and classified it was in the 80s when ritalin had come out. My mother at first did not want me to take it. But once I did take it things were going so much better for me in school. I was a severe case because of the hyperactivity. It also had a lot to do with boredom or because of difficulty in some classes. I was only 7 years old. My matter was kindergarten level and my reading was middle school level. That's another thing they saw. I was always wandering the halls when math class came because I hated it. Then we would have English and I would be found wandering because I was bored. I was disrupting my class because I would just get up and walk out or I would act up and get in trouble. I understand what you're saying about discipline but how does a kid know that? This kind of behavior is expected in boys but once a girl does this it's a red flag. Obviously now that I am older I know about that. But I already have the discipline to do my work. I am motivated to do well. I am all the things a student is supposed to be. It is different for everyone. No person is the same. All of my teachers are now aware of the ADD. Before that,they did not understand why I am failing tests. I have an understanding of everything I am learning. When the test comes,I have very bad anxiety. I have a hard time applying what I learned. I am getting a 100 in clinical and failing the actual fundamental class. I took a critical thinking HESI and scored very high. So how does that happen? It's frustrating to have this happen because I AM reading,studying, making notes,doing all of that....so this is me personally that knows the medication will help me. As for the general population it might be something else. Saying you're not disciplined or motivated makes it more frustrating for me bc I am. When I was in school growing up,I had the child study team working hard for me. I was always put in special ed classes. So that also meant there was 2 teachers and less students. It was less of a distraction for me to learn. In nursing school it is a big distraction because there's over 39 students in my class and everyone is always talking even with me sitting up front, it is still hard for me because there's one teacher. I don't have someone there constantly reminding me to do assignments and coaching me to manage time. It takes me twice as long to complete things because of how I learn and because I am not taking my meds there's a focus issue. My mind is all over the place. That's why I know I needs to get a reading evaluation and go back in the meds. I notice the difference for myself. Someone else might be different.

Sharing as RN w/ADHD · Dec 3, 2011

Hello fellow nurses with ADHD!

I was diagnosed late in life. Back in the 80's it was commonly missed d/t the fact that children with ADD/ADHD may be highly functioning and get good grades- which was my case... However my relationships as a "professional" in the 5 years of nursing last led me to several changes of venue-sedation, endoscopy, telemetry, PCU/ICU, and now Psych. I was never an unsafe nurse, but I struggled with my relationship with my peers at work. I made them uncomfortable with my hyperactivity, hyper focusing, distraction, and trouble staying engaged in meetings and prolonged conversation. It created a stigma around me-frequently going under the microscope, getting "special attention", and the atmosphere of a raised eyebrow. These situations were often prolonged for preforming my duties, engaging well with patients, and having a good attitude at work. At the end of these repeated cycles of scrutiny, my self-esteem plumetted-filled with self-doubt, and anxiety it finally became unbearable and often resigned my job. I wasn't doing anything wrong. finally I went for help from a psychiatrist, convinced I had some mental disorder- I was told about my ADHD and started therapy and medication.

My life had been saved. I could be a nurse again, slow down and communicate well with my co-workers.

My heart goes out to nurses with ADD/ADHD. I'm sure they have suffered the same.

willing to share my war stories and overcoming this hurdle.

Carol1958 · Dec 12, 2011

Hello,

I'm so glad people are still posting to this thread because I will be completing (hopefully) nursing school in May. This semester I have come face to face with my undiagnosed ADD. I have been seeing a therapist who suggested (without my input) that I get evaluated for ADD. I have "known" for years that if I was a younger person, I would definitely have been given the ADD label in school, but they didn't know about it when I was in school. I was born in 1958 (yes, I'm am an older nursing student).

So, I'm struggling with school, but getting through. I'm not sure if I will be evaluated in time to get to try medication before my program is over - I'm on a waiting list for ADD evaluation. And I'm not even sure if I want medication. So, in the meantime, I am trying to exercise more, which definitely helps. And I'm trying to eat better and take more vitamins and herbs that help with brain power.

I think my biggest problem is procrastination and organization. This leads to problems with time management, which leads to sometimes feeling overwhelmed in clinical. It also means that I am "learning more slowly" than my fellow students. And all of this leads to feeling of low self-esteem and irritability. It sucks. So, I'm looking at nursing school as something I will endure and make it through.

On the bright side, I know that when I finally learn something, I understand more about that topic than most people. My theory is that while learning something, I need to understand all aspects of it, therefore slowing me down with getting the basics. But, once I learn it I know it inside and out, giving me more flexibility with what to do with that information. Giving me more ability to be creative with that information, more ability to make connections with other pieces of information. I think that's the good side to my "disability."

I hope this makes sense - so now I have to get back to studying for my final tomorrow. I think this is so wonderful that we are here to support each other.

etaoinshrdluRN · Dec 14, 2011

Carol,

I appreciate your post, especially the bit about needing to know all aspects of a topic in order to integrate it. I've often felt that way about different paperwork procedures. I deeply need to know why I am doping what I am doing. Might be perceived as impertinence and restlessness by some, I suppose.

finallyfound10 · Jan 27, 2012

There are also really good ADD/ADHD threads started on the 'Nurses with Disabilities' Forum.

I discovered my ADD in my late 30's when I failed a nursing class. It makes so much sense why all through school growing up things were harder for me. I take 36mg Concerta and 150 mg Zoloft (depression and anxiety are very often present along with ADD/ADHD.)

Great resources:

Attention Deficit Hyperactivity Disorder Forums

CHADD Live | Home Page

Good Luck to all of you!!!