Nurses with ADD

[happytexas]

I found a thread on this issue that had been closed.

I am struggling at my new job.

I moved from Texas to California, and went from nights to days.

New hospital, new state, new computer charting, now calling doctors, dealing with families, y'all know the difference between nights and days....

I have one year of experience. ADN completing RN-BSN.

I am formally diagnosed with ADD, not hyper just scattered. I have a prescription for Adderall. If I take it, I'm focused, but my people skills go out the window. At this point my people skills are all I have going for me.

My manager called me to the carpet and put me back on orientation on nights for a little while until I can get organized. She specifically said I was too disorganized, and that I was missing things. No med errors, well a couple of late administration of meds, which is an error, but not wrong drug, route, dose or anything like that, no falls or anything, just being able to keep up with discharges and admits, charting and busy work. Prioritization and multitasking-organization.

This has been a tremendous blow to my confidence.

Any advice?

[xoemmylouox, ASN, RN]

Try to with your strengths and try to avoid your weaknesses. If you catch yourself multitasking when you should be focusing on one task. Stop. Take a deep breath. And start again. Right now things are very tough. You moved, started a new job, and are in school. Anyone would be a bit off I think. Best of luck.

[JustBeachyNurse, LPN]

Have you made an appointment with your treating physician to discuss your concerns and potential options? That would be the best place to start.

[VivaLasViejas, ASN, RN]

I'd like to see you get a full psychiatric evaluation---by an actual psychiatrist or psych nurse practitioner---in your new location. I can't help wondering if you've been given the right diagnosis, because there are other disorders which are often mistaken for adult ADD, or which co-exist with it. I get the same way at times---can't focus, get distracted easily, start a half-dozen projects that I never get around to completing, forget what I was doing, etc., but I have a totally different condition which sometimes mimics ADD. And Heaven forbid I ever get hold of a stimulant like Adderall---that would be a disaster of epic proportions as far as my "people skills" go.

Trust me, it's worth it to get checked out again to make sure you really have ADD and not a mood or personality disorder, or if you do have it AND some of its frequent co-morbidities. Good luck.

[Sand_Dollar, BSN]

I just passed my NCLEX so I can't give you sage advice from the floor, but can share what I have learned to do during my clinicals. I too have ADD...like you, not the hyperactive kind but the attention kind. I tried the whole spectrum of meds, but ended up with Ritalin. I only used it when I had hours of studying I needed to do. I never used it during clinicals because I compensate for it with organization tricks.

I did my senior practicum in an ICU in a new hospital with software I had used before. My first day, I watched my nurse...closely. I wrote down everything that needed to be charted, everything that was done Q1, Q2 and Q4 hours. That night I made myself a brain sheet, with a section on the side just for what to do during the shift, by hour. I had a section on the bottom of things to remember when charting, so I checked them off when I was done and even a TO DO section. This helped me immensely and I'm constantly tweaking it. I was able to keep track of my patients, things to do for them (Dr calls) and my schedules. By my last day I was on my own with a full patient load and had everything done by the end of shift.

I had one day where I felt 'scattered' and never felt caught up (even though I got everything done by shift change). I looked back and analysed what was different that night. My nurse had decided to help me and by doing things I was going to do and interrupting my planned flow, it totally threw my system off. I started to lose my focus and did my charting in bits and pieces rather than whole sections and I missed things, stupid things. I can't multitask on the floor it's too easy to not get anything done, I learned to do one thing fully at a time then move quickly to the next.

Watch the other nurses, they have great systems. I like how they did their patient sheets and I will be adopting it when I know more of what to ask and look for. This will happen to you too once you find your groove. Sometimes it take finding your base routine and then adding things to it a little at a time.

I know I don't have a lot of experience on the floor, but I am older and have lived with ADD for a long time (didn't know what it was, just joked that I was the queen of the multitaskers). I think it is one of the reasons I am organized to the max, I had to compensate for my scattered thinking when it was important.

Good luck, you will get the hang of it, don't be too hard on yourself!!

~SD

[Sparrowhawk]

I have ADD but also fall on the DID continuum..... Adderall is helping me focus like crazy, but I have noticed my people skills lacking as well (Which of course my inner people help with) .. I like what Viva said, get checked by a Psych and see if theres something that can help, maybe therapy....or explain to your bosses....mine know.... about the ADD not the DID continuum.

[mmc51264, BSN, MSN, RN]

I don't have ADD but I have the same issues as an orientee: I am in the middle of doing something and I am interrupted by preceptor and I can't get back into the "swing" of things. I bought this up to two different preceptors (we have several during a 6 month internship to get diff viewpoints) and when they let me work as I want, I get things done and feel better. I still feel overwhelmed at times and I have them lean on when I need help, but I feel that I am ore effective when they don't hover. Some if it is to challenge us, but I can have Jekyll/Hyde days depending on how my preceptor treats me. They are all very professional, and I get along with them, but they all seem to have just a slightly different way of doing things. I have been a nurse for a year, but in this internship for 4 1/2 months (of 6!!! almost done), I have so much more to learn.

Hang in there, make lists, find an organizational sheet that works for you-I notice that each nurse has their own version of that. I am still trying find my way.

Good Luck!!!!

[ugadawg1696]

I found a thread on this issue that had been closed.

I am struggling at my new job.

I moved from Texas to California, and went from nights to days.

New hospital, new state, new computer charting, now calling doctors, dealing with families, y'all know the difference between nights and days....

I have one year of experience. ADN completing RN-BSN.

I am formally diagnosed with ADD, not hyper just scattered. I have a prescription for Adderall. If I take it, I'm focused, but my people skills go out the window. At this point my people skills are all I have going for me.

My manager called me to the carpet and put me back on orientation on nights for a little while until I can get organized. She specifically said I was too disorganized, and that I was missing things. No med errors, well a couple of late administration of meds, which is an error, but not wrong drug, route, dose or anything like that, no falls or anything, just being able to keep up with discharges and admits, charting and busy work. Prioritization and multitasking-organization.

This has been a tremendous blow to my confidence.

Any advice?

Happytexas, I am interested in talking more with you about your add. I am diagnosed with severe inattentive ADD and would love to get in touch and see how you are doing and how you cope with your ADD. Email me at [email protected]

[ugadawg1696]

I'd like to see you get a full psychiatric evaluation---by an actual psychiatrist or psych nurse practitioner---in your new location. I can't help wondering if you've been given the right diagnosis, because there are other disorders which are often mistaken for adult ADD, or which co-exist with it. I get the same way at times---can't focus, get distracted easily, start a half-dozen projects that I never get around to completing, forget what I was doing, etc., but I have a totally different condition which sometimes mimics ADD. And Heaven forbid I ever get hold of a stimulant like Adderall---that would be a disaster of epic proportions as far as my "people skills" go.

Trust me, it's worth it to get checked out again to make sure you really have ADD and not a mood or personality disorder, or if you do have it AND some of its frequent co-morbidities. Good luck.

Vivalasviejas, what other conditions are there that mimic add? Please email me at [email protected], I am interested in what you may have to say

[VivaLasViejas, ASN, RN]

Check your PM box.

[serenidad2004]

Nurse with ADD here!! I too take adderall. I have dealt with multiple issues at work because of my ADD, from being told I leave thing half done prior to being diagnosed and getting my meds right to being told that I help too much and am driving other staff nuts.

I have found a happy medium by staying as focused on the task infront of me. I have my brain sheet that I write all of my important notes on and unless the issue or request from other staff or patients is urgent I finish the task I am doing before assisting other staff.

I also have a good relationship with my psych doc and NP, so when I notice changes like increase in symptoms despite meds that aren't just situational I discuss it with them to get a plan of action.

Sounds so easy when I write it out but in all reality it has taken me 2 years to get to this point, and I still have days where I am like a fart in a skillet.

Good luck to you!!! It is hard but do-able

[VivaLasViejas, ASN, RN]

A fart in a skillet!!!! I've gotta remember that!!! LOL

I also love that you have the Serenity Prayer in your avatar. :)